ANTC68H3 Chapter Notes -Debridement, Addiction, Social Cost
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ANTC68 WINTER 2013
Week 5: Self-Mortification and the Stigma of Leprosy in Northern India by Barrett
Introduction
Social stigma of leprosy is far worse than the disease itself – Hansen’s Disease (HD)
also known as leprosy is a mildly contagious condition that can be readily treated
with antibiotics in most cases – other cases simple precaution and careful
observation is all that is needed to prevent the onset of permanent disabilities
Stigma and untouchability status of lepers creates lifelong prospects of divorce,
eviction, loss of employment, and ostracism from family and social networks
This disease illustrates the distinction between pathophysiology of a disease and the
human experience of illness as suffering
Physical and social stigma of HD are interconnected and leprosy is best approaches
as an illness of discrimination INCLUSIVE of its physical condition
Study is an ethnographic in nature looking at the HD patients in colony/ashram and
squatter/street settings – 72 in total
3 destructive processes by which social stigma became physically expressed
o Concealment leading to under treatment
o Dissociation and self-neglect
o Self-mutilation under conditions of extreme poverty
As a result of these processes, people embodied the local prejudices that
exacerbated their condition in the first place
The Bacteria & the Burden
Mycobacterium leprae is among the least contagious of human pathogens
Social mark of leprosy is highly contagious leading to courtesy stigma – friends and
relatives of people with HD risk severe social and economic losses for their affiliations
HD is treated with a combination of three antibiotics known as multi drug therapies –
non-infectious in 30 days and no infected in six to nine months
Social stigma however can last a lifetime and follow you everywhere
Selective infection of peripheral nerves leads to limb anesthesia diminishing a
person’s ability to rely on touch and pain to prevent injuries and requires constant
observation to avoid injury, ulcers, etc.
Permanent neuropathy that results in physical deformities and disabilities can be
avoided through the use of custom footwear and training in injury prevention – but
people must be hyper aware of their surroundings and visual inspect themselves to
protect themselves from injuries that they would normally be alerted by due to pain
or sensation. They do not have this ability because of loss of function of their nerves
Leprosy on the Ganga
2 communities
o Leprosy treatment facility or ashram Kusht Seva Ashram (KSA)
Indigent squatter community beside the river Ngo Sponsored clinic outpatients
Disavowal & Under treatment