Spanish built first leprosarium

As early as the 1600s, Western explorers documented seeing Chamorros of the Mariana Islands afflicted with apparent Hansen’s disease, or leprosy. Still, it wasn’t until hundreds of years later that a government-sanctioned policy of seclusion and confinement of Hansen’s patients gained a foothold on Guam. The Spanish government, and to a greater extent the US government, saw Hansen’s as a public health threat and constructed various hospitals and colonies, on and off-island, which were little more than prisons for Chamorros afflicted with this disease.

The first known leprosy “patient’s” hospital on island was built in 1831, ordered by Spanish Governor Francisco Ramon de Villalobos. The facility was constructed in Adelup, a barrio of the capital city of Hagåtña. Four years later, the Spanish government began sending the island’s leprosy patients to a leper colony in Saipan, the second largest island in the Mariana Islands archipelago, located north of Guam.

In April 1890 the government established another facility in Pago, Guam, for the placement of more than 100 people believed to have leprosy. However, this number dwindled to just one patient by 1899. Patients left the facility, as treatment was not enforced, and opted for health care provided by traditional Chamorro healers called suruhånus and suruhånas (also spelled suruhano or surohana in written documents) rather than Spanish doctors.

Americans confined patients

Before Western influence, Hansen’s patients on Guam generally were cared for by their families, who had little concern for catching the disease. John H. Clifford, who was a US marine assigned to the First Marine Division on Guam in 1899, wrote about those afflicted with Hansen’s disease on Guam and their treatment:

On the island there are a great many lepers. It was a common sight to see them walking the streets without hands or eyes and noses, also with one leg. Men, women and children were afflicted with this dreadful disease. At the church and on the street no attention was paid to it until Governor Leary gave orders to get rid of the horrible disease.

Within three years after the U.S. arrival in 1898, however, the standard of treatment for Hansen’s patients changed dramatically and was modeled after a system established elsewhere in the Pacific. In 1865, Hawai`ian monarch, King Kamehameha V, established the leper colony at Moloka`i Island. Fearing the spread of the disease, the Hawai`ian government sent people diagnosed with Hansen’s disease to a remote peninsula, surrounded by ocean on three sides and a sheer cliff on the fourth. As the disease reached epidemic proportions in Hawai`i in the late 1800s, more and more native Hawai`ians were taken from their families and sent to the colony against their will. By the turn of the century more than 1,000 patients lived at the colony.

The perceived success of the Moloka`i colony in segregating the afflicted from the rest of the population was cited by Guam Governor G.L. Dyer in 1905 in demonstrating need for these drastic measures to be taken on Guam.

“Lepers” exiled

Borne of ignorance and misconceptions about Hansen’s disease, and the Chamorro culture and customs, the naval administration sought to remove people suspected of having Hansen’s disease from the general population, a task they found difficult. Lieutenant Commander Vincedon Cottman stated in an 1899 report that the Chamorro people were indifferent to the disease and weren’t concerned about catching it from those who were apparently afflicted with it. Governor Leary’s assistant, Lieutenant William E. Safford, echoed the same concerns in his diary. Moreover, the administration’s decision to confine people was an act of self preservation; to prevent the disease from spreading to military personnel.

Through the issuance of General Order No. 43, US Navy Governor Seaton Schroeder set up a leper colony on Guam in 1902 in Ypao, Tumon. Shroeder stated that the site was selected specifically because it was:

a very pretty spot, and healthy, fronting upon a nice clean beach.

The order also called for the identification, apprehension and confinement of those suspected of having leprosy. The naval authorities’ aggressive efforts to isolate leprosy, however, led to the misidentification of ailments. Relatively few leprosy patients existed in the leper colonies. Instead there was a higher number of people incarcerated who were afflicted with the more prevalent diseases of syphilis, or yaws and gangosa.

The reality of the colony was less than picturesque. After condemning the land and constructing a high barbed wire fence on three sides (with the ocean on the fourth), the colony was equipped with shelters with barred windows and padlocks on doors. Guards were posted at the perimeter to stop escapees, and the “inmates,” as they were called in documents from the period, were allowed only limited family visits. The governor had to approve requests and issue written permits for anyone entering the compound. Punishment for those who tried to run away from the colony was harsh. Gov. Schroeder ordered:

… any inmate who goes beyond the the limits of the Colony without the requisite permission shall be punished by ten to twenty days of ball and chain for the first infraction, and by one to six months for a repetition of the offense…

Despite this, there was a great deal of resistance from Chamorros who were determined to see their family members, help them escape or hide them from authorities. This resistance, the costs of maintaining the colony, and the extent of the perceived threat that the disease could spread prompted naval authorities in 1911 to request that Hansen’s patients be transferred to a large existing colony on Culion Island, in Palawan Province, south of Manila in the Philippines.

This colony, established in 1904, housed hundreds of Hansen’s patients not only from the Philippines but from around the region, including at least one American. Eighteen people confined at the Tumon colony were the first to be forcefully transferred from the island, most would never see their families again. In December 1912, after their transportation to Culion, the Chamorros found themselves in isolation and poverty, facing a food shortage and unable to communicate with other patients who spoke one of various Filipino dialects and other Asian languages. Dr. Anne Perez Hattori wrote in her book Colonial Dis-Ease: US Navy Health Policies and the Chamorros of Guam, 1898-1941 that:

…from 1912 to 1924, any Chamorro diagnosed with leprosy, regardless of gender or age, was sent to Culion on the next available transport.

This inhumane treatment led to considerable tension between the general Chamorro population and the US military health care givers on island. Finally, in 1924, the navy government allowed some of the Culion patients to return to Guam and those newly diagnosed to live at the Tumon colony.

The exile of leper patients continued through the first half of the century, though in smaller numbers. “Leper Island” on Yap began housing Guam patients in 1925, and in 1948, a handful of Guam patients were sent to receive care at a hospital in Tinian.

By Connor Murphy

For further reading

Angeny, G.L. “Leprosy in Guam.” The Military Surgeon: Journal of the Association of Military Surgeons of the United States 25, no. 1 (July 1909): 312-317. Also available online at Google Books: The Military Surgeon (accessed August 12, 2010).

Clifford, John H. History of the Pioneer Marine Battalion at Guam, L.I., 1899, and the campaign in Samar, P.I. 1901, By John H. Clifford, Ex Priv. U.S. Marine Corps. Np., (1901?). Also available online History of the Pioneer Marine Battalion at Guam, L.I., 1899, and the campaign in Samar, P.I. 1901 (accessed August 12, 2010).

Cosgrove-Mather, Bootie. “Last days of a leper colony: Days, and funerals, dwindling for residents of former leper colony.” CBS News, March 22, 2003. Available online at CBSNews.com (accessed August 12, 2010).

The Culion Leper Colony Dr. Therese Kohen Foundation website. From a “Brief History of Culion Island” by Patricia Hila. (accessed August 12, 2010).

Hattori, Anne Perez. Colonial Dis-Ease: U.S. Navy Health Policies and the Chamorros of Guam, 1898-1941. Honolulu: University of Hawaii Press, 2004.