Conclusion

For Caribbean plantation economies to function and prosper, European colonizers needed Others – African slaves. In Empire, Michael Hardt and Toni Negri write about this production of Others, the creation of racial boundaries, and the dark Other as the negative component of European identity as well as the economic foundation of European economic systems. They identify contagious diseases as one of the most important threats to the boundaries between self and Other. For Hardt and Negri, ‘The horror released by European conquest and colonization is a horror of unlimited content, flow and exchange – or really the horror of contagion, miscegenation and unbanded life. Hygiene requires protective barriers.’...

Colonial medicine and folk beliefs in the modern era

The on-going adherence of the Afro-Surinamese and of new British Indian and Javanese migrants to their own folk beliefs and practices necessitated a response from Dutch colonial medicine. If modern leprosy politics were to succeed, some degree of cooperation and compliance from the population was necessary. Folk beliefs were not seen as a possible alternative to Western science and medicine on a conceptual level; however, Dutch colonial medicine found elements in folk beliefs useful for its own health propaganda and communication, while at the same time emphatically rejecting the folk medicine practitioners’ worldview underlying these beliefs. In this sense Dutch colonial medicine did not limit itself to the interventions from above based on biomedical knowledge that historians have found typical of ‘Imperial Tropical Medicine’, but actively sought the compliance of the population.

Introduction

In the 2012 American animated comedy film The Pirates! Band of Misfits, the pirates attack and board a ship. To their horror, they are confronted with leprosy sufferers. One of the sufferers pulls off his arm and the pirates, aghast, beat a hasty retreat. Of course, this scene was not meant as a serious depiction of leprosy or Hansen’s disease, as it is called today. However, patients who had formerly had Hansen’s disease complained and the filmmakers hastily changed the leprosy ship into a plague ship. ...

Towards a modern colonial state: reorganizing leprosy care, 1890–1900

Fears of leprosy as an ‘imperial danger’ spread globally after 1890. These coincided with a reorganization of leprosy care in Suriname. However, this reorganization had a dynamic of its own tied to the heritage of Surinamese confinement policies and the necessity for an accommodation between the dominant Christian religious groups in the colony (Protestants and Catholics) and with the colonial state. The reorganization of leprosy care in the colony was intended to establish better-organized leprosy asylums that should be more accommodating to the citizens of a ‘modern’ colonial state. Moreover, the colonial government acquiesced to pleas from medical doctors for more humane treatment, and managed the interests of religious groups and missionaries who wanted to maintain or gain a foot in leprosy care. However, the new care continued the traditions of contagionism, compulsory segregation, and racist prejudices that had characterized Surinamese leprosy politics since the eighteenth century, long before the international concerns of the 1890s.

A policy of ‘Great Confinement’, 1815–1863

The exclusion of leprosy sufferers in Suriname began to resemble a ‘Great Confinement’ in the period from 1830 and 1860. Close to one of every one hundred inhabitants of the colony was condemned or suspected of having leprosy or elephantiasis, confined to the Batavia leprosy asylum, or segregated at home or elsewhere. The leprosy asylum did not function in the first place as a medical establishment, but rather as an instance of colonial order. Confinement policies were intense, especially in the period from 1830 to 1855, but the degree of effectiveness or the thoroughness of the segregation of all leprosy and elephantiasis sufferers remained unclear. The chapter argues that it was not the difficulty of enforcing the policy of segregation or doubts about its effectiveness, but the approaching abolition of slavery that put an end to the ‘Great Confinement’.

Transformations and discussion: Suriname and the Netherlands, 1863–1890

This chapter examines Dutch debates about leprosy between 1863 and 1890. The debates took place when the threat of a ‘return’ of leprosy to the Netherlands appeared to materialise. While Dutch policy makers and doctors had to call upon medical expertise from Suriname, at the same time European medicine questioned the validity of a contagionist theory for leprosy. In the Dutch East Indies, with much less direct Dutch control over the population, the hereditarian view of leprosy was embraced. However, in the Dutch West Indies, the international shift in medical thought towards a hereditarian rather than a contagionist view of leprosy did not affect the principle of segregation, that remained in place after the abolition of slavery in 1863, and during the transformation of society because of the immigration of indentured labourers from British India and Java. The chapter argues that developments around leprosy in Suriname remained autonomous and were not directed from the Netherlands.

The making of a colonial disease in the eighteenth century

Leprosy became a visible problem among African slaves in Suriname in the 1750s, and seemed to threaten to return to Europe. This chapter argues that, driven by the needs and interest of Surinamese slave society and economy, Dutch colonial medicine framed the disease with negative connotations: originating among slaves in Africa, caused by unhealthy living conditions, and related to disreputable sexual morals - a danger to European dominance. The sufferers of the disease who threatened this dominance had a supposedly inferior racial and/or social status. By the end of the century, the solution was to compulsorily segregate and isolate them, and leave them to their fate. Leprosy management became an important aspect of slave labour management in the colony.

Complex microcosms: asylums and treatments, 1900–1950

This chapter explores the modern leprosy asylums in Suriname. In the modern Catholic and Protestant asylums of Majella and Bethesda Christian missionaries gave leprosy care a central place in their activities and in the presentation of these activities to their co-religionists and financiers in Europe. Together with the Groot-Chatillon state asylum, Christian asylums were interconnected parts of a system of leprosy care that was created after accommodation between the colonial state and the Christian churches in the 1890s. What resulted was a system including care and medical treatment by colonial medicine that ideally would return cured and grateful citizens back to society. Looking from ‘below’, the asylums were characterised by their own infrapolitics of friction and resentment. The permeability of asylum boundaries characterised by movement of patients between asylums and the outside world, and even between asylums was apparent. In everyday life there were limits to the disciplinary power of the regimes in the asylums.

Developing modern leprosy politics, 1900–1950

This chapter discusses 20th-century leprosy politics in Suriname in the context of a modernizing colonial state and in an era of ‘authoritarian high modernism’. Modern leprosy politics were a Janus head. On the one side, the politics were based on the latest developments and fashion in medical views on leprosy: sufferers should be treated as patients, not as criminals; medical treatment in asylums and in outpatient clinics should be encouraged; and a humane organization of life in the asylums should be promoted. However, unlike in other colonies, the idea of compulsory segregation was never abandoned. Sufferers with non-European backgrounds, especially the Afro-Surinamese and the British Indians, were still stigmatized and seen as unwilling or unable to cooperate. They had to be forced into segregation. On the other side of the Janus head, policies of surveillance, detection, and compulsory segregation were therefore intensified. A new edict of 1929 inaugurated a renewed era of increased detection and segregation of sufferers. By the 1940s, the colonial state claimed that leprosy was finally under control. However, this claim is doubtful.

‘Battleground in the jungle’: the Batavia leprosy asylum in the age of slavery

The Batavia leprosy asylum served to segregate the poor and the slaves among the Surinamese leprosy sufferers. Here the colonial government entered into a working relationship with the Catholic Church, in which the church had an essential role in maintaining some kind of moral and social order in the asylum. The Church was also allowed to use the asylum as an important recruiting ground for new converts. In the asylum, Catholic priests attempted to establish a ‘Christian leper identity’ on the sufferers, who had to shed their former heathen cultural identity to receive the care of Catholic compassion. But not all of the sufferers went along with the establishment of this new identity: Batavia was a place with its own infra-politics of non-compliance and contestation that was not so much evident in open resistance as in a cherishing of autonomy in everyday life.