It was established by the U.S. government in order to rid leprosy from the Philippine Islands through the only method known at the time: isolating all existing cases and gradually phasing out the disease from the population.
[3] In addition to segregating the disease from the rest of the population, the island was later established in order to offer a better opportunity for people afflicted with leprosy to receive adequate care and modern treatments.
In the 16th century Franciscans established a shelter for the care of those afflicted with leprosy close to their monastery in Manila, where the hospital San Juan de Dios is located.
[5] In 1632 the emperor of Japan, knowing that the Spanish Catholic Church had an interest in caring for those afflicted with disease, sent 134 Japanese lepers by ship to Manila.
The Spanish Franciscans, initially reluctant to accept the shipment from the emperor, eventually took in the Japanese patients and housed them in the Hospital of San Lazaro in Manila.
[7] By the time American forces landed in the Philippines at the beginning of the 20th century, surveys estimated that approximately 3,500 to 4,000 people with leprosy were living on the islands, and some 1,200 new cases were developing each year.
[5] However, construction did not begin until 1905 due to issues financing the project and conflicting opinions amongst medical professionals arguing whether segregation was an appropriate method of controlling and eradicating the disease.
Over 400 houses, a theatre, a town hall, a school, a piped water supply with reservoirs, and a sanitary sewer system were built for the colony's patients and staff.
[12] Under the direction of Heiser, the colony's municipal government was made up of a chief physician and representatives from each tribal group living on the island, composing of the Visayan, Tagalog, Ilocano, Bicolano, Ilongo, Moro, English and Americans.
[11] A police force enforced the laws set up by the chief physician and the representatives and regularly patrolled the outlying districts and maintained order inside the colony.
Before Filipino authorities established a ban on marriage in the colony, Christian groups on the island, along with authorities, took an active stand against the marriage between lepers, citing that "marital life is not conducive to their own well being ... they usher into the world healthy and innocent children who are born only to be separated from their parents and placed under the care of the Welfare Commissioner or of a relative, so that they may not suffer the fate of their progenitors.
"[11] Authorities were also opposed to marriage because statistics at the time showed that if babies were not removed from their mothers before they were six months old, approximately half of them would become leprous.
The Common people of the East can often, by mere glance, detect a leper when the American or European physician, after clinical examination, fails to find evidence of the disease.
Dr. Strong was outraged, but the inspector’s diagnosis turned out to be true.The use of chaulmoogra oil, first demonstrated in a Louisiana leper colony, became an effective way of treating the disease as many cases became negative after the first year.