Leprosy Doctors in China's Post-Imperial Experimentation: Metaphors of a Disease and Its Control by Shao-Hua Liu (review)

Social researchers studying diseases frequently have to answer the question: How is this relevant to other people? "Other people," of course, refers to those members of society who do not suffer from the disease being studied. For those who study diseases in non-Western contexts, "other people" may also include people in the West. To address the question, some researchers argue that medical knowledge reflects and reproduces power relations in society. Others examine the causes of disease and reveal that social factors shape health conditions in profound ways. Then there is Shao-Hua Liu, a medical anthropologist who tackles the expansion of leprosy prevention in socialist China. Liu spent more than ten years researching this public health movement, which was seldom discussed publicly before the 1980s and yet is unusual in its scale and influence. While there is a substantial amount of literature on the link between public health and race, the relationship between public health and state building still requires discussion. Liu's work significantly advances our understanding of this important topic. She not only shows how medical workers took part in China's state-building project but also illustrates how a state eager to establish and transform itself into a modern one was able to formulate disease-prevention policies that used disease stigma as a mode of mobilization.

In Leprosy Doctors in China's Post-Imperial Experimentation: Metaphors of a Disease and Its Control, Liu investigates the formation and evolution of leprosy knowledge and prevention as a part of China's postimperial state-building project. In the early years of its establishment, the People's Republic of China strove to eliminate influences left behind by imperial China, the colonial empires, and the Republic of China. To the newly established state, leprosy was a disease that constituted a national shame, an enemy to be defeated alongside political enemies, class enemies, and traditional ideologies. Leprosy prevention and treatment were known to China even before its contact with the West, but the People's Republic of China was innovative in adopting a strategy to defeat leprosy that combined revolution, class reform, and public health. While the new Chinese government was taking over leprosy hospitals established by missionaries, it was also actively training new leprosy workers, conducting epidemiological investigations, and establishing new institutes, including a central institute located in Beijing specializing in leprosy, venereal diseases, and skin diseases. From the mid-1950s, the new China entered a phase when every rural area saw the establishment of people's communes. While most countries were abandoning segregation because of the introduction of effective antileprosy drugs, China, under the influence of collectivism, started to build leprosy settlements to segregate patients. By the end of 1956, there were 52 newly established or rebuilt leprosy hospitals, 114 leprosy villages, 157 dispensaries, and 10,914 leprosy patients registered.

One especially noticeable characteristic of leprosy prevention as developed in socialist China is an underlying rationale combining scientism and Marxism-Leninism. As the trend for collectivism intensified, leprosy prevention served political ends more than scientific and health ones. Trying to compete with the most prominent nations of the West, China launched the Great Leap Forward, aiming to transform itself into a modern communist society. Reflecting this broader trend, many new doctors were recruited and trained in simplified ways of treating leprosy. The results were mixed. On the one hand, the devotion of the many newly trained leprosy doctors to case-finding and segregation did stop leprosy from spreading further, and the prevalence rate had dropped significantly by the 1980s; on the other, the stigma associated with leprosy intensified. More than before, people—both medical workers and laymen—were scared of the disease. One serious consequence was that many patients hid away and thus missed the best timing for receiving treatment. They had to live with deformities and disabilities even after the disease was treated. Overall, what...