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APHA Scientific Session and Event Listing

Recorded presentation

Paul Johansen, MA, Hansen's Disease, Analysis & Inference, Inc, 1489 Baltimore Pike, Suite 305, Springfield, PA 19064, 484-213-1223, IguanaPhoto@aol.com

One of the most common responses to people with Hansen's disease (HD, or leprosy) was to round them up – sometimes using police force – and to place them in isolated locations where they were perceived to be less threatening to the public health. It was assumed (incorrectly) that the disease was highly contagious and that the benefits of this extreme action justified the wholesale stripping of these people's civil rights. Decisions were made during a time when knowledge of the disease was rudimentary and without a deep public discussion about the advantages and disadvantages of doing so.

In hindsight, it is painfully clear that isolation was borne out of inappropriate fear. But what effect did isolation have on the spread of the disease? Is there any evidence that isolation led to a reduction in the spread of HD? Was this an effective public health practice? This presentation focuses on the Kalaupapa Settlement on the Hawaiian island of Molokai (www.nps.gov/kala), to begin examining these questions for a relatively well-defined population. The Kalaupapa Settlement was established by law in 1865, and is still home to a handful of residents who are now free to come and go as they please.

Our modern age has brought emerging infectious diseases to the forefront of public consciousness and discourse (HIV/AIDS, West Nile virus, SARS and avian flu). The Centers for Disease Control and Prevention are currently amending federal quarantine laws for the first time in 25 years.

Learning Objectives: Participants will

• understand the factors leading to the establishment of the Kalaupapa Settlement in 1865;
• understand the effect that isolation had on the prevalence of Hansen’s disease in Hawaii;
• develop an appreciation for the tension between protecting individual civil liberties and the public health.

Keywords: Infectious Diseases, Human Rights

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation