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1.
Glob Public Health ; 15(7): 1030-1039, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31971879

RESUMO

Leprosy stigma is more neglected than the disease itself since global interventions towards leprosy are focused on the medicalisation of individual-sufferers and statistical counting of documented cases and less prioritising the impact of leprosy stigma towards society. This paper examines the impact of courtesy stigma on society through comparative ethnographic method conducted in two sites in East Java Province, Indonesia. Investigation in the first site, Mandangin Island, found that the island suffers underdevelopment of public facilities such as clinics and clean water and migration and medical knowledge bottlenecks. In the second site, Sumberglagah village, leprosy patients and the community they live with are also socially separated from the locals and they are engaged in controversial businesses exploiting the public fear of leprosy. This study finds that leprosy stigma in two leprosy-impacted communities in East Java, Indonesia, does not only isolate individuals but also a whole community from a bigger society regardless of whether all of the community members have leprosy. This study also detects problems related to leprosy education within the two impacted communities. It is suggested that efforts to address the problems require holistic approaches and commitments from various actors in the area in complement to existing global health missions.


Assuntos
Hanseníase , Estigma Social , Antropologia Cultural , Humanos , Indonésia , Hanseníase/psicologia
2.
Rev. cienc. salud (Bogotá) ; 17(spe): 88-108, dic. 2019. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1058234

RESUMO

Resumen Introducción: La representación social de la lepra como una enfermedad del pasado, el carácter local que la circunscribe a los sanatorios y el escaso contacto de trabajadores de la salud foráneos con la enfermedad hace pensar que el conocimiento sobre su cuidado ha circulado entre generaciones de una manera más o menos confinada. Ese saber que incorpora no solo conocimiento biomédico, sino expresiones en saberes, creencias, prácticas, relatos, los actores que las construyen y recrean y su relación compleja con las dinámicas de inserción en el territorio, se constituye hoy, en sí mismo, en un patrimonio vivo, que merece ser narrado. Desarrollo: Se parte de comprender la memoria de los cuidados no médicos de la lepra en Agua de Dios, por medio de un estudio etnográfico, cuyos resultados permiten proponer dos expresiones. La primera involucra a agentes de salud no médicos y su relación con los sujetos de cuidado; que muestra que el cuidado demanda no solo conocimiento científico, sino también disposiciones particulares de los sujetos, como capacidad de escucha, observación, paciencia y trascendencia, acompañadas de un posicionamiento y negociación cotidianos en el territorio. La segunda está compuesta por las alternativas de cuidado intermediadas por otros agentes con saberes autorizados, que agrupan una amplia farmacopea relacionada con el uso de plantas medicinales, referencias a curanderos y prácticas solidarias de tutoría entre pacientes y relaciones de su bienestar con el medio ambiente. Conclusiones: Todas estas expresiones de cuidado desafían los discursos y prácticas canónicas de la biomedicina alrededor de esta enfermedad.


Abstract Introduction: The social representation of leprosy as a disease from the past, its local character that circumscribes it to the sanatoria, and the scarce contact of health workers with it suggest that the knowledge about its care has circulated between generations more or less confined. This confined knowledge, which incorporates not only biomedical knowledge but also expressions in knowledge, beliefs, practices, stories, the actors that construct and recreate them and their complex relationship with the dynamics of insertion in the territory in a living heritage, deserves to be narrated. Development: We begin by understanding the memory of the non-medical care of leprosy in Agua de Dios, through an ethnographic study, whose results allow us to propose two expressions of these. The first one, involving the non-medical health agents (especially nurses) and its relationship with care subjects, showed that this demands particular dispositions from the subjects as listening ability, observation, patience, and transcendence, accompanied by daily positioning and negotiation in the territory. The second is the care alternatives mediated by other agents with authorized knowledge that group a wide pharmacopeia related to the use of medicinal plants; references to healers and solidarity practices of mentoring between patients and relationships of their well-being with the environment. Conclusions: All these expressions of care challenge the discourses and canonical practices of biomedicine around this disease.


Resumo Introdução: A representação social da lepra como uma doença do passado, seu carácter local que a circunscreve aos sanatórios, e o escasso contato de trabalhadores da saúde estrangeiros com a doença, faz pensar que o conhecimento sobre seu cuidado, tem circulado entre gerações de uma maneira mais ou menos confinada. Esse saber "confinado", que incorpora não só conhecimento biomédico, senão expressões em saberes, crenças, práticas, relatos, os atores que as constroem e recriam e sua relação complexa com as dinâmicas de inserção no território, constitui-se hoje em si mesmo, em um patrimônio vivo, que merece ser narrado. Desenvolvimento: Partimos de compreender a memória dos cuidados não médicos da lepra em Agua de Dios, através de um estudo etnográfico, cujos resultados nos permitem propor duas expressões destes. A primeira que envolve agentes de saúde não médicos e sua relação com os sujeitos de cuidado, mostrou que esta demanda não só conhecimento "científico", mas também disposições particulares dos sujeitos como capacidade de escuta, observação, paciência e transcendência, acompanhadas de um posicionamento e negociação cotidianos no território. A segunda a constituem as alternativas de cuidado intermediadas por outros agentes com saberes "autorizados" que agrupam uma ampla farmacopeia relacionada com o uso de plantas medicinais; referências a curandeiros e práticas solidárias de tutoria entre pacientes e relações de seu bem-estar com o meio ambiente. Conclusões: Todas estas expressões de cuidado, desafiam os discursos e práticas canónicas da biomedicina ao redor desta doença.


Assuntos
Humanos , Hanseníase , Cultura , Medicina Tradicional , Antropologia Cultural
3.
Health (London) ; 21(4): 392-408, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-26865214

RESUMO

When Hansen's disease became treatable in Taiwan in the mid-20th century, a group of Hansen's disease patients lost their sick role despite still having lingering symptoms that continued to evolve. While sociologists have explored in-depth situations in which the social role of the sick is ambiguous, few studies have investigated body experiences under liminality that requires sick people to find a new sick role. Living with lingering symptoms in a post-Hansen's disease world, the Hansen's disease patients I have studied face the conundrum of having to find an alternative sick role. Ethnographic fieldwork demonstrates how patients develop a specific set of body techniques that shape and are shaped by their membership in a patient community. Exploring the reinforcing projects of re-embodiment and sociality around Hansen's disease, I argue that patients are able both to legitimate each other's feelings of sickness and to use those feelings to manage their illness and, as such, to collectively acquire an alternative sick role. Adding to existing discussions of active patients, this article identifies the body mechanical as a way of practicing active patienthood organized around fixing, trials, mending and functionality.


Assuntos
Nível de Saúde , Hanseníase/psicologia , Papel do Doente , Antropologia Cultural , Comorbidade , Empatia , Feminino , Teoria Fundamentada , Humanos , Relações Interpessoais , Hanseníase/complicações , Masculino , Pesquisa Qualitativa , Autocuidado , Taiwan
4.
Belém - Pa; s.n; 2017. 157 p.
Tese em Português | ColecionaSUS, ColecionaSUS | ID: biblio-943576

RESUMO

A atual Vila Santo Antônio do Prata foi erguida sobre o território tradicional dos Tembé/Tenetehara, no nordeste do estado do Pará. Com fins civilizacionais, criou-se um Núcleo Colonial, associado a dois Educandários, com foco nas crianças indígenas. Anos depois, estas instituições foram substituídas por um Centro Correcional e, em seguida, por um Leprosário. Esta tese analisa a conformação da paisagem da Vila do Prata, a partir dos seus remanescentes materiais (edificações e objetos), das narrativas Tembé/Tenetehara e de ex-internos hansenianos, tendo em vista os diversos períodos de sua constituição histórica. Considerando a sua instalação, as diferentes apropriações das edificações, usos do local no último século e com base na cultura material, busco compreender como a paisagem construída incorporava ao longo do tempo as estratégias de controle aos quais seus moradores foram submetidos. Além disso, analiso as formas de reapropriação da paisagem pelos agentes alvos dessas estratégias de controle


The current Santo Antônio do Prata village was built on the traditional territory of the Tembé/Tenetehara,in the northeast of Pará state. With civilizational purposes, a Colonial Nucleus was created, associated with two schools, focusing on the indigenous children. Years later, these institutions were replaced by a Correctional Center and then by a leper colony. This thesis analyzes the conformation of the Vila do Prata landscape, from its remaining materials (buildings and objects), the Tembé/Tenetehara narratives and the ex-Hansenian inmates, considering the different periods of its historical constitution. Considering its installation, different appropriations of buildings, placeusage in the last century and based on material culture, I try to understandhow the built landscape incorporated the control strategies in which its own residents were submitted over time. In addition, I analyze the forms of re-appropriation of the landscape by target agents of these control strategies


Assuntos
Masculino , Feminino , Humanos , Antropologia , Antropologia Cultural , Arqueologia , Saúde de Populações Indígenas , Política de Saúde , Serviços de Saúde do Indígena , Hanseníase
5.
Lepr Rev ; 82(2): 109-23, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21888136

RESUMO

Synoptic life history accounts and case studies of people with leprosy have tended to follow conventionalised narrative forms, with the onset of leprosy causing a violent rupture in otherwise positively construed life courses. Many of those I worked with in India, well-versed in relating their stories to donor agencies, were also aware of the power of such narratives to access funding. While case studies can be informative about the politics of representation, then, they often obscure as much as they reveal about the lives of those described within them, emphasising leprosy-related stigma at the expense of other forms or drivers of social exclusion. Drawing upon a series of interviews with a leprosy affected man I have known and worked with for 25 years, this paper demonstrates how more nuanced--and, from a policy perspective, more useful--accounts might be achieved through intensive biographical interviews carried out over time. In particular, analysis of such biographies, set against the wider backdrop of ethnographic research, allows for a more subtle reading of leprosy-related stigma, contextualised in relation to a range of intersecting socio-political, cultural and economic concerns.


Assuntos
Hanseníase/etnologia , Hanseníase/psicologia , Estigma Social , Estereotipagem , Antropologia Cultural , Biografias como Assunto , Cultura , Humanos , Índia , Masculino , Classe Social
6.
Lepr Rev ; 82(2): 155-67, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21888140

RESUMO

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.


Assuntos
Hanseníase/etnologia , Hanseníase/psicologia , Estigma Social , Estereotipagem , Antropologia Cultural , Humanos , Índia , Hospitais de Dermatologia Sanitária de Patologia Tropical/estatística & dados numéricos , Meio Social , Identificação Social , Fatores Socioeconômicos
7.
In. Almeida, Marta de; Vergara, Moema de Rezende. Ciência, história e historiografia. São Paulo, Via Lettera, 2008. p.139-160.
Monografia em Português | LILACS | ID: lil-520542

RESUMO

Apresenta e analisa dois textos relacionados a expedições científicas realizadas em 1912: o da viagem do médico e antropólogo Edgard Roquette-Pinto aos então chamados sertões do Noroeste, como integrante da Comissão Rondon, descrita e comentada no livro 'Rondônia', e o relativo à viagem dos médicos Arthur Neiva e Belisário Penna a regiões do Nordeste e Centro-Oeste brasileiros, iniciativa do Instituto Oswaldo Cruz e da Inspetoria de Obras contra as Secas, publicado nas 'Memórias do Instituto Oswaldo Cruz'. Divulgados principalmente em palestras, artigos de jornais e em revistas de ciências e letras, as fortes metáforas utilizadas pelos participantes dessas publicações, situando-as no debate mais amplo sobre a incorporação dos sertões brasileiros, um dos temas predominantes nos discursos científicos e políticos durante os primeiros anos da República. Enfocando, apenas, os textos originais dos cientistas, pretende sugerir que o discurso adotado é marcado pela ambivalência em que se, de um lado, a representação sobre a natureza e as populações brasileiras afirmava um projeto de matriz iluminista, com a defesa do progresso e a da civilização e do papel a ser desempenhado pela ciência, de outro, não se abandonava por completo a representação romântica sobre os sertões brasileiros, com ênfase em sua autenticidade e papel de matriz da nacionalidade brasileira, temas que haviam sido abordados nos primeiros anos da República no clássico 'Os Sertões', de Euclides da Cunha.


Assuntos
História do Século XX , Antropologia Cultural/história , Expedições/história , População Rural/história , Saneamento Rural , Saúde da População Rural/história , Brasil
8.
In. Almeida, Marta de; Vergara, Moema de Rezende. Ciência, história e historiografia. São Paulo, Via Lettera, 2008. p.139-160.
Monografia em Português | HISA | ID: his-16600

RESUMO

Apresenta e analisa dois textos relacionados a expedições científicas realizadas em 1912: o da viagem do médico e antropólogo Edgard Roquette-Pinto aos então chamados sertões do Noroeste, como integrante da Comissão Rondon, descrita e comentada no livro 'Rondônia', e o relativo à viagem dos médicos Arthur Neiva e Belisário Penna a regiões do Nordeste e Centro-Oeste brasileiros, iniciativa do Instituto Oswaldo Cruz e da Inspetoria de Obras contra as Secas, publicado nas 'Memórias do Instituto Oswaldo Cruz'. Divulgados principalmente em palestras, artigos de jornais e em revistas de ciências e letras, as fortes metáforas utilizadas pelos participantes dessas publicações, situando-as no debate mais amplo sobre a incorporação dos sertões brasileiros, um dos temas predominantes nos discursos científicos e políticos durante os primeiros anos da República. Enfocando, apenas, os textos originais dos cientistas, pretende sugerir que o discurso adotado é marcado pela ambivalência em que se, de um lado, a representação sobre a natureza e as populações brasileiras afirmava um projeto de matriz iluminista, com a defesa do progresso e a da civilização e do papel a ser desempenhado pela ciência, de outro, não se abandonava por completo a representação romântica sobre os sertões brasileiros, com ênfase em sua autenticidade e papel de matriz da nacionalidade brasileira, temas que haviam sido abordados nos primeiros anos da República no clássico 'Os Sertões', de Euclides da Cunha (AU)


Assuntos
História do Século XX , Expedições/história , População Rural/história , Saúde da População Rural/história , Saneamento Rural , Antropologia Cultural/história , Brasil
9.
Am J Phys Anthropol ; 128(4): 727-33, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16134162

RESUMO

Finds of deliberate dental modification have for the first time been found in archaeological human skeletal material from Europe. The type of modification is a horizontally filed furrow on the frontal upper part of the tooth crown. The furrows are single or, more usually, multiple, and are found on the front teeth in the maxilla. The affected individuals are 24 men from the Viking Age (ca. 800-1050 AD), found in present day Sweden and Denmark. The marks are so well-made that it is most likely they were filed by a person of great skill. The reason for, and importance of, the furrows are obscure. The affected individuals may have belonged to a certain occupational group (such as tradesmen), or the furrows could have been pure decoration.


Assuntos
Antropologia Cultural , Densidade Óssea , Estética Dentária/história , Paleodontologia , Paleopatologia , Doenças Dentárias/história , Adolescente , Adulto , Distribuição por Idade , Criança , Estética Dentária/estatística & dados numéricos , Feminino , História Antiga , Humanos , Hanseníase/história , Masculino , Práticas Mortuárias , Suécia , Doenças Dentárias/epidemiologia
10.
Med Anthropol Q ; 19(2): 216-30, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15974328

RESUMO

This article examines the biocultural dynamics of social discrimination and physical disfigurement among people with leprosy, or Hansen's disease (HD), in Banaras, northern India. Based on the narratives and observations ofpeople living in colony and street settings, I trace three destructive processes by which the social stigmata of leprosy become physically expressed. First, strategies of concealment further the progression and spread of HD through late detection and undertreatment. Second, the internalization of stigma can lead to bodily dissociation and injury through self-neglect. Finally, some people intentionally seek injuries under conditions of desperate poverty. As a result of such mortification processes, these people came to embody, quite literally, the prejudices that exacerbated their condition in the first place.


Assuntos
Efeitos Psicossociais da Doença , Hanseníase/psicologia , Adulto , Antropologia Cultural , Negação em Psicologia , Transtornos Dissociativos/etiologia , Feminino , Humanos , Índia , Hanseníase/complicações , Masculino , Pobreza , Preconceito , Automutilação/etiologia
11.
Med Anthropol ; 23(1): 69-88, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-14754668

RESUMO

The national and international agencies working to eliminate leprosy are also dominant in setting the boundaries of official discourse on the issue. Within these boundaries the disease is commonly represented as a medical problem with negative social consequences, and it is believed that both problem and consequences will be resolved if leprosy is eliminated and its victims treated and (if necessary) reintegrated within their social groups. For those affected by leprosy the issues are frequently different, elimination in some respects representing a problem as much as a solution. Against this background, which I describe with reference to a group of leprosy-affected people in South India and their position vis- -vis leprosy organizations, I explore some of the contexts in which leprosy patients actively manage their own situations, often in defiance of prevailing development orthodoxies. I conclude that closer observation and analysis of the strategies patients use to manage their disease status have important policy implications.


Assuntos
Hospitais de Dermatologia Sanitária de Patologia Tropical/organização & administração , Hanseníase/etnologia , Hanseníase/reabilitação , Autocuidado , Autoimagem , Meio Social , Antropologia Cultural , Educação em Saúde , Humanos , Índia , Pobreza , Qualidade de Vida , Organização Mundial da Saúde
12.
Soc Sci Med ; 42(1): 3-19, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8745104

RESUMO

The study analyzes the traditional beliefs and practices concerning leprosy of the Limba people of Sierra Leone. It shows that this dialectally diverse ethnic group has two views of leprosy and its cause, and two varieties of stigma associated with the disease. The Limba have abandoned their traditional treatments for leprosy in response to an effective leprosy control programme, but retained their traditional world view, including its definition of illness, which holds a person seriously ill only when he has severe pain or disability. Thus, they seek treatment from the programme, but often at a relatively advanced stage of the disease. The study shows that the Limba have reinterpreted the notion of 'germs' as introduced by medical workers, and that leprosy control workers have their own misunderstandings of Limba beliefs and practices. The study points the way to improved communication between leprosy workers and Limba patients by focusing on the points at which their views differ, and by identifying concepts within Limba world view that can be adapted by leprosy workers to help convey their message. The study emphasizes the importance of world view as a key to understanding patient attitudes and behaviour in developing countries, and to making valid cross-cultural comparisons, but notes that it can take years for an investigator to understand the world view of a particular culture. It argues that in short-term research projects there is an advantage to working with an anthropologist who has in-depth knowledge of the culture, but who may not be a specialist in medical anthropology.


Assuntos
Atitude Frente a Saúde , Evolução Cultural , Educação em Saúde , Hanseníase/prevenção & controle , Antropologia Cultural , Comparação Transcultural , Humanos , Hanseníase/etnologia , Hanseníase/terapia , Medicina Tradicional , Fitoterapia , Preconceito , População Rural , Serra Leoa/etnologia , Valores Sociais , Bruxaria
14.
East Afr Med J ; 72(10): 649-53, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8904045

RESUMO

In providing health care, the busy medical practitioner often lacks the "I-You" quality of the personal experience of illness. This paper reports the perceptions, beliefs and practices of persons living in a hyperendemic focus of onchocerciasis in Nebbi District, north-western Uganda. The study involved the use of focus group discussion and semi-structured interviews designed to explore the experiences, meanings, and illness-related coping strategies employed by the community. The results indicated that oncherciasis is considered to be a mysterious elusive disease which cannot be treated by local herbs. The disease is often mistaken for measles (odyer), and leprosy (dhobu). Persons who suffer from onchocerciasis believed that the cause of the disease is the small black fly (Kamacur), dirty water or rivers. However, non-affected individuals believed that the condition is caused by poor personal and environmental hygiene, and personal contact with persons affected by onchocerciasis. Affected people recommended public health education to control the disease while non-affected people, recommended the avoidance of personal contact with affected people, ensuring personal hygiene, and the improvement of environmental sanitation and the nutritional status of community. The belief systems of the community are probably responsible for the discriminatory practices of the people against those affected by the condition. The results indicate that onchocerciasis is a serious public health problem which needs to be controlled.


Assuntos
Oncocercose/etnologia , Oncocercose/psicologia , Preconceito , Adolescente , Adulto , Antropologia Cultural , Estudos de Casos e Controles , Estudos Transversais , Etnopsicologia , Feminino , Humanos , Masculino , Medicina Tradicional Africana , Oncocercose/prevenção & controle , Oncocercose/transmissão , Inquéritos e Questionários , Uganda
15.
In. Mallac, M. J de. A frensh look at Hansens disease. New York, Vantage Press, 5 ed; 1992. p.7-48.
Monografia em Inglês | SES-SP, SES-SP, HANSEN, HANSENIASE, SESSP-ILSLACERVO, SES-SP | ID: biblio-1243493
16.
Bull World Health Organ ; 43(6): 863-77, 1970.
Artigo em Inglês | MEDLINE | ID: mdl-5314018

RESUMO

An epidemiologically useful method of calculating exposure to leprosy is described. The method is based on the application of anthropological principles, and was used successfully in the Karimui Leprosy Research Project in New Guinea. The method could also be adapted for use in other epidemiological studies.The importance of patterned social relationships, and therefore contacts not only within but also outside the household of residence, is stressed. The patterned relationships are presented as a set of structural distance scales which allow a score to be awarded for contacts at various levels of intensity, taking into account age, sex, marital status, etc. An individual numbering system is used so that relationships can be coded for computer analysis. In view of the large number of comparisons to be made, in even small communities, the use of a computer is essential for the application of this method.


Assuntos
Métodos Epidemiológicos , Hanseníase , Antropologia Cultural , Computadores , Família , Feminino , Humanos , Relações Interpessoais , Hanseníase/etiologia , Masculino , Nova Guiné
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