I.A Suitable Island Site':

eprosy in the Northern Territory

and the Channel Island Leprosarium

~r ~uzanne ~aunaer~ Historical Society of the · Northern Territory Darwin 1989

'A SUITABLE ISLAND SITE': LEPROSY IN THE NORTHERN TERRITORY

AND THE CHANNEL ISLAND LEPROSARIUM 1880-1955

SUZANNE SAUNDERS

Historical Society of the Northern Territory Darwin

1989

f;URR!GUU.lf'.1 L4f30R!\TfJRY F~f1t';.J :, : r' ·, ,r:. r:,-"·~ 1 /~~,ATICJI\J

NORTfiC.lilJ T c:.:l,,: :·;;-'"~:r; ~, Ui\f/V[~}i;:JJTY

. '

Published by the Historical Society of the Northern Tenitory PO Box 40544, Casuarina NT 0811

Darwin, 1989.

Copyright: S Saunders

ISBN NO 09588093-2-1

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List of Tables

List of Plates

Abbreviations

Acknowledgeinents

Introduction

Chapter 1 The Tradition

Chapter 2 Australia Challenged

Chapter 3 Administrative Evasion

CONTENTS

Chapter 4 The Promise - the Disappointment

Chapter 5 The People

Epilogue

Conclusion

Notes on Sources

Bibliography

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6

19

29

41

56

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LIST OF TABLES

1 Recorded leprosy cases in Australia 8

2 Recorded leprosy cases 1930-1950 17 ;'1

3 Channel Island 1931-1955 42

4 Racial origins of patients admitted to Channel Island 1932-1938 43

5 Cases being treated outside Channel Island 46

LIST OF PLATES

1 Mud Island Lazarette showing small corrugated 25 iron accommodation hut. c.1890

2 Aboriginal accommodation huts on Channel Island. c.1939 31

3 European accommodation showing cyclone damage and water tanks. 1937 31

4 Matron Jones, who with her husband, cared for the Channel Island patients until 1942 37

5 A Bathurst Island patient is buried with a Catholic ceremony by the nursing staff. c.1945 38

6 Channel Island's only female European patient with fellow patients. c.1939 44

7 Western Australian patients who were transported to the leprosarium during the early 1930s 45

8 Aboriginal patients outside the recreation hall. c.1946 53

9 Patients preparing for a fishing expedition, post-war 53

MAP Location of Mud Point and Channel Island 26

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}.;'TR.A

GRR

PROS A

AA

AANT

h'"'f As

h1TI'G

ABBREVIATIONS

Northern Territory, Report of the Administrator

Government Resident's Report

Public Record Office of South Australia

Australian Archives, Canberra

Australian Archives, Northern Territory

Northern Territory Archives Services

Northern Territory Times and Gazette

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ACKNOWLEDGEMENTS

In the writing of this history I received assistance, support and encouragement from many people, several of whom deserve particular mention. Nancy Croft and Jack Gibbs, fonner Channel Island pati~nts gave of their time and friendship with great generosity. I trust dlat in some small way the publication of this history repays their kindness. The Power and Water Authority demonstrated their commitment to the preservation of Channel Island's historical precinct by funding this research and assisting financially with this publication. Keith Presnell lent the project his unqualified support, and Dr Bob Reece gave valuable criticism, practical advice and constant encouragement As always the indulgence of my family allowed me to pursue my research in a congenial and supportive atmosphere.

Suzanne Saunders

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INTRODUCTION

Leprosy is a relatively recent introduction to Australia. It is highly unlikely that the Aboriginal people suffered from leprosy prior to European settlement but when it became e.ndemic. they. were the. group most severely affected. The Northern Territory's response to leprosy among the Aborigines was to establish a leprosarium on Channel Island in the Darwin Harbour in 1931 and for the next 24 years all persons known to have leprosy were isblated there. An island leprosarium was not a uniquely Australian phenomenon but part of an old European tradition. The policy of isolating leprosy patients had emerged with

knowledge. of the disease in· the Western world and became a tradition so deeply entrenched that it was as powerful in twentieth century Australia as it had been in medieval Europe. The tradition was so widely accepted that, even though conditions on

island were often loudly decried, the need for the institution was rarely challenged.

The leprosarium was set up and ended in the yeriod of Commonwealth administration of .the Northern Territory (1911-1978) and dunng its existence governments in Canberra changed from Labor to non Labor and back again several times. But changes of administration had little significance for leprosy patients in the Territory; policies affecting them were more dependent on individual medical officers in the Northern Territory and the prejudices of both the public and the medical profession in Australia. The hope of the patients Jay in the development of new drugs and a new order of medical officers prepared to fight for less repressive legislation and a more enlightened approach to the treatment of leprosy.

A new dimension was added to the traditional stigmatisation of leprosy sufferers largely because. so many of them were Aborigines who were not only a low status group but were also subject, under protection and welfare policies, to administrative institutionalisation from the late 1930s onwards. The problems of dealing with the disease among Aborigines caused the Australian authorities to resist world-wide trends in leprosy prophylaxis and to maintain an isolation policy.

In the past it has been members of the medical profession who have displayed the greatest interest .in leprosy and this has been largely confined to its epidemiology. Doctors like C E Cook, J A Thompson and J H L Cumpston, all prominent men in Australian public health services, have endeavoured to trace its means of entry into Australia and its spread among Aboriginal and European populations. Their primary purpose was to justify the policies employed in leprosy ~atment More recently, Dr W A Davidson, a retired member of the Public Health Department, Western Australia, has provided the only detailed account of leprosy in Western Australia, or indeed any Australian state. As with studies conducted.. by doctors in the past, his main concerns were the epidemiology of leprosy and the administrative problems involved in implementing an isolation policy.

Only in more recent times have historians shown more than a passing interest in disease in Australia, and more particularly, disease amongst Aborigines, with smallpox, tuberculosis wid influenza receiving the most attention. Because of the small numbers involved, leprosy has received little detailed inquiry to date. And yet, because of the legislation passed directly relating to leprosy, the active seeking out of leprosy sufferers by doctors and police and the removal of patients to isolation institutions, it is a significant part of the history of disease in Australia. In the Northern Territory, the impact of leprosy was widespread, not only because of the debilitating nature of the disease but because the isolation policy permanently removed some Aborigines from their families and sent others into hiding. Although there can be little doubt that a serious disturbance of Aboriginal

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lifestyle and cultural activities resulted, and that profound psychological effects and antipathy followed, it has been impossible to explore these matters historically in this work. Instead, our attention is focussed on the evolution of the isolation policy in Australia and its implementation in the Northern Territory, the more obvious Aboriginal responses to that policy and the experience of those who were isolated on Channel Island.

Before proceeding, some reference must be made to the terminology employed in this history. In the interests of historical accuracy, the world 'leper' has been used, rather than the now more acceptable term 'leprosy patient', but it has .been done without subscription to the perjorative, emotive and stigmatizing connotations which usually accompany it. In deference to people who have already suffered much as a result of the disease, it will be avoided where possible when referring to those afflicted during the twentieth century, although even here the word cannot be entirely avoided. Not only was it in common usage during this period, it became the legal term for those certified as suffering from leprosy. Also, it is plainly ridiculous to refer to people who received no medical treatment as 'patients', and as treatment for leprosy was not introduced in the Northern Territory until 1923, many people in this account were indeed lepers. They came to the notice of the authorities only as a result of the disease and their removal from society was to protect the wider community rather than provide relief to the sufferer. The term 'half-caste' has also been avoided, although that too was in common usage and was given legal status through legislation. As the racial origin of leprosy patients was a significant factor in determining the treatment they received, the tenn 'part-Aboriginal' has been used to distinguish people of mixed Asian/European/Aboriginal d.escent.

This book is based on a thesis of which copies are lodged in the Northern Territory University Library, Murdoch University Library and State Reference Library. In preparing the book the original text was reduced in length and a reseatch worker may need to consult the original for additional detail supporting the argument and for the sources of many citations, especially those drawn from archives. In the bibliography to the present volume there is a list not only of works mentioned but also of other printed sources consulted. ·

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CHAPTER ONE

THE TRADITION

Of all the diseases known to man, leprosy has had, until very recently, the reputation of being the most feared and dreadful. There are other diseases which strike more swiftly and fatally than leprosy, and some which are equally gross in their physical manifestations, but none which excite a reaction so violent that its sufferers have been systematically ostracised si11ce ancient times. The history of leprosy is the history of a great and persistent fear among the public, the contradictory determination and helplessness of the responsible authorities and, above all, the despair and wretchedness of tho~ afflicted and doomed by their fellow man to a life outside society.

Leprosy is a disease of the peripheral nerves which also affects the skin and other tissues. If left untreated it can cause crippling of the hands and feet and loss of muscle control. Where eye tissue is involved, blindness can occur. The incubation period of leprosy is generally three to five years, but in some cases, may exceed a decade. The specific micro­organism responsible for leprosy, Myco-bacterium leprae, was identified by Dr G H Armauer Hansen, a Norwegian scientist, in 1873. Despite the isolation and identification of the bacillus, scientific understanding of the disease remains incomplete. There is no simple diagnostic test available.• diagnosis remains dependent on clinical observation and microscope examination - and attempts to develop a vaccine have so far provided futile. However with an estimated 15 million people in the world still suffering from leprosy, scientific interest in the disease remains high.

The tradition

In Australia, the reaction of both the public and the authorities to leprosy was largelr based on a tr.adition.wbich had evolved in the medieval world of Western Europe and it came to be .associated. with ostracism, degradation and criminality. Fear of the disease was carried in the highly charged and emotive word 'leper'. This label carried with it the horror of biblical denunciation since in the translation of the Bible from Hebrew to Greek, the Greek word lepra later became the English word leper.

The medieval understanding of the nature and the cause of leprosy had serious implications for those suffering from the disease. While it was claimed that leprosy resulted from illicit and degrading sexual activity or from sour vapours and black h1.Jlllours, the underlying assumption fostered by the church was that it came as a punishment from God for wrong-doing. Levitical law which was based on a confused translation of the Hebrew word tsara' ath, denounced the leper as unclean and demanded bis removal from society. Ostracism not only completed the divine punishment but removed the risk of the leper tainting the pure, for the influence of a leprous person could render an unwary or uncaring associate open to evil and to the judgement of a retributive and undiscerning God. The reasons for enforced isolation are not easily defined, and they varied from place to place and from one era to the next, but for the greater part of the Middle Ages religious sanctions were predominant. In time they became confused with isolation through fear of contagion until by the seventeenth century, the latter was more consistently given as the reason for segregation.

During the times when religious tradition associated leprosy with immorality and defilement, the contagion nature of the disease was realised even if the mechanism of contagion was not understood. The waning power of the church in the seventeenth

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century did not result in a relaxation of segregation laws: where the Church no longer enforced isolation laws, the civil authorities did. Civil law refrained from officially judging the leper morally responsible for his affliction but the long-held views of the church persisted in the minds of people. If the afflicted were most often from the poorer classes or, as happened with European colonialism, were members of a native and therefore inferior race, the belief was reinforced and given a practical reality. Any disease which resulted in isolation for the sufferer would be feared but when segregation Was combined with gross physical disfigurement and certain death the fear was intensified and the isolation policy in turn strengthened.

The existence of the tradition of isolation suggests that while . fear of contagion and impurity are proffered as reasons for .segregation there are probably religious and scientifo:: sanctions of deeper psychological motives. Man is a social creature and his survival depends on communication. When afflicted with leprosy, two important organs of self expression, the face and the hands, are often deeply mutilated. Drawings, paintings and photographs from the pages of history ·bear testimony to the power of leprosy to mutilate and destroy and to render the human form repulsive. Humans are inherently afraid of that which is ugly, and more particularly, of the ugly which they have no power to change. To understand why this is so it is helpful to refer to Mary Douglas' work on pollution and prohibition.

In her search for an understanding of contagion and purification Douglas (1966) explored the idea of symbolism in the universal struggle for order,· Her study has interesting implications for the question of segregation in leprosy. Religion is a means of establishing order in an otherwise chaotic world and givhi.g JDeaning to an otherwise futile existence. Leprosy worked against life, it was seen to be an implacable evil force which relentlessly· destroyed and it was, until very recently, beyond human control. It could only be ordered through segregation. The disease, unable to be cured or in any other way controlled by human agency was relegated to the area of the unclean, the impure and the outside. Douglas writes: ·

ideas about separating, purifying, demarcating and punishing trans­gression have as their main function to impose a system on an inherently untidy experience (1966, 4).

Through the power of banishment, leprosy is controlled and order maintained. In a medical study of the role of segregation, Hoffman (1930, 15) draws the same conclusion, saying that 'because of the incurability of the disellse rather than its infectiousness, the system of compulsory segregation was resorted to in the past'. Douglas' analysis provides an avenue for exploring the tenacity of the notion of leprosy being immoral, dirty and venereal. "'

Institutional care, even when prompted by the most noble of motives, promulgl,lted the mystery and secrecy of leprosy, inhibiting a rational approach to the disease. The afflicted were hidden away, the patient afraid to declare the nature of his illness when such a disclosure could adversely affect his. family, social and work life. There was no easy solution to the problem of where to break oqt of the cycle; should social understanding of the disease be rectified before the names of· the sufferers were revealed, or should the patient and doctor fight misconceptions by refusing to ac~ in secrecy? As the etiology of leprosy was slowly uncovered, its mysteries explained and chances of a cure increased, so the fear ebbed and with it the drive for compulsory segregation. This spelled the end of the Channel Island leprosarium.

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Leprosy in British dependencies

Although leprosy was no longer endemic in Britain in the twentieth century - the isolated cases still reported having been contracted overseas - the British were heavily involved in the worldwide fight against the disease. Britain's dependencies in South-East Asia, India, . Africa, South America and the West Indies all recorded leprosy in some degree. Although the incidence of the disease in many countries was not sufficiently high to be considered a major health problem, the horror of leprosy was keenly felt and for humanitarian reasons alone the British were prompted to endeavours to control its spread. But economic motives were also alleged. One contemporary French colonist, Jeanselm (1901), suggested that Britain was influenced as much by economic a~ philanthropic motives. An indigenous labour force debilitated by leprosy was a great disadvantage to colonial economics. There was also the real fear that the disease would be introduced into the European colonial community.

In 1924 Sir Leonard Rogers, founding member of the British Empire Leprosy Relief Association, reported the number of leprosy patients in British dependencies to be 300,000. By 1942 this number had increased to over 800,000. In both cases this was acknowledged to be an under-estimate of people actually suffering from the disease. The number of cases whfoh had not come under attention, either through deliberate concealment or because the infected person was unaware of his condition, was thought to be as many as one-third again of those identified, The dramatic increase in the recorded number of sufferers was not entirely due to the increased incidence of the disease, but reflected a better knowledge of leprosy and improving means of tackling the disease. The

. prophylaxis for leprosy showed a certain uniformity throughout the British Empire although health authorities in some countries responded more quickly to new ideas and methods of treatment than did others.

With the identification of the leprosy-causing organism Myco-bacterium leprae by Hansen in 1873, the way was opened for a better understanding of the disease but the myths, misconceptions and superstitions which surround it were slow to clear. During the nineteenth century it was widely believed that leprosx was hereditary, a belief which gained strength from the very definite pattern of familial infection. However, notable cases ·such as that of Father Damien, who contracted leprosy while working among the patients of Hawaii, gave rise to doubts, and when coupled with Hansen's discovery, the theory lost ground.

Another belief which had currency around the turn of the century was that the leprosy infection was of telluric nature, that is, it occurred spontaneously as a result of specific factors in the earth or, more generally, in the environment. While not quite the black humours and foul vapours of Medieval times, the idea contained an element of the magical although it was argued within the bounds of early twentieth century medical knowledge and couched in scientific terms. When investigating leprosy in Australia in 1925, Cecil E Cook felt obliged to acknowledge the possibility

that leprosy is not an infectious disease as between man and man but is a malady contracted from some condition of the environment found in certain localities (Cook 1927, 16)

only in order to refute it He also rejected the theory widely discounted by 1925, that the consumption of particular foods was responsible for leprosy infection.

More enduring than either the hereditary, dietary or environmental theories was the belief, which had emerged strongly during the seventeenth century, that leprosy was a highly

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contagious disease. Despite evidence to the contrary, medical opinion on this point was slow to change and social opinion even slower. Alarm among medical and civil authorities at the alleged contagiousness of leprosy and the question of its mode of transmission from one person to another resulted in a strengthening of segregation laws throughout the British Empire about the turn of the century, An international conference for leprosy workers held in Berlin in 1897, concurred with the British move and passed a resolution which stated that isolation was the best means of controlling the spread of leprosy. In some countries compulsory segregation was introduced under general ordinances dealing with infectious diseases, but often it was introduced under Acts of Parliament passed specifically for the purpose of controlling .the spread of leprosy. Ceylon (1901), Malaya (1901), Malta (1919), Fiji (1900), South Africa (1892) and Queensland, Australia (1892) all had Leper Ordinances which enforced the segregation of every person known to have leprosy. In Malaya and Ceylon, home isolation, although difficult to monitor, was permitted and in some of the British West Indian countries, laws affected only those plying certain trades. In most instances legislation made the police responsible for enforcement; those thought to be suffering from the disease were to be arrested, detained in custody, certified as lepers, and under some laws, convicted. In India and the African colonies, segregation was on a voluntary basis. The number of leprosy patients in these countries was in the hundreds of thousands and segregation for all patients was beyond the financial capability of the government.

Up until 1930, when compulsory segregation laws were being modified, island sites for leper settlements were often chosen. With no hope of being cured, leprosy patients were hidden away in institutions from which escape was impossible and where they could not offend the public eye. When an island site was l:Jnavailable, solid brick walls were erected behind which the patients could be incarcerated. In these prison-like leper settlements, only token attempts were made at treating patients. As new methods of treatment with an increased chance of a cure became available, mainland sites with easy access to health workers and food and medical supplies became more common. Robben Island, South Africa's leper settlement, was abandoned early in the twentieth century, while island isolation settlements in other countries became less important as out-patient clinics were established. The settlement in Malaya established in 1932, possibly as well planned and operated as any in the British Empire, was built just 12 miles from the capital of Kuala Lumpur. Sites on previously uninhabited islands continued to be chosen in the small countries of the Pacific and Indian Oceans where large tracts of land on main islands were unavailable. In Australia, however, island sites were still being chosen at a time when other countries were turning to mainland sites; Channel Island (NT) was established in 1931 and Fantome Island (Qld) in 1940. The large number of leprosy patients in Africa necessitated a different approach and successful agricultural colonies were established on land made available by local chiefs. Life in these villages differed little from that in surrounding villages. In some, out~patient clinics were established, but for many Africans, isolation was· the only prophylaxis. As coercion had proved negative, the move to an agricultural colony was made on a voluntary basis, with local leaders being encouraged to persuade any of their people suffering from leprosy to.move to one of the leper villages.

In most countries of the British Empire, particularly in Africa, the campaign against leprosy was greatly assisted by missionary organisations, some working under government supervision, but others entirely funded, organised and staffed by church societies. During the post-war period, Catholic nuns, operating under Govemment control, staffed the three Australian institutions which catered for Aboriginal people, while in India, the Mission to Lepers was largely responsible for providing the facilities to isolate infectious patients and asylum for the mutilated cases. The Mission to Lepers, inaugurated in 1874, was an inter­denominational philanthropic organisation with branches throughout the Commonwealth and often acted as a lobby group to improve the conditions of leprosy patients. The

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Empire Leprosy Relief Association, which provided much needed financial and help throughout British dependencies, had been fonned in 1923 for the express

:-:::'.s!"DO:~e of ensuring the adoption of improved treatment throughout the Empire (Rogers In 1925 the League of Nations joined the fight against leprosy by appointing a

·· Leprosy Commission 'to inquire into certain statistical and epidemiological aspects of ~e;prosy' which, it was envisaged, would bring some consensus on the much disputed 4u.estions of treatment and isolation (Burnet 1931). Another widely influential body, the farernational Leprosy Association, was founded in 1930 to collect and disseminate the

of scientific research into leprosy. These agencies provided services which governments were unable or unwilling to supply. Without them the lot of many leprosy Datients would. have been unendurable.

I!:! most respects, the Australian approach to leprosy prophylaxis was similar to that in comparable countries within the British Empire. Legislation relating to leprosy sufferers was introduced, compulsory isolation was enforced and leper colonies were established in the early decades of this century. It was only during the 1930s that a major difference began to emerge. During this period compulsory isolation laws in most countries were gr,;,atly modified while in Australia they were strengthened. Although the reasons for this rue complex, primary contributing factors were the social position of Aborigines, the group most severely affected by leprosy in Australia, and European perceptions of the relationship between the white and black population. To this was added a leprosy tradition which had been generated in medieval Europe and retained in the cultural memory and in Western literature. The tradition had been emphasised and confirmed in the colonial experience and the combination of circumstances in Australia ensured its survival.

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CHAPTER TWO

AUSTRALIA CHALLENGED

The history of the epidemiology of leprosy was a significant factor in determining the course pursued in leprosy prophylaxis in Australia. By the beginning of the twentieth? century the majority of European countries had been free of leprosy for at least a hundred years and in the colonial experience leprosy came to be viewed as a disease of the coloured races. This experience was confinned in Australia when leprosy was first found among the Chinese. The notion that leprosy was a disease· of the coloured and inferior races was further strengthened when it reached epidemic proportions among the Aborigines. It was the combination of these two elements that so adversely affected the attitude of both public and government toward leprosy in Australia and resulted in the refusal to follow world-wide trends of adopting modem methods of treatment.

The move away from compulsory isolation

By 1930, British leprologists were strongly advocating a modification of the existing semi-penal legislation and allowing voluntary isolation of patients who were infectious and treatment in out-patient clinics of those in little danger of spreading the disease. This move was prompted by three developments, the most significant of which was new methods of treatment.

The oil of the chaulmoogra and hydnocarpus tre~s had long been as.sociated with the cure of leprosy in India and Asia, but at the tum of the. century the old Welsh proverb 'you will find no convalescent leper' still rang true. However, the production and administration of chaulmoogra and hydnocarpus oils was greatly refined during the early decades of the twentieth century. Taken orally, the mixture was nauseating and of little value, but injected intra-muscularly and subcutaneously it proved to be beneficial. This was an excruciatingly painful process which had to be carried out at least twice a week for a minimum of two years. The addition of an analgesic to the oil reduced the pain, but even then, with injections, and oral preparations for those able to tolerate it, treatment for leprosy was so extremely unpleasant that patients were given regular periods of respite. Nor was success guaranteed. Those who wrote in enthusiastic tones of a 'well established remedy' capable of 'ridding the country of the baneful disease' were exaggerating the power of chaulmoogra oil and its derivatives for, although the word 'cure' was commonly used during this period, 'greatly improved' or 'disease arrested' would have more accurately described the situation. Ortly rarely were all leprosy bacilli in the body destroyed and the chances of a 'cured patient' suffering a relapse were high. Oil of chaulmoogra did not have the direct anti-bacilli action of the· later-developed sulp'hone drugs, and its curative power may have been .its promotion of general good health which allowed the body's immune system to work more effectively.

The rate of arrested cases varied from one country to another within the British Empire; Malaya with its superior facilities and committed approach, was achieving a commendable 30 per cent early in the 1930s. In Australia the number of patients discharged varied from state to state but was never as high as in Malaya. At their institutions in the Philippines, Hawaii and Louisiana, the Americans were reporting that as many as 53 per cent of patients were being 'paroled' by 1925. This figure went as high as 80 per cent when treatment was administered within the first two years of the onset of the disease. Although the British were lagging behind, by 1930 treatment had improved to such an extent that leprologists were urging that wider use be made of out-patient clinics and that hospitalisation be reserved for initial treatment and for the highly infectious cases.

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proposed modification of existing legislation was also based on negative experiences countries with compulsory legislation. Not only was the inhumanity of such laws

decried but they had resulted in many early cases being hidden. This not only ----''""'~"u the risk of the disease spreading but prevented the treatment of the most ~;.;cw-1.Hv cases. E H Molesworth, a noted Australian protagonist of voluntary isolation

out-patient treatment, summed up the argument thus:

The temptation for patients and relatives to conceal the disease under existing regulations for incarceration of lepers may expose the immediate associates of the patient to infection for a much longer period than would be the case if the patient could be treated without internment, as he can be and is with success in countries where segregation is not compulsory (Molesworth 1926, 369).

Temporary discharge during periods of remission of the disease was practised on an ::Jonnal basis in India and Africa because it was recognised that it broke down opposition

those with the disease. Where out-patient clinics were introduced it was found that :m}se, suffering from leprosy presented themselves earlier than hitherto.

The primary reason that had been given for the drastic compulsory isolation measures L::irroduced in the early twentieth century was the alleged high contagiousness of leprosy. ,-\s early as 1898, statements asserting that 'leprosy is a contagious and infectious disease, ::Cut is only communicable after prolonged contact' (von During 1898) were being made :':ut it was several decades before this was widely accepted in medical circles. By 1930 sufficient documentation was available to substantiate the claim that leprosy was indeed 1,Jnly slightly contagious and that a small percentage of cases would naturally abort, In ~894 Impey (1895) had claimed that some cases ofleprosy were self-cured and although ~e was ridiculed for his idea, subsequent bacteriological testing supported his theory. These cases, where the disease had worked itself through leaving the patient non­mfectious, were referred to as 'burnt-out', and careful examination revealed that in some leper settlements they made up the greater part of the population. Thus, although Zeprosy's mode of transmission remained imperfectly understood, the.realisation that not all leprosy patients were infectious and that the overall infectivity was low, meant that the last remaining justification for total compulsory segregation was removed.

During the 1930s the governments of Malaya, Ceylon, British Guiana and the British West fndies, Fiji and Samoa responded to the move towards voluntary isolation by opening country clinics and out-patient facilities in the city, while retaining control over those open infectious cases who refused treatment.

Australian policy and legislation

At this time Australia, rather than responding to modem developments in the treatment of leprosy, was only just beginning to face the unwelcome fact that leprosy was endemic in the country and that its spread could only be controlled through positive action. Leprosy had been introduced into Australia principally by the Chinese, although other races, Kanakas in Queensland and Malays in.Western Australia, are thought to have contributed. The earliest recorded case is that of a male Chinese in Queensland in 1855. Both New South Wales and Victoria had recorded cases by 1860 and Western Australia and the Northern Territory by 1890. With the exception of Victoria, leprosy became endemic in each of these states, reaching epidemic proportions in Queensland, Western Australia and the Northern Territory. South Australia and Tasmania remained free of the disease, the rare case coming to the attention of the authorities, having been contracted outside their

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states. Table 1, compiled by J H L Cumpston, the first Director of the Comll1onwealth Department of Health, shows those cases identified and recorded prior to 1925 (Cumpston, n.d., 316).

In Queensland, Western Australia and the Northern Territory, the Aboriginal people were most severely affected and by 1930 they accounted for the majority of notified cases. :Tue only major endemic foci among Europeans were in Queensland, the Europeans in New South Wales being affected to a much lesser extent

Table 1 Recorded leprosy case,s in Australia

Year NSW Vic Qld SA *WA Tas NT Total

1850-60 1 0 2 3+ 1860-70 3 30+ 1 34 1870-75 7 15 22 1875-80 10 2 12 1880-85 13 3 6 22 1885-90 18 4 8 2 11 43 1890-95 35 1 31 6 73 1895-1900 9 2 82 1 12 106 1900-05 36 3 67 2 108 1905-10 20 84 18 1 3 126 1910-15 11 2 56 8 2 79 1915-20 6 2 57 6 9 80 1920-25 3 31 17 46 97

162 72 421 54 1 95 805

Many cases of leprosy were known to exist among Chinese in the population but the number was never recorded.

During the 1880s all colonies except Tasmania provided for the detention and isolation of lepers under public health acts. In Queensland alone this was thought to be an insufficient safeguard and, in response to public alarm, a leprosy act which allowed for the isolation of any person thought to be suffering from leprosy, was passed in 1892 (Evans 1969). In the following decades, the clauses dealing with leprosy in public health legislatiol\c in other states was expanded and provisions for isolation were more clearly defined. ·

In the Northern Territory before 1928, leprosy patients hadbeen isolated under clauses of the public health ordinance of 1915 dealfug with infectious diseases. The Chief Medical Officer, C E Cook, who was actively pursuing a policy of compulsory isolation for all persons found to be suffering from leprosy, found that his power under this ordinance was too limited. As a result of his advice to Cumpston, an ordinance of 1928 for the suppression of leprosy, legalising an already well established practice, was passed. Like the earlier Queensland ordinance it dealt with the detention, certification, isolation and release of leprosy patients but failed to stipulate conditions under which detention was to be effected. When the Queensland leprosy .act was repealed in 1937, the provisions of the old legislation being incorporated in the new public health act, the Northern Territory alone had an act dealing only with leprosy. In the Northern Territory, the Leprosy Act was revised in 1954 and again in 1958 with no lessening of isolation powers.

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New South Wales an area of the Coast Hospital near Sydney was set aside for the "'"·"'~"'-..,.., .. ~ of leprosy patients but more common were island lazarets. In Queensland, '4il&'"""tP.,m Australia, Victoria and the Northern Territory use was made of a number of small

where lepers were isolated under appalling conditions; in some cases no buildings provided and few rations. By 1930 the move away from lazarets, where lepers were

·.· detained for the protection of the community, to leprosariums, where the community was v~'bguarded but patients received treatment, was beginning. Isolation was made compulsory.

other countries isolation laws were being modified at this time and outpatient clinics ,.zere being opened where sufferers could receive treatment while maintaining contact with their families. To illustrate the difference in policy, a comparison can be made between

legislation introduced in Malaya in 1926 and that of the Northern Territory in 1928. Underthe provisions of the Malayan ordinance, a person suffering from leprosy remained fre.e while he observed the restrictions contained in the legislation. Prohibitions included

plying of certain trades and the use of public facilities such as hotels, transport and bathing places. Infringement could result in a fine not exceeding 50 pounds and/or .~nforced isolation in a leper settlement. The suggestion of criminality was not introduced unless the law was broken, nor were the police involved until this had occurred. Unless detained by law, leprosy patients were required to apply for admission to a leper settlement for a. term nominated by the applicant. Only persons of Malay nationality would· be admitted, in fact they could not be refused admission. Medical officers and

· police not below the rank of inspector were authorised persons under the legislation and no person could be declared a leper without the agreement of two medical practitioners.

1n the Northern Territory ordinance, enormous power was invested in the Chief Medical Officer. He alone was empowered to issue a certificate declaring a person to be a leper and to order the leper to be confined to a Leper Hospital. However, any police officer or medical officer was authorised to take a leper or leper suspect into custody and to enter any premises to effect such an arrest. This in effect made the person suffering from

· leprosy a criminal, as having the disease made him liable to arrest, certification and indefinite detention. Some discretionary powers were invested in the Chief Medical Officer enabling him to decide if a certified leper was to be institutionalised but prevailing isolationist policies resulted in every person suffering from leprosy being confined to a Leper Hospital. In neither the Malayan nor the Territory ordinances, was the infectiousness of the person given consideration, a crucial point for Northern Territory sufferers and one which became increasingly important as both treatment and bacteriological testing was refined.

In 1930 Rogers, a prominent member of the British Empire Leprosy Relief Association and a strong advocate of voluntary isolation, challenged Australia's insistence on compulsory isolation. In an article entitled 'When will Australia adopt modem prophylactic measures against leprosy?', he pointed out that three decades of compulsory isolation in Australia had not only failed to reduce the incidence of leprosy but had failed to prevent its spread. Of his own wide experience Rogers (1930) said:

Three years intensive study of leprosy literature of the previous six decades convinced me that rigid compulsory segregation has never yet succeeded in stamping out leprosy and rarely even [in] reducing it materially in any warm climate.

Rogers went on to outline a prophylactic plan based on the systematic examination of all contacts on a regular basis over a five year period and the treatment of early cases until

9

bacteriologically negative. However, Rogers was unfamiliar with Australian conditions. Increasingly, leprosy patients were being drawn from Aboriginal groups scattered across vast stretches of sparsely inhabited country in the north of Western Australia, Queensland and the Northern Territory. Molesworth, who had advocated a similar plan four years earlier, had clearly been referring to European patients as he stated in his rebuttal of Cook's criticism that 'the control of the Aboriginal side of the problem may be impossible or impractical (and) with the rapid dying out of the Aboriginals ... this problem Will probably solve itself' (Molesworth 1927; Cook 1926).

In the following two decades laws affecting Europeans were modified, to a greater extent in New South Wales than other states, but nevertheless the chances of European patients receiving out-patient treatment or being discharged from an institution in all states was increased. Conditions in isolation hospitals and treatment for European patients also improved during this period. In New South Wales, European patients continued to be treated at Prince Henry Hospital (formerly The Coast) and in Western Australia at the Woorooloo Tuberculosis Sanatorium. In Victoria, a lone leper was reported to be isolated on Coode Island in 1937 but later patients were treated at Fairfield Hospital. Both European and Aboriginal patients were isolated at Peel Island, Queensland until 1940, but a sufficiently high number of European patients ensured that it was accorded the status of a European institution, although on the scale of health care for Europeans generally it rated very low indeed. Both European and Aboriginal patients were also treated at Channel Island in the Northern Territory but because of the preponderance of Aboriginal patients there, it was regarded as essentially an Aboriginal institution and funded accordingly. A leprosarium had been opened in Derby in 1936 for West Australian Aboriginal patients. In 1940 Fantome Island Leprosarium was opened for Queensland Aboriginal patients making it the third institution in Australia for the treatment of Aboriginal leprosy patients. Reflecting a division which cut across every sphere of life in Australia, European patients received superior treatment, their institutions were better staffed with medical officers in more regular attendance and they were provided with better facilities.

Leprosy and the Aborigines

There is little evidence that in any of the three Aboriginal leprosariums any serious effort was made to cure patients before the introduction of sulphone drugs in the early 1950s. Europeans also suffered from the general lack of interest of the Australian medical profession in leprosy. Few Australian doctors demonstrated any special interest or expertise in the disease. Cook, as a Wandsworth scholar from Britain, had made a study of leprosy in Australia but his interest had been over-ridden by involvement in the organisation of health services on a national and state basis. Molesworth's interest was limited by the constraints of private practice where the number of leprosy patlbnts he treated was small. LA Musso, of the Western Australian Health Department, did manage to carry out some research but was restricted by the number of problems with. which he had to deal and the vast area of the north-west for which he. was· responsible. Both Cumpston, the Commonwealth Director· of Health, and Sir Raphael .Cilento, Director­General of Health in Queensland were interested more in the development of policy than practical involvement with patients.

That no leprosy expert emerged from the ranks of the Australian medical profession is understandable. In comparison with other countries, the number of leprosy patients was small; in Malaya approximately 2,000 patients were being treated in institutions in 1934 (Ryrie 1934) while in Australia for the sanie year the.number would not have exceeded three hundred. During the period under review, 1930 to 1950, it was not the practice of state authorities to appoint resident doctors to leprosariums. Supervision of leprosy

10

'%1'-&_,,_.,;:Q .. " was given to health department doctors stationed in the area and formed only a part of their overall duties. In all three Aboriginal institutions nursing was carried

Catholic nuns, with medical officers making periodic visits. In March 19481 the C!ffl:ntnonwealth Minister for Health and Social Services suggested that a resident doctor · ~ffJ°:~li~J~ the Channel Island leprosarium, to which the Acting Director-General of

None of the medical staff in the Northern Territory can be regarded as having any specialised knowledge of leprosy. In fact, in the whole of Australia there are very few who might be regarded as specialists in this subject; If it were possible to obtain a keen young medical practitioner, who was interested in the subject and was prepared to live on a Leper Station, he would readily acquire the knowledge of this disease which would qualify him to specialise in the subject. However, it is felt that few medical men, unless they were inspired with a missionary spirit, would be prepared to isolate themselves on a place such as Channel Island, or any alternative settlement, unless conditions were made extremely attractive (A.A. CRS A1928, Item 71513811, letter undated c.10March1948).

Lhting conditions on the island and employment conditions were of such a low standard mat it is doubtful if any doctor would have been attracted to the leprosarlum even if the Commonwealth had been prepared to fund such a position. For leprosy experts, Australia remained dependent on doctors like Musso who gained practical knowledge in the field

were prepared to read widely. Musso's interest in leprosy prompted him to keep abreast of research developments in other countries and, where time and money permitted, adapt them to suit local needs and conditions. In Queensland limited experiments, again resulting from overseas research, were conducted on European patients at Peel Island. Little was done amongst the Aboriginal patients on Fantome Island and the lack of interest is clearly indicated in successive annual reports which, after detailing developments on Peel Island, go on to state: 'no opportunity has presented itself through the year of visiting Fantome Island' (Annual Reports of the Health Department, Queensland, 1945, 1947, 1948).

Under the auspices of the National Health and Medical Research Council, inaugurated in 1937, the Commonwealth government demonstrated a particular interest in the control of leprosy but this was limited to supporting isolation policies. Initially this interest was motivated by the perceived threat to the white community and at the second session of the Council in June 1937 the resolution that all Aborigines be examined for the disease was passed. Although the oft made recommendation, that leprosy control be made a Commonwealth responsibility, was never adopted, almost all leprosy work in the late 1930s was funded by the Commonwealth. In 1937, 500 pounds of the projected annual research budget of 30,000 pounds was granted to the Queensland government for leprosy surveys. In the same year Western Australia was granted 2,000 pounds for a two year survey project in the north-west of the State. Queensland was granted a further 1,000 pounds in 1938 towards the construction of a leprosarium on Fantome Island, and an additional 1,000 pounds annually for a medical officer who was to provide treatment on the island and conduct regular surveys in endemic areas. The latter plan came to little because Cilento was experiencing staffing difficulties and was unable to fill the position. Considering the number of people affected by the disease, funds directed to leprosy control were small indeed; one wonders what direction state authorities would have taken had not the Commonwealth provided financial support. As it was, very little laboratory work into the nature of the disease or its treatment was carried out and, except amongst the European patients on Peel Island, little work was done amongst the patients themselves. Research in both Western Australia and Queensland consisted of determining the extent to

11

which leprosy had spread and in bringing patients in for treatment. That the National Healtil and Medical Research Council was satisfied with the accounting is exemplified in its positive reaction to Musso' s work, the success of which was measured in the number of patient:! i,1aced in isolation. During the war years the Council's interest in leprosy control was ove:ai'.:..,dowP,d by other concerns and it was not until the earlier fifties when increased funding was given to Aboriginal welfare that the leprosy control program again received attention. \-

There were many reasons for the unwillingness of Australian aµthorities to finance institutions of a high standard for the treatment of Aboriginal leprosy patients. One was the belief that the Aborigines would never become part of the Australian social fabric. They were thought to have little to offer socially, culturally and most importantly, economically, notwithstanding the evidence that in the northern areas of Australia, Aboriginal labour not only made the life of Europeans tolerable by providing domestic assistance but in pastoral areas made the industry itself viable. Despite this, Aboriginal workers were poorly treated, ill-housed if accommodation was provided at all, under­nourished and neglected when sick. After two years in the Northern Territory during the Second World War, M Schneider, an army doctor noted:

The white man's attitude to his black employees can be summed up by the statement that it is motivated by gain but is otherwise one of complete indifference ... All too frequently in return the native is not viewed as an indispensable servant, but is despised and spurned and only tolerated if he is able-bodied and useful (Schneider 1946, 100).

As there were generally more Aborigines·.than there were jobs, many employers did little to help sick workers, some of them abdicating all responsibiliiy. The Aborigines were, as Ann McGrath argues in her study of Aboriginal labour in the pastoral industry (1983, 28), 'the ultimate exploitable and expandible labour force'.

Not only were the Aborigines thought to have little to offer the Australian nation, they were not expected to survive long enough to become part of it. However, in his 1928 report on the Aborigines of the Northern Territory, J W Bleakley, Queensland's Chief Protector of Aborigines, came to the conclusion thatthe Aboriginal population would not continue to decline if given adequate protection. He proposed a policy of benevolent protection of tribal Aborigines and the assimilation of part-Aborigines into European society. These aims were to be achieved through the regulation of Aboriginal employment, the creation of reserves and the enlistment of mission support. Although Bleakley suggested that kindly assistance be offered Aborigines in times of illness and distress, medical care for them during the next two decades became a priYile&e, not a right, and it was a privilege very few came to experience. Even among~st those sympathetic to the Aboriginal cause and more particularly to the Aboriginal leprosy patient, as was Reverend W Eddy of the Australian Mission to Lepers, high standards of medical care were not advocated. Eddy, having been given a hearing by Cumpston, · advised the Minister for Home and Territories that

Peel Island ... should be made an A.I. institution (for the treatment of white patients) and Darwin and Cossack (WA.) be sufficiently well appointed to meet the leprosy problem as it affects the Aborigines chiefly (AA. CRS A1928 Item 63518, Eddy to Minister for Jlome and Territories, letter dated 24 February 1928).

12

~e

as

~~:r did J McEwen, Minister for the Interior, see the need to extend or improve ,~-""""' facilities for the Aboriginal people. In outlining the new Aboriginal policy in

he stated that

proper medical attention is already given to the natives of the Northern Territory. There are aboriginal wards in the hospitals where natives receive care which is quite comparable to that given to whites (AANT CRS F 1 ltem38!46; <commonwealth Government's Policy with Respect to Aboriginals' 1 issued by J McEwen, 1939).

c. ls significant that the Aborigines to whom this care was extended were those living in y, ;;nriractwith European communities and whose diseases were seen as a threat to the white .a, f":ipulation. ic al promise which had been expressed in Bleakley's report was not reflected in the :r- lttitude of either the administrators of Aboriginal welfare or the public. The growing he number of Aboriginal support groups in the south had little effect on the daily contact

't'~t'.veen white and black in the northern areas of Australia and the belief that the Aborigines were an inferior race, whose inability to adapt to the civilised western world r;;,-cntld result in their demise, persisted.

tle as 8),

ey 28 ief \Ot mt :an ial .gh ,nd t a )Se

)Sy of

on,

Isolation policies

Leprosy had been thought to be a disease of coloured aliens and Aborigines and the evidence of leprosy among whites caused acute public concern. Ion Idriess both reflected

· and inflamed public opinion when he wrote a sensational newspaper article in 1934:

There is an uneasy feeling throughout the north that the Spotted Terror is slowly spreading - its tentacles may have gripped even deeper than dreamed of,· that the whites may have become infected. An odd one may even be a victim now and not know it. Even if our generation of whites escape, will the scourge die when the blacks die? (Courier Mail 22 February 1934; also the Herald).

For as long as leprosy remained a major medical problem among the Aborigines, European fear of contagion from Aboriginal sources - there was even a suggestion that the disease became more virulent having passed through the Aboriginal population - did not abate. In 1952 a leading Australian newspaper reported:

Government medical officers are alarmed at the spread of leprosy in the Northern Territory and consider the disease now threatens the white population ... Recently a coloured child sitting next to a white child in a Darwin school was taken to the leprosarium (Age 24October1952).

Fear that leprosy would become endemic in the European population, as indeed it had in Queensland, was a primary motivating factor in the insistence of the Australian authorities on a rigid isolation policy. Although little effort was made to cure Aboriginal leprosy sufferers and no effort made to rehabilitate them, it was thought that if they were confined to an institution the danger of the spread of leprosy by Aboriginal patients was minimised even though the medical care was of low standard in the institutions. Thus the Queensland authorities reassured the European population in 1938:

the detection of lepers ... far from being an indication of increased danger, demonstrates the fact that lepers who might otherwise be wandering round

13

the countryside with opportunity for broadcasting infection are now under supervision, and the community is correspondingry better protected (Annual Report of the Health Department, Queensland, 1938, 14 ).

In 1926 Cook had outlined a control program as progressive as any at that time which provided for improved conditions in lazarets, leave parole for patients responding W,ell to treatment, out-patient treatment and regular surveys (Cook 1926). Regrettably, however, he did not feel the need to incorporate these conditions into his policy for the Northern Territory where most leprosy patients were Aborigines. He became an outspoken isolationist and later wrote:

The pernicious ififluences which the coloured races exercise upon the hygienic, social and economic development of areas where white settlement is sparse, and upon the public health where hybrid remnants concentrate in the poorer quarters of cities or on the fringes of country towns, continues for the most part unsuspected ... The employment of natives in white households in intimate domestic contact with children, the intermarriage of natives with the white race and the raising of a generation of hybrid children having contact elsewhere with children of European stock, create a situation threatening the wide dissemination of leprosy from the coloured to the white race and imperil the security of the white population (Cook 1949, 569-70).

Cook's determination to implement an isolation policy is exemplified in the Northern Territory's leprosy ordinance of 1928 but he wa~ not alone in pursuing such a course. In 1934 Cilento advised R CE Atkinson, Commissioner of Public Health, Western Australia, that all Aboriginal leprosy patients should be removed from their tribal country and never returned. He suggested the establishment of leper villages which would become the permanent home of all Aboriginal leprosy patients (Cilento to Atkinson, undated letter c.31 July 1934, A.A. CRS A1928 Item 635/34). Cilento adopted this policy in Queensland, as did Atkinson in Western Australia, although the model leper villages of which Cilento spoke never became a reality. In 1937 Cilento introduced some modification of isolation laws as they affected Europeans but stated that 'no present modification is possible in respect to coloured persons' (Cilento 1937, 49). The National Health and Medical Research Council supported Cook and ·cnento and in 1950, and again in 1956, re-affirmed compulsory isolation as the prophylaxis for leprosy in Australia and established conditions of discharge which made it almost impossible for an Aboriginal patient to leave a leprosarium (NHMRC nd, 20-6).

The treatment of leprosy patients in isolation . hospitals also had the adv~ntage of increasing the control of the authorities over sufferers. When hidden behind 'officially erected barriers and treated in secrecy, leprosy was mystified, resulting in an important psychological difference between the healthy and the diseased. In Australia leprosy patients became curiosities - in official correspondence they were constantly referred to as 'poor unfortunates' - and were placed outside the conmmnity, thus strengthening official hold. During the years when isolation policies for Aboriginal leprosy patients were strongest, protectionist policies for the settlement of Aborigines on reserves as a solution to the 'Aboriginal problem' were also receiving wide acceptance.

The stigma which had been traditionally associated with leprosy was further intensified in Australia by the control of patients through legislation. When the majority of those thus controlled were Aborigines, stigmatisation of leprosy took on a new dimension. In the Australian experience leprosy became inextricably associated with Aborigines at a time when the relationship between white and black Australians was at its very lowest ebb.

14

h 0 r, n n

n n 1, ~r

e

.n )f 1e lt tl n .d tl

)f .y lt :y ts 11 :e lll

ln lS le le b.

incidence of leprosy confirmed the popular opinion that Aborigines were of a and that for the mutual benefit of both societies, control should be exercised

· To be an Aborigine in White Australia was a serious social and economic -1~-s""f"iv"'"''t<I<,,,. but when to this was added the stigma of suffering the disease most feared

£grope.ans, the public image of not only Australian leprosy patients but all Aborigines further reduced.

diseases of an equally serious nature also reached epidemic proportions among the ,~''ErJnm~s during the 1930s, but lacking the popular tradition of leprosy, the response of

~mno11m~s was not as rigid. Tuberculosis, which was recognised by the medical .~!tes;sm1n to be more contagious and a more rapid and certain killer than leprosy, was ~11:k:5tlrea,u in the Northern Territory and all other States. 'Herbert Basedow, the first

:!lleJ: l:'rote<;tor of Aborigines in the Territory under the Commonwealth, reported (1932, the decimation of large groups of Aborigines due to tuberculosis and in 1945, R T

an army doctor stationed in the north, reported 21 tuberculosis patients in a 12 period (Binns 1945, 459). During the 1930s Cook established a tuberculosis clinic

. m Darwin and for some years new cases reported exceeded those of leprosy. Despite the incidence of the disease, and the recognised danger to the European population, no

m:,..~pt to· isolate all patients was made. A similar pattern of venereal infection was also ~~-fident but again no serious attempt to isolate patients was made, although, under pressure from pastoralists and humanitarians, Lock Hospitals were established in Western Australia. However, although not being treated by compulsory isolation, the general move :ro. institutionalise Aborigines which reached its peak during the late 1930s was seen as a means of controlling the spread of infectious disease among the Aborigines and their

to the European population.

The Aboriginal response

Australia faced its greatest challenge to compulsory isolation from the Aborigines themselves. For most Aborigines found to be suffering from leprosy, removal to a l:eprosarium was a life time sentence. All tribal connections were abruptly severed, the 'patients' being lost to their land and their people. Understanding of the psychological significance of this aspect of Aboriginal culture has increased during the last two decades but even in the 1930s and 40s it was recognised to some extent. In 1942 Edward Ford, a medical officer with the Northern Territory service, wrote:

It is usual, among the bush people of North Australia for suspected lepers to hide at the approach of a medical officer, for naturally enough, a widespread/ear exists of the possibility of long or permanent removal from the tribe (Ford 1942, 236).

· Both police and medical officers adopted surprise tactics in an effort to examine as tnany Aborigines as possible. Constable Ted Fitzer, stationed at Timber Creek, was asked to investigate reports of leprosy on surrounding stations in 1939. He reported:

I patrolled to near Auvergne Station and raided the station and bush camps at daylight on the morning of the 30th. A successful raid was carried out and 22 natives in the bush camp and 24 employed natives were detained and medically examined for any leprosy or other diseases (Fitzer to Superintendent of Police, 11May1939, AANT CA 1070 Item 391593).

Fitzer was not quite so successful at the next station where most of the Aborigines employed about the homestead had taken to the bush leaving behind only women too old to travel.

15

Bill Harney, a long term resident in the Northern Territory, claimed on the basis of first hand knowledge, that the isolation of lepers aggravated the Aborigines' terror of white doctors. He was told by one old Aboriginal man who refused to seek medical help for his sick wife: 'better die with us than in the hands of strange people' (Hamey 194~). Harney heard tales of leper colonies where Aboriginal people hid sick members of their tribe to avoid detention.

The negative effects of compulsory isolation on the Aboriginal people were acknowledged by health authorities but nevertheless they insisted on the policy and it was endorsed by the public. Because compulsion was used, the authorities faced a difficult task in selecting suitable sites for leprosariums. In 1927 an island site was chosen for the Territory's new leprosarium. Discussions surrounding this choice of site are consiqered in greater detail later but the main thrust of the argument for Channel Island was the natural security it afforded. An island site was also recommended for the Western Australian leprosarium in 1934 but Atkinson insisted that a mainland site would enable leprosy patients to be given proper medical supervision (Davidson 1978, 48). In 1937 Cilento stated that 'there is not sufficient reason for requiring leprosy stations to be on an island; the disadvantages of such a location are greater than the advantages' (Cilento 1937, 52), but when the new Queensland leprosarium was established three years later, Fantome Island was chosen.

In all three states, health authorities faced the problem of leprosy patients 'absconding'. Escape from Fantome Island was impossible and if Aborigines were to avoid detention, their bid for freedom had to be made before transfer was effected. Many succeeded in escaping while in transit.. Similarly, patients escaped from custody while being transported to Derby and Channel Island. Escape from both these institutions was possible but their great distance from the traditional country of lllllDY of the patients kept the number low.

Problems of leprosy control

The Australian authorities had an unenviable task in trying to combat the spread of leprosy in the northern areas of Australia. In answer to international criticism, they pleaded unique circumstances. and were right to do so. Nor were they without their supporters in the medical world. Many leading leprologists acknowledged the need to provide total care in cases where geographic and demographic conditions made out~patient clinics impracticable and where the living standard of the patient was not conducive to the arrest of the disease. Provision of out-patient clinics in many areas of the sparsely populated north would have been prohibitively expensive. Much of the medical attention available to Aborigines in remote areas was administered by police officers and missionaries and, in the larger centres, bush hospitals. Even had these been willing to provide leprosy treatment there was no guarantee that the Aborigines would present themselves twice weekly for the painful process of multiple injections. Within the Aboriginal culture, sources of sickness and disease were clearly defined and formed an inextricable part of a larger understanding of the human condition. Western explanations for disease were outside the Aboriginal culture, although where Western treatment was shown to have the power to cure, it was accepted. The Aborigines had little reason to believe that leprosy could be cured, and indeed it could not unless treatment was commenced early. Even where remission of the disease was achieved, few Aboriginal patients were discharged. Under such conditions it proved impossible to gain the confidence of the Aboriginal people and for every two patients in isolation, there was likely to be one who had avoided detection.

16

The difficulties of the authorities were further aggravated by the poor living conditions of the Aborigines where the risk of discharged patients suffering a relapse was as high as ninety per cent in some areas. Ernest Muir, an eminent British leprologist, recognised that the leprosy problem was inextricably associated with many other public health, economic and social problems and suggested that not until these problems were solved would leprosy be controlled (Muir 1938, 239). In Australia, however, leprosy was not only treated by isolation but in isolation. The squalor of semi-permanent camps on the fringes of towns, cattle stations and mission settlements where malnutrition and unhygienic living conditions predisposed to leprosy infection and relapse in arrested cases, could not be combated by Health Departments alone. It was a problem which needed, but did not receive, the unequivocal commitment of both state and Commonwealth governments and European acceptance of Aboriginal people.

Although the difficulties of leprosy control in Australia can readily be seen, isolation as it was practised in Australia prior to 1950 had little to recommend it All leprologists, whether isolationist or not, stressed the importance of early detection and early treatment 'Vhich could only be achieved through regular and thorough surveys of all known and possible contacts of diagnosed cases. Although the need for such surveys in Australia was recognised, they were not instituted until after 1950 due to the shortage of medical staff, the difficulties of transport and the inability of medical personnel to contact all Aboriginal groups through either deliberate avoidance on the part of the Aborigines or the inaccessibility of their living areas. Lack of surveys often meant that patients were well advanced in the disease before they received treatment, increasing the risk of spreading the infection and reducing the chances of a positive response to treatment. Conditions in all Aboriginal leprosariums were poor and the reluctance of the authorities to grant even temporary 'parole' resulted in many cases being hidden. The staffing of leprosariums by Catholic nuns who, as unpaid help, did. tremendous work under very trying conditions, is nevertheless indicative of an abnegation of responsibility on the part of the authorities. Moreover, as the figures in Table 2 indicate, the policy was unsuccessful in reducing the incidence of leprosy among the Aboriginal people.

Isolation could only have been justified - and then only on very tenuous grounds - had it been combined with a survey system which would have ensured early detection of cases most amenable to treatment, a high standard of medical care in all leprosariums and the early release of as many· patients as possible. As it was, the leprosy control program, whilst considered essentially an 'Aboriginal problem', was never accorded the vote needed to make it in any way successful. The well known Aboriginal practice of avoiding detection wherever possible, the isolation of patients who had been infectious for years, and the poor standard of treatment in the leprosariums, reduced the policy to an unproductive farce.

With the introduction of sulphone drugs in the early 1950s, medical officers at last saw their way clear, despite National Health and Medical Research Council's recommendations to the contrary, to increase the number of patients discharged. As had been found in other countries some 25 years earlier, the change was dramatic. Where the patient returned home free of the disease after only a relatively short absence, others willingly presented themselves for treatment. John Hargrave, leprologist in the Northern Territory for 30 years, recalls telling people of Milingimbi that, as the leprosarium was full, patients would have to be treated in their own community. Within a short period of time a number of previously unknown cases had presented themselves for treatment. The increased use of medical officers and nursing sisters in preference to police also aided this process as did greatly improved conditions in leprosariums after 1955 and the introduction of some out-patient treatment.

< 17

1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950

Table2 Recorded leprosy cases 1930-1950

WA* 0 2 5

39 45 64 27 16 45 62 52 43 26 69 70 31 41 41 49 47 58

NT* n/a

7 4

21 44 28 13 18 24

n/a n/a n/a n/a

8 6 8

13 19 6

27 53

* includes a small number of European patients

QLD 1 5

10 8 6

12 11 9 6

10 11 11 9 2 8

10 8

n/a n/a 10 10

Western Australian and Queensland figures have been drawn from the Health Reports of those States.

Leprosy, known among the Aborigines as 'the big sickness', although not entirely eradicated, is not the serious problem it was in the past. However, it remains vivid in the Aboriginal memory. The detrimental effects of the rigid isolation policy practised between 1930 and 1950 are incalculable. The extent of the hardship and heartbreak and the distrust it generated, may never be known.

18

CHAPTER THREE ADMINISTRATIVE EVASION

The history of the first 50 years of leprosy in the Northern Territory is largely one of administrative evasion. The apparent slow increase in the incidence of the disease allowed for the ad hoc evolution of a policy which was only ever a temporary expedient. It was many years before it was finally acknowledged that leprosy was endemic in the Northern Territory and that a carefully planned and executed policy of prevention was needed. Unfortunately this realisation came too late for the Aboriginal people who were, and still are, the group most severely affected by the disease. ·

Introduction of leprosy to the NT

. The earliest evidence of leprosy in the Northern Territory is a case of a Chinese male reported in 1882 (Thompson 1897, 225). Two of Australia's leading leprologists, Dr J A Thompson, Chief Medical Officer of New South Wales, and Dr CE Cook, Chief Medical Officer of the Northern Territory, considered the question of endemic leprosy among the Australian Aborigines prior to European settlement (Thompson 1895; Cook 1927). Neither was able to find reference to any condition resembling leprosy among Aborigines in records. of early contact in various parts of Australia. This is also t:rue of records relevant to the Northern Territory. After several years of attentive observation of the Aborigines on the Cobourg l'eninsular during the 1830s,. G W Earl, linguist to the garrison at Victoria, wrote an article which made .no mention of leprosy or any other disease or physical deformity (Earl 1846). The reports of early navigators and explorers in the Territory make no reference to any condition resembling leprosy although their knowledge of the Aborigines was usually superficial. Leichhardt, however, became sufficiently well acquainted with them when enlisting the help of the Gulf Aborigines. to note their practice of circumcision with great interest but made no further mention of anything unusual in their physical appearance (1846, 288). In 1886 Searcy, a customs officer with the South Australian Government, reported:

the Aborigines appear to be a fine healthy lot. I did not notice any dis~ase amongst them, save in one or two cases, the scars of ancient smallpox (quoted in Macknight 1986, 72)

Conclusions drawn from lack of evidence always leave room for further inquiry but it may reasonably be assumed that leprosy was probably introduced after the South Australian Government successfully established a settlement in the Northern Territory in 1869.

In his 1927 study, Cook (1927, 37) asserted that Chinese indentured labour, brought to .the Territory in 1874, was responsible for the introduction ofleprosy and this has been widely accepted. While there can be no doubt that the Chinese were probably the major source of infection, there are other possibilities which cannot be entirely dismissed.

Macassan traders from the Celebes, who had been visiting the northern coast of Australia · for several centuries prior to .European settlement, have long been blamed for the introduction of a wide variety of diseases (Macknight 1971-2). They came each. year in search of trepang and stayed for several months during the monsoon season, setting up semi-permanent camps along the coast from the Cobourg Peninsula to the Sir Edward Pellew group of islands.

19

Macassan contact with the Aboriginal people of these coastal regions was long and often intimate. Trade patterns were established between the two groups, the Aboriginal people exchanging tortoise shell, pearl shell and pearls for tobacco, food, cloth, alcohol and other items of interest or novelty. Although the Macassans were not dependent .on Aboriginal labour it is known that Aboriginal men assisted with the gathering and curing of trepang and took great delight in sailing, sometimes as far as Macassar, on Macassan praus (Macknight 1976, 85). The crews of the praus were invariably all male and the structure of Aboriginal social patterns was such thai Aboriginal women. were available to the visitors. Campbell Macknight writes, 'any form of contact, but particularly sexual contact, is likely to have introduced the Aboriginals to foreign disease' (1976, 87). He suggests that the diseases probably carried by the Macassans would have been smallpox, yaws and various venereal diseases but further adds that 'across this distance in time, it is impossible to distinguish the Macassan from any other source of infection' (see also Butlin 1985, Campbell 1985).

A more likely source of initlal infection, apart from the obvious Chinese and doubtful Macassan ones, was Marcus Baker, an American born European male who died in the Palmerston Hospital of complications arising from advanced leprosy in 1889. Little is known of this man's life in the Territory except that he was a teamster who had been resident there for 13 years. His condition was diagnosed seven years after his arrival and, given the long incubation period of leprosy, it is possible that he had contracted the disease outside Australia and that he was a source of infection among inhabitants of the Territory. It was not until after Baker's death that his condition became publicly known when it was revealed by Dr H H Bovill, who had. been stationed at Burrundie. Bovill had conducted a protracted battle with the government over conditions. at Burrundie and when he resigned on 28 May 1889 his parting shot had been to :reveal that Baker, an inmate of the Palmerston Hospital for 18 months, had died of leprosy. In the resulting public outcry (see North Australian, issues in June 1889) the question of contagiousness was raised and, reflecting medical opinion generally, the case was argued strongly from both sides. However, it was agreed that leprosy was incurable and all victims ought to be isolated. Wood and Bovill were severely censured for failing to notify the Hospital Board of Baker's condition. It appears that no infection resulted from Baker's presence in hospital but the possibility remains that he was responsible for dissemination of leprosy among the Aborigines. A detailed mediclll. account of the case appeared in the Australian Medical Gazette (Thompson 1897, 226). Although in his inquiry Thompson acknowledged this evidence, he lent toward a telluric theory ofleprosy and so largely discounted all ideas of a foreign introduction of the disease. Assuming he knew of it, Cook ignored the incident altogether, revealing a stubbornness that was to have far reaching effects on the lives of Territory leprosy patients. However, COok's hypothesis that many Chinese arrived in the Territory suffering from leprosy, and that certain endemic foci among the Aborigines resulted from this source of infection, is correct. •

Four years after the successful settlement of the Northern Territory in 1869, Asian immigrants, mostly Chinese, were introduc.ed as indentured labourers. By 1888 the. total non-Aboriginal population of the Territory was 7,533 of whom 6,122 were Chinese. In the first two decades of Chinese immigration, the majority of Chinese worked either on the goldfields - initially in the employ of mining companies but increasingly on their own diggings - or on the railway. A small number found employment in and around Palmerston. Chinese market gardeners supplied most of the town's fresh fruit and vegetables and they were highly valued as cooks and domestic servants. Some found their way into outback areas, often to the consternation of Europeans there who were in constant dread of a rush of Chinese into all quarters of the Territory. Alfred Searcy, who travelled extensively along the coast while fulfilling his duties as customs officer, encountered Chinese in the McArthur River region in .1885 and they comprised a

20

significant proportion of Borroloola's population during the 1880s, running the butchery, bakery and market gardens (Neal 1977).

Although no mention of leprosy appears in official records until 1884, Colonial Surgeon R J Morice infonned Thompson that he first found leprosy in a Chinese in 1882, closely followed by a further two, all of whom were sent back to Hong Kong. In 1884 a respected Chinese merchant gave infonnation to a member of the District Council about Chinese lepers resident in Palmerston (North Australian 4 January 1884). A delegation subsequently visited Chinatown and found two men suffering from leprosy, one of whom had previously come to the attention of Morice who mis-diagnosed his condition. Alarmed residents were reassured leprosy was not contagious but that steps would nevertheless be taken to isolate the men. According to Thompson's information, the men were isolated in a hut somewhere near Palmerston and were supplied with rations by the police. Public outcry was short lived with the local paper refusing to publish letters on the incident as 'the leprosy matter had been satisfactorily cleared up' (North Australian 18 January 1884).

But this was only the beginning. Within months Morice had diagnosed leprosy in two more Chinese and by the end of 1884 three more cases had come to the notice of the authorities. Dr PM Wood became Colonial Surgeon on Morlee's resignation and in the five years to 1889 he was responsible for the detection and isolation of ten Chinese male lepers. All complacency was gone and reports of Chinese lepers, often made by members of the Chinese community, sent police searching diggings, railway workers' camps and the Chinese quarter of Palmerston. At times the reports were ill-founded or the lepers, warned of the authorities' approach, had gone into hiding. Both doctors and police in the Territory were responsible for a widely scattered population and, judging from their reports, tracking down elusive lepers was a job they could well do without Despite the introduction of legislation providing for detention of lepers, action remained irregular and decisions were made on each case as it was notified. Telegrams to the Government Resident notifying the arrest of a leper usually asked 'what shall we do with him'. When Dr Teleman detained a leper at Burrundie he quickly rid himself of the problem. by sending a terse message stating that he was sending down a 'leper to be dealt with in the customary manner'.

'The customary manner' for a Chinese lep~r was isolation on Mud Island until repatriation could be facilitated. Repatriation was then a general solution to various problems concerning Chinese in the Territory. In 1885 leprosy was declared 'a dangerous, contagious and infectious disease' under the South Austrl\lian Public Health Acts Amendments Act, 1884, and in 1885, under provisions of the same Act, Mud Island was gazetted as a Leper Station. Of the 20 lepers found up until 1889, six are known to have been returned to Hong Kong, one escaped, one died and two remained in custody on Mud Island when Dr L S O'Flaherty succeeded Wood under the new designation of Chief Medical Officer and Protector of the Aborigines. The fate of the other ten is not known although it is possible that some of them were repatriated. Certainly the residents of Palmerston, although not reacting with the near .hysteria evident in Queensland (Evans 1969, ch8), were most anxious that all lepers be removed and their fair shores he left untainted by this 'fearful disease'.

Repatriation of Chinese lepers continued until after the tum of the century although transport was both expensive and difficult to obtain. Many shipping companies refused outright to carry lepers while others quoted exorbitant prices. Repeated requests for transportation of lepers from several Australian colonies led to the commissioning of the Whampoa for this task in 1896. No lepers were in detention in the Northern Territory at

21

this time but 25 from other Australian ports were duly shipped to Hong Kong. The last Chinese leper repatriated from the Territory was in 1906, bringing the total to at least·13.

The South Australian Quarantine Act of 1877, to which all persons entering Palmerston from foreign ports were subject, did little to prevent the introduction of leprosy. Until 1887, unless coming from a port declared infected - usually with cholera, typhoid or smallpox - ships entering Port Darwin were given only a cursory examination; the report provided by either the ship's surgeon or captain was usually sufficient evidence of the health of the passengers. When no infectious diseases were ·reported,· passengers were permitted to disembark with a minimum of delay. However, repeated outbreaks of smallpox during which a customs officer became infected· resulted in all ships arriving from Hong Kong being placed in quarantine .. Many Chinese, resentful of being thus confined, were uncooperative and endeavoured to conceal any condition which might protract their period of quarantine, at times casting the afflicted overboard with no more than a piece of wood to keep them afloat (Searcy 1909, 333).

While quarantine measures were effective against diseases such as smallpox, the long incubation period and covert nature of leprosy made it very difficult to detect, particularly in its early stages. Similarly, the enforcement of immigration ordinances in Asian countries could not prevent infected Chinese entering the Northern Territory. Immigration officials in Hong Kong assured Territory authorities that they were doing all within their power to prevent persons infected with leprosy from leaving the country but that lepers could avoid detection by boarding ships carrying less than 20 passengers and were therefore not liable to medical examination. Unable to control the introduction of leprosy through quarantine measures, the need for routiQe house-to-house searches was voiced on several occasions by the Chief Medical Officer but the level of staffing was never sufficient for this to be instituted. Thus, through the lack of knowledge, the shortage of facilities and ineffective policies, leprosy gained easy access to the Northern Territory and by the turn of the century was endemic among the Aborigines,

The Aborigine8 and leprosy

The European population of the Northern Territory treated the Chinese as social inferiors and held themselves aloof from all but a minimum of contact, With the Aborigines, however, the Chinese established more congenial relationships. Aborigines became frequent visitors of Chinese. camps both in the towns and mining camps and often the Chinese employed them. The proportion of males in the Chinese population was extremely high and consequently Chinese men often found sexual partners among Aboriginal women (Inglis 1967).

The first Aborigines officially reported to .be suffering from leprosy (Thompson's knowledge of the McArthur River leprosy patients came from private cor.respondence) was in 1890, some eight years after the first case was discovered amongst .the Chinese. No further cases were detected among the Aboriginal people until 1894 · when a male Aborigine from the Alligator River district was found to· be suffering from advanced leprosy.

In 1894 Government Resident Dashwood, travelling in the East Alligator River area, was 'surprised and alarmed' to find several Aborigines suffering from leprosy. The extent of their disfigurement - complete loss of fingers in one case and toes in another and several with facial defonnities - indicated the presence of the disease among them for several years. Mr Paddy Cahill, a buffalo hunter working in the Oenpelli district during the 1890s reported seeing as many as 50 Aborigines suffering from leprosy. Dr F Goldsmith, Medical Officer and Protector of the Aborigines from 1897 to 1904, expressed his concern

22

at this allegedly alanning rate of spread in terms of the danger to the European population. He admitted that it was a difficult situation but one which 'should be taken in hand before the disease has spread to those tribes that live in proximity to our white centres of population•.

For almost 20 years rumours, occasionally substantiated by a positive case, persisted without any preventative action being taken as successive Medical Officers continued to underestimate the extent of the spread of leprosy in the Aboriginal population.

In 1906 Dr WR Smith of the South Australian Health Board arrived in Palmerston to investigate health and hygiene in the Territory and although his terms of reference specifically included leprosy, he did not visit those.places where leprosy was most likely to be found but relied on verbal reports of those familiar with the country and the people (Smith 1906). He believed leprosy to be endemic among the Chinese and the Aborigines but not to any great extent. Smith was among those who believed leprosy to be only slightly contagious and, as the disease had yet to make its appearance among the European population, he could afford to be complacent:

It is to be remembered that in the Territory one is not dealing with an overcrowded, or even crowded, population of whites - among whom the blacks may spread leprosy,' nor is one dealing with a black race whose mode of ltving tends to spread leprosy from one individual to another ... the probability of orze aboriginal giving the disease to another is so small as to be negligible,' and I would recommend that every blctckfellow found to be a leper should be sent back to his tribe, in accordance with the practice that has been followed during the past eleven years (Smith 1906, 7).

For over a decade Smith's conclusions were accepted and his advice followed.

When the Commonwealth assumed control of the Northern Territory in 1911, a party of experts was sent north to investigate conditions and advise on future policy, among them Dr A Breinl, the Director of tbe Australian Institute of Tropical Medicine. He travelled as far as the Roper . River Mission Station, visiting mining camps, townships and pastoral properties along the way. :He examined Aborigines whenever he could establish contact and, although he found no cases of leprosy, he did not rule out the possibility that it was prevalent among the coastal tribes (Breinl 1912; 51).

On his transfer to the position of Medical Officer and Protector of the Aborigines in 1912, Dr M J Holmes also endeavoured to ascertain the truth of the persistent rumours of leprosy among the Aboriginal people. He conducted a survey among the coastal tribes to the east of the Alligator River, and finding no incidence of leprosy, reported: 'the Territory is conspicuously free from the great majority of those diseases which cause such devastation in other countries within the tropics. Smallpox, cholera, Kala-azar, plague, yellow-fever and leprosy are unknown and beri-berl is rarely seen' (Holmes 1912). However, rumours persisted and during the following year he organised visits to Aboriginal camps at Bowen Straits, Croker Island, Malay Bay and the East Alligator River region. He found only two patients suffering from leprosy and came to the conclusion that earlier reported cases had been diagnosed by laymen who had little knowledge of the disease and who had mistaken the destructive changes brought about by yaws and syphilis as those of leprosy. Like Smith, Holmes argued that conditions did rtot favour an increase in the incidence of leprosy:

The probabilities are that the disease was introduced to the north coast by Malay trepangers and pearlers, but has not spread freely owing to the

23

nomadic habits of the blacks, their open-air life, and the small size and temporary character of their camps, which are constantly being shifted to new localities. There is but little likelihood of the disease spreading, and the possibilities are more in favour of the gradual disappearance of the disease (Northern Territory, Report of the Administrator, 1913, 48).

In 1915 Breinl conducted another survey of the Aboriginal population of the Territory, a task which he completed with the help of Holmes. Breinl and Holmes conceded the presence of leprosy but believed it to be a rare complaint amongst the natives of the Territory. Cahill infonned them that leprosy had been more prevalent in the past years, no doubt giving the pleasing assurance that under existing practices, the disease was on the decrease and reinforcing Holmes' belief th.at leprosy did not pose a serious threat to the Aboriginal population (Breinl and Holmes 1915, 4-5). It was not until the appointment of Dr H L Jones as Chief Medical Officer in 1916 that a substantial revision in the policy was introduced.

Mud Island lazarette

Jones, evidently subscribing to the contemporary medical opinion that leprosy was highly contagious, expressed the need for continuous house-to-hou.se searches in the Chinese and Asiatic community and the isolation of all leprosy patients. Six lepers were discovered in 1917-18 but if Cook's information is correct, all were Aboriginal or part-Aboriginal, not the expected Chinese (Cook 1927, 39). Only two Chinese were found in the next ten years, one in 1921 and another in 1924. There was no suggestion that t.hese patients be deported, possibly because they were long term, Territory re.sidents ~the White .Australia policy having effectively stopped Asian immigration ·- and the difficulty of obtaining transport. Like all lepers from 1916 onwards they wereiSolate<l at Mud Island Until this time Mud Island had been used principally as a transit station until the transport of lepers could be facilitated; Chinese being returned to Hong Kong and Aborigines to the tribal country. The make-shift nature of their detention had been amply reflected in conditions on .the island and, although under fortes' policy isolation was to .be pennanent. little was done to improve facilities at the lazarette. Dr JD Norris, appointed Quarantine Officer in 1925 and given the supervision of Mud Island, expressed the policy succinctly as •the system of weeding out the lepers from the otherwise non-leprous coastal native'.

Mud Island, also referred to both officially and locally as Middle Point or Leper Point, was situated some. three miles across the harbour from the town of Palmerston.· It was not truly an island but rather the tip of the peninsula, cut off from the mainland during high tides and readily accessible. only by sea·where a little sandy beach presented an approach for small craft. Beyond the· narrow beach was a short stretch of scrubland which was backed by dense mangrove swamps, making penetration from the. mainland extremely difficult. Being devoid of natural. fresh water and having ortly limited vegetation and animal life it was a desolate site which could in no way ease. the burden of ill-health and isolation suffered by leprosy patients.

Accommodation on Mud Island was always inadequate, and indicative of both the South Australian and Commonwealth govertunents' unwillingness to address the problem of leprosy in the Northern Territory. Indeed, general opinion corttinued to support the idea that if leprosy was not on the decrease then at least it could be readily controlled. The first leprosy patient, escorted to Mud Island in 1884 by Wood, was provided with a tent which probably became this man's last home as Wood reported in April the following year that Ah Sang1 the only patient in isolation, had died Some huts must have been erected during the first few years as Searcy tells of one man who, severely deformed by leprosy, crawled from the huts to the beach whenever Searcy had fish to give away. When Jones' vigorous

24

Plate 1: Mud Island Lazarette showing small corrugated iron accommodation hut c.1890

25

BEAGLE

cox PENINSULA

0 5 10 15

SCALE IN KILOMETBES

GULF

Location of Mud Point and Channel Island

26

Jones' vigorous campaign and new policy yielded a permanent population, two new buildings were erected, Jones hopefully suggesting that they would provide 'all the required accommodation for some years'. His hope was not fulfilled, for two years later he found it necessary to erect another building.

Govermn.ent parsimony did not affect rations as seriously as it did accommodation. Food supplies delivered to the island weekly included a variety of dry and tinned goods in adequate quantities but lacked fresh fruit and vegetables. For those whose health pennitted, fishing was good and the lazarette, with more hope than assurance, had been supplied with a gun for hunting. An early attempt to stock the island with goats as an additional source of fresh meat had failed due to the scarcity of fresh water. In a rush of enthusiasm for his new position, Norris greatly extended the variety of foods and tried again to keep goats and fowls on the island, but the severe water shortage continued to be a problem. Several galvanised water tanks had been placed on the island and were regularly filled by carting water across the harbour by barge in old 4-gallon petrol drums. Water caught from roof drainage during the rainy season supplemented this meagre supplr~ Because of the cost and inconvenience, only sufficient water for drinking was supplied. For all other requirements, sea water was used.

In 1922 leprosy patients on Mud Island began receiving treatment for the first time. Under such inadequate conditions there was little hope that any dramatic results would be achieved although in most cases diet brought about a notable improvement within a short time. In the absence of a medical attendant or supervisory staff, only those willing to treat themselves were supplied with chaulmoogra oil. Full-blood Aboriginal people rejected western explanations of leprosy and, having little reason to believe the power of chaultnoogra oil to cure, declined self-administration, thus treatment was limited to patients of mixed Aboriginal/European descent. Without the support of the Administrator and the Commonwealth Government, little could be done to improve the situation. In 1925 the annual cost of supporting patients on Mud Island was 2 pounds per head, an expense which Jones was loath to increase. The greatest additional expense would have been staff, an unwarranted move according to Jones and a difficult one unless 'some martyr from some religious order will volunteer ... to fill the position'. The position was not created nor was Jones' supposition tested as the patients on Mud Island continued to receive only weekly visits from a medical officer.

The lot of those isolated on Mud island was harsh indeed. Harney referred to the lazarette as ~an excrescence, an island of mud and sand, swarming with mosquitoes and sand.flies; a blessing indeed that disease numbed the limbs of these lonely, miserable people and made them p:roof against the savage bites of insects' (Harney 1945, 228). Several patients, faced with the prospect of life on its lonely shores, committed suicide. Others like Ah Sang died unattended, their deaths not known for days. Others sought their own solutions and escaped, some to perish in the bush and a few to disappear without trace. The Chinese of Palmerston were suspected of assisting their incarcerated countrymen and the Aboriginal people generally left the island in groups, at times the majority of the inmates making a combined bid for freedom. In three escapes, 1923, 1925 and 1927, a total of 26. Aborigines left the island, a number of them successfully avoiding further detention. When accused of maltreatment and neglect the authorities gave squabbling among the patients.as the reason for these incidents. However, considering the rapidity with which the patients headed for their tribal countries, homesickness and all it entailed for the Aboriginal people was more likely a primary motivating factor.

The population of Mud Island increased steadily; 13 in 1925 rising to 26 in 1931 when the 1azarette was finally abandoned. Four part-Aboriginal patients were being treated in the isolation ward at Darwin Hospital, conditions on Mud Island being considered

27

unsuitable for their detention. Mission Stations began refusing to send their charges to the Leper Station fearing the ill-effects of life in an unsupervised camp and under the circumstances, the government had no power to make them do otherwise. In 1906 Smith had described the island as 'unsuitable for any being of the human species' and conditions did not improve in later years. In a more carefully worded expression of dissatisfaction, Norris admitted to 'several disabilities' which he believed could be remedied by the location of the lazarette on 'a convenient, accessible mainland site and the appointment of a trained orderly to administer treatment'.

By 1925 conditions on Mud Island were receiving wide m~a attention and articles dubbing the island as the 'Living Hell Lazarette' appeared in local and southern newspapers. Reverend W Eddy of the Mission to Lepers was reported as stating that he found the lepers living in pitiful conditions:

No one came to care for them, even to dress their wounds. No one fed them or clothed them, and at last, in the extremity of their suffering and despair, nine of them escaped to the mainland, swimming through water irifested with sharks and crocodiles (Argus 26May1927).

For several years public attention and condemnation continued, causing the government considerable embarrassment. The urgent need for re-appraisal of the leprosy policy and increased expenditure was realised but bureaucratic indecisiveness kept leprosy patients on Mud Island for a further six years. In 1931 the move to Channel Island was made, opening a new era full of hope and promise for leprosy patients in the Northern Territory.

28

CHAPTER FOUR

THE PROMISE· THE DISAPPOINTMENT

Channel Island quarantine station

In 1884 the South Australian Government had gazetted Channel Island as a Quarantine Station, a move which it was hoped would ease the burden of endeavouring to carry out quarantine measures without adequate facilities. Stril1gent economic measures prevented the realisation of this; the two iron roofed, bamboo biiildings erected in 1886 in no way met the demand. Use of the island was publicly decried as the lack of fresh water caused much unnecessary hardship. Hulks which had been hired intennittently prior to this time continued to provjde most of the accommodation. Ships in quarantine were obliged to anchor in waters off Channel Island, both a hazardous and inconvenient position .

. As a quarantine station, Channel Island was fraught with difficulties, the island itself only infrequently used when under South Australian administration, nevertheless it was the site chosen by the Commonwealth for continued use as a quarantine station.

At federation, quarantine became a Commonwealth responsibility, a change in authority which had very little impact on Channel Island for some years. In 1914 three new buildings, a great improvement on the flimsy structures of the past, were erected. These buildings formed the core of the later leprosarium. Despite improved facilities, Channel Island continued to be rarely. used, successive Medical Officers reporting that no foreign epidemics had reached the port. It was, however, used in a local influenza epidemic after the first world war and in a whooping cough epidemic in 1930 and in other years it remained unoccupied, visited only when an inspection of the buildings was made. In October 1931 the first of the leprosy patients arrived, some to remain for the next 30 years.

Choosing a site

The move towards establishing a new, modern leprosarium came at a time. when great advances were being made in the prophylaxis of leprosy and, although certain cure was still a thing of the future, increased knowledge of the disease and improved treatment gave a promise of ho~e for many sufferers. In the Northern Tenitory increased funds were made available m 1930 for the care of leprosy patients and a new leprosarium was approved. The one jarring note in these otherwise encouraging developments was the insistence of the authorities on an island site for the new leprosarium: an early indication that Australia would fail to keep abreast of developments in other countries.

As early as 1921 Jones had suggested the use of the Quarantine Station on Channel Island as a leprosarium but by 1925 he had suffered a change of heart and thought Melville Island better suited for isolation purposes, Furthermore, 12 months in the Northern Territory had dampened his assistant Norris' enthusiasm for a mainland site and by late 1925 he was advocating an island leprosarium 'from which escape would be difficult, if not impossible'. Jones concurred and further stated:

I have worked medically amongst natives for the best part of eleven years, and anyone who maintains that Aboriginal lepers can be cotifined on the mainland, unless within four substantial walls, is ignorant of the psychology of the Northern Territory Aboriginal (AA., CRS A431, Item 5013597, Memo No. 261347, Summary, Site for Leprosariwn).

29

Melville Island was again suggested as a possible site but, short of removing the Tiwi people, whose home it was, and effectively preventing their return, the island offered no more advantages than a leprosarlum on the mainland.

Of those doctors involved in the discussion on the choice of a site, only two strongly recommended a mainland leprosarium. Dr Holmes considered that it would be 'neither satisfactory nor humane to segregate aboriginal lepers or their close contacts on a small island without any chance of living the life to which they have been accustomed'. A large mainland area such as the Cobourg Peninsula, he suggested, would allow non-infectious cases and contacts the freedom of a large well-watered and well"'.stocked stretch of land -some 900 square miles - while open cases . could .be cared for on the adjacent Croker Island.

Dr Cumpston, Director-General of Commonwealth Health, supported Holmes' recommendation, stating that any attempt to control leprosy by enforced island isolation would inevitably fail. Although Cumpston pointed out to Cook that island isolation was not considered the most effective method of treating or controlling leprosy by men experienced in the field, he eventually accepted his recommendations.

By September 1927 the matter had been finalised. 'Channel Island', it was concluded, 'was the most suitable site for the control of lepers'. However, before the promise could become a reality, a new quarantine station had to be erected on the mainland and additional facilities made ready on Channel Island, a task which took almost four years to complete.

From the official point of view, the. physical situation of Channel Island offered. several advantages. It was sufficiently remote from settled areas to be beyond public prying eyes: it reflected an 'out of sight, out of mjnd' strategy whic}l was successful most of the time. When some incident, such as the escape of patients, stirred public interest and curiosity, the island's remoteness readily enabled the authorities to enforce restrictions on access. Communication with the mainland was minimal, even non-existent at times, a considerable advantage to an already over-taxed medical staff as patients had no means of demanding services other than those provided by resident staff. A further advantage lay in the difficulty of leaving the island. Patients could, and did, walk or wade off the island during a low tide but access to the hinterland was severely restricted by dense mangrove swamps.

The disadvantages of Channel Island far outweighed the advantages but it was the patients and res.ident staff who suffered the disadvantages. The island had neither fresh water nor soil suitable for cultivation of any kind, although the value of this kind of activity it) promoting physical and mental well .. being had long been recognised. Stores, which included drinking water, had to be taken across the harbour, which limited both the quantity and variety of supplies. The remoteness of the. island further disadvantaged patients and staff in obtaining help in an emergency; in more. than one case this resulted in the death of a patient and public accusations of neglect against the staff. The list of disadvantages could be extended; it is sufficient to show that those in authority who insisted upon Channel Island as the site for the new leprosatium could never have seriously entertained notions of establishing a model institution.

Staff

In February 1927 Cook was appointed Chief Medical Officer, Chief Quarantine Officer and Chief Protector of Aborigines, positions which made him extremely influential in

30

Plate 2; Aboriginal accommodation huts on Channel Island. c.1939

Plate 3; European accommodation showing cyclone damage and water tanks. 1937.

31

-ir-'. ,, ..

appointing staff to the leprosarium. As early as October 1930, an offer was made by the Catholic Order of St John of God stationed at Broome, Western Australia, to care for leprosy patients and this was repeated annually until 1933. Although the Catholic sisters were prepared to work without payment other than provision of food and accommodation, the proposal had little to recommend it in the way of immediate economic advantage as additional living quarters and transport for the sisters from Broome to Darwin would be required. Cook, who had little sympathy for church groups of any persuasion, used this to his advantage and further expressed concern that what was a government responsibility should be handed over to a religious group. It .. is evident, however, that Cook's main concern was loss of control and, although reassured by the Acting Administrator that 'control' would remain with the Chief Medical Officer, he advised against the move:

I cannot conceive it to be possible for this staffing arrangement to prove satisfactory and in the event of its proving unsatisfactory, I feel there can be no remedy and no return to the present system for I believe the Commonwealth wou/4 hesitate to offend an organisation of this nature (Cook to Administrator, 5 'March 1934. AA., CRS 3412154, Item 451111887).

The sisters accepted the polite but persistent rebuffs and withdrew, leaving their offer open.

Cook favoured the appointment of a man as curator whose wife could fill the position of matron and accordingly, Mr and Mrs JR O'Sullivan were appointed in 1927. At the time of their appointment, the O'Sullivans were on l~ve in the south and prior to their return to Darwin, spent several months being instructed in the care of leprosy patients ·at Peel Island. However, the O'Sullivans never took up their appointment on Channel Island as Mr O'Sullivan was due for retirement by. the time the leprosarium was ready for occupation. Replacements were not hard to find; each time the position was advertised, more than 30 joint applications were received.

In the decade leading up to 1942, three couples were appointed to the position, Mr and Mrs C F Jenkinson being the first. On the Jenkinsons' resignation in 1934, Mr and Mrs W F Stromberg, a newly wed couple with considerable experience in the Territory, were appointed and remained for two years before moving south. The last of the resident curators and matrons were Mr and Mrs R J Jones whose children boarded with friends in Darwin for several years. Mrs Jones' work in the Northern Territory was highly praised and she was awarded the MBE.

In January and February 1942, as war moved closer to Darwin, a number of patients, European and yart-Aborlginal, were evacuated south while others were cared for at .the quarantine station on the mainland. Three male Europeans declined transfer preferring to take their chances and remain on Channel Island. Following the first Japanese raid, many Aborigines and part-Aborigines left the island in the.resulting.confusion andthe curator gave permission for all remaining patients to leave the island and fend for themselves in the bush. Several small camps were established in the Berry Springs area but before long, reports were being received from widely scattered pastoral stations of the arrival of fonner Channel Island inmates. With the assistance of the police, these people were returned to the leptosarium, their continued freedom being considered a . threat to the troops now stationed in the Territory.

For 12 months those . patients who had remained on Channel Island were without supervision and treatment. When, under military control, a semblance of order was restored to the town, Bishop Gsell of the Catholic Church was asked to provide staff for

32

the leprosarium. He agreed to station two sisters on the island despite the Commanding Officer's disconcerting admission that he could not guarantee their evacuation in the event of an enemy attack. The two sisters, Gabriel and Campion, of the Order of the Daughters of Our Lady of the Sacred Heart were duly installed with the help of Kirkland who had returned to Darwin as a Major in the army and under whose orders they operated for the duration of the war. Two more nuns were sent to the island soon after and a staff of four was maintained from then on. Because a large number of the patients were male adults, a male attendant was $ought to be necessary and, after the army had constructed a small cottage for his use, Brother McCarthy took up residence on the island. With only a small turnover, Catholic sisters continued to staff the leprosarlum on Channel Island until its move to the mainland in 1955. In 1945 the Northern Territory Administration was re­assembled in Darwin and in May 1946 Channel Island was once more the responsibility of the Commonwealth Department of Health.

Facilities

During its 25 years of operation, interest in Channel Island surf aced on several occasions, resulting in improved conditions but the overall trend was one of pro~ssive deterioration. Until the departure of Cook in 1939, the leprosarium on Channel Island was regarded as being permanent, the only suggestion that it might cease to function coming from those optimists who envisaged a gradual phasing out of activities as the leprosy problem came under control. In 1931 ~e three buildings which had formed the nucleus of the quarantine station were put to use as a hospital and dormitories for part-Aboriginal females and part-Aboriginal males. To these were added eight huts of a simple corrugated iron design with cement floors for Aboriginal patients. The huts were situated on a ridge overlooking the sea some distance from the central buildings, the idea being to provide for some division between the races. A cottage for the curator and matron was built a little less than a kilometre away from the hospital and various out-buildings, for use as kitchen, store and laundry, completed the design. By 1934 the institution was overcrowded and a further six native huts were built. In March 1931 a cyclone swept .over Channel Island, severely damaging most buildings. Reconstruction was commenced during the dry season and two additional. dormitories and a recreation hall were completed in 1938, During that same year the island's first white female patient arrived, a sixteen year old from Darwin, and a small cottage, later converted to a chapel, was built for her.

The inadequacies of these facilities were further highlighted by the severe limita.tions of the geographical features of the island. The lack of fresh water was the most serious and persistent problem. Indeed, if there is any one recurring motif in the history of Channel Island, it is the corrugated iron water tanks which stood alongside every building and when discarded as unserviceable, were put to other uses by the patients. Insufficient supplies of fresh water had delayed the opening of the leprosarium in 1931, but it was an omen which was ignored. Cook felt certain that fresh water was available by drilling and when none had been found at the completion of construction, two 20,000 gallon water tanks were erected in addition to smaller tanks. This was later supplemented by a 30,000 gallon concrete tank set into the ground. Sea water was used for cleaning and those patients sufficiently mobile bathed in the ocean.

During the dry season, fresh water was rationed, at times the daily allowance per patient falling as low as two gallons. Water was brought across the harbour by barge and depending on the serviceability of equipment, pumped into the main storage tanks. When the pumps were not in use, patients carted the water up the hill in buckets. The wet season brought relief from restrictions and the water delivery routine. Kitchens at the leprosarium had been fitted with wood burning stoves and by 1939 the island was almost completely denuded, every suitable tree having been used for firewood. Replacement was

33

! \

: ;

impossible because of the lack of water. From the broken rocky ground, buildings stood out starkly, exposed to harsh tropical sun and wind. A few tiny gardens and an odd shade tree, carefully nurtured by determined patients, provided the only relief in an otherwise desolate scene.

The inadequacies of the facilities during this period were a reflection of the official attitude to the disease itself and to the Aborigines, the people most often affected. With the change of Territory health services to direct Commonwealth control in 1939, another element which was to adversely affect conditions on the island for the next 15 years, was added to an already negative .attitude. Cumpston, who had always. remained dissatisfied with the choice of Channel Island, began to work toward a change of site and he had a ready ally in Holmes. In 1939 Holmes, then a State Medical Officer with Commonwealth Health, was sent north by Cumpston to report on health services in the Territory. He reported that 'the island is so unsuitable in every way that it is considered that further expense should not be incurred on it'. A site at Gunn Point was tentatively selected and Channel Island, now seen as a 'temporary' convenience, was given only minor repairs and maintenance.

An increii.sing military presence in the north prevented the idea of a new leprosarium becoming anything more than a hope for the future until in 1943 Cumpston was given another chance to have the leprosarium abandoned when plans were made to remove a number of Channel Island patients to other places. Although these plans fell through, Cumpston persisted in urging that a new site be found and. settled as soon as possible. Major-General Allen ruled that it was a p()st-war matter. and Cumpston's opportunity was lost.

In December 1944 several senior army personnel v.isited the leprosarium.and reported that

Channel Island is in a serious state of disrepair, owing to lack of maintenance dating back to pre-war days ... Much sympathy is felt for the staff and inmates of the institution, who are in a very unenviable plight, and it is recommended that urgent action should be taken in the matter.(Adm. Comd. NT Force toL.H.Q., 23112144, AA CRS Al928, ltem 71513811)

The inspectors found patients relying on wet mangrove timber for cooking, buildings devoid of paint, louvres and doors rotten, kerosene lamps still in use for lighting, no emergency contact with the mainland available, and much of the plumbing connecting tanks to the huts unusable. Two lists were drawn up, labelled 'essential works' and 'desirable works' but the works were of a 'repair and maintain' nature rather than the much needed improvements and extensions. Such work was not the responsibility of tlJe Defence De~artment and the Health Department had not entirely given up hope or a chan¥e of site. The work carried out by the army did little to halt the progressive detenoration of the leprosarium and when the situation again came under scrutiny in 1946, the appalling conditions on the island were publicly revealed in the press.

Little evidence is available about conditions on the island . except that collected by investigations such as the one conducted in 1946. In October 1946, 23 disgruntled patients waded off Channel Island during a low tide, having planned to walk to Darwin to present a list of complaints to the Chief Medical Officer. This long remembered and widely publicised event became known as 'the walk out'. The party failed to reach Darwin, the police were infonned of their presence on the mainland when they walked into an allied works camp some miles from Darwin. However, they achieved the attention they sought. An Investigating Committee consisting of the Acting Government Secretary, the Chief ClerJ.c of Native Affairs, the Superintendent of Police and the Chief Medical

34

Officer was appointed. Investigations arising from it revealed that conditions on the island had reached an all time low.

The Investigating Committee found accommodation overcrowded and in a bad state of disrepair. Two white patients were living in a shack of their own construction, dotmitories provided enough space only with the use of open verandahs and the Aborigines were living in unlined galvanised iron huts. The kitchen was an open fly­infested shed where a broken down tWo-oven wood stove provided the only cooking facilities. No means of storing perishables was available on the island. Meat, often exposed to the sun when being transported, had to be cooked immediately. The supply of an electric power plant suggested by the army had not been effected, kerosene lamps still provided the only light, and emergency contact with the mainland was still unavailable. Apart from beds, the Committee saw little furniture.

The shortage of water was extreme, nursing staff suffering privations along with the patients. Sister Eucharia, resident on the island at the time, recalls the extreme measures required to conserve water.

Because the patients unloaded the water barge, we took the precaution of only using water caught in our tanks during the wet season. During the dry season our supply ran very low. In the evening we would bathe by quickly wetting ourselves all over, then turn off the shower while we soaped and scrubbed. A quick rinse would finish us off, with the water we had saved in the bottom of the bath being· used for washing our clothes. Outside we had a tiny garden which we kept alive with what remained of our washing water (interview Aprll 1985).

The recommendations of the Investigating Committee included the repair and maintenance of buildings, provision of additional accommodation, supply of furniture, kitchen and cooking utensils, clothes, electric light plant and an emergency supply of water until the .monsoons. broke, Also recommended was the transfer of thre~ European patients to southern institutions, thus reserving Channel Island for Aboriginal and part­Aboriginal patients. Finally, the Committee urged that 'the proposed removal of the station to a new site be expedited'.

The Channel Island improvements recommended in 1946, were slow to be carried out. A review of the situation in 1948, again brought about by an upsurge of public criticism, revealed some progress but conditions remained below the standard of other institutions operated by the Health Department in the Northern Territory. Two Sydney Williams huts were erected in 1948 to relieve the pressing problem of overcrowding (seven patients were sleeping in one 12' by 12' Aboriginal hut) but by 1951 the survey activities of the Health Department steadily added to the population of Channel Island. In bureaucratic thinking, Channel Island continued to. he a temporary institution, an attitude which prolonged the patching-up process. The idea of moving to Melville Island was not abandoned until 1950 when the decision to move to the quarantine reserve on the mainland was made. In 1951 a press statement announcing plans for a large modern leprosarium to be built at a cost of 100,000 pounds was released. With an optimism which could hardly have been inspired by past record, it was announced that the new leprosarium was to be completed within 18 months.. Meanwhile the temporary expedient of adding accommodation and increasing the cartage of water was continued for another four years. Even this practice had reached its limits and by the time the transfer to the East Arm Settlement was effected in 1955, the intake of patients to Channel Island had been halted. However, the timely arrival in the Territory of doctors dedicated to resolving the leprosy problem, and the development of

35

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drugs able to successfully combat leprosy, provided a hope which contrasted oddly with the long neglected institution on Channel Island.

Patient care

It was not until 1950 that any doctor in the Northern Territory displayed any extraordinary , interest in leprosy. Cook, having worked towards the establishment of Channel Island in ' 1931, showed little further interest in the care of patients or the day to day administration of the institution.

As in most leprosariums the majority of patients on Channel Island lived in a semi­independent fashion within the obvious constraints of the institution. The hospital itself was reserved for those patients requiring constant care, usually those in the last stages of leprosy or patients suffering leprosy related illnesses. However, other patients requiring full-ti.me care, such as accident or the occasional maternity cases, were admitted. Patients living outside the hospital ward attended daily for injections, dressings and oral medication, although not all patients were willing to receive treatment. One European patient who spent ten years on the island, refused treatment altogether when, after several years of treatment with chaulmoogra oil, his condition had not improved, while other patients attended only on an irregular basis. In 1946 Sister Michaelene reported that most Aboriginal patients were amenable to discipline and could generally be persuaded to attend to treatment but part-Aboriginal patients came only , if so inclined. However, despite the problems of scattered community and limited staff, the majority of patients were receiving regular treatment.

Apart from the O'Sullivans who had some experience of leprosy treatment from Peel Island, resident staff of Channel Island received no specific training in the care of leprosy patients, a problem which continued well. into, the 1960s. Ellen Kettle, a survey sister with the Health Department, recalls ,treating leprosy patients during the 1960s with only minimal, success due to a lack of lmowledge. No specialist training was available in Australia in pre-war days and Channel Island staff relied on their general nursing training and instruction received from visiting doctors. All three matrons were qualified nurses, as were three of the four Catholic sisters. The fourth sister acted as housekeeper, often doubling as school teacher, allowing the others to devote their entire day to the care of patients. Several part-Aboriginal females were trained as nursing assistants and to them fell much of the daily routine of administering chattlmoogra oil injections and tablets and changing dressings. During the years immediately following the wm· some full-blood Aboriginal patients were also trained in basic clinic work but complaints from European and part-Aboriginal male patients put a stop to this. While the interest and participation of supervisory staff stationed in Darwin varied, resident staff, although often severely restricted by lack of funds and facilities, provided a continuity of patient care that was the mainstay of the leprosarium.

In 1939 the Northern Territory Medical Service was transferred to the Commonwealth Health Department. Against his personal wishes, Cook was transferred, to Sydney and the Channel Island leprosarium was brought under the direct control of Cumpston. This move coincided with a series of complaints made by James .Carney, a Channel Island inmate, about the running of the institution and the conduct of the curator. Subsequent investigation cleared Jones but revealed an appalling state of affairs in the administration of the island. Visits by medical officers had become very irregular, sometimes months apart. Fast running tides and wet season squally weather often meant that visits were of short duration, the attendant doctor seeing no patients and only having time to speak with the matron. The radio which had enabled staff to contact Darwin at a set time each day was unserviceable; it was replaced by a lamp and at a pre-arranged time each evening,

36

Plate 4: Matron Jones, who with her husband, cared for the Channel Island patients until 1942

37

i ' ··~

Plate 5: A Bathurst Island patient is buried With a Catholic ceremony by the nursing staff. c.1945

communication with the Police . Station by Morse code could b.e established. Patient medical records were almost non-existent. Cook had earlier stated his reasons for not establishing records:

... dealing as we are here almost wholly with Aborigines and half-castes, history records are extremely difficult to obtain and very unreliable when · obtained. From the scientific point of view, medical histories of Aborigines are practically worthless - even worse by reason of their being misleading. Their preparation involves a considerable amount of work in each individual case and I doubt whether the expenditure of time involved is justified from any standpoint - practical or theoretical (Admin. to Sec. Dept. of Interior, 2119134, AA. CRS AJ928 Item 635138).

<'

As difficult as records were to establish, to maintain them was thought equally futile as, regardless of possible progress, there was very little chance of patients· being disclJ.arged from Channel Island.

The leprosy ordinance of 1928 provided for the release. of leprosy patients at the discretion of the Chief Medical Officer:

The Chief Health Officer shall, at least once in every six months, examine every leper detained at any Leper Hospital in.order to determine whether any leper may be released (Section 19).

Although this clause was repeated in the 1954 leprosy ordinance the decision to discharge patients was considerably more involved than the clause indicates. Patients whose clinical conditions indicated an improvement were bacteriologically tested over a period of

38

months until a specified number of tests had been returned with a negative reading or the patient had negative smears for two years. In pre-war days the number of negative smears needed for a patient to be considered for discharge had been set at 15, a magical and unattainable number in the experience of most. One part-Aboriginal recalls, with a mixture of bitterness and resignation, reaching 14, only to be disappointed with the fifteenth; she remained at the leprosarium for 20 years.

Being recognised as non-infectious did not guarantee discharge, particularly if the patient was an Aborigine. The danger of any patient suffering a relapse was real and, in the case of an Aborigine, it was believed that should a relapse occur, the chances of the patient presenting himself again for treatment were remote indeed. In 1939 Holmes found a number of Aboriginal and part-Aboriginal patients on Channel Island who were non­infectious. Although he was amongst the more liberal in his attitude to isolation, Holmes did no more than suggest the transfer of these patients to a mainland site where they could be kept under surveillance .

. .In a bitter letter of complaint to the local paper, one Channel Island patient asserted that no patient had every been cured or discharged adding that 'if this course of keeping patients as souvenirs is continued, coupled with the fact that they are also breeding them on the island, this leprosarium is due to assume gigantic proportion' (Northern Standard 10 March 1939). Investigations by Kirkland revealed that during Cook's period as Chief Medical Officer, one part-Aboriginal patient had been discharged in 1936 although annual reports for the period, compiled by Cook, list 18 patients discharged only one of whom was said to be 'free from clinical and bacteriological evidence of infection'. The discrepancy between Kirkland and Cook of the remaining 17 cases is difficult to explain.

Cumpston was ambivalent about discharging patients. He conceded that it was largely a local problem with much being dependent on personal knowledge of the patient and local conditions. However, he went on to suggest that 'as much uniformity as possible between procedure adopted in the Northern Territory and that operating in Queensland and Western Australia be sought' and referred Territory authorities to the recommendations of the National Health and Medical Research Council. After much deliberation Kirkland decided on a policy which differed little from that introduced by Cook.

Although the new administration under Cumpston altered little in regard to discharges, other improvements were made. Regular weekly visits by a Medical Officer were instituted with patients' access to doctors considerably extended. One doctor was sent to the island for days at a time until detailed records of all patients had been compiled. Once those were completed, Cumpston advised that they were to be kept up to date by the visiting doctor with as little reliance on resident staff as possible. To keep doctors informed of the latest developments in the treatment of leprosy, Cumpston regularly sent copies of the international journal Leprosy Review to staff in the Territory. Nevertheless, improvements occasioned by Cumpston's innovations were short lived. Within three years the war had thrown the administration of Channel Island into total disarray.

When treatment was recommenced in 1943 under the supervision of Kirkland, .regular weekly visits to the leprosarlum were again ordered but could not be sustained when the leprosarium was returned to the control of the Health Department in May 1946. During 1946 Dr J G McGlashan, who as Chief Medical Officer was responsible for Channel Island, visited only infrequently, on an average once in every two months. He was well liked by the patients although they regretted his inability to attend more regularly. When complaints were received, regular monthly visits were made but staffing shortages would not allow more frequent visits. Altogether, morale was at a low ebb at this time, with only two patients being discharged in two years.

39

Until 1947 chaulmoogra oil injections and oral tablets had been given to all patients who were willing, orwho could be persuaded, to accept treatment. As mentioned previously,. this was the majority of Channel Island's population. Except for those unable because of temporary illness to tolerate the painful injections and nauseating tablets, treatment was given twice weekly. In pre-war days patients took much needed breaks from the weekly routine of treatment by taking camping trips to uninhabited parts of the mainland around the harbour. During the 1950s these became official holidays and every assistance vlas given to enable patients to take advantage of them. By this time the introduction of new drugs had lessened the need for relief from treatment but the psychological value of temporary release from institutional life was recognised.

In 1947 drugs of the sulphone group which had been developed during the war at Carville, America's leprosy centre, were available in Australia and were tried on Channel Island. During this early stage the results of sulphones was still uncertain but Channel Island patients, hopeful of a cure, willingly participated in experiments. As new sulphones became available they were used at Channel Island, the most significant being Sulphetrone which was introduced in November 1948 (Humphry 1952, 573) .. Occasionally patients suffered severe reactions to· sulphones, necessitating. careful monitoring of doses under the supervision of a doctor. After 1950 the frequency of doctors' visits was increased and by 1951 all patients were being treated with sulphones with increasing success.

The use of sulphone drugs increased the number of patients eligible for discharge and although strict regulations regarding the release of leprosy patients were still enforced, the rigid thinking of the past which confined all patients to the leptosarium regardless of infectiousness, was gone. In 1951 Dr SD Watsford, Deputy Director of Health· in the NT informed Canberra that he was releasing patients who had been free from any sign of activity of the disease for at least 12 months, and who had shown a steady improvement for two years, but only if they were in good physical condition. However, he advised that only those patients who cou1d be sent to a tnission or settlement where a trained nurse was stationed, would be discharged. These conditions showed a greater flexibility than those promulgated by the National Health and Medical Research Council driring the same period, but nevertheless a number of patients who were non-infectious continued to be denied their freedom. ·

Patient records, which Cumpston had ordered to be established in 1939, had been lost or tnisplaced in the intervening decade and it was not until the appointment of Dr A H Humphry who became responsible for Channel Island in 1949, that detailed records were again kept. Watsford complained that a proper system of records was lacking in all areas of native disease, a situation which he was still endeavouring to rectify in 1954.

The appointment of Humphry to the supervision of Channel Island coincided with an upturn in the tide of Territory affairs. The work of anthropologists, notably Professor A P Elkin, was substantially influencing the Commonwealth Government's attitude to the Aborigines and when Paul Hasluck became the Minister for Territories in 1951 the Aboriginal vote was extended. In the changing atmosphere, Humphry introduced limited but significant changes to the isolation policy and, with the help of new drugs, improved treatment. Unfortunately his progressive changes were hampered by the constraints of a lepros!U'ium on a distant and waterless island and the bureaucratic wrangling which had to be endured before a change was effected. The anomaly between improving treatment and deteriorating facilities on Channel Island was not resolved until the move to East Ann. After 1955 both in-patient and out-patient treatment was improved and, with the general improvement in the welfare of the Aboriginal people, new hope was introduced into the battle against leprosy in the Northern Territory.

40

CHAPTER FIVE

THE PEOPLE

Sociological studies have provided us with much information about the effects of institutionalisation on the individual. When considering the lives of both patients and staff on Channel Island it becomes obvious that the 'disculturation' explored by Erving Goffman in his work Asylums, although not as far reac~g as in many total care institutions, did significantly modify the behaviour of patients. This became of greater significance in cultural terms when the incarcerated patients were Aboriginal people whose removal from their homelands not only severed personal and religious ties with family and country but prevented the individual from fulfilling particular and often important roles within the group. This question was given little thought by protagonists of isolation policies - interest in the preservation of the dignity of the Aboriginal people was a thing of the future - and it was not until the early 1950s that individual doctors, often in defiance of higher authorities, gave serious consideration to the negative effects of removing patients from their homes for treatment. However, before proceeding further with this aspect of the history of Channel Island, some consideration of the statistical make-up of the island's population is needed and, as the experience of the patient is of concern here, some discussion of the patient's initial contact with the authorities and transport to the island.

Patient numbers

Because of the inconsistencies in record keeping and the loss of records, the compilation of statistics of Channel Island patients has proved most difficult .. The figures in the tables below have been gleaned from three main sources; Annual Reports of the Administrator, a report compiled by Watsford for the Director-General of Health in 1951 and a similar report in 1954. Watsford's report contains the unsurprising admission that 'records relating to the leprosarium are completely lacking in Darwin up to 1939 and are so scanty from 1939 to 1945 as to be useless'. While bearing in mind the limitations of working with incomplete figures, some observations can be made from the collected data.

During the first decade of the leprosarium's existence, not all patients on Channel Island were from the Northern Territory. In 1927 the Western Australian Government had been approached with the offer of accommodation of leprosy patients from the north-west of the State at the proposed new Darwin leprosarium. The offer was accepted, the Western Australian Government agreeing to pay a maintenance cost of 38 pounds per head per annum for all Western Australian patients. This cost was calculated on a basis which· gave the Commonwealth the advantage but was accepted, Davidson suggests (1978, 33), as a popular political move enabling Western Australia to rid itself of lepers. The first patients to arrive on Channel Island on 10 October 1931 were 12 Aborigines from Cossack, Western Australia, with another five arriving soon after. Three days later, 27 patients were transferred from Mud Island and four part-Aborigines from the isolation ward at Darwin hospital on the 14 October. By June the following year four more patients, one European and three Aborigines, were sent to the island.

Transport of patients from Western Australia presented enormous difficulties, as will be discussed later, and this, coupled with a dramatic increase in the number of noted cases of leprosy in Western Australia, ended the transfer of patients to the Northern Territory in 1935. The initial group of Western Australian patients had been joined by a further 31 in

41

1934 and 21 in 1935. Admission figures for the 1932-33 period did not distinguish Western Australian patients from Territory patients and thus the total number of Western Australian patients cannot be calculated although it would have been in excess of the known 69. In 1940, 22 patients were returned to the Derby Leprosarium in WA which had been commissioned in December 1936. At least one Western Australian patient elected to remain on Channel Island and several had died there.

Table3 Channel Island 1931·55

Period Admissions Discharges Deaths M F Total

Ending June 1932 52 2 1933 21 3 1934 44 12 1935 28 12 1936 13 3 7 1937 18 13 11 1938 24 4 15 1939 1940 1941 1942

Ending December 1943 6 2 8 1944 4 2 6 1945 6 2 8 1 1946 8 5 13 1 4 1947 13 6 19 2 8 1948 4 2 6 7 7 1949 23 4 27 23 7 1950 30 23 53 2 1951 21 13 34 4 5 1952 31 7 1953 20 6

Ending May 1954 18 4 1955

Note; In June 1956 there were 189 patients at East Ann

Remaining on island M F Total

38 12 50 49 19 68 64 36 100 73 43 116 72 47 119 67 46 113 73 45 118 80 49 129

62 66 73 81 91 83 82

137 164

191

The increase in the number of admissions in the post-war period, shown in Table 1, would appear to indicate rapid spread of leprosy during this time. This assumption was commonly made, the increase being attributed to the number of patients who returned to their homes in 1942 and avoided further detention. However, an increase in the incidence of the disease has always been noticed when regular.medical surveys have been instituted

42

or Europeans have penetrated hitherto little frequented parts. of the country. As we have seen, Aboriginal communities were only sporadically surveyed until 1951. The more frequent and thorough surveys conducted after this, together with an actual increase in the incidence of leprosy would account for a higher number of patients admitted to Channel Island.

The radio of male to female patients on Channel Island, the figures for which are only available to 1938, is consistent with findings in most parts of the world (Hargrave 1980, 135 confirms this). This may reflect the male population's greater mobility and therefore increased opportunity for contact with art infectious person rather than a higher susceptibility to the disease. Or it may indicate that, as Kirkland suggests, Aboriginal males were more readily contacted and examined by police and doctors.

Table4 Racial origins of patients admitted to Channel Island 1932-1938

Part Europeans Asiatics Aborigines Aborigines Total

Ending June 1932 1 1 4 46 52 1933 1 7 13 21 1934 1 7 36 44 1935 2 4 22 28 1936 1 3 9 13 1937 3 2 13 18 1938 2 1 4 17 24

The greatest number of Etiropeans at any one time on Channel Island was from 1939 to 1942 when nine males and one female were in isolation. Three of these patient$ were evacuated south in 1942. Full-blood Aboriginal people were, and continued .to be, the most severely affected section of the population with cases coming from all age groups. Between 1943 and 1951 a total of 26 children under the age of 15 were admitted to Channel Island. Two children were born on the island before 1939 according to official reports and several during post-war years'. Of the births recorded, several died in early infancy. A number of children from mission stations who had been evacuated south during the war were found to have leprosy and were admitted to Prince Henry Hospital. They were later transferred to Channel Island where the cost of maintenance was far less.

With the introduction of sulphone drugs in 1948, an increasing number of patients were discharged.· For continued c<>titrol over the disease, maintenance doses of the drug were needed for a number of years and patients released required continued treatment. Many of those listed in Table 5 as being treated outside the leprosarium were former Channel Island patients but many were new cases who could not be accommodated in the already overcrowded facilities at the leprosarium. On transfer to the East Arm Settlement in. 1955 a number of these patients were brought in for isolation and further treatment.

From the above data it can be seen that the Channel Island population was predominarttly Aboriginal, helping to reinforce the popularly held belief that leprosy was a 'native

43

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Plate 6: Channel Island's only female European patient with fellow patients. c.1939

44

Plate?: Western Australian patients who were transported to the leprosarium during the early 1930s

45

Tables Cases being treated outside Channel Island

Period

Ending December 1949 1950 1951 1952 1953 Ending June 1954

Number of Cases

2 5

31 59 92

150

disease' and, although a small number of European patients remained on the island, the leprosarium was regarded as essentially an Aboriginal institution. This is emphasised by the repeated attempts of the health authorities to transfer European and part-Aboriginal patients to leprosariums in other States. These plans foundered because of the great difficulty of transporting people known to be suffering from leprosy, both interstate and within the Territory itself. It was .a problem which was never satisfactorily overcome during the period under review and the indignities suffered by those being transported to the island supported the idea that they were . being ·singled out and isolated for reasons other than their need of medical treatment. .

Transport of patients

Under the provisions of the Northern Territory leprosy ordinance of 1928, being diagnosed as suffering from leprosy made a person immediately liable· to transfer to Channel Island. However, transporting patients from widely scattered and isolated communities was not a simple undertaking. Transport of any kind was ()ften difficult to obtain and, where available, expensive. When transport was required for leprosy patients, owners of trucks and luggers increased their charges, often dramatically, either hoping to cover the cost of disinfecting vehicles and possible loss of other contracts or to force the authorities to seek alternative arrangements. The response of the government was to move patients as cheaply and as quickly as possible, often at the expense of the comfort and dignity of those forced to endure the journey, making this initial contact between patients and authorities an inauspicious beginning to a long association. ·

By 1930 leprosy patients were being drawn from numerous communities in the northern portion of the Territory, extending southward during the following decades. fu many cases Aborigines were detailed as 'leper suspects' and conveyed to Darwin or Katherine where they could be examined by a medical offer. Whether a 'leper' or a 'leper suspect', treatment and transport was the same.

In the leprosy ordinance of 1928, the police were specifically charged (S.9) with the duty of apprehending leprosy patients.

When any police officer suspects that any person is affected with leprosy or is notified ... that any person is suspected of being affected with leprosy, he shall forthwith· notifY the Chief Health Officer by telegraph of the circumstances of the case, shall detain the person ... and shall escort him to the nearest medical officer for examination.

46

As we have seen, the involvement of the police in leprosy management was largely negative as it sent people into hiding and reinforced the association of leprosy With criminality, During the period 1930-1955, the police were often the only representatives of authority and civilisation in many parts of the Northern Territory and a multitude of chores fell to them including the treatment of accident cases and administering drugs to syphilitics. In dealing with leprosy patients some police officers acted with great humanity but unfortunately there were occasions when the callousness displayed was horrifying even by contemporary standards. One former patient, a girl of 13 at the time, vividly recalls the 'round-up' of patients with whom she was to travel to the leprosarium;

there were twenty there I think ... they were all there. with chains around their necks, under their legs and on to the next person and the next like that to the women ... I can't forget that because I cried when I see that (Interview,' T Puertelano, Derby, May 1986).

The group had travelled on foot some hundreds of miles in chains and it was only after pressure was put on the responsible policeman that he agreed to release them for the next stage of the journey. Although careful to disinfect cells and vehicles after they had been occupied by leprosy patients, police were conscious of their own exposure to infection and in 1948, following the lead of the Queensland Police Force, the Northern Territory Police Force applied for an allowance to cover the risk of infection when escorting lepers. In August an allowance of ten shillings per day spent in escorting lepers was granted.

From remote areas of the Territory, transport was required for leprosy patients and suspects to Darwin or Katherine or later, Tennant Creek, for examination by a medical officer. After examination, confirmed cases were transferred to Channel Island. The usual procedure was to bring the patients in by foot, motor transport or horse as far as the railway line, which ran from Darwin to Birdum and from there they could complete the journey by train. Police Officers relied heavily on horses in pre-war days and police station journals contain frequent references to mounted constables bringing in Aboriginal lepers, often together with prisoners and witnesses. Presumably patients, prisoners and witnesses walked. Cars and trucks were used on occasion. Ted Heathcock, a noted Territory policeman, used a car for the transport of leprosy patients. The car was probably his own as he received an allowance for fuel. From the McArthur River and Victoria River regions patients were, on occasion, taken to Darwin by lugger, the overland journey being long and arduous. Dr Clyde Fenton, whose aircraft gave him a greater mobility than that enjoyed by other Territory doctors, was able to examine leprosy suspects in centres across the north but there is no evidence that he used his plane for their transport to Darwin. Planes were used increasingly after the war when the Territory's aerial medical service was extended.

Holding stations for leprosy patients awaiting transport to Darwin or examination by a medical officer were entirely inadequate and the cause of much concern. Police were reluctant to house leprosy patients in cells, the cells being required for their original purposes and the detention of the patients often long. Hospital staff at Katherine demonstrated an equal reluctance to accommodate them, with the result that leprosy patients were usually kept in the police yard under a makeshift shelter and often in chains. Concern was expressed, if not for the Aborigines, then for the adverse public attention that the circumstances of detention might provoke.

One much-needed improvement was effected during the 1939 period, possibly because Commonwealth Railways accepted financial responsibility. Having been gathered at various stops along the railway, leprosy patients travelled to Darwin in a conveyance

47

I I' ' i'

'> >I

1'i 'I; < ' i ';

·, 1'

commonly known as the 'leper van'. This van was no more than a converted cattle truck. It had slat sides and several pieces of corrugated iron nailed to the top sufficed for a roof. The van afforded the patients no shelter from the elements, no sanitary facilities and no privacy. For police officers its flimsy construction gave no guarantee that leprosy patients would still be inside when the train reached Darwin. One Aborigine queried with brutal frankness:

Why sick feller put in case all the same bullock and prisoner him go in train all the same white man? (Secretary, Department of Interior to Commissioner for Railways, 16 December 1937, AA. CRSAl Item 37113696).

Confinement in the leper van could last several days with overnight stops at some sidings and it was alleged that gazing at caged lepers had become a form of public entertainment, prompting Administrator Abbott to ask that the van be detached from the train before it pulled into the Darwin Railway Station. Abbott also requested the provision of a new carriage but positive action was not taken until 12 months later. A newspaper article commenting on the day and a half journey of a six year old girl in the leper van raised embarrassing questions in the Senate which resulted m a flurry of activity. In 1939, The Northern Standard reported with some satisfaction that the new van was in use (6 January 1939).

The ordeal endured by leprosy patients or suspects did not end on arrival at Darwin. Until assessed by a Medical Officer, Aborigines and part-Aborigines were kept in what was politely referred to as 'very indifferent accommodation' at Kahlin Compound and later in the leper hut at Bagot Reserve. In 1941 the Bagot Reserve Supervisor lodged a complaint about the disgraceful condition of the leper hut, suggesting that no further Aborigines be sent there. In reply, Kirkland advised that it was impossible to examine suspects in their home colllfilunities as there was no departmental doctor stationed anywhere between Darwin and Tennant Creek, but that he would endeavour to by-pass the holding hut by sending all patients directly to Channel Island. This last leg of the journey was taken by launch.

The journey Western Australian patients were compelled to endure was even more arduous and it attracted much adverse publicity. Collected from Cossack, Beagle Bay, Broome and Derby, leprosy patients were taken to Darwin by lugger, often in appalling conditions. In some cases patients were bed-ridden, but no medical assistance was provided. All Western Australian patients were Aborigines or part-Aborigines and although prevailing sentiment in the north, succinctly expressed by Idriess, was that the passengers headed for Darwin were 'only niggers' (Herald 22 February 1934), the conditions of the transport caused concern in the south. Western Australian health authorities had little choice in the selection of luggers as few were available for such a journey and few captains were willing to expose themselves to the risk of infection. Like the Territory authorities, they were inclined to accept any offer which would not overtax their limited funds, often turning a blind eye to obvious deficiencies. The transfer of Western Australian patients to Channel Island ended in 1935.

When, in 1940, surviving Western Australian leprosy patients were transferred to the leprosarium at Derby, land transport was used. The Western Australian Health Department provided two trucks for the 14 day journey. Territory authorities, horrified at the lack of comfort and space and fearing public criticism, delayed departure until awnings had been fixed, mattresses and medical supplies provided and a nurse engaged to accompany the patients. Two part-Aboriginal girls who were to have travelled with the group were kept in Darwin until arrangements could be made to have them flown to

48

r

" f. 0 :s J

s

v

Wyndham. Several of the patients were in an advanced stage of the disease and died soon after their arrival in Derby. Expectations of avoiding public notice were not fulfilled. The Northern Standard, ever the champion of the under-dog, published an article (5 July 1940) lamenting that human beings should be subjected to primitive and degrading treatment from civilised people.

These Aborigines were brought to Darwin in luggers under conditions comparable with those found only in cattle boats ... the whole procedure (of their relUrn) has been shrouded in secrecy so as to suggest that the authorities are again mishandling people suffering from the dread disease leprosy.

The patients

Although the public often expressed concern over the treatment which leprosy patients were receiving and the conditions under which they were detained, there was rarely any suggestion that they not be sent to Channel Island and the suggestion that isolation was unnecessary was even rarer. One lone protest, voiced through a letter to the editor of the local paper, proposed an alternative mainland settlement for European patients as:

men who have committed no crime should not be banished to an arid, barren island ... where there are none of the ordinary comforts of civilisation ... It is surely time that the authorities found ways and means of accommodating these men under much more favourable conditioltS ... with a neat ward cottage (Northern Standard, 4April1935).

Patients, too, although they might wish for better conditions, accepted that for the protection of their families and the community, they required isolation. It was seen as the inevitable fate of the leprosy sufferer.

Once on the island all patients, whether European, Aboriginal or part-Aboriginal, were faced with the knowledge that their confinement was for an indefinite period. Little evidence survives to indicate the degree to which patients adjusted emotionally to their new environment. The platitude 'the patients are as content as their unfortunate circumstances will allow' was frequently voiced in both official and unofficial reports and the number of 'escapes' from the island was used as a barometer of patient morale. In the first year of operation, Cook reported with evident satisfaction:

The behaviour of the inmates has been exemplary. There were no attempts to escape during the year. On the other hand all patients appeared to be as contented and as happy as their unfortunate affliction will permit (NTRA, 1932,23).

It appears that Cook's optimism was well founded for while there were various reports of patients escaping while being escorted to the island, none concerning patients leaving the island appeared for several years. However, from 1937 when a group of four left the island, closely followed by another group of seven, 'escapes' were a regular occurrence. The determination of some to return home is exemplified by the experience of one young Aboriginal man who after four days on the island swam to the mainland and following an eleven day overland journey, used a canoe to reach his home on Melville Island (Northern Standard 26 October 1937). He suffered the indignity of being summarily returned to Channel Island but a similar bid for freedom made by an Aboriginal woman from Dellisaville in 1951 came to a happier conclusion. She was permitted to stay with her husband and receive out-patient treatment. In 1951, Watsford, justifiably irritated at the

49

):'

long wait for the promised new leprosarlum, capitalised on the criticism occassioned by the 'escape' of nine patients. He infonned the Director-General of Health that:

it is quite obvious why people want to leave Channel Island for the deplorable state of that institution is as well known to you as it is to us ... Until the new leprosarium is built, there is no prospect that there will be any improvement ... and with this unusually dry year, conditions are going to be very bad ... and it is expected that large numbers of natives may abscond (Watsford to Director General of Health, letter dated 1812151, AA. CRS A1658, Item 25811/3).

The majority of those leaving the island were Aborigines who had a strong sense of community and a reasonable chance of avoiding further detection. The Aborigines were also assured of being welcomed by their families, something European patients could be almost equally certain would not happen. Even those few Europeans discharged as cured, suffered privations and humiliations due to the popular dread of leprosy. One young woman had the experience of seeing people make a hurried e:xit as she entered Church on Sunday. The same young woman unconsciously caused a panic in Terowie, South Australia, when she was evacuated in 1942. Terowie was a resting place for evacuees and the women of the town had opened their homes to the travellers, but when it was revealed they had entertained a 'leper' all generosity was quickly withdrawn.

Many of the part-Aboriginal patients on the island came from institutions, either church or government, and their desire to leave was dampened by having no home in which they could seek refuge. fudeed, many of them had gone to the island as children and knew little of the outside world. With the introduction of sulphone drugs a number of these patients became eligible for discharge but long years of institutionalisation, particularly when it covered the years of adolescence, made rehabilitation a difficult process. Any attempt to detennine the level of patient morale from the number of patients leaving the island illegally can only be of limited value.

During the early 1950s, officers of the Native Welfare Branch took an increasing interest in the patients on Channel Island and appear to have been the first to have shown a particular concern for the emotional response if not the cultural response of the patients to isolation. The initial visits of the welfare officers to the island were received with some hostility by the Catholic nuns whose past experiences made them wary of newcomers. However, once this problem had been overcome, regular visits were made, allowing patients to receive news of relatives and friends and send messages home. Patrol officers were particularly assiduous in these duties, exchanging photographs with patients and home communities, corresponding with relatives through pastoral station managers and assisting in the financial affairs of the patients. <'

Separation could be and often was for a life-time; of the 443 patients recorded as admitted to the leprosarlum at least 142 died and were buried on the island. Children grew up remote from family and culture, many never to return. The more fortunate found relatives among the patients on the island but the extent to which they could have practised tribal customs would have been severely limited by the size of the group and their estrangement from their own lands.

Isolation caused serious marital disruption although there were several married couples among the patients on Channel Island. Other unions were fonned on the island but infonnation regarding the extent to which they confonned to traditional kinship patterns, their permanence and the fate of the resulting offspring is not readily available. Health Department rolls for Channel Island, which made some attempt at recording the tribal

50

origins of patients, do not indicate any tribal affiliation of children born on the island, but where unions were impermanent, presumably children remained with their mothers. Sexual relationships of any kind were not provided for in the planning and administration of the island but received tacit sanction in that arrangements between the patients were not interfered with and at least two Christian marriage ceremonies were conducted in the chapel. In the huts provided for Aborigines, no specific accommodation was set aside for married quarters and patients tended to organise themselves in groups along traditional lines but donnitory style accommodation was provided for young unmarried Aboriginal females and later for boys. Similarly, part-Aborigines were provided with separate male and female dormitories and when they married they moved into separate accommodation.

As in the wider Territory community, social barriers based' on racial differences were observed on Channel Island. The authorities firmly established these barriers by providing superior accommodation for European patients with similar but overcrowded buildings for part-Aborigines and huts for other Aborigines. The patients themselves insisted on discrimination in some areas and effectively prevented Aboriginal women from working as cooks and clinic assistants. Part-Aboriginal patients were arguably in the best position, finding friends and companions among both European and Aboriginal patients. Also, their services as paid assistants were acceptable to both the administration and the Europeans, although the number of jobs available never· exceeded six and some were of such a demanding nature that a roster system was used. Nevertheless the wages received, which had been negotiated.with the help of the North Australian Workers Union, gave these patients a small measure of independence, enabling them to order small luxuries from Darwin. Some Aborigines had small amounts of money credited to them in trust accounts from previous employment but most were entirely dependent on Health Department rations which included clothes, food, tobacco and sweets for the children.

European patients, although having a greater faith in the treatment they received, reacted in different ways to their confinement and, because of a superior social position, their actions were more readily observable. Several railed continually at the people and the system which had placed them on Channel Island, releasing tirades of abuse and complaint through the local press and at government officials. However, the only European female to be sent to the island, a 16 year old from Darwin, turned her considerable energy and talents to any sphere of life on the island where she could be of help. She taught the younger children their lessons and, when the Australian people responded to her stozy with the donation of two pianos, she taught the children to sing and played at concerts. Other patients withdrew, cutting themselves off from the institution and refusing leprosarium accommodation, preferring huts of their own construction on sites remote from the main complex. These men received rations but chose to cook for themselves. For most, their removal to Channel Island had come abruptly and it was from the remoteness of the island that they were obliged to close business affairs and farewell friends.

In 1926 Cook had placed before the Acting Director of the Institute of Tropical Medicine a proposal that the dependents of leprosy patients be provided with a living allowance 'equal to the earning power of the leper before the onset of the disease'. Cook suggested the scheme initially for Queensland but he had hoped to see it adopted by the Commonwealth Government It was taken up by neither authority and, in the Northern Territory, families left without support were dependent on any grant the government was prepared to make and the generosity of the local people. In one notable case when a man and his eldest daughter were removed to the Channel Island, the family home, a small cottage, was burnt down as a precautionary measure against the spread of the disease and the man's wife and six children provided with a government house. The Administrator obtained permission to provide the woman with a small income which was supplemented

51

by a public charitable fund for a time. Some of the European and Aboriginal patients were eligible for the Old Age Pension but Aborigines were granted pocket money only. The removal of a family provider from among the Aborigines was likely to produce severe hardship, particularly in the cattle industry where the question of dependents was already a matter of contention.

The question of allowance for a leprosy patient was raised once more at the thirtieth' session of the National Health and Medical Research Council. A recommendation was made that leprosy patients - at least, European patients and part-Aboriginal patients living according to 'white standards' - be provided with an allowance commensurate with that given to tuberculosis patients under the tuberculosis act of 1948. The recommendation was rejected by the government and although leprosy patients had become eligible for some financial assistance under the social services consolidation act of 1947, detention in a total care institution greatly reduced the chances of this being granted. Greater concessions for both European and Aboriginal patients were granted in later ordinances but Colin Tatz, commenting on the situation during the 1960s (1964, 129), argued that further revision was still necessary as Aboriginal ·patients who contracted leprosy remained economically disadvantaged.

Lack of financial resources and separation from family and community made Channel Island patients largely dependent on the people of Darwin for organised entertainment and such recreational facilities as were considered luxuries by the authorities. Visits by families and friends, although not actively encouraged until the Native Welfare Branch become involved in the early 1950s, were permitted. Church groups made regular visits in pre-war days, organising concerts and delivering hampers and toys for the children. A public subscription was used to purchase a wireless set for patients and one patient claimed that it was this alone which prevented him succumbing entirely to the monotony and boredom of life on the island.

Although charitable events and church activities occupied only a small amount of patients' time, they provided a valuable outlet for energy, enthusiasm and, at times, grievances. When in 1946 the patients brought themselves to the attention of the public by staging what became known as the 'walk out', it is possible that patient resentment was due not only to what was perceived as official neglect but to the fact that visits by outside groups had come to an abrupt halt four years earlier. The important psychological contact with the outside world had ceased.

In this walkout, 23 patients waded off Channel Island at low tide in October 1946 with the idea of demanding better living conditions and a change of staff. They arrived hungry, tired and thirsty at an allied works camp some 12 miles from Darwin and, when their identity became known, they were returned to the leprosarium. They had, however, succeeded in directing attention to themselves and in extracting a promise of a fair hearing from the Chief Medical Officer. The incident further strained an already uneasy relationship between the Health Department and Native Affairs Branch, and VJ White, Chief Clerk of Native Affairs, complained:

The spectacle of a group of bedraggled and semi-exhausted half castes and native lepers travelling along the North-South road and reporting at a large A WC camp for food does not conduce to good publicity either for the Health Department or the Native Affairs Branch (White to Government Secretary 21October1946, AANT CRSFl Item44!219).

As. a direct result of the 'walk out' recreational facilities were improved. The investigating committee had found the recreation hall un~sed, no art and craft facilities

52

Plate 8: Aboriginal patients outside the recreation hall. c.1946

Plate 9: Patients preparing for a fishing expedition, post-war

53

available, books of any description a rarity and the patients alternately listless and rebellious. The unenviable situation of the isolated community once more aroused the compassion of the Darwin people. Among those to come to their relief was the Salvation Army. With the generous support of local people and businesses, the Flying Padre, Captain (later Brigadier) Pedersen, mtroduced movie picture shows .and as his work involved outback travel he was able to show slides of patients' families and homes. Metro Goldwyn Mayer later supplied films free of charge but only when old films could be donated for permanent use .on the island. Fear of contagion prevented films being supplied on a loan basis despite Brother Carter's earnest assurance that 'the projector and the films are handled only by myself, and at no time do the patients touch any part of them'.

The most persistent request put forward by patients to the investigating committee was for the replacement of the Catholic staff by Health Department workers. Patients looked back on the days when the Jones' were matron and curator on the Mand. Matron Jones, a robust, friendly and purposeful woman, well accustomed to working with Aborigines, had provided the patients with a sense of security. Likewise, her husband had proved to be a competent organiser who had included the patients in the running of the institution, even teaching them Morse code signalling with a Lucas lamp as this was the means of communicating with the mainland. Brother McCarthy, although well liked for his friendliness, had failed to establish a strong sense of order and discipline, leaving the sisters without support and the patients disgruntled.

The staff

In 1943 four Catholic sisters with Sr M Michlielene in charge, and one Brother had taken up nursing and administrative duties on Channel Island at the request of the military authorities. They were under the supervision of a government doctor but with communication with the mainland so difficult and at the best weekly visits by a doctor, staff on the island carried the major workload. For their services the staff received a small clothing allowance and their household requirements were met by the Health Department.

In 1946 staff were accused by the patients of neglect and of showing favour to patients who shared their religious beliefs. The anger and discontent of the patients had been brought about by the insufferable conditions on the island, the apparent indifference of the staff and the oppressive October weather. It was further increased by the agitation of two patients: one, a woman whose plans of organising and encouraging the younger Aboriginal women to capitulate to the sexual demands of the men had been thwarted, the other a man who was fighting a bitter battle for release. Cleared of any neglect in the ensuing investigation, the Catholic staff remained at the leprosarium. The appoint:QJent of salaried Health Department workers was a financial commitment the government was not prepared to make and indeed a change of staff would have done little to improve conditions as it was not the staff but the back up medical support and facilities which were lacking.

The Catholic sisters were eager to continue to work among leprosy patients and when the move to Melville Island seemed imminent they petitioned the government through N E McKenna, the Minister for Social Services, for continued control of the leprosarium. An element of inter-denominational rivalry became evident in the following years with the Church of England asking the government in 1947 'to staff and control the leprosarium with a government staff and that control be not given to any one religious denomination'. The following year the Church Missionary Society (Church of England) put forward a proposal to establish a leprosarium on Bickerton Island. Neither suggestion was adopted and the Catholic staff remained on Channel Island but by 1948 work and living conditions

54

;;.(

were so extremely poor that, when a dispute arose between them and the visiting doctor, they were on the point of withdrawing.

Unlike the patients on Channel Island, the staff came willingly. In pre-war days the Northern Territory Administration experienced no difficulty in attracting applicants for the positions of matron and curator, nor was there a shortage of relief staff. Religious staff came for humanitarian reasons. The nuns were capable, practical and determined women and there was little evidence of martyrdom in their approach to their work. However, the inter-denominational rivalry mentioned previously may have added to the determination of the Catholic Church to continue staffing·the island. Throughout the Territory, missions tended to become possessive of the Aboriginal people among whom they established themselves. The most successful Catholic mission in the Teriitory was on Bathurst Island and the Tiwi people of both Bathurst and Melville Island came under its influence. As the Tiwi people figured predominantly among the patients on Channel Island, Catholic staffing of the leprosarium ensured a continuity of pastoral influence.

Because the leprosarium staff went to the leprosarium voluntarily, they were in a better position to bargain for improved conditions but even they were unable to overcome the disinterest of the authorities. It is possible that the reliability of their services even further disinclined the Health Department to involve themselves in the running of the leprosarium until the changed atmosphere of the 1950s made it imperative that they do so. The patients, other than leaving the island and facing the perils of a long bush journey or creating a disturbance, preferably with the support of the local press, had few avenues for complaint.

The situation was never rectified while the leprosarium remained on Channel Island. Until the move to East Ann Settlement in 1955, conditions on the island were, to quote Bishop O'Loughlin, a frequent visitor to the leprosarium, 'scandalous' (NT News 23 October 1952). From 1950 on, treatment had been steadily improved but real progress was hampered by poor facilities, a chronic shortage of equipment and lack of expertise. In 24 years the isolation policy had undergone only slight modification and then only as it was practised, not as a result of any legislative changes. But in the 1950s the first tentative moves to improve the lot of the leprosy patients had been made and the move to the mainland site ensured that they continued.

55

EPILOGUE

In 1955 the Channel Island leprosarium was abandoned and all patients were moved to the East Arm Settlement on the mainland, some 19 kilometres from Darwin. Although not bearing the name leprosarium, East Arm was a total care institution in which all leprosy patients were to be confined. However, in contrast to Channel Island, it was situated on a pleasant site with access to the town water supply, electricity and telephone. The number of staff, Catholic sisters still, was increased, treatment was greatly improved and a doctor was in regular attendance.

In 1954 and again in 1957 the leprosy ordinance was revised, with no lessening of compulsory isolation powers. The older generation of medical men such as Cook, who had been breaking new ground before 1950 and formulating policy in frontier areas, had moved to the newly created seats of power in the rapidly developing state and Commonwealth Health Departments. The National Health and Medical Research Council played an increasingly important part in the development of policies for the Northern Territory, leaving the younger members of the medical service, who were generally prepared to adopt more enlightened approaches to the treatment of leprosy, without the power to institute change. However, men like Humphry and later Hargrave, were prepared to battle policy makers in the south and, where approval for change was not forthcoming, to 're-interpret' established policy. New drugs which successfully combated leprosy, rendering the patient non-infectious within a few weeks, aided their cause, as did the growing interest of the public and government in .the welfare of the Aboriginal people. Even so, change was slow to come. People diagnosed as suffering from leprosy generally spent a minimum of two years at East Ann until the early 1970s. By the mid-seventies, compulsory isolation had been phased out entirely although the leprosy ordinance was not repealed until 1981. It was then replaced by the notifiable diseases act of 1981 by which medical officers were empowered to enforce isolation for a maximum period of two months but leprosy was not included in the schedule of diseases subject to the legislation.

The people of the Northern Territory no longer need fear leprosy. Now it is regarded as any other serious but curable illness and treated in hospitals and clinics in the ·same manner as other diseases. The positive response to voluntary isolation and out-patient treatment, first recognised by Humphry and Hargrave during the 1950s, has continued. As patients no longer need hide to avoid isolation, diagnosis in the early stages of the disease means that, at last, the period of infectiousness is reduced to a minimum resulting in a steady decrease in the incidence of leprosy. The significance of early diagnosis, made possible because of the fear of isolation was removed, can be readily seen. In statistics compiled by Hargrave (1980) it is evident that, despite improved treatment, there was no appreciable decline in the incidence of the disease until compulsory isolation had ceased. During the sixties, an average of 45 new cases were diagnosed per year. In the following decade, when the policy of compulsory isolation was abandoned, this figure was reduced to 14.

New cases of leprosy, approximately five per year, are still being diagnosed in the Territory, some of them requiring a short period of hospitalisation. However, an endeavour is now being made to achieve a greater synthesis between the Aboriginal lifestyle and understanding of disease and the treatment of leprosy. Any new challenge to the control of leprosy in the Northern Territory is expected to come from the new drug­resistant strain of leprosy which has surf aced, but, should this not become a major problem, Hargrave predicts that the geographical spread of leprosy will continue but the mcidence of the disease will continue to decline.

56

After being abandoned as an isolation hospital, the building material being removed to the Catholic mission on Bathurst Island, Channel island lay unoccupied for the next 25 years, visited only by the occasional fishing party. When in the late 1970s the Northern Territory Electricity Commission was looking for a suitable site for their proposed new power station, Channel Island was considered promising. It offered seclusion from the city while being not so distant that, with modem technology, transport and communication were difficult. Channel Island was also just sufficiently distant to offer Darwin protection from the visual, noise and smoke pollution of a power station. Ironically, it was these 'discreet' qualities which had made the island a 'suitable site' for the leprosarium 50 years ago.

57

, ' . (

CONCLUSION

The policy of segregating those suffering from leprosy has a long history which reaches back to medieval times when the popular tradition which associated leprosy with physical decay, moral defilement and degenerate sexual practices took shape. This tradition was legitimised in ecclesiastical law and later state law and became sufficiently powerful to become self-perpetuating. Even when no laws were enforced, lepers continued to be isolated and stigmatised through social pressures. In the early decades of the twentieth century, laws were again instituted, this time in various colonial settings, and although a modern scientific rationale was provided for this, the older tradition continued to prevail in the minds of the public. The leprosarium on Channel Island, which was in operation between 1931 and 1955, and other similar institutions in Australia became part of that older tradition of segregation.

In Australia another dimension was added to this popular tradition. By the beginning of the twentieth century the Aboriginal people were already a severely disadvantaged group in Australian society. The social-Darwinism of the period gave justification to the inactivity of the government as Aboriginal numbers continued to fall. It also justified the belief that the Aborigines were an inferior race of low intelligence. Aboriginal culture was not understood and few had any interest in gaining deeper understanding. At a time when leprosy reached epidemic proportions among the Aborigines they were a stigmatised group, suffering severe social and economic disadvantages and were seen as a 'problem' by white Australians, a problem to be dealt with by institutionalisation.

Because leprosy came to be seen as an 'Aboriginal disease' in Australia, and as the Aborigines were already a disadvantaged and stigmatised group, the response of the Australian authorities and the public was largely negative. Segregation, which had been legitimised as the solution to other problems, was strengthened in regard to leprosy and the superimposition of the traditional leprosy isolation policy on the policy of segregating and institutionalising Aborigines ensured that in Australia the world-wide trend of relaxing compulsory isolation laws and introducing out-patient clinics was not followed. Leprosy itself was accorded a very low status in professional circles, Few medical men were interested in a disease which was given an extremely low research priority, the funds channelled into the leprosy control program being used almost exclusively for 'round-up' surveys and minimal maintenance of leprosy institutions. There was no prestige to be gained from specialising in a disease where the majority of patients were Aborigines.

The extent to which individuals were able to influence either the isolation policy itself or its execution on Channel Island varied over time. Cook had been very influential in strengthening the legal basis of the policy by introducing the leprosy ordinance and establishing a new leprosarium. He had to his advantage the prestige of post-graduate research in the field of leprosy and growing public concern as leprosy reached epidemic proportions in the Northern Territory. Kirkland had been thoroughly schooled by Cook and even had he thought the isolation policy inadvisable or inappropriate, it is doubtful whether he could have introduced any change given the climate of public opinion. Nor could Kirkland or any other medical officer single-handedly have achieved major change to the facilities of Channel Island when the financial affairs of the Territory were determined in far away Canberra with little understanding of local needs. The health budget for the Northern Territory during the first half of this century was never sufficient to meet needs and even with the discretionary budget powers of the Chief Medical Officer, institutions such as Channel Island were ill-equipped, under-staffed and poorly administered. In the last few years on Channel Island, Humphry and Watsford were able

58

to improve treatment and modify isolation to some extent, but facilities remained inadequate until the move to the East Arm Settlement in 1955.

Although public criticism of conditions on Channel Island was severe from time to time, the suggestion that the leprosarium should be situated on the mainland was rarely put forward and the strength of the isolation tradition was such that the possibility of patients being treated the same as other sick people was never entertained. Segregation on an island was an acceptable means of dealing with the leprosy problem, the popular sentiment being that patients ought to be treated kindly but kept at a distance.

This acceptance of isolation extended to the European patients and in the Northern Territory neither the patients nor the European community· objected to isolation, even when it was seen to be a life-time sentence. Leprosy and isolation were synonymous and although the tragedy was acknowledged, no one doubted that the patient should be removed to an isolation hospital. What was objected to were the conditions on Channel Island and the confinement of Europeans in an Aboriginal institution where facilities and treatment were poor.

That the isolation policy failed to achieve the purpose for which it was ostensibly introduced is abundantly evident. The number of patients admitted to Channel Island, and later the East Arm Settlement, continued to increase and the geographical spread of the disease went unchecked. Not only did the policy fail, however, it exacerbated the leprosy problem. To suffer any debilitating disease was misfortunate enough bui when that was combined with the loss of freedom, friends, family, work opportunities and a familiar environment, the distress associated with the disease was intensified. Legislation gave legal support to the stigmatisation of leprosy patients by withdrawing freedom and civil rights. Stigmatisation also made it extremely difficult, and in the case of Europeans and part-Aborigines almost impossible, for patients to achieve successful rehabilitation on discharge from a leprosy institution. Fear of isolation led many sufferers to hide their condition, thus greatly reducing the chances of a complete cure. This meant that cases remained untreated for a longer period of time, increasing the opportunity for others to become infected when chaulmoogra oil, the only treatment available before 1948, was effective only in early cases.

The negative effects of the policy of isolation on Channel Island are still being felt. Writing in 1981 about its impact on Aborigines, Hargrave commented: 'although leprosy patients have not been subject to isolation for many years now, at least in the Northern Territory, beliefs die hard and isolation is still fresh in the memories of the adult population' (1981, 163). Although not the serious problem that it was in the past, fear continues to result in the hiding of leprosy cases, delayed treatment and the development of otherwise avoidable defonnities. Isolation as it was practised on Channel Island created more problems than it ever solved.

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NOTES ON SOURCES

Many sources that one would expect to be available for a study of Channel island were in fact unobtainable. The medical service in the Northern Territory has undergone a number of significant changes in administration during the last century. The change from South Australian control to Commonwealth control was further complicated by internal re­construction of health services and the interruption of the Second World War. It appears that when these changes were made not all correspondence and records were retained. Records generated during the first decade of the Channel Island leprosarium were misplaced during the war and records from the following decade were destroyed when Cyclone Tracy devastated the administration block at the East Arm Settlement. Hargrave believes that a small number of patient record cards are among an unsorted collection at the Royal Darwin Hospital but these are unavailable for research purposes as yet. Lack of patient records has made a more detailed study of mortality and morbidity of the Channel Island population impossible. However, despite the paucity of material from the leprosarium itself, numerous administrative records are available from the Australian Archives, both in Canberra and Darwin, and to a lesser extent the Northern Territory Archives and the Public Record Office of South Australia. The health of the Aborigines in the Northern Territory has been largely overlooked by historians to date, making secondary sources of only limited use. Similarly oral sources were not used extensively, although not because of their scarcity but because I did not feel well enough equipped to elicit useful information from Aboriginal sources without further anthropological study. However, the assistance of a number of part-Aboriginal patients and staff members helped me gain understanding of life on Channel Island and the response of particular groups of patients to their confinement. The attitude of the public toward leprosy, the isolation policy and leprosy patients was clearly demonstrated in contemporary newspapers and official records.

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