The Ubiquity of Chronic Illness.

This is a review of five different books dealing with some aspect of what might be termed a "chronic illness" - Alzheimer's disease, lupus, addiction, erectile dysfunction, and leprosy. The array of different subjects examined in these books points to the negotiable limits of this hugely open category. What exactly constitutes an "illness"? Why not use a less biomedical term instead: "disturbance", "problem", or simply "condition"? And how are we to understand "chronic" - simply as the flipside of "acute" or "curable"?

Communities of the afflicted: constituting leprosy through place in South India.

With the promotion of community-based rehabilitation (CBR) as a solution to health-related issues across the global South, leprosy colonies have long been out of vogue for nongovernmental organizations and State institutions alike. Such colonies, however, have endured. As is being increasingly recognized by those working in the leprosy field, such places have played a particular role not only in the provision of leprosy-related care but also in forging new and collective identities for people affected by leprosy that might otherwise not have been possible. In this article, I draw on ethnographic fieldwork in one such colony in coastal Andhra Pradesh, South India, and explore the values invested in it as a particular kind of place; its geographical location on the peripheries; and its architecture and layout (inspired in part by colonial sanatoriums), which have particular implications for how leprosy and its ramifications are constituted and managed.

Leprosy as a neglected disease and its stigma in the northeast of Brazil.

Hansen's disease is an infectious and degenerative chronic disease with a high potential for incapacitation. Due to the explosive epidemic of leprosy cases worldwide (especially in Brazil), the social difficulties faced by these patients are an important subject for research. This work aimed to identify the stigma experienced by these patients. The qualitative research for this study was completed at the National Reference Centre in Dermatology in Fortaleza. The study took place in northeast Brazil from September 2010 to November 2012. The research subjects included 20 people with Hansen's disease of both sexes between 20 and 70 years old. The data collection consisted of a semi-structured interview. From the discourse analysis of the participants, several changes experienced by persons affected by leprosy were noted from the empiric categories emerged. Changes occurred in the family, the receptiveness of neighbours and co-workers and the patients' social lives were experienced by the persons affected after the diagnosis of Hansen's disease. From the data obtained, it was concluded that the patients are stigmatised. Sometimes they are forced to hide from relatives, friends, neighbours and co-workers. Despite their social exclusion, they believe their isolation is justified. Leprosy is a chronic, degenerative and curable infectious illness that continues to be a serious public health problem, mainly in the poorest region of Brazil.

Hanseníase e estigma / Leprosy and stigma

Representações sociais são compreendidas como estruturas dinâmicas que regulam as escolhas e ações dos sujeitos e dos grupos em diferentes situações da vida, em especial nos episódios de adoecimento.Raras são as doenças em que, como na lepra, se encontra tão evidenciada a associação entre doença e estigma, deformidade física e condenação moral.Com o objetivo de comparar as representações sociais de uma geração de pacientes que passou pela internação compulsória com o diagnóstico de leprae outra mais tarde tratada ambulatorialmente com o diagnóstico de hanseníase, indaga-se em que medida permanecem invariáveis alguns dos traços da milenar representação estigmatizante da lepra, apesar das mudanças havidas na denominação e na compreensão da natureza e do tratamento da doença.

Social representations are understood as dynamic structures that regulate the choices and actions of individuals and groups in different situations of life,especially in episodes related to sickness. In few diseases is the association between the illness and the stigmata, and between the physical deformity and the moral conviction, as clear as in leprosy. In order to compare the social representations of a generation of patients subjected to compulsory confinement under a diagnosis of leprosy with those of a generation of outpatients diagnosed with Hansen’s disease, this work asks to what extend some aspects of the historically stigmatizing representation of leprosy persist to the day, despite the changes in the denomination and in the understanding of the nature and the treatmentof the disease.