Gnawing Pains, Festering Ulcers, and Nightmare Suffering: Selling Leprosy as a Humanitarian Cause in the British Empire, c. 1890-1960

Abstract

When British attention was drawn to the issue of leprosy in the Empire, humanitarian organisations rose to take on responsibility for the ‘fight against leprosy’. In an effort to fundraise for a distant cause at a time when hundreds of charities competed for the financial support of British citizens, fundraisers developed propaganda to set leprosy apart from all other humanitarian causes. They drew on leprosy’s relationship with Christianity, its debilitating symptoms, and the supposed vulnerability of leprosy sufferers in order to mobilise Britain’s sense of humanitarian, Christian, and patriotic duty. This article traces the emergence of leprosy as a popular imperial humanitarian cause in modern Britain and analyses the narratives of religion, suffering, and disease that they created and employed in order to fuel their growth and sell leprosy as a British humanitarian cause.

From the late nineteenth century, medicine became one of the most prominent humanitarian causes in the British Empire.¹ This medicine was provided primarily by missionaries, and although medical mission was first and foremost an evangelical endeavour, many missionaries also believed that healing the body was a humanitarian responsibility as important as the evangelical imperative to heal the soul.² As colonialism expanded, British missions devoted increasingly large proportions of their resources to the promotion of health in the mission field, which primarily lay in the Empire.³

While there is a growing historiography on humanitarianism and empire, and also on medical mission and empire, between these two sets of literature there is a conspicuous absence: literature that explicitly addresses the importance of health as a humanitarian cause. The humanitarian historiography of empire focuses primarily on the anti-slavery movement or aid in times of military conflict, bypassing what remains one of the single largest areas of humanitarian spending: health.⁴ While some historiography of medical mission and empire discusses the theme of benevolence, most focuses on the relationship between evangelism and medicine and the links between mission and empire.⁵ This article draws on newspaper articles, primarily from the popular London Times; the publications of missions heavily involved in mission work, primarily the Church Missionary Society, which was held up as a model for leprosy work in the British Empire; and the publications of British leprosy charities, specifically the British Empire Leprosy Relief Association (BELRA).⁶ These sources are analysed in an attempt to begin addressing the gap in historiography linking humanitarianism, medicine, and empire, specifically analysing the ways in which humanitarian rhetoric was successfully adapted and employed in order to make leprosy one of the most popular imperial medical causes.

Between 1870 and 1940, British men and women founded a variety of humanitarian organisations and projects dedicated to the care and treatment of leprosy sufferers, and the eradication of leprosy in the colonial world. These missionary societies, religious charities, and secular health organisations drew on a number of themes to promote charitable support of leprosy: Christianity and evangelisation; the elimination of suffering among vulnerable leprosy patients; and humanitarian and patriotic duty. This article discusses the context in which leprosy arose as a humanitarian cause in modern British history and analyses humanitarian leprosy propaganda in order to formulate an understanding of the ways in which narratives of disease, suffering, and religion were mobilised in the furtherance of ‘this great humanitarian crusade’.⁷ At a time when many domestic and imperial charities competed for the attention of British humanitarian donors, leprosy fundraisers used this rhetoric to promote their vision for the health and civilisation of the British Empire.

Leprosy’s Emergence as a Humanitarian Cause in the British Empire

Victorian England witnessed a proliferation of philanthropic societies, due in no small part to a nineteenth-century religious revival and denominational competition.⁸ Many of these charitable societies were religious in character, and mission societies in particular were some of the largest nineteenth-century charities.⁹ The predominantly religious leprosy charities founded in the 1870s and 1890s can be seen as a part of the larger growth of Victorian charities, which looked to promote welfare, civilisation, and Christianity in England and abroad. As colonialism became entrenched in the nineteenth century, stories of leprosy in the tropical colonies began filtering back to Britain, and leprosy became the object of public attention for the first time since the Middle Ages. Initially, leprosy drew the attention of the British imperial medical community. In the 1850s British doctors began to write more frequently about leprosy in medical journals: previously theoretical and metaphorical discussions of the disease began shifting to concrete discussions of the leprosy cases encountered in increasing numbers in the British colonies. Medical interest in leprosy grew enough that in 1867, the Royal College of Physicians published a report on leprosy, which was based on surveys completed by British medical professionals throughout the Empire.¹⁰

Shortly thereafter, leprosy began drawing the attention of the British humanitarian community. In the 1870s, much of the public attention towards leprosy was on India, which was the focus of Britain’s earliest leprosy research and charity. The Mission to Lepers was founded by a Northern Irishman working with leprosy sufferers in India in 1874.¹¹ By the 1880s, public attention began to turn toward individual missionaries who had travelled afar in order to care for leprosy sufferers. The most celebrated missionary was Father Damien, a Belgian priest who took up work at the Molokai leprosy settlement in Hawaii in 1873, and who remained until his death in 1889. Father Damien rose to fame ‘as such a hero and such a saint’ after he was diagnosed with leprosy in 1884.¹² His death from leprosy in 1889 sparked a precipitate growth in leprosy’s popularity as a humanitarian cause.

The death of a European missionary of leprosy, in a tropical leprosy settlement, drew the ‘gaze of the world’ to the issue of leprosy.¹³ News of Father Damien’s death spread rapidly across the globe; photographs of him on his deathbed sold by the thousands in London, and one photo displayed in a shop window in Birmingham caused such a crowd that police were called to clear the streets.¹⁴ For months after Father Damien’s death, the London Times teemed with articles about the spread of leprosy. These articles, and other magazines and newspapers besides, focused on three main strands: medical uncertainty about the aetiology of leprosy; Father Damien’s death as evidence of the possibility that white Europeans could be infected with leprosy; and Father Damien as a role model for the charity and compassion due to leprosy victims. In a speech at the launch of a new leprosy charity in 1890, the Prince of Wales explained that Britain had up until recently neglected the problem of leprosy because: ‘It was only last year that we had before us the case of one who lost his life through doing all he could to alleviate the sufferings of those who were afflicted by this fell disease. I allude to Father Damien’.¹⁵ In keeping with the admiration of Father Damien’s humanitarianism and the concern over leprosy’s spread, over the course of the 1890s, British men and women founded the largest concentration of leprosy charities in modern British history.

In the 1890s, Britons founded several leprosy charities that intended to provide assistance to leprosy settlements for the treatment of leprosy patients around the world, and to support medical research on leprosy, all in the name of alleviating human suffering. In 1890, the Prince of Wales launched a National Leprosy Fund, a charity intended for the erection of a monument to Father Damien, and the:

Medical treatment and care of indigent lepers in the British Empire, and…for the endowment of two studentships, one student to make the United Kingdom and the remainder of Europe his field of investigation, and the other to go abroad and study the disease in India, China, the colonies and elsewhere.¹⁶

In 1895, a former worker of the English Red Cross, Kate Marsden, founded the St. Francis Leper Guild in 1895, which became a Catholic charity supporting the work of leprosy settlements predominantly in the British Empire.¹⁷ The pre-existing Mission to Lepers expanded its work from India to other parts of the British Empire in 1891, founding leprosy settlements and subsidising leprosy treatment by Protestant missions.¹⁸

The British interest in philanthropy and welfare continued into the twentieth century, and in the wake of World War I, British leprosy charities experienced another surge. As part of the disruption that remained after the war and the decline of Christianity in twentieth-century Britain, and the resulting growth in emphasis on secular charities, a number of secular, international leprosy organisations were founded.¹⁹ In Britain, these charities were geared primarily towards the Empire. BELRA, with its explicitly secular and humanitarian agenda, quickly became the largest of Britain’s leprosy charities, funding research and offering sizeable grants to leprosy settlements throughout the British Empire.²⁰

While international, secular humanitarian organisations were largely responsible for coordinating research on the treatment, care, and curing of leprosy patients, it was the missions that were responsible for enacting the lofty visions for the control and potential elimination of leprosy. The resources and expert knowledge that secular humanitarian organisations generated and distributed around the world were important, but Christian missionaries set up most of the world’s leprosy settlements, treated the greatest number of leprosy patients, and cooperated with colonial governments to formulate and enact local leprosy control policies.²¹ The largest number of leprosy settlements were founded in the 1920s and 1930s, mainly in Africa and India. The Church Missionary Society, the Seventh Day Adventist Mission, and the Church of Scotland Mission were some of the most heavily involved in this process.²² Mission leprosy work throughout the British Empire can be characterised by the foundation of in-patient settlements that functioned as hospitals and model villages, fulfilling a medical, social, and religious role.²³

Fundraising for the Humanitarian Cause of Leprosy

The humanitarian and religious organisations supporting leprosy treatment in the British Empire had a variety of methods through which they spread the propaganda about leprosy that would solicit money for their support. Narratives about leprosy were most effectively mobilised in the annual reports, journals, magazines, pamphlets, and books published by leprosy charities and their members. In its early years, BELRA also sponsored lectures across Britain, and from the 1930s, BELRA had an exhibition that travelled across England, educating people about leprosy and eventually broadening popular awareness of BELRA and raising extra funds. The Exhibition had illuminated models showing the history of leprosy up to the present, a hospital showing how leprosy patients in the Empire were treated, films demonstrating life in leprosy settlements, a market where they sold goods from the Empire, and a tea room. Accompanying the lectures were a variety of short talks with information about leprosy.²⁴ Occasional radio addresses also spread information about leprosy and garnered further financial support for the leprosy charities that sponsored them. Members of the British aristocracy were heavily involved in leprosy charities, and this was drawn upon to encourage donations. BELRA, in particular, had the patronage of the Prince of Wales, and they opened several annual reports with a letter he had written in support of their organisation.²⁵

Each humanitarian organisation also had a variety of fundraising activities that relied more upon the mobilisation of communities in shared fundraising activities, than on the individual consumption of narratives and educational information. Missions like the CMS garnered significant resources through gifts in kind, from used magazines to clothing and bandages prepared by work parties. Some CMS missionaries had prayer partners who offered material as well as religious support, and with whom they exchanged regular letters, while many other missionaries were affiliated with specific parish churches that sent regular donations. CMS missionaries spent six months of their year-long leave on deputation, travelling around Britain to give talks about their work in leprosy settlements, and bolstering support. The Catholic St. Francis Leper Guild held an annual ‘Spring Flower Ball’, which, in the earliest years of the charity, raised almost as much money for the charity as subscriptions.²⁶ They also instituted a ‘Father Damien Day’ on the anniversary of Father Damien’s arrival at the leprosy settlement in Hawaii, on which schoolchildren were asked to donate a penny for leprosy’s cause.²⁷ BELRA also encouraged children to becoming involved in fundraising, with thousands of children taking collection boxes door to door to raise money for the charity. The BELRA Players performed operas to raise funds for BELRA, and in addition BELRA sold jigsaw puzzles, Christmas cards, and more. They also established branches around Britain and the colonies, in which expatriate Britons became involved.²⁸

In their earliest years, the religious and lay organisations that supported leprosy work in the British Empire were primarily dependent upon donations from individuals and churches for their maintenance. For example, in 1930, 89 percent of BELRA’s revenues came from individual subscriptions. More than 95 percent of these subscriptions, and 80 percent of the revenue, came from subscriptions of five pounds or less, which indicates that the charity’s finances were reliant upon persuading a wide variety of donors to give small amounts of money.²⁹ The Church Missionary Society, the Mission to Lepers, and the St. Francis Leper Guild faced a similar situation. Given the necessity of reaching a wide variety of donors, it stands to reason that missions and leprosy charities like BELRA were responsible for the majority of leprosy’s publicity in twentieth-century Britain, when leprosy fundraising was most active. This leprosy fundraising propaganda utilised three main tropes: Christianity; the elimination of suffering; and humanitarian and patriotic duty.

The Role of Christianity in Leprosy Fundraising

Leprosy has a millennia-long relationship with Christianity, and leprosy’s popularity as a humanitarian cause stems from the treatment of leprosy in the Christian Bible. In the nineteenth and twentieth centuries, the Bible was the first point of reference on leprosy for most of the British public. In the Old Testament, leprosy was identified as a visible manifestation of a transgression against God, sent by Him as punishment for sin.³⁰ The book of Leviticus states:

Now whosoever shall be defiled with leprosy, and is separated by the judgment of the priest, shall have his clothes hanging loose, his head bare, his mouth covered with a cloth, and he shall cry out that he is defiled and unclean. All the time that he is a leper and unclean, he shall dwell alone without the camp.³¹

There is ample evidence to suggest that the Old Testament’s portrayal of leprosy was extremely influential to the public’s perception of the disease in modern Britain. In 1916, The Times reported on a legal case in which the estate of a deceased leprosy patient was charged with bringing leprosy to a lodging house and conspiring to conceal his disease. One defence lawyer objected to the prejudice of the jury, stating that ‘one’s horror of leprosy arose at the earliest age, for as children they learned from the Bible to regard a leper as a horrible person; and there was, therefore, a danger of prejudice against the defendants’.³² Another lawyer remarked that ‘four of the jurymen…had been seen to hand to each other the Bible, no doubt with reference to the 13^th chapter of Leviticus, which dealt with the treatment of leprosy’.³³ British Church Missionary Society members working in Ugandan leprosy settlements classified those who did not suffer from leprosy as ‘untainted’, while leprosy sufferers were ‘tainted’: terminology that bears a striking resemblance to the Bible’s reference to leprosy patients as ‘unclean’.³⁴ Leprosy was very rare in modern Britain, and had been for centuries, and thus it was the Bible that provided the most widely accessible conceptualisation of the disease.

From the association between leprosy, the Bible, and stigmatisation grew the idea that leprosy was universally stigmatised: a belief that was central to leprosy’s popularity as a humanitarian cause. In 1911, Doctor Ernest McEwen wrote that:

There are many reasons for believing that the extraordinary fear of leprosy, which is so universally present today and which has worked hardship and misery to so many unfortunate victims of the disease, is a result, in part at least, of the influence of the biblical references to “leprosy.” These accounts, when interpreted literally, depict the condition as most terrible, and belief in them is widespread since the Bible, accepted by millions as a revelation of the divine, is the most read book in the world.³⁵

This Christian belief in the universality of stigma towards leprosy was augmented by the belief that it was only natural to fear those whose bodies were disfigured. Medical missionary Stanley Browne wrote:

It would be quite wrong, and historically unjustifiable, to attribute wholly to the influence of biblical and Christian teaching the widespread stigma attached to leprosy…The victim of leprosy often does present a repulsive, even nauseating appearance, a travesty of the human form. In many non-Christian lands and non-Christian civilizations, there exist an innate dread and fear of true leprosy.³⁶

Europeans were so convinced that leprosy was universally appalling that they adapted medieval history in order to provide a historical precedent for leprosy’s complete stigma. In recent years, historians have pointed out that medieval attitudes to leprosy were far from uniform; while ‘lepers’ were feared and stigmatised, they were also considered special objects of Christ’s love, and they were recipients of charity and even worship, in the case of medieval ‘leper’ saints.³⁷ Yet, during the nineteenth and twentieth centuries, most people who wrote about medieval leprosy emphasised that stigma and segregation were complete.³⁸ The stigma of leprosy was considered to be universal, historically and geographically, and because all victims of leprosy suffered socially and physically, they were vulnerable to stigma and cruelty and needed to be saved.

The attraction of saving leprosy sufferers came not only from a conviction of their vulnerability, but also through the positive example of compassion and healing demonstrated by Christ in the New Testament. In three Gospels of the New Testament, Christ ignores the injunctions forbidding contact with leprosy patients by touching and talking to those suffering from the disease, and further urges all Christians to ‘cleanse the lepers’, or in other words, to heal those suffering from leprosy.³⁹ His example was conscientiously followed not only in the Middle Ages, but also by humanitarians in nineteenth- and twentieth-century Britain. Missionaries wrote often that in healing they were following in the footsteps of Christ, and this was truer of leprosy than other ailments, given Christ’s injunction.⁴⁰ As one CMS mission nurse wrote: ‘I am so glad that [lepers] appealed to Christ as they did, because He has set us an example’.⁴¹ This example was mentioned in almost every appeal for leprosy aid put forth by religious humanitarian organisations, and even played a role in the publications of some secular humanitarian organisations that targeted leprosy.

Christian evangelism was central to publicity and fundraising for voluntary organisations that supported leprosy work. In publicising leprosy, the Christian duty to ‘cleanse the lepers’ and the unique success of evangelism among leprosy patients were mentioned frequently by religious and secular charities. The CMS portrayed medical missions as ‘the most favourable environment in which to win the confidence and disarm the prejudices of those who are opposed to it’.⁴² Leprosy, in particular, was a powerful force for conversion, and CMS missionaries in Africa wrote frequently of the successes of evangelisation in leprosy settlements, including donors in that success:

Fifty-two boys and girls were discharged symptom free, all without deformity, and all of them baptized Christians—potential witnesses for Christ in their own villages. Equipped to face life and to be channels of life to their own people: this is triumph indeed over a “vampire” form of suffering. “We are grateful to all our friends at home,” writes Miss Laing, “who have given these children this wonderful opportunity of living healthy lives, free of a loathsome disease, and of growing up in the knowledge of the love of Jesus, the Friend of little children.”⁴³

The CMS gave leprosy work in Africa much greater publicity than their equally extensive leprosy work in India, most likely because they tended to have far greater success in evangelisation in Africa rather than Asia.⁴⁴ The more evangelisations that could be reported to their religious subscribers, the more donations they could expect. However, even when they could not report high rates of conversion, they were still able to publicise the value and necessity of Christianity as a tool for healing leprosy.⁴⁵ One doctor wrote:

To these sufferers the story of the love of God in Christ comes as the dawning of a new day. I have never met any class of patient which has been as receptive of the Gospel as the lepers; and it seems as though, just as it was when Jesus was here among men, He loves to stretch forth His hand and touch them. The acceptance of the Gospel, with its assurance of pardon, and the redeeming experience of the life in Christ, means that for the leper a mental state of such peace and joy that all specific treatment is enhanced in value.⁴⁶

Even if small numbers of leprosy sufferers were converted to Christianity, their status as ‘special objects of divine compassion’ offered the likelihood that their conversion would be more sincere than those of their healthy peers.⁴⁷ Christianity was a means of healing leprosy, a frequent choice of religious faith among patients living in leprosy settlements, and therefore a tool for mission propaganda.

It was not only religious organisations that called upon Christianity to motivate support for leprosy settlements, but also secular organisations. In their 1928 Annual Report, BELRA wrote:

It is a Christian duty to help provide for lepers. Never let it be forgotten that the one particular class of sick people singled out by Jesus Christ for special attention, were the lepers. He Himself, when He was here, “touched” the lepers and healed them, and He it was Who gave the distinct command: “Cleanse the lepers.”⁴⁸

BELRA perceived itself as ‘a health organisation on a grand scale’ rather than an organisation ‘conducted in an essentially missionary spirit’.⁴⁹ However this did not stop them from playing on one of the motivations that had been heretofore proven as successful in fundraising for the ‘fight against leprosy’: Christianity. Despite BELRA’s self-professed secularism, most of its directors had been medical missionaries themselves, and likely believed that humanitarianism could be well served by Christianity.⁵⁰ Given that evangelisation was the ‘first and foremost’ goal for missions, which were the primary non-governmental institutions providing support for leprosy settlements, and that even secular leprosy organisations called upon Christianity as a means for motivating financial support, it would be fair to say that Christianity was the touchstone of Britain’s leprosy fundraising during the age of empire.⁵¹

Humanitarianism and the Elimination of Suffering in Leprosy Propaganda

The Role of Innocence, Vulnerability, and Children

While Christianity was an explicit and important motivation for humanitarian aid to leprosy patients, the perceived vulnerability of the leprosy sufferer added to the humanitarian attraction of leprosy as one of the special objects of Christ’s compassion. Historically, the most popular causes of humanitarianism and charity have been those that offer care to the people considered most vulnerable. The more vulnerable the object of charity was, the more satisfactory the emotional, religious, or humanitarian reward. Leprosy humanitarians wrote about victims of leprosy as the most vulnerable people in the world, based on the debilitating physical condition of the disease and the supposedly universal stigma that they faced. In one of their annual reports, BELRA went so far as to state that leprosy was ‘Worse than Slavery’.⁵² The abolition movement was one of the biggest humanitarian causes of the nineteenth century, and arguably the original cause of humanitarianism itself.⁵³ BELRA was therefore making quite a strong statement about the vulnerability of leprosy patients when it placed the horror of leprosy beyond that of slavery, and to support this statement, they dehumanised leprosy sufferers just as slaves were dehumanised:

It is not an exaggeration to say that of all diseases leprosy is the most terrible—not killing, but mutilating by slow degrees, and ultimately destroying even the semblance of a human being. Men, women and children become moulded into that ghastly form, in which personality, sex, and age, are blotted out, and the victim becomes a mere caricature of humanity.⁵⁴

This dramatic language of suffering, disfiguration, and dehumanisation was commonplace in humanitarian discussions of leprosy, and reflected a belief in the ultimate vulnerability of the leprosy victim, which humanitarians drew on in order to attract aid.

Children with leprosy were perceived as particularly vulnerable, and they were accordingly mentioned frequently in leprosy propaganda. Children have been at the centre of many humanitarian appeals throughout the twentieth century. In a world where charity was often predicated upon a judgment of whether the poor and suffering were ‘deserving’ or ‘undeserving’, the perceived innocence, vulnerability, and defencelessness of children often led to them being cast as the most needy and worthy recipients of humanitarian aid.⁵⁵ Humanitarian leprosy propaganda made use of children for fundraising purposes: there was no one more deserving of aid than someone who was doubly vulnerable, and doubly cursed, as a ‘leper’ child.

When the Church Missionary Society discussed leprosy in their publications, children were almost always a feature. Occasionally, CMS missionaries focused on the terrible plight of leprous children as a means of garnering support. In an article entitled ‘Is it nothing to you?’, one missionary wrote: ‘Look around on this group, and what do you see? Sickness and disease in every conceivable form. Little children covered with sores, ill-nourished, unkempt. Yonder—alone—sits a little child—a little leper. What is there in life for that little one?’⁵⁶ More commonly, CMS missionaries wrote of the happiness and relative normality of child leprosy patients’ lives. Many humanitarians believed that they were in the best position to ameliorate a child’s suffering, by giving them a life of normality and happiness.⁵⁷ It was this reclamation of childhood that CMS missionaries focused on in their publications: ‘It is not an exaggeration to say that we do see a change in their faces after they have been with us a short time…They quickly find their place in the home, and that sad, unchildlike look with which they came gives place to a cheery smile, and once more they look like children’.⁵⁸ Children were meant to be happy, and to live a ‘normal’ life in spite of their disabilities, and in order to demonstrate the value of leprosy mission to children, CMS missionaries wrote frequently about all the activities that children with leprosy took part in.

The children’s leper home—although it may sound repulsive to some—is full of joyous work…There certainly is a real spirit of love and happiness among the children, in spite of their rather loathsome disease. A happier band of youngsters it would be difficult to find anywhere…The children have a very happy school life. They learn reading, writing, simple arithmetic, and singing. Handwork consist [sic] of making bead necklaces, mats, and rope. They are also being taught to sew. There are several children without fingers and toes, and my heart goes out to them in love and pity for they miss so much. Games consist of netball, football, skipping, and country dancing. From this you will see that much is done to make these children, as children should be, full of joy and happiness.⁵⁹

Missionaries placed even more emphasis on ‘saving the children’ of parents with leprosy. Most leprosy settlements had a crèche for ‘untainted’ babies, which were separated from their parents in the hope of preventing leprosy’s contagion.⁶⁰ At one CMS leprosy settlement in Uganda, the crèche, called the ‘House of Life’, was a ‘babies’ paradise’, for children who were ‘every day and in every way getting jollier and fatter—another instance of money spent on life-saving’.⁶¹

Of all the leprosy charities fundraising in Britain, BELRA was most explicit in using children as a tool for fundraising. After five members of the British royal family adopted child leprosy patients in 1947, BELRA’s sponsorship scheme became more popular than ever. BELRA wrote:

Would you like to give a child health and happiness? Would you like to play fairy godfather or godmother to some small child who might otherwise grow up maimed and despondent? Belra has arranged an adoption scheme whereby the admission to, and keep and treatment of a leper boy or girl in a Nigerian settlement can be secured…and the child thus rescued from what might be a living death.⁶²

For just over five pounds a year, donors could support one child living in a leprosy settlement, and in return they would receive a photograph of and information about the child.⁶³ Many donors further pursued a charitable relationship with their adopted child by sending additional gifts.⁶⁴ British schoolchildren also grouped together to sponsor child leprosy sufferers in Africa and Asia, and an additional ‘Children’s Fund’ was established for those who could not afford to sponsor an individual child. Between them, these children’s schemes accounted for 17 percent of BELRA’s revenue in 1948, which indicates not only the power of the royal family to set a charitable trend, but also the power of children in fundraising for humanitarian causes. Fifteen years later, the Children’s Fund alone accounted for even more than 17 percent of BELRA’s revenue.⁶⁵ Children became increasingly important in raising funds for leprosy humanitarian organisations, and because children were also perceived as the most susceptible to leprosy, their care and treatment were also most beneficial from a medical perspective.

The Role of Suffering in Secular Humanitarianism

Though Christianity was present in almost every humanitarian discussion of leprosy, and leprosy humanitarian action was dominated by missionary societies, the humanitarian motivations of leprosy work did not have to be explicitly religious. Even without the example of the Christian Bible, leprosy sufferers could be perceived as vulnerable and in need of a salvation that was emotional and material, if not religious. In their 1928 annual report, BELRA offered potential donors three primary reasons why they should aid the organisation in ridding the British empire of leprosy. The first among these reasons was humanitarianism:

It is a humanitarian work to do something for the hundreds of thousands of lepers in the Empire. They suffer from a very terrible disease which creates such loathing in the minds of their neighbours, and even their nearest relations, that they are often turned adrift to pick up a precarious living by begging. They badly need our help.⁶⁶

While patriotic duty and Christian duty were mentioned as secondary and tertiary motivations for aid, professedly secular organisations like BELRA explicitly relied on humanitarian sensibility when seeking support. They emphasised the simple need to address the suffering of humanity, for the ‘“Leper” in the mind of most people, and in literature, stands for all that is poignant in the way of suffering’.⁶⁷

The overarching ideology of humanitarianism is that, all humans being equal, it is one’s responsibility to relieve the suffering of other humans.⁶⁸ From the eighteenth century, with campaigns for the abolition of the slave trade, humanitarians have recognised the use of narratives of pain and suffering in mobilising empathy and therefore financial support for their causes.⁶⁹ Emphasising the suffering of leprosy patients was an easy and powerful method of attracting support for leprosy philanthropy: all publications about leprosy were rife with dramatic descriptions of the physical and emotional suffering of the world’s ‘lepers’. The following description of leprosy, from a BELRA annual report, is typical.

How terrible is the scourge. Leprosy does not often kill. It is a lingering disease, which pursues its relentless course for years, causing awful disfiguration of the features, festering ulcers on various parts of the body, and in the later stages, pain and insomnia. As a result of the disease fingers and toes are frequently eaten away, and the leper becomes such a disgusting sight that in most people he inspires horror more than pity, and even his nearest relatives often refuse to have anything to do with him. He is turned adrift to seek a precarious living by begging. He has no friends. No one will willingly go near him. His life is as miserable and lonely as it is possible for that of any human being to be. It is not without reason that leprosy has been described as “the world’s worst disease.”⁷⁰

The ‘leper’ was portrayed as the ultimate sufferer, not only because of the toll that leprosy took on the body, but also because of the presumed universal stigma against the disease. When CMS Dr. Smith wrote that leprosy was ‘the disease more shunned than any other by civilised humanity’, his use of the word ‘civilised’ was purposeful.⁷¹ While he recognises at the beginning of the article that leprosy sufferers in south-western Uganda were neither feared nor shunned, he closes the article on a note of horror, making use of words such as ‘misery’, ‘devastating’, ‘wearisome’, ‘appalling’, and ‘ugliness’. It is not difficult to imagine that Smith made this choice because suffering, rather than acceptance, was far more likely to appeal to the supporters of BELRA and CMS who were reading the article. Further, Africans who were so ‘primitive’ as to accept leprosy were badly in need of the enlightened and civilising influence of the British.

Humanitarianism was not only about alleviating instances of suffering, but also about addressing the cause of that suffering.⁷² To this end, leprosy humanitarians strove not only to care for and treat leprosy patients, but also to eradicate stigma towards leprosy. The editor of the Leprosy Review began its first issue in 1930 by stating that: ‘the disfigurement that the disease produces in the later stages, the deformities that so often result, and the social stigma attached to the leper, all make it of utmost importance that something more than mere eradication of the disease should be the aim’.⁷³ This ‘something more’ was the elimination of leprosy’s stigma. While leprosy control policies initially involved segregating leprosy sufferers as in-patients, which often increased local stigmatisation of the disease, the discovery of an effective treatment for leprosy in the late 1940s paved the way for later community outreach programmes that more successfully sensitised communities about leprosy.

Humanitarianism during the colonial period was grounded in the idea that the British, with their superior culture and civilisation, had a moral obligation to improve the lives of their colonial subjects by drawing them out of backwardness through the teaching of civilisation: the civilising mission.⁷⁴ This was a justification for colonialism, and the supposition upon which additional voluntary aid was based. It was also a common ground between local colonial governments and the missionaries who most frequently acted as the agents of humanitarianism. Humanitarianism and the civilising mission could be just as important to colonial officials as missionaries, and in some colonies the government poured as much money into leprosy as did the missions, in spite of its low impact on the overall public health of the colony.

Apart from justifying colonialism and fulfilling human moral obligations, another reason for secular or government interest in leprosy as a humanitarian cause was patriotic duty. In the nineteenth century, Britons believed that philanthropy was a measure of the country’s international standing, and patriotic duty was often called upon in twentieth-century BELRA reports as fundraising motivation.⁷⁵ BELRA wrote that ‘It is a patriotic duty to try and make every part of the Empire as healthy as possible’, and they endeavoured to ‘arouse the public conscience’ to this responsibility.⁷⁶ In their travelling exhibitions, they displayed a film about leprosy entitled: ‘A Stain on Our Empire’s Flag’, and in several annual reports, BELRA tried to play on national pride by comparing the United States to Britain:⁷⁷

The people of the United States have just raised two million dollars as a result of an appeal for a “Wood Memorial Leprosy Fund,”…The British Empire comprises one-fifth of the earth’s surface, and contains a larger number of lepers than any other political grouping. For Britain’s subjects who are from one of the worst diseases human flesh is heir to, can nothing be done?…Let it never be said that Britain could not control this awful scourge because her people were not ready to supply the ammunition necessary to pursue a determined warfare.⁷⁸

This appeal to the British individual’s sense of responsibility for colonial subjects was portrayed as bearing fruit, for a few years later, BELRA wrote that: ‘The British public is gradually awakening to its responsibility to our suffering fellow-subjects among the backward races of our Empire’.⁷⁹ The civilising mission, patriotic duty, and the elimination of suffering were all brought together in the humanitarian fight against leprosy.

Conclusion

This article is about the narratives that philanthropists created and employed to sell leprosy as a humanitarian cause. With hundreds and hundreds of charities competing for the financial support of British citizens, it was imperative that charitable organisations develop effective publicity that convinced donors of the need and worthiness of the recipients. In an age of Empire where millions of British colonial subjects were considered in want of ‘civilisation’ and aid, fundraisers had to set leprosy apart from all other causes. They emphasised leprosy’s religious associations to call on Britain’s sense of Christian duty, and wrote of the unique power and success of Christianity in healing leprosy as an appeal to the moral obligation of Britons to civilise their colonial subjects. They drew on leprosy’s long history and terrible symptoms to cast the leprosy sufferer, and particularly the leprous child, as the most vulnerable and needy subjects in the British Empire, thereby mobilising the empathy of potential donors. Finally, they drew upon the patriotic and human responsibility of all Britons to ensure the welfare of Britain’s colonial subjects, in a world where philanthropy could be a measure of national pride. In publicising these narratives of the vulnerability and suffering of the leprosy patients, British humanitarians created an image of the outcast, vilified, and contagious ‘leper’ that continues to contribute to modern conceptions – or misconceptions – of the disease.