What do you think?
Rate this book
Faber Faber Outcast A History of Leprosy, Humanity and the Modern World.
A singular, compassionate history of humanity, told through the lens of a misunderstood disease.
'Superb.' TELEGRAPH
'Fascinating.' SPECTATOR
'Shocking, moving and sensitive.' TLS
'Uplifting.' THE TIMES
'Remarkable . . . grippingly and humanely recounted.'
PHILIPPE SANDS
'It is impossible not to be moved by the lives unfolding in these pages, impossible not to be left transformed and enlightened. '
LEILA ABOULELA
WINNER OF THE 2023 RSL GILES ST AUBYN AWARD
The story of leprosy is the story of humanity.
It is a story of isolation and exclusion, of resilience and resistance, one which has permeated global cultures in myriad ways for thousands of years, dividing the world into the 'clean' and the 'unclean'.
Oliver Basciano's journey to demystify leprosy takes him from the Romanian border, the hinterlands of Brazil and the fringes of Siberia to the Japanese archipelago, Robben Island and the northern provinces of Mozambique. It reveals the image of medieval leprosy to be a nineteenth-century myth invented to justify gross mistreatment of patients, a blueprint used for further state-sanctioned colonialism and racism, religious and economic exploitation.
Basciano meets those living with leprosy today, those exiled to various leprosaria around the world and forced to find homes away from home; he hears stories of community and perseverance in the face of grave circumstances, of lives bound to each other through shared experience and a refusal to be cast aside.
A work of outstanding empathy, Outcast shines new light on the human condition, does a society's sense of itself always rely on ostracisation?
'A new kind of travel book - across continents and, more importantly, across the partitions that separate the healthy from the damned - Outcast is a revisionist history that makes you realise, when you turn its last page, how differently you look at the world than you did when you first cracked its spine.'
BENJAMIN MOSER
'Superb.' TELEGRAPH
'Fascinating.' SPECTATOR
'Shocking, moving and sensitive.' TLS
'Uplifting.' THE TIMES
'Remarkable . . . grippingly and humanely recounted.'
PHILIPPE SANDS
'It is impossible not to be moved by the lives unfolding in these pages, impossible not to be left transformed and enlightened. '
LEILA ABOULELA
WINNER OF THE 2023 RSL GILES ST AUBYN AWARD
The story of leprosy is the story of humanity.
It is a story of isolation and exclusion, of resilience and resistance, one which has permeated global cultures in myriad ways for thousands of years, dividing the world into the 'clean' and the 'unclean'.
Oliver Basciano's journey to demystify leprosy takes him from the Romanian border, the hinterlands of Brazil and the fringes of Siberia to the Japanese archipelago, Robben Island and the northern provinces of Mozambique. It reveals the image of medieval leprosy to be a nineteenth-century myth invented to justify gross mistreatment of patients, a blueprint used for further state-sanctioned colonialism and racism, religious and economic exploitation.
Basciano meets those living with leprosy today, those exiled to various leprosaria around the world and forced to find homes away from home; he hears stories of community and perseverance in the face of grave circumstances, of lives bound to each other through shared experience and a refusal to be cast aside.
A work of outstanding empathy, Outcast shines new light on the human condition, does a society's sense of itself always rely on ostracisation?
'A new kind of travel book - across continents and, more importantly, across the partitions that separate the healthy from the damned - Outcast is a revisionist history that makes you realise, when you turn its last page, how differently you look at the world than you did when you first cracked its spine.'
BENJAMIN MOSER
320 pages, Hardcover
Published June 19, 2025
3 people are currently reading
105 people want to read
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 2 of 2 reviews
August 21, 2025
This is not a book which I would normally pick out for myself, but after hearing Basciano speak at its launch, I knew I would regret it if I didn’t get my hands on a copy.
Turns out I was very right, because this book is fascinating, moving, and beautifully written.
Though it is a niche subject, the author has zoomed it on Hansen’s disease and uncovered the full spectrum of Homosapiens - from the heart-wrenching and downright haunting, to the inspirational and uplifting.
All in all, I am glad this book found me, and I hope it gets the recognition it deserves.
Turns out I was very right, because this book is fascinating, moving, and beautifully written.
Though it is a niche subject, the author has zoomed it on Hansen’s disease and uncovered the full spectrum of Homosapiens - from the heart-wrenching and downright haunting, to the inspirational and uplifting.
All in all, I am glad this book found me, and I hope it gets the recognition it deserves.
October 8, 2025
Full review here: https://hararereview.wordpress.com/20...
It took me longer than normal to read this book; in certain places it’s really hard to get through—for empath reasons. It shows so clearly how humans fail other humans when they (re)make societies—how they’ve failed those who look different, those who are ill… Those who’ve needed the most help. And there’s a reason for my separation of myself from the acts of such humans, as this has not at all been a universal tendency, as the book will show you: The history of leprosy is now inextricably tied up with the history of empire and colonialism.
Basciano’s modern history starts its journey around the world in St Albans, in the UK, where the St Mary de Pré Priory was founded in 1194 for thirteen women with leprosy. (There’s no longer any evidence of a similar institution for men started fifty years before.) Basciano uses this a stepping off point to explore the medieval history of leprosy in Europe, through to the first leprosy conference in 1897 in Berlin, and the emergence of more “modern” methods of isolation that led to the stigma leprosy patients have suffered through in the last two hundred years. Much is down to Norway’s famous son, Gerhard Armauer Hansen, who identified the bacterium (Mycobacterium leprae) that causes the disease, and who gave his name to it (particularly in Brazil and Japan). Hansen was a dedicated and conscientious scientist, but an inhumane policy maker: as Norway’s Chief Medical Officer for Leprosy, he pushed for the seclusion of patients in leprosaria through the Seclusion of Lepers Act of 1885, a draconian policy that disproportionately affected the poor. Because of the politics of the time—the heyday of colonial exploits—and the association of the disease with poverty and lower class, it was not long before colonial administrators made it a ‘tropical’ disease and used it as an excuse for segregationist health plans in the colonies. Basciano explains this while detailing how Britain made leprosy the dirty disease of India.
Through the book, we learn about personalities in the history of leprosy around the world—like Father Damien, a Belgian missionary, who lived among people with leprosy in Hawaii, and eventually succumbed to the disease. (Leprosy arrived in Hawaii with foreigners; it was unknown before that.) This section of the book is exceedingly uncomfortable to read, as Basciano outlines white saviourism, exoticism, and a weird sexual fetish associated with the disease by some, including writers Jack London, Paul Theroux and Roald Dahl. And American Charles Warren Stoddard may not have focussed on racial differences when thinking about leprosy, but he apparently “found” a kind of freedom for his queerness among those living with leprosy there.
On the other side of the world, the formidable Kate Marsden, a British nurse, signed up at eighteen in 1877 to serve as a Red Cross nurse in the Russo-Turkish war. Interestingly, she too, queer and an outcast, found refuge in serving those with leprosy, first encountering two men with it on the Bulgarian banks of the Danube during the war. Marsden’s story is fascinating: she later taught first aid to miners in New Zealand and also found there what she thought was leprosy (it may have been eczema) among the Maori. She eventually travelled to St Petersburg ‘via Alexandria, Jerusalem, Constantinople and Tiflis’ on a “roving commission to hunt up lepers wherever she had an inkling of their existence,” through incredible trials. Basciano speculates that Marsden may have been a ‘leprophiliac’, after Graham Greene (another unsettling section of the book follows). Marsden gained both fame and notoriety in Victorian England; she was elected to the Royal Geographical Society, among the first woman to achieve this. However, she also gained powerful enemies, leading to her precipitous fall from grace.
Another gripping aspect of the history of leprosy in Basciano’s book is the previously unknown to me association of Robben Island with the disease: Leprosy patients from the Cape were interned there from 1845 for nearly a century before the maximum security prison whose most famous inhabitant was Nelson Mandela was built.
It took me longer than normal to read this book; in certain places it’s really hard to get through—for empath reasons. It shows so clearly how humans fail other humans when they (re)make societies—how they’ve failed those who look different, those who are ill… Those who’ve needed the most help. And there’s a reason for my separation of myself from the acts of such humans, as this has not at all been a universal tendency, as the book will show you: The history of leprosy is now inextricably tied up with the history of empire and colonialism.
Basciano’s modern history starts its journey around the world in St Albans, in the UK, where the St Mary de Pré Priory was founded in 1194 for thirteen women with leprosy. (There’s no longer any evidence of a similar institution for men started fifty years before.) Basciano uses this a stepping off point to explore the medieval history of leprosy in Europe, through to the first leprosy conference in 1897 in Berlin, and the emergence of more “modern” methods of isolation that led to the stigma leprosy patients have suffered through in the last two hundred years. Much is down to Norway’s famous son, Gerhard Armauer Hansen, who identified the bacterium (Mycobacterium leprae) that causes the disease, and who gave his name to it (particularly in Brazil and Japan). Hansen was a dedicated and conscientious scientist, but an inhumane policy maker: as Norway’s Chief Medical Officer for Leprosy, he pushed for the seclusion of patients in leprosaria through the Seclusion of Lepers Act of 1885, a draconian policy that disproportionately affected the poor. Because of the politics of the time—the heyday of colonial exploits—and the association of the disease with poverty and lower class, it was not long before colonial administrators made it a ‘tropical’ disease and used it as an excuse for segregationist health plans in the colonies. Basciano explains this while detailing how Britain made leprosy the dirty disease of India.
Through the book, we learn about personalities in the history of leprosy around the world—like Father Damien, a Belgian missionary, who lived among people with leprosy in Hawaii, and eventually succumbed to the disease. (Leprosy arrived in Hawaii with foreigners; it was unknown before that.) This section of the book is exceedingly uncomfortable to read, as Basciano outlines white saviourism, exoticism, and a weird sexual fetish associated with the disease by some, including writers Jack London, Paul Theroux and Roald Dahl. And American Charles Warren Stoddard may not have focussed on racial differences when thinking about leprosy, but he apparently “found” a kind of freedom for his queerness among those living with leprosy there.
On the other side of the world, the formidable Kate Marsden, a British nurse, signed up at eighteen in 1877 to serve as a Red Cross nurse in the Russo-Turkish war. Interestingly, she too, queer and an outcast, found refuge in serving those with leprosy, first encountering two men with it on the Bulgarian banks of the Danube during the war. Marsden’s story is fascinating: she later taught first aid to miners in New Zealand and also found there what she thought was leprosy (it may have been eczema) among the Maori. She eventually travelled to St Petersburg ‘via Alexandria, Jerusalem, Constantinople and Tiflis’ on a “roving commission to hunt up lepers wherever she had an inkling of their existence,” through incredible trials. Basciano speculates that Marsden may have been a ‘leprophiliac’, after Graham Greene (another unsettling section of the book follows). Marsden gained both fame and notoriety in Victorian England; she was elected to the Royal Geographical Society, among the first woman to achieve this. However, she also gained powerful enemies, leading to her precipitous fall from grace.
Another gripping aspect of the history of leprosy in Basciano’s book is the previously unknown to me association of Robben Island with the disease: Leprosy patients from the Cape were interned there from 1845 for nearly a century before the maximum security prison whose most famous inhabitant was Nelson Mandela was built.
Displaying 1 - 2 of 2 reviews