As the United States began to administer overseas possessions of Hawai'i and the Philippines in the late-nineteenth century, physicians and colonial officials adapted photography as a useful instrument for leprosy surveillance and biomedical experimentation. They photographed suspected leprosy cases to document and determine who would be sent to isolated settlements, generating thousands of clinical photographs that were included in patient files and later found their way into a vast array of medical and non-medical literatures. Capturing Leprosy investigates these medical photographs of leprosy (Hansen's disease) and their critical role in the biomedical racialization of U.S. colonial subjects from the late-nineteenth to mid-twentieth century. Centered on Hawai'i and Philippines, this study examines how leprosy photography produced under conditions of duress effectively taught clinicians how to see race and racial difference, although it purported to be race-neutral and clinically objective. In medical print culture, the leprous body and the racialized body became indistinguishable. Furthermore, photography in the settlements operated as an integral part of coercive biomedical experiments, including live bacilli inoculations of uninfected patients. Scientists photographed every phase of the disease and directed patients to expose their disfigured bodies. This modern medical gaze brought Asian and indigenous populations into wide visibility and influenced broader ways of seeing colonial populations as potential pathogens. Thus the book's first major objective is to analyze how racial difference and disease were mutually constituted through medical photography and print culture. Its second major objective is to counter institutionalized views of leprosy, utilizing underexplored visual practices of leprosarium residents from the twentieth century. With their own discrepant use of photographs, patients disrupted the medical gaze and advocated for disability and patients' rights. Finally, the book offers a contemporary case study of Native Hawaiian bioethical training in a former leprosy settlement to assess ways Hawaiian cultural protocols and decolonizing principles are shifting clinical paradigms of care in medically underserved indigenous communities. Three years of support from an NLM Grant for Scholarly Works in Biomedicine and Health will enable the PI to complete research and write this book. Based on heretofore unstudied, yet extensive, archives of clinical photographs from Hawai'i, Germany, the Philippines, and Louisiana, as well as fieldwork in indigenous bioethics, this study offers a comparative, multi-sited, and interdisciplinary approach to the history of medicine. The work will be of interest to public health scholars and practitioners; scholars in bioethics, disability studies, critical race studies; as well as active communities of former Hansen's disease patients and their descendants.
Capturing Leprosy is relevant to public health in four major ways: 1) it is the first monograph to analyze clinical photography of leprosy (Hansen's disease) patients as a coercive instrument of biomedical management and experimentation in U.S. leprosy settlements in Hawai'i and the Philippines; 2) it provides a model for an interdisciplinary, visual studies-oriented history of public health by examining how racialized communities were medically imaged as potential pathogens in the twentieth century; 3) it investigates how communities directly affected by the visual imaging of disease - Hansen's disease patients who were largely racialized minorities and people with disabilities - utilized photography to critique U.S. public health institutions and policies; and 4) it examines how contemporary Native Hawaiian medical practitioners are interpreting the historiography of leprosy to reshape bioethics and clinical care at the site of the former leprosy settlement in Hawai'i.