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The authors have no conflicts of interest related to leprosy. No funding was obtained for this project. As a Canadian, one considers leprosy to be an illness associated with isolation and disfigurement relating to ancient civilizations, the Biblical era or remote settlements of the eastern world. However, leprosy held serious implications for Canada at the turn of the 20th century, with two leprosaria established by 1891. The Canadian Pacific Railway was completed in 1885 with much of the labour performed by Chinese immigrants. Following this, the Chinese in the province of British Columbia suffered from staggering unemployment rates and the bankruptcy of local businesses. Caucasians were not immune to this economic decline, and mounting hostility towards the Chinese arose from their willingness to accept reduced salaries in the face of decreasing labour opportunities. As such, the Chinese were marginalised into overcrowded and unsanitary Chinatowns. When in 1891 the sanitary commission for the city of Victoria discovered five individuals with leprosy in Chinatown, the municipal government immediately set to work exiling those affected to D’Arcy Island, about 25 km off the shore. Motivation likely stemmed from the need to avoid another mass protest against the Chinese immigrant population like the one that occurred in 1887. The public was relieved that the leprosy in the area was ‘relocated’, and it was reported that the majority of locals were indifferent to the sufferers’ fates. By 1906, D’Arcy had seen 23 residents, almost all Chinese. Evidence for racism directed toward the individuals with leprosy on D’Arcy comes from a comparison of the treatment at D’Arcy to its concurrent leprosarium serving a Caucasian population in Tracadie, New Brunswick. At Tracadie – which held 18 individuals by 1902 and 218 throughout its existence – patients were well taken care of by volunteer nuns. – 6 At D’Arcy, however, there was no caretaker so that residents depended on each other to maintain habitable circumstances. As time wore on, the individuals at D’Arcy became increasingly incapacitated by their disease – their digits particularly susceptible to loss of sensation,

Mistreatment of Immigrants: the History of Leprosy in Canada