La lepra en Colombia: estigma, identidad y resistencia en los siglos XX y XXI / Leprosy in Colombia: stigma, identity and resistance in XX and XXI centuries

Este artículo analiza la historia de la lepra o enfermedad de Hansen como un concepto reelaborado a lo largo de la historia por los discursos científicos, políticos, religiosos y por los saberes populares, puesto en relación al problema de la estigmatización. Buscamos realizar un análisis desde la teoría del estigma como un proceso social, que produce el aislamiento, la exclusión, discriminación y rechazo al enfermo y su familia, deteriorando la identidad de los mismos. Encontramos y analizamos cómo se produce en la interacción social la estigmatización, y a su vez, cómo los enfermos reelaboran su identidad, generando una serie de estrategias de afrontamiento y ocultamiento del estigma, estrategias de resistencia con las que reconstruyen su tejido social. Las categorías de análisis de la información fueron percepciones y creencias sobre la enfermedad, relaciones sociales y familiares, construcción de la imagen del enfermo y las metáforas de la enfermedad, actos de discriminación y rechazo, y actos de ocultamiento y afrontamiento del estigma. En este trabajo de carácter cualitativo, analítico y diacrónico, se utilizaron metodologías de investigación cualitativa, consistentes en entrevistas, observación etnográfica, trabajos de memoria y cartografía social, y revisión y análisis de fuentes primarias y secundarias, recolectando información de Colombia, específicamente los municipios de Agua de Dios, Cundinamarca y Contratación, Santander, considerando como marco temporal los siglos XX y XXI.

This article analyzes the history of leprosy or hansens disease as a concept that has been re elaborated throughout history by popular opinion and political, religious and scientific influence, all in relation with the problem of stigmatizing. Here we seek to make an analysis of the theory of stigma as social process that produces isolation, exclusion, discrimination and rejection of the sick and his family, reducing their own identity. We find and analyze how social interaction in stigmatization works, and how those with the disease recreate their identity, generating a series of coping strategies, ways of hiding the cause of stigma, and resilience strategy with which they rebuild their social network. The information was analyzed through the categories of perceptions and believes of the disease, social and family relations, self image construction of the sick and the metaphors of the disease, acts of discrimination and rejection, acts of hiding and confronting the stigma. In this work of analytic, qualitative and diachronic characteristics, we used qualitative investigation methodologies, consisting in interviews, ethnographic observation, social cartography and memory exercises, and reviews and analysis of primary and secondary sources. Information was collected from Colombia, specifically the towns of Agua de Dios, Cundinamarca and Contratacion, Santander, taking into account the XX and XXI century as the time frame.

Leprosy and hepatitis B coinfection in southern Brazil

To investigate the association of leprosy with hepatitis B virus (HBV) infection, as yet unknown for South Brazil, we assessed hepatitis B virus coinfection in 199 South Brazilian leprosy patients (119 lepromatous, 15 tuberculoid, 30 borderline, 12 undetermined and 23 unspecified) and in 681 matched blood donors by screening for the hepatitis B virus markers HBSAg and anti-HBc, using ELISA. Positive samples were retested and anti-HBc+ only samples were tested for the hepatitis B surface antibody (anti-HBs). There was a strong association between leprosy and hepatitis B virus infection (OR = 9.8, 95% CI = 6.4–14.7; p = 0.004·E−30), as well as an association between HBV infection and lepromatous leprosy, compared to other forms (OR = 2.4, 95% CI = 1.2–4.8; p = 0.017). We also found that confinement due to leprosy was associated with hepatitis B virus infection (OR = 3.9, 95% CI = 2.1–7.4; p = 0.015·E−3). Leprosy patients are susceptible to develop hepatitis B virus infection, especially lepromatous. Institutionalized patients, who probably present a stronger Th2 response, have higher risk of being exposed to hepatitis B virus. This clearly emphasizes the need for special care to leprosy patients in preventing hepatitis B virus coinfection in South Brazil.

Escravos no purgatório: o leprosário do Tucunduba (Pará, século XIX) / Slaves in purgatory: the Tucunduba Leprosarium (Pará, nineteenth century)

Analisa a experiência dos escravos recolhidos ao leprosário do Tucunduba, em Belém, no Pará, ao longo do século XIX. Libertos depois de exibir no corpo as marcas da lepra, esperava-se deles submissão à política de segregação que pretendia afastá-los do contato com o restante da população. A documentação produzida pela Santa Casa de Misericórdia do Pará e autoridades políticas da província revela as estratégias desenvolvidas pelos escravos no enfrentamento dessa política, utilizando-se da predominância numérica no leprosário para criar uma rede de solidariedade que lhes permitisse recriar a vida e se contrapor ao tipo de nação sonhada pelas teorias higienistas da época.

The article analyzes the experience of the slaves interned at the Tucunduba Leprosarium in Belém, state of Pará during the nineteenth century. The slaves were freed once they showed the marks of their leprosy, and expectations were that they would submit to the segregation policy meant to keep them from contact with the rest of the population. The documentation produced by Santa Casa de Misericórdia hospital in Pará and by the province's political authorities reveals the strategies the slaves devised in response to this policy; they used their numerical predominance at the leprosarium to create a network of solidarity that allowed them to recreate their lives and stand in opposition to the type of nation that the era's hygienist theories envisioned.

O Hospital-Colónia Rovisco Pais: a última leprosaria portuguesa e os universos contingentes da experiência e da memória / The Hospital-Colónia Rovisco Pais: the last Portuguese leprosarium and the contingent universes of experience and memory

O Hospital-Colónia Rovisco Pais foi inaugurado em Portugal na década de 1940, com vistas ao tratamento, estudo e profilaxia da lepra, de acordo com modelo de internamento compulsivo, cuja configuração remete ao conceito de instituição total proposto por Goffman. Trata-se de um importante projeto higienista do Estado Novo. O seu paradigma educativo combinava elementos inspirados na medicina social europeia e na ideologia do regime ditatorial paternalista português. O Hospital-Colónia será aqui ponderado como dispositivo disciplinar, desenvolvendo-se reflexão acerca do confronto entre o poder disciplinar e a experiência. A memória emerge como instrumento contingente para o acesso às práticas e aos significados intersticiais tecidos no quotidiano do Hospital-Colónia, buscando-se auscultar a experiência de seus ex-doentes como sujeitos políticos.

The Hospital-Colónia Rovisco Pais was inaugurated in Portugal in the 1940s for the treatment, study and prophylaxis of leprosy based on the compulsive internment model, whose configuration reflects the total institution concept proposed by Goffman. It concerns an important hygiene project of the Estado Novo. Its educative paradigm combined elements inspired in European social medicine and the ideology of the paternalistic Portuguese dictatorial regime. The Hospital Colony here will be thought of as a disciplinary dispositive, developing considerations regarding the confrontation between disciplinary power and experience. Memory emerges as a contingent instrument to access the practices and interstitial meanings woven into the Hospital Colony's daily life, seeking to find out about the experience of its former patients as political subjects.

St. Lazarus and Hansen's disease / 나학회지

The name of St. Lazarus is commonly found in relation with leprosarium throughout the world but the historical background about how it has been used is less well known. Originally Lazarus was the man who was resurrected by Jesus Christ four days after his death caused by an illness. Considering the unique personal history of Lazarus, it is understandable that Lazarus was revered as the patron for patients with serious illnesses in the society of Christianity thereafter. The actual popularity of his name in Europe was from the era of Crusade in Middle Age, when the Order having its name was first founded. The Order contributed greatly for the leprous patients rapidly increased in Europe after the Crusade. Subsequently lazarhouse came to be regarded as leprosarium. At the present time, the Order is still working for the poor countries and human rights.