Latest news with #OliverBasciano
Times
17-06-2025
- Health
- Times
Clappers, colonies and poisoned wells: a surprising history of leprosy
'What strange ideas people have about leprosy, doctor,' a character wonders in Graham Greene's 1960 novel A Burnt-Out Case, set in a Congolese leper colony. 'They learn about it from the Bible, like sex,' the doctor replies wearily. There's a great deal of historical truth in this wry exchange, the journalist Oliver Basciano tells us in this wide-ranging, globetrotting survey of the disease. Leprosy makes its literary premiere in Leviticus. In the Old Testament, those stricken with tzaraath are unclean and unworthy, deserving of ostracism as well as charity. The coinage lepra — scaly, in the manner of a snake — we owe to the Alexandrian Jewish scribes who translated the Hebrew Bible into Greek. But in the New Testament and later in the Middle Ages leprosy was regarded as a divine blessing. Basciano's chapter on medieval leprosy is the most arresting of this book. Living with leprosy was deemed akin to suffering in purgatory. At death, then, the leper could expect an easy passage to Heaven.
Telegraph
02-06-2025
- General
- Telegraph
Leprosy never went away – here's proof
Leprosy, as Oliver Basciano notes in his fascinating and humane book Outcast, is more than an illness. It's a byword, a 'cultural artefact' that functions as 'a receptacle for nightmares and prejudice'; a kind of 'Ur-stigma' that has run through our collective nightmares for two millennia. Those who suffer from leprosy aren't just sick, but unclean. They were infectious and contagious long before infection or contagion were understood, and they still are, long after the latter were understood well enough to be tamed. Even though the reach of the disease itself has shrunk – from five million cases worldwide in the 1980s to a little under 200,000 today – the charge around it has not. Basciano's mission is to uncover the ways in which leprosy has been seen. He wants to provide something that's less a 'medical biography' of the disease than a cultural archaeology of the fears that become attached to it, and the ways they attach to other modes of isolating and casting out the 'undesirables' among us. While the medical facts are present, the resulting book – part history, part travelogue – is above all an analysis of the realities of prejudice and ways in which shared fears exert such outsized grips on communities. And, as Basciano tracks the disease from his native St Albans to Japan, via outposts across the world, it also becomes a meditation on the flipside of such fears: a hymn to the resilience of the cast-out and the lives they have managed to make. One medical fact shines out with painful irony: this symbol of contagion is not, in fact, all that contagious. 'Ninety-five per cent of the world's population', Basciano explains, 'is naturally immune', and most people with 'a good diet and the privilege of hygiene could spend a lifetime living with someone who is actively affected with the disease and not contract it'. For those who do contract it, Mycobacterium leprae, first isolated in 1873 by the Norwegian doctor Gerhard Armauer Hansen, is 'incredibly slow to replicate'. Its victims can remain asymptomatic for anything between five and 25 years, with the bacterium hiding out in the extremities of their body, in the far reaches of the nervous system, before the effects become manifest as a slowly increasing numbness. After that, the results can be devastating. Rashes or lesions appear – the 'scales' that give the disease its name, from the Greek leprós (scaly) – then 'damage to the skin, the upper respiratory tract, toes and fingers, the eyes and the inside lining of the nose'. As the bacterium proliferates, much of the physical harm to a sufferer's body is accidental: numbness allows knocks and cuts to go unnoticed, leading to secondary infection and scarring. Despite being treatable through a multidrug therapy that has been available since 1981, its capacity to lie dormant combines all too well with the vicissitudes of public health in countries such as India, Brazil and Indonesia. Slow diagnosis and poor treatment networks allow it to stubbornly persist. In Britain, where Basciano begins, leprosy has decayed into legend: a bogeyman of a half-real, half-imaginary medieval era. Searching out the meagre traces of a leper hospital, or leprosarium, built at the gate of medieval St Albans to house 13 devout sufferers in 1194, he outlines the gaps between the reality and the legend. Behind the 'cliché of the 'medieval leper'' with his rags and bell lay a more complex reality of leprosaria – some 19,000 across Western Europe, according to the 13th-century chronicler Matthew Paris – formed as religious communities, upheld by wealthy patrons, and run in ways that often accorded large degrees of agency and democracy to suffers. Leprosy could be seen – as in Chaucer 's 1380s poem Troilus and Criseyde – as a form of divine punishment; it could also be seen as a holy affliction, bringing the sufferer closer to God. Lepers might be subject to the same kind of persecution as Jews, yet they might be accorded surprising degrees of respect and autonomy, even to the point of being considered divine in their own right. Richard of Wallingford, elected as abbot of St Albans in 1327, remained in post despite falling prey to the disease, devoting his attention to designing and building a clock for the abbey while a coadjutor carried out the 'more strenuous duties'. The historical portion of Basciano's narrative continues with thoughtful chapters on Hansen and his promulgation of the doctrine of strict medical isolation for sufferers; on 19th-century contemporaries 'Father Damien' and Kate Marsden, who became celebrities for their dedication to the disease's victims; and on the leprosarium on South Africa's Robben Island, the isolatory regime that anticipated the apartheid government's incarceration of ANC activists there. Where the book really takes off, though, is when Basciano steps into the living legacies of leprosaria in the present, with trips to Romania, Mozambique, Brazil and Japan. Face to face with sufferers, Basciano's writing blossoms. In Mozambique, he confronts the realities of illness in a time of civil war, when aid programmes cease to function, diagnoses cease and patients disappear. In Japan, where forced sterilisations and abortions of patients continued long after the theory of hereditary transmission had been refuted, 720 patients live on in scattered sanatoria, winners of a long legal battle for recognition, simultaneously victims and members of a community on the verge of extinction. Leprosaria were refuges too, Basciano writes: places where 'utopian seeds' could take root on the stoniest ground, shielding their inmates from secret police, overriding nationalism, and even war. While the historical sections of Outcast are absorbing, Basciano's encounters turn this book into something altogether more moving and important. This is a cautionary tale: leprosy might be fading into history, but there is always another human 'contagion' to fear, if we let our fears control us. Deftly balancing learned and elegant reflection on illness and prejudice with the very human faces of the disease's sufferers, Basciano has crafted a quite brilliant book. It's a fitting tribute to outcasts who should never have been cast out.
