Charmaine Robson’s Missionary Women, Leprosy and Indigenous Australians deepens existing understandings of the long and violent history of segregation, institutionalisation, and racialised medical discourse in Australia. Primarily examining structures and experiences of care in twentieth-century leprosaria, Robson’s work demonstrates how, in an era of staunch religious sectarianism, racialised infectious disease management offered Catholic missionary women unparalleled proximity to over two thousand Indigenous leprosy-affected people living above the Tropic of Capricorn in Western Australia, the Northern Territory, and Queensland.

This book contributes to a long genealogy of colonial pathological studies that explore why the ‘colonial leper’ operates as a subject of religious fascination and exceptional exile. Within Australian historiography, Robson’s historical health research adds to a growing discourse on the European missionary imperative spearheaded in recent years by Regina Ganter and Katharine Massam.Footnote ¹ The central subjects of Robson’s book are the Catholic missionaries dually responsible for caregiving and carrying out the moral settler-colonial imperative and the Indigenous leprosy-affected who made their life while housed in the confines of the leprosaria. Robson carefully traces the complex relationships between these different bodies to highlight the gendered dynamic of missionary work and how Indigenous agency was fostered and sustained in spite of institutionalisation. Circumventing the glorification of mission work espoused in papal documents by using oral interviews, Robson prioritises and elevates the voices of both former patients otherwise eschewed by the boundaries of settler-colonial record-keeping and sisters whose testimonies refreshingly disrupt the dominant histories of Catholic patriarchy. These methodological interventions enable the author to emphasise Indigenous resilience over victimhood.

This eleven-chapter book begins in the interwar years, at a time when medicalised constructions about the susceptibility of racialised and sexualised ‘others’ fuelled protectionist fears to spark segregative public health practices in northern Australia. Early chapters situate Australian responses to leprosy within a broader global socio-cultural history of the disease, noting that connotations of ‘ignorance, immorality and lawlessness’ were intrinsically bound to understandings of leprosy in Western Christian societies from antiquity to the twentieth century.Footnote ² Robson’s work then chronologically traces the lifespan of four government leprosaria for Indigenous leprosy-affected people in Channel Island, Derby, Fantome Island, and later East Arm. Following the removal of papal decree bans on female religious nursing in 1936, missionaries began staffing leprosaria and exerting control in the 1940s. While still diligently documenting the traditional approaches to care adopted by qualified nursing sisters, middle chapters sought to explore themes beyond the biomedical, unearthing the ways missionaries devised their own holistic methods to improve patient health and the daily reality of patient experience. Examining socio-cultural life at the leprosaria, Robson explored the educational, cultural, and linguistic pursuits of inpatients and detailed the labour expectations applied to the able-bodied leprosy-affected – which were microcosmic of wider society in their gendered and racialised patterns of exploitation. Discussing morality, discipline, and protest, chapter seven alludes that sexual surveillance and control were similarly maintained in leprosaria at ‘protected’ reserves across Australia. Latter chapters acknowledge that the book spans a period of intense national, epidemiological, and therapeutic development by documenting how caregiving in each leprosarium changed in light of post-war socio-medical advances, assimilation policies, and the introduction of effective drug therapy to treat leprosy-affected patients. In the final chapter Robson documents the closure of each leprosarium in the 1970s and 1980s following a decline in the incidence of disease and a rise in more effective methods of local control. Noting the enduring effects of institutionalisation, the author carefully illustrates that leaving was only one of many outcomes for patients removed to the leprosaria, and if experienced, discharge was often coupled with long-term high dependency.

The greatest strengths of this book stem from Robson’s desire to highlight the seldom acknowledged caregiving capacity of religious women and understand Indigenous patients as more than their health status. The book critically acknowledges the role of missionaries in sustaining ongoing colonial violence in the leprosaria whilst also shedding light on the ways in which women religiously advocated for and worked to build genuine interpersonal relationships with Indigenous patients. Efforts to convey how leprosy, borrpoi in Yolŋu, was understood and dealt with in Arnhem Land during the period of inquiry were important. This inclusion served to strengthen the author’s argument by highlighting the depth of difference in thought between Indigenous communities and colonial authorities, consequently emphasising the scale of intergenerational pain caused by segregation and removal policies. The training and experience of Indigenous health assistants as intermediaries in the leprosaria would be a worthy subject for future exploration, especially considering that this period immediately precedes the implementation of community and government Indigenous Health Worker Training and Education programs in the latter decades of the twentieth century.

Overall, Robson’s work makes strides to disrupt a ‘collective disquiet’ on the history of the leprosaria’s patients, staff, and governance. Confronting a historiographical blind spot in studies of the intersection of race, religion, and health in Australia, this timely book holds contemporary resonance by reminding us that responses to infectious disease in settler-colonial societies have been historically and unequally filtered according to racial status. This highly readable work will be of keen interest to audiences who want to learn more about the histories of settler-colonial medicine, the missionary movement, institutionalisation, gendered caregiving, and the long tradition of racialised segregation and separation in Australia.