Category	Leprosarium
Country	Cameroun

This first leprosy-home project [in Cameroun] was, however, considered not so much the start of a systematic and long-term plan, but rather as an exceptional solution. The administration was, with good reason, avoiding drastic isolation measures, which, given the ethnic and religious characteristics of the affected tribes, could hardly be implemented. A cautious approach to leprosy control was particularly important with the islamicized and more self-reliant tribes of the northern hinterland.

But new reports of the spread of leprosy meant that a laissez-faire approach could not be maintained for long. In Yaounde, for instance, as the Administration’s doctor Prof Dr Haberer had to report, a leprosy case could be found in every tenth house. He also observed the sharing of clothes and eating utensils among diseased and healthy household members; he urged the need to prevent patients from wandering about, and to provide “explanations to the natives of the danger of infection”.

In the following years [after 1906], these warnings were vindicated in the hinterlands by an accepted morbidity of over 2%, showing a level of danger at which the systematic control of leprosy was now inevitable. The Administration’s reports on the threatening situation evidenced the new “native-friendly” “Kolonialpolitik“ of Bernard Dernburg, who, by 1907, as Secretary of State, had taken over the direction of the recently established Reichskolonialamt – the Imperial Colonial Office. Governor Theodor Seitz’s 1908 Announcement of Leprosy Control must, considering the threatening situation, be seen as prudent and sensitive.

The question arose now of how to observe the urgent hygienic and economic requirements for isolation - but without the use of undue force or compulsion - and in such a way that the isolated inmates would have a sense of “well-being”. Only this way could the likelihood of escape be avoided. Meetings of the chiefs, traders and merchants in sympathetic areas should provide explanations of disease-prevention, and promote the establishment of special settlements.

Naturally the broad objective of the Announcement was geared towards the tremendous hygienic and economic necessity for isolation – but this could only be viable where escape was avoided. The Announcement permitted the settling of un-infected family members. It also regulated the protection of the healthy population through legal debarment directed at “open businesses” and occupations with close public contact (trading, tailoring, butchery, saddlery, cooking, hardware, fish shops); and set up systems for the routine reporting of cases through district offices, army staff and other representatives of the protectorate. These regulations gave the doctors and officials the necessary legal standing within the current flexible framework required to develop their controls.

The outcomes were varied. In one case, on an island settlement, Mondoleh, established in 1909, measures had not been taken to resettle local fishermen and quarrels broke out with the leprosy patients, until a half-island was provided for the healthy fishermen; the patients could start growing their own food, and even raise ducks and hens. By 1910, there were no longer attempts to escape from Mondoleh. Three new settlements were opened, using abandoned villages in the districts of Younde, Ebolowa and Garua in northern Cameroun. In the colony near the Yaounde Station, easily reached by the Station doctor but sheltered by the bush and a stream, patients were fed at first by chiefs from their home villages; by 1911, a plantation was developed where maize, kasava, groundnuts and vegetables were grown. Dr Eckard dealt well surgically with as many as possible of the skin lesions of his 217 patients, and administered chaulmoogra oil while supplies permitted. Reports on the fate of the village suggest it had failed by 1913, through the unwillingness of inmates to be interned; all further efforts to contain the leprosy patients of the district were in vain.

(Translated from Wolfgang U Eckart. Medizin and Kolonialimperialismus: Deutschland 1884-1945, pp 208 – 213, by Ms Helga Patrikios)