Infectious diseases and even some non-communicable diseases have been stigmatized throughout history. There are ample examples, including tuberculosis, leprosy, mental illnesses, and congenital anomalies. The stigmatization might have served the purpose of a survivor in earliest human history by decreasing spread in case of communicable diseases – but its continuation has led to social stigma and taboos around these illnesses. This – despite available treatment – leads to non-treatments mortality, morbidity, and further spreading.
In modern times, HIV generated similar shame and stigma. In Kashmir, context presence of leper colony is an archaic reminder of such stigma. With emerging epidemics like coronavirus in the era of economic globalization, shame and stigma will lead to wider spread and devastating consequences. Individuals with or at risk for stigmatized diseases may avoid seeking health care in order to avoid being stigmatized.
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Countries in fear of being looked down upon will attempt to minimize or suppress true information about emerging infectious disease epidemics and also to protect economic interests associated with being linked to a potentially stigmatized disease.
Thus, in-the current era, stigma, shame, and exclusion, increase the suffering of persons with the disease and also those at risk will not volunteer for available care hierarchy. Or when they do, it is late already thus almost making it impossible for public health to function at primordial and primary prevention level.
Most importantly, those associated with providing care might suffer themselves from emotions of stigma and fear leading to vital impediment to care the field may also become stigmatized.
The public reaction around people suspected of, or infected, with coronavirus, makes me understand why and how Leprosy and Tuberculosis were stigmatized. And how it took ages to remove the stigma around it and how it became a barrier in the treatment. It wasn’t a dark age but the darkness hidden in all of us that created stigma and shame. It is the same streak of darkness again which is becoming an impediment to treatment and might be catastrophic if we continue with othering and mentally isolating instead of physical isolation.
There is a need to do physical isolation quarantine but coupled with emotions of love, empathy, longing, and prayers for the wellbeing of infected and suspected. It will, in turn, decrease the stigma, shame, and exclusion, while making people self-regulate and cooperate in a way that will help us defeat the epidemic. Those who volunteer to self-isolate are doing it for their families, friends, and elderly – for all of us. They are all heroes, not villains.
Dr. Arshad Hussain is a professor at the Institute of Mental Health and Neurosciences, Kashmir
The comment also appeared in our 23 – 29 March 2020 print edition.