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Opinion: Making monkeypox the new leprosy repeats our past public health mistakes

Leprosy has a long history of being used to disenfranchise already socially marginalized populations.

Photo by Clay Banks on Unsplash

(RNS) — No, monkeypox is not leprosy.

What might seem like an obvious conclusion nonetheless prompted a fact check by Reuters in response to a widely shared Facebook post suggesting that monkeypox was indistinguishable from “biblical-era leprosy outbreaks.” “THIS IS SIMILAR TO THE DAYS OF NOAH,” the post declared.

It’s not the first time monkeypox has been conflated with leprosy. In June, a headline in the British newspaper the Telegraph reported, “Monkeypox upgraded to same severity level as leprosy and plague.” The article goes on to clarify that doctors in the United Kingdom are required to report new monkeypox cases to health authorities, as they are when they find 33 other communicable diseases, including malaria and rabies. Leprosy just makes for the flashiest headline.

Why leprosy? As an expert in the history of the disease, I’ve spent my career grappling with this question.The short answer is the Bible. The mention of leprosy immediately evokes for many readers the sufferers healed by Jesus in the Gospels of Matthew and Luke, or the separation of “lepers” stipulated in the Book of Leviticus. “He shall remain unclean as long as he has the disease; he is unclean. He shall live alone; his dwelling shall be outside the camp,” reads the book’s 13th chapter.

The disease’s biblical associations made leprosy a fixture in popular culture. “Ben-Hur,” both the 1880 novel and 1959 film, presented an influential fictionalization of the disease, which television shows from “The Simpsons” to “Call the Midwife” have built on. Most recently, HBO’s “Game of Thrones” and “House of the Dragon” series have continued this pattern with the disease called “Greyscale.”

In fact, the traditional translation of the biblical Hebrew tsa’arat as “leprosy” is inaccurate — the word likely refers to any number of skin ailments, none of which can be what doctors refer to today as Hansen’s disease. Our conception of leprosy as highly contagious and grotesquely disfiguring are also mistaken. Only moderately communicable, the chronic infectious disease caused by Mycobacterium leprae is difficult to transmit among humans and easily curable.

It also has nothing to do with monkeypox. Granted, the monkeypox virus can result in painful skin lesions, but it belongs to a different disease family: the Orthopoxvirus genus, the same grouping as smallpox. The only reason to associate the two is to bring the moral opprobrium that made outcasts of “lepers” in the Bible on vulnerable people today who contract monkeypox.

Leprosy has a long history of being used to disenfranchise already socially marginalized populations. Between 1865 and 1969, more than 8,000 leprosy sufferers in Hawaii were  forcibly relocated to settlements on the island of Molokai. More than 90% of those affected were Native Hawaiians, who renamed the disease “ma’i ho’oka’awale ‘ohana” (the separating sickness). Those afflicted with Hansen’s disease in the mainland United States were confined to a facility at Carville, Louisiana.

Contagionists favoring forcible segregation for leprosy “patients” repeatedly appealed to two authorities: the Bible and medieval history. Medical journals published articles with titles such as “Leprosy Overcome by Isolation in the Middle Ages,” imbuing biblical separation rites with a veneer of medical legitimacy.

Over time, the rhetoric became more racist and xenophobic. One physician at Molokai supported the widespread belief that leprosy was advanced syphilis — and that the Native Hawaiians were at fault for leprosy’s spread. On the eve of passage of the Chinese Exclusion Act in 1882, California medical professionals blamed leprosy on the presence of Chinese immigrants and used the disease as justification for labeling the population a threat to white residents.

More recently, Fox News fearmongering over migrants repeatedly includes the spurious claim that illegal immigrants are laden with leprosy.

The xenophobic rhetoric about leprosy was effectively recycled during the AIDS epidemic. After AIDS first appeared in the United States, the press infamously adopted the phrase “4H Club” to identify groups at the greatest risk for contracting the virus that causes AIDS: hemophiliacs, homosexuals, heroin users and Haitians. In 1986, The Journal of the American Medical Association published a theory — under the title, “Night of the Living Dead” — that Haitian voodoo rituals were responsible for the spread of AIDS.

Despite the questionable nature of these arguments, the stigmatization of Haitian immigrants became so pronounced that the U.S. Food and Drug Administration eventually banned all Haitians from donating blood.

Attempts to conflate leprosy and monkeypox follow this problematic script. To be sure, the current outbreak of monkeypox necessitates medical interventions, especially in underrepresented communities. But we must not allow monkeypox to stigmatize the disempowered. Stigmatization has been shown to undermine public health responses, and panic over monkeypox is already increasing the stigma around other skin diseases, such as psoriasis. The lack of information and communication about monkeypox has already brought comparisons to the U.S. government’s initial dismissiveness about AIDS.

Not least, the exploitation of leprosy for shock value is disrespectful to the thousands who still suffer from the disease and its stigma.

Despite the religious allusions to leprosy, Christians have been among the most dedicated advocates for leprosy sufferers, with figures such as Francis of Assisi, Father Damien of Molokai and Mother Marianne Cope devoting their lives to caring for this stigmatized population.

Maybe instead of summoning dark, misguided biblical parallels between monkeypox and leprosy, we can honor these faithful heroes and learn from past public health mistakes.

(Mark Lambert is a teaching fellow at the University of Chicago. The views expressed in this commentary do not necessarily reflect those of Religion News Service and/or Presbyterian Outlook.)

by Mark Lambert, Religion News Service