Leprosy:anoldsocialstigma

In the Middle Ages, vitiligo, psoriasis, scurvy, leprosy, among other dermatological diseases, were indiscriminately associated with the Latin term leprae. Its meaning was linked both to the Arabic word al-judhâm, referring to Greek elephantiasis, morphea, and to the Hebrew tsara'ath found in the Torah and the Bible with the meaning of divine punishment. Its symptoms were hardly ever overlooked, since they manifest on the skin, in plain sight of everyone. But it was not merely a disease of the body. The sores were considered symptoms of the moral corruption of the person who bore them.

Brought by colonizers and enslaved people to Portuguese America in the 17th century, the disease, with all its stigmas, began to be mentioned in the correspondence exchanged between the king of Portugal, members of Rio de Janeiro's City Council and governors of the captaincy. Throughout the 18th century, the term came to be identified with a specific set of symptoms, such as the so-called "leonine appearance" and insensitivity.

Lazars or lepers – as people with leprosy were then known – were part of the city's urban landscape. Until the mid-19th century, when Rio de Janeiro's physical spaces were not yet fully segregated, they shared the streets with street vendors, enslaved people, and the poor.

In the first half of the 18th century, the governor and captain-general of Rio de Janeiro, Gomes Freire de Andrade, future Count of Bobadella, began, at the request of dom João V, the construction of a lazaretto. The undertaking amounted to the construction of small houses that would shelter approximately 52 lepers at the foot of the São Cristóvão hill, a remote place untouched by the flow of people. Gradually, the disease came to be regarded as a threat to public health.

Image description: The image is a black-and-white photograph of a housing colony, dated 1972. From left to right, we see a row of houses with sloped roofs and side structures covered with roof tiles. The houses have windows and doors with light-colored frames. In front of the houses, there is a sidewalk and small gardens with plants and shrubs. At the top of the image, there is a horizontal red line that appears to have been added later.

After the death of Gomes Freire in 1763, one of the members of the triumvirate that took over the government of the captaincy, the bishop dom Antônio do Desterro, passed on to the Santíssimo Sacramento da Candelária the responsibility of caring for the lepers gathered in São Cristóvão. A former Jesuit monastery was renovated and, in 1766, began housing the Hospital dos Lázaros. Until 1929, when the Hospital-Colônia Curupaiti, in Jacarepaguá, was inaugurated, it was the only institution dedicated to the isolation and treatment of leprosy sufferers, not only in the capital, but throughout Rio de Janeiro.

Image description: This is an engraving showing a mountainous landscape. On the left side, we see calm water with boats floating on it. In the center, there is a building with several windows, possibly a church or public building, located on a hill. To the right, there are a few more houses and smaller structures. In the background, forest-covered mountains form the horizon. The image is in black and white.

At the top of the main entrance to the Hospital dos Lázaros, the verses of Italian poet Dante Alighieri were inscribed: "Abandon all hope, ye who enter here." The verses caused outrage in emperor Pedro II. The quote was removed under his orders in 1886, and a stained-glass window with the inscription "Here hope is reborn" came to decorate the place.

Image description: This image is a painting divided into two parts. On the left side, we see a standing male figure wearing a military uniform with a badge and an order sash. The figure is in an indoor setting, with a wooden floor and classic furniture. On the right side, there is a stained-glass window with human figures and an inscription that reads "AQUI RENASCE A ESPERANÇA" ("HERE HOPE IS REBORN"). The stained-glass window is set within a decorative frame, depicting a religious or moral scene.

The disease became increasingly dissociated from the idea of sin – after the discovery of the causative bacillus, the bacterium Mycobacterium leprae, in 1874 – to become linked to the danger of contagion. It was necessary to protect the healthy population and to admit, often compulsorily, people diagnosed with leprosy. Curupaiti became almost a small city: the leprosarium was intended for the isolation and treatment of the sick; the dispensary housed family members and other people who had had contact with patients; and children who were separated from their parents, many right after birth, were sent to the preventorium.

Image description: This is a photograph of an urban view with strong emphasis on a historic building located at the center of the image. On the left side, we see a metal structure, possibly part of a roof or the covering of an industrial building. In the center, there is a white palace with columns and a red roof, which appears to be the Frei Antônio Hospital, also known as the Hospital dos Lázaros. On the right, there are other smaller and more modern buildings. In the background, we see a range of mountains covered with green vegetation. At the top of the image, there is a watermark with the logo "tyba.com.br".

Between 2013 and 2016, there was a decline in the number of leprosy cases in Rio de Janeiro. However, the number of cases subsequently rose again. Current actions are aimed at ending the stigma and achieving early diagnosis, so that the impression caused in poet Olavo Bilac by the sight of a "leper" does not happen again: "Alone!... In the midst of life's bustle, alone, among those who love, alone among those who laugh, alone among those who cry, alone among everyone, isolated by his hideous disease, the leper lives more abandoned in the midst of social communion than if he were in the absolute wilderness of the most unexplored African sands."

Brazil currently holds the sad 2nd position in the world among countries recording new cases.