A resilience building collaboration: A social identity empowerment approach to trauma management in leprosy-affected communities.

OBJECTIVES: Communities affected by leprosy encounter multiple traumas and adversities and are some of the poorest in the world. A diagnosis of leprosy can have catastrophic implications for peoples social, health, and economic circumstances. In this article, we describe a reciprocal collaboration with a nongovernmental organization (NGO) that supports people affected by leprosy, trauma, and adversity in rural Nepal. We offer a social identity-based empowerment approach for two reasons. We argue this approach is particularly suited to support those impacted by trauma and its psychological aftermath as those affected are disproportionately from disempowered and marginalized groups. Second, we know that people gain strength from others with whom they share experiences. METHOD: We offer longitudinal data (N = 71) to support this model of a mutually respectful, participatory, and collaborative approach with the Nepal Leprosy Trust (NLT), a social development NGO. RESULTS: Findings of mediation analysis highlight that where a traumatic experience is highly stigmatized and isolating there is value in a group-based, self-help approach that emphasizes empowerment. CONCLUSION: A group-based approach that focuses on increasing knowledge and collective social resources is empowering for those affected by leprosy and adversity, because these resources build resilience. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pride and prejudice--identity and stigma in leprosy work.

This article sets out to expand the way stigma, and those affected by it, are understood within leprosy discourse and to apply these insights to the analysis of the experiences of leprosy workers. The term stigma is often used simply as shorthand for 'negative social experience'. However, to reduce the negative aspects of complex everyday life experiences to a single word is often overly simplistic and can serve to objectify, rather than illuminate, the experiences of those affected. This article argues that in order to understand the lived experience of stigma we must come to understand stigma as an ongoing, dialectical social process and develop an approach to stigma that analytically separates stigma from its negative social consequences. The article applies these insights to data collected during 14 months of fieldwork with front-line leprosy workers in India, which suggests that falling leprosy prevalence rates and a rapidly changing policy landscape have led to leprosy workers feeling marginalised and stigmatised within their own organisation. The article argues that, rather than seeing stigma merely as a negative process in which leprosy workers are passive victims, we must recognise that stigma also plays a key role in the creation and maintenance of leprosy workers' identity and is utilised as a strategic tool in the struggle for influence between different groups within the organisation. Finally, the article argues for the benefit of expanding our understanding of stigma across public health and of applying these insights to designing future interventions.

Leprosy, the key to another kingdom.

OBJECTIVE: In India, many people affected by leprosy still live in self-established settlements, commonly referred to as leprosy colonies. Aid organisations generally attribute the social segregation of colony members to the stigma attached to leprosy. In this article, I argue that the common approach towards leprosy colonies is actually based on a limited understanding of social relations between colony members and others. The insights from this study will hopefully facilitate re-thinking current approaches to stigma reduction in leprosy. DESIGN: An ethnographic study conducted over a period of three months in and around a leprosy colony in India. With the help of a local research assistant, I carried out semi-structured interviews, informal conversations, and participant as well as non-participant observation. I conducted interviews with 22 colony members and 25 residents from the adjacent neighbourhoods of the colony. RESULTS: This study reveals that the differentiation between colony members and others derived at least as much from community membership as from stigma. Leprosy-affected people living outside the colony, for example, perceived the colony members as widely different from themselves, whilst stigma affected both groups. Programmes with the aim of reducing stigma need to approach stigma relations as embedded in various interrelated physio-emotional and socio-cultural processes, rather than approaching social aspects of leprosy by focusing exclusively on the notion of stigma.