Hansen鈥檚 disease in Esp铆rito Santo:

Col么nia de Itanhenga

(Col么nia Pedro Fontes)

by Patr铆cia D. Deps

Department of Social MedicinePostgraduate Programme in Infectious DiseasesFederal University of Esp铆rito Santo, Brazil

and Sebasti茫o Pimentel Franco

Postgraduate Programme in the Social History of Political RelationsFederal University of Esp铆rito Santo, Brazil
08/10/2020

Between 1920 and 1924, the Federal Government of Brazil created a rural sanitation policy to combat diseases, including Hansen鈥檚 disease, in several states of the federation. However, it was from the rise of Get煤lio Vargas from 1930 onwards that more effective action by the State in relation to the fight against Hansen鈥檚 disease and assistance to persons affected was seen. At that time, a large number of persons affected by Hansen鈥檚 disease were identified in Brazil.1

The compulsory isolation of these people in "colonies" was based on a warped web woven from power and knowledge. Society, doctors, public authorities and affected persons themselves were mistakenly convinced of the need to protect the population from a lethal and contagious disease whose aetiological agents were unknown.

An example of this practice is the phrase: "For the sake of the healthy, Lazarus loses his freedom" - the health education slogan of the Society for the Protection of Lazarus and Defence against Leprosy, in 1931, which portrays perfectly the situation of persons affected by Hansen鈥檚 disease at that time in Brazil.2

The federal Hansen鈥檚 disease programme was based on organized research and census, and the 鈥榯ripod鈥 of Hansen鈥檚 disease control comprising the 鈥榗olony鈥, dispensary and 鈥榩reventive clinic鈥.3 Souza-Ara煤jo has estimated that there were approximately 50,000 people affected by Hansen鈥檚 disease in Brazil at that time.4

Whether or not to build colony hospitals was a question only of finance, because the need for colony hospitals was taken for granted and the fate of persons affected by Hansen鈥檚 disease - compulsory isolation in institutions - had already been decided.

The history of Hansen鈥檚 disease in the state of Esp铆rito Santo is tied to the construction of Itanhenga Colony, or Pedro Fontes Colony. Until 1922, very few cases of Hansen鈥檚 disease were diagnosed in the state. It was after the arrival of Doctor Pedro Fontes in 1927 that Hansen鈥檚 disease cases were detected.4,5 After some years of work visiting doctors and persons affected by Hansen鈥檚 disease in the capital, Vit贸ria, and in the interior of the state, Pedro Fontes verified the existence of 370 patients. In December 1930, Pedro Fontes wrote to Captain Jo茫o Punaro Bley, administrator of the state of Esp铆rito Santo, about the endemic situation and requested the creation of a space for isolation of affected persons.

Pedro Fontes's provisional suggestion to solve the problem of a lack of resources was for the state to create an emergency asylum on the island of Cal, for the immediate reception of the sick.1,4 In 1931, they adapted a house on this island to receive women and children, and the following year they built a pavilion to receive men. Pedro Fontes meanwhile advocated for the construction of a colony hospital for the compulsory isolation of the sick.1 In April 1937, the Itanhenga Colony was inaugurated, later renamed the Pedro Fontes Colony.4

Photograph 1. Entrance of 鈥楥ol么nia de Itanhenga鈥 (1937). Source: Souza-Ara煤jo, 1937.4

Intended to receive up to 380 internees, the Itanhenga Colony was built 14 kilometers from the capital city of Vit贸ria and 80 meters above sea level, in Cariacica, a municipality in the metropolitan region of Greater Vit贸ria. The total area of the colony was 1,200 hectares, and it was divided into three parts, each with a specific function: one for the colony itself; another for the preventive area, still to be built; and a third area for agricultural purposes, to receive the future egresses of the colony hospital.4

The recommended plan for the construction of colonies was that they should be divided into three distinct zones, categorized as healthy, intermediate and sick. This division was intended to preserve the health of the staff who would care for the sick.4,5

All buildings intended for use by medical staff, administrators and other employees without the disease were located in the healthy area. In the intermediate zone were the religious, suspected cases, the kitchen, pharmacy and laboratory. The sick or contagious zone was where the 12 "Carville" type pavilions and the 20 houses that accommodated the sick were located, together with other facilities where persons affected were permitted to circulate. There was also a football pitch, church, library, morgue, and cemetery.4

From May to October 1937, 230 people previously diagnosed with Hansen鈥檚 disease were admitted to Itanhenga Colony. These people were easily located and picked up by the health service and taken to Itanhenga Colony, because they had already been visited by travelling doctors and had received information about the disease and admission to the Colony.4

According to a report published by Pedro Fontes in 1941, there were 1,081 persons affected by Hansen鈥檚 disease and 200 suspected cases in the colony.1

Compulsory confinement of persons affected by Hansen鈥檚 disease was abolished in 1962 after the discovery of effective treatment, long after international recommendations in the 1920s to discontinue therapeutic isolation. From the 1960s there was a period of reconsideration of public health edicts and restructuring of colony hospitals, alongside the emergence of social movements. The Pedro Fontes Colony hospital admitted persons affected by Hansen鈥檚 disease until the end of the 1970s.6

Photograph 2: Resident of Hospital Col么nia Pedro Fontes (2010). Source: Tadeu Bianconi

References

  1. FRANCO, Sebasti茫o Pimentel; BARROS, Luiz Arthur Azevedo. A lepra no Esp铆rito Santo: de fagueira ilus茫o 脿 Col么nia de Itanhenga. Dimens玫es, Vit贸ria, ES, v. 34, p. 228-254, 2015.

  2. MACIEL, L. R. Em proveito dos s茫os, perde o l谩zaro a liberdade: uma hist贸ria das pol铆ticas p煤blicas de combate 脿 lepra no Brasil (1941-1962). 2007. 380 f. Tese (Doutorado em Hist贸ria) - Universidade Federal Fluminense, Niter贸i, 2007.

  3. A INTERVENTORIA Federal e o Servi莽o de Prophylaxia da Lepra. Di谩rio da Manh茫, Vit贸ria, ES, p. 3, 25 nov. 1934.

  4. SOUZA-ARAUJO, Heraclides Cesar de. A lepra no Esp铆rito Santo e sua prophylaxia: A 鈥淐olonia de Itanhenga鈥 鈥 Lepros谩rio modelo. Mem贸ria Instituto Oswaldo Cruz, v. 32, n. 4, p. 551-605, 1937.

  5. DEPS PD, SANTO RBE, MER脟ON FS. Pedro Fontes, o m茅dico que descobriu a hansen铆ase no estado do Esp铆rito Santo, Brasil. Mirabilia Journal, Oct 2018 (11): 7-12.

  6. DEPS PD, CASER L, MENDES LA, FREITAS BA, QUINTELA L, CHICON CD, SIQUEIRA M, CATARINA MA. Have we learned from the mistakes of the past? Segregation of leprosy patients until the twentieth century. Mirabilia Journal, v. 5, p. 1-15, 2015.

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