ANTC68H3 Chapter Notes -Sick Individuals, 1918 Flu Pandemic, Leprosy

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29 Jan 2013
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ANTC68 WINTER 2013
Week#5: Stigma in the Time of Influenza: Social and Institutional Responses to
Pandemic Emergencies by Ron Barrett & Peter Brown
Introduction
Stigma was originally a classic Greek term for a permanent mark that branded a
person as a criminal but now describes the process of negative discrimination against
people with certain physical, behavioral or social attributes
It can be argued that stigma is an illness itself comorbid with respect to its marked
physical conditions
Stigma exacerbates the disease itself such as in the case of leprosy, Hansen’s
disease and AIDS
Farmer and Kleinmann: AIDS pandemic caused suffering that was created by
socioeconomic inequalities, compounded by the inappropriate use of resources,
magnified by discrimination, augmented by fear and amplified by the loss of social
identity.
Stigma can be seen as a biosocial phenomenon with 4 essential elements:
o Stigma presents barriers to health seeking and reduces early detection &
treatment and furthers the spread of disease
o Social marginalization leads to poverty and neglect therefore increases the
susceptibility of populations to the entry and amplification infectious diseases
o Potentially stigmatized populations may distrust health authorities and resist
cooperation during a public health emergency
o Social stigma may distort public perceptions of risk resulting in mass panic
among citizens and disproportionate allocation of health care resources by
politicisations and health professionals
Increased focus on bioterrorism applications of infectious disease that are
only worst case scenarios, increased focus on unknown risks from new
diseases and he unknowable consequences of bioweapons at the expense of
known threats such as influenza
From Plague to Influenza in Western India
- 1994, city of Surat was at the epicentre of an plague epidemic in Western India
- This led to fear, discrimination, flight, neglect, quarantine, distrust, economic losses,
isolation
- Stigma epidemic spread much farther and faster than the pathogen itself, severely
inhibiting disease containment and control efforts and creating additional social and
health problems related to major economic losses (stock market)
- Following this, the city improved sanitation, provision of PHC, increased public
confidence in health authorities and their message, and improved religious relations
between Muslims and Hindus
Is Influenza Different?
- Unlike the 1994 plague epidemic in India, 1918 influenza pandemic was seen as
more democratic as it impacted all segments of society regardless of status
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