The latest in the ‘Social Histories of Medicine’ series from Manchester University Press, Stephen Snelders’s in-depth monograph on Dutch Suriname makes several key contributions to global scholarship on the leprosy. First, and most importantly, Snelders provides a needed corrective to the historiography concerning how Western science began to see leprosy as a colonial problem. His monograph is one of very few that search for the racialised roots of leprosy discourse as far back as the eighteenth century. In the Caribbean, increasingly reliant on plantation slavery, leprosy was seen as a uniquely African malady. As he righty claims, ‘The first constructions of leprosy as a danger to white dominance transmitted by an “inferior” race, and as a disease similar or identical to biblical and medieval leprosy, began in the Caribbean’ (p.5). In his early chapters on the pre-emancipation era, he refines his reading of rare texts by European physicians in Suriname who wrote about their observations on leprosy, cementing the idea that the disease was contagious and hereditary, and that interracial sexual contact was especially dangerous to the colony’s health. Rules regarding compulsory segregation of leprosy sufferers waxed and waned over the course of the colonial era, as did international medical theories about the risk of contagion—but the fact that the majority of sufferers were Afro-Surinamese (along with a smaller number of Asian migrant labourers or their descendants) meant it remained a feared and stigmatised condition well after Norwegian Dr Gerhard Hansen’s 1873 discovery of the Mycobacterium leprae. (Some readers may have wished Snelders to use the less-charged term ‘Hansen’s Disease’, but as he explains in the first chapter, he uses the term ‘leprosy’ as part and parcel of understanding the term and its historical valences (p.12), rather than taking on the futile task of determining post-facto whether patients actually had been infected by the Mycobacterium leprae or suffered another ailment with similar symptoms.) Snelders also maintains the trend in recent scholarship to look at modern leprosy asylums as more than just instruments of state control and repression, but rather as ‘complex microcosms where the sufferers had agency and everyday life was continuously renegotiated’ (p.219). As part of that effort, Snelders takes his time to respectfully and carefully read against the grain of the archival bias to attend to the bottom-up context of leprosy in Suriname in two of nine chapters. He describes various Afro-Surinamese understandings of boasie (the most commonly-used African-derived term for leprosy), during slavery, after emancipation, and in modern usage. Snelders pays special attention to an Afro-Surinamese approach to disease aetiology as requiring both spiritual and bodily healing. He writes at length about the locally-defined complex of meanings relating to the treef, a food or animal taboo—possibly, he asserts, a corruption of the Hebrew word tereifa, used by Jewish inhabitants of Paramaribo to indicate violations of dietary regulations (p.85). Although Afro-Surinamese approaches looked at many symptoms of leprosy as treatable with locally-developed herbal remedies, other symptoms might be due to a violation of the individual’s treef, and had to be addressed by spirit workers, like the lukumen, skilled therapeutic practitioners working at the nexus of magic, medicine and divination (p.81). Snelders even finds that some colonial doctors began to take seriously the wisdom behind popular treef prohibitions by acknowledging that food sensitivities or other ‘idiosyncrasies’ affecting individual bodies might deserve attention in the study of leprosy, still so poorly understood in the nineteenth- and early-twentieth centuries (pp.204–7). Suriname’s Western-trained public health workers recognised that outright rejection of presumably ‘superstitious’ understandings of leprosy/boasie led to non-compliance with quarantine and treatment protocols. Finally, the author must be praised for bringing rarely-used primary sources to an anglophone audience—incorporating Dutch-language sources from twelve archives in the Netherlands, England and Suriname as well as print media and published government records, papers of international medical organisations, and some religious organisations. Snelders’s well-organised chapters are clearly written and without the tedium often found in archive-heavy monographs. Given the monograph’s long chronology of 200 years, experts may find some holes in the primary sources. This reviewer would have liked to see more varied primary sources from the Catholic and Protestant groups who ran Suriname’s several leprosaria during the nineteenth and twentieth centuries to understand their spiritual approaches to healing. We know more about how those asylums were administered than how residents lived in them—admittedly difficult to reconstruct due to the vagaries of archival production. Were some faith-based approaches more conducive to creating supportive communities of care and concern? Nevertheless, Snelders’s longue durée study greatly expands historians’ understanding of leprosy in Suriname as a microcosm of colonialism’s racial, social and administrative structures. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
Social History of Medicine – Oxford University Press
Published: Aug 1, 2018
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