In this groundbreaking work, Susan L. Burns examines the history of leprosy in Japan from medieval times until the present. At the center of Kingdom of the Sick is the rise of Japan’s system of national leprosy sanitaria, which today continue to house more than 1,500 former patients, many of whom have spent five or more decades within them. Burns argues that long before the modern Japanese government began to define a policy toward leprosy, the disease was already profoundly marked by ethical and political concerns and associated with sin, pollution, heredity, and outcast status. Beginning in the 1870s, new anxieties about race and civilization that emanated from a variety of civic actors, including journalists, doctors, patent medicine producers, and Christian missionaries transformed leprosy into a national issue. After 1900, a clamor of voices called for the quarantine of all sufferers of the disease, and in the decades that followed bureaucrats, politicians, physicians, journalists, local communities, and leprosy sufferers themselves grappled with the place of the biologically vulnerable within the body politic. At stake in this “citizenship project” were still evolving conceptions of individual rights, government responsibility for social welfare, and the delicate balance between care and control. Refusing to treat leprosy patients as simply victims of state power, Burns recovers their voices in the debates that surrounded the most controversial aspects of sanitarium policy, including the use of sterilization, segregation, and the continuation of confinement long after leprosy had become a curable disease. Richly documented with both visual and textual sources and interweaving medical, political, social, and cultural history, Kingdom of the Sick tells an important story for readers interested in Japan, the history of medicine and public health, social welfare, gender and sexuality, and human rights.
The unknown story of the only leprosy colony in the continental United States, and the thousands of Americans who were exiled—hidden away with their “shameful” disease. The Mississippi River between Baton Rouge and New Orleans curls around an old sugar plantation that long housed one of America’s most painful secrets. Locals knew it as Carville, the site of the only leprosy colony in the continental United States, where generations of afflicted Americans were isolated—often against their will and until their deaths. Following the trail of an unexpected family connection, acclaimed journalist Pam Fessler has unearthed the lost world of the patients, nurses, doctors, and researchers at Carville who struggled for over a century to eradicate Hansen’s disease, the modern name for leprosy. Amid widespread public anxiety about foreign contamination and contagion, patients were deprived of basic rights—denied the right to vote, restricted from leaving Carville, and often forbidden from contact with their own parents or children. Neighbors fretted over their presence and newspapers warned of their dangerous condition, which was seen as a biblical “curse” rather than a medical diagnosis. Though shunned by their fellow Americans, patients surprisingly made Carville more a refuge than a prison. Many carved out meaningful lives, building a vibrant community and finding solace, brotherhood, and even love behind the barbed-wire fence that surrounded them. Among the memorable figures we meet in Fessler’s masterful narrative are John Early, a pioneering crusader for patients’ rights, and the unlucky Landry siblings—all five of whom eventually called Carville home—as well as a butcher from New York, a 19-year-old debutante from New Orleans, and a pharmacist from Texas who became the voice of Carville around the world. Though Jim Crow reigned in the South and racial animus prevailed elsewhere, Carville took in people of all faiths, colors, and backgrounds. Aided by their heroic caretakers, patients rallied to find a cure for Hansen’s disease and to fight the insidious stigma that surrounded it. Weaving together a wealth of archival material with original interviews as well as firsthand accounts from her own family, Fessler has created an enthralling account of a lost American history. In our new age of infectious disease, Carville’s Cure demonstrates the necessity of combating misinformation and stigma if we hope to control the spread of illness without demonizing victims and needlessly destroying lives.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
This well-illustrated book is a comprehensive guide to the cutaneous clinical presentations of mycobacterial infections. The Mycobacterium genus includes over 170 species, nontuberculous mycobacteria (NTM) having been added to the obligate human pathogens such as M. tuberculosis and M. leprae. NTM are widely distributed in the environment with high isolation rates worldwide; the skin is a major target with variable clinical manifestations. A current resurgence in tuberculosis is aggravated by the synergy with human immunodeficiency virus, the breakdown of health care systems, and the rise in multidrug-resistant disease, as the incidence of leprosy remains stable, at around 250,000 new cases annually, regardless of effective antibiotic therapy. Presentations of various cutaneous infections caused by mycobacteria may be overlooked by clinicians owing the lack of familiarity with tuberculosis, leprosy, and the related NTM clinical features. This handy guide will help the dermatologist to spot the different clinical manifestations, make a prompt diagnosis, and apply effective treatment.
The emergence of severe acute respiratory syndrome (SARS) in late 2002 and 2003 challenged the global public health community to confront a novel epidemic that spread rapidly from its origins in southern China until it had reached more than 25 other countries within a matter of months. In addition to the number of patients infected with the SARS virus, the disease had profound economic and political repercussions in many of the affected regions. Recent reports of isolated new SARS cases and a fear that the disease could reemerge and spread have put public health officials on high alert for any indications of possible new outbreaks. This report examines the response to SARS by public health systems in individual countries, the biology of the SARS coronavirus and related coronaviruses in animals, the economic and political fallout of the SARS epidemic, quarantine law and other public health measures that apply to combating infectious diseases, and the role of international organizations and scientific cooperation in halting the spread of SARS. The report provides an illuminating survey of findings from the epidemic, along with an assessment of what might be needed in order to contain any future outbreaks of SARS or other emerging infections.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.