Fears of the spread of leprosy also grew in the 1890s and in 1891 the Leprosy Repression Act was passed making it a legal imperative that all sufferers of leprosy (identified as a ‘black disease’) be isolated from society in leprosaria. By 1892, the Infirmary on the Island was the only leprosarium in the Cape colony, and both black and white patients were admitted. ‘Rules of the Leper Hospital” in 1892 enabled formal racial segregation of lepers, i.e. before their separation according to the stage of their disease. However, this practice only became law 10 years later.
As the treatment of leprosy improved, some people diagnosed with non-infectious leprosy were allowed to the leave the Island. The Leprosarium’s closure in 1931 was the result of three (3) main factors, i.e. increased marginality, the expense of maintaining the institution on the Island and the establishment of racially exclusive and specialised facilities on the mainland which patients utilised instead of the Island. The remaining patients of the Robben Island hospital were transferred to the Westfort Hospital in Pretoria.
Many patients with leprosy died while on the Island and were buried in the Leprosarium graveyard, established 45 years ago. The graveyard is north of the Church of Good Shepherd and extends to the site of the Maximum Security Prison.