title: [Coping with leprosy in the Dutch West Indies in the 19th century; opposing but meaningful views from Suriname].
abstract: Leprosy was highly prevalent among African slaves in the Dutch West Indian colony of Suriname. Largely based on observations in Suriname, Dutch physicians described the aetiology of leprosy in terms of'a substrate' to which all sorts of mixtures of infection, heredity and hygiene contributed ('seed and soil'). This explanatory model with multiple options for prevention and treatment left room for different developmental trajectories to control the spread of the disease in the various tropical colonies of the Dutch empire. In Suriname there was a growing worry in the 19th century regarding the spread of leprosy, threatening the health of slaves, settlers and colonial administrators. And this could be harmful to an already weakening plantation economy. This concern prompted the local administration to develop a rigorous policy of strict isolation of leprosy sufferers. This, in turn, intersected with a changing insight in Europe - including the Netherlands - that leprosy was non-contagious. However,'in splendid isolation' in the economically and politically marginal colony Suriname, Dutch physicians like Charles Landre and his son, Charles Louis Drognat Landré, could afford to ignore the European non-contagious approach and continue to support the strict isolation policies. Moreover, they developed a dissident radical explanation of leprosy as a disease caused only by contagion. In the absence of a receptive Dutch audience Drognat Landré published his contagion theory in French and so succeeded in inspiring the Norwegian Hansen, who subsequently discovered the culpable micro-organism. At the same time colonial administrators and physicians in the economically and politically important Dutch colonies in the East Indies adhered to the prevailing European concept and changed policies: the system of isolation was abolished. Given the rather different trajectories of leprosy health policies in the Dutch East and West Indies we point out the importance of a comparative approach.
authors.affiliation: VU-University Medical Center, Afdeling Metamedica, Amsterdam. henk@hemenke.demon.nl
authors.forename: Henk
authors.initials: H
authors.lastname: Menke
authors.forename: Stephen
authors.initials: S
authors.lastname: Snelders
authors.forename: Toine
authors.initials: T
authors.lastname: Pieters
mesh_terms: D006291:Health Policy / Q000266:history; D049672:History, 19th Century; D006801:Humans; D007918:Leprosy / Q000266:history* / Q000517:prevention & control; D010356:Patient Isolation / Q000266:history; D013532:Suriname; D014900:West Indies