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PubMed2003

[Health service organization during the age of pestilence. 2].

The author presents the history of the places where patients with epidemic pathologies were isolated. Since the study of medicine began, such places have been known as asclepiei, xenodochi, hospices, lazarettos, sanitary cordons, and quarantine stations and they contributed to controlling epidemics in Europe. Important not only in the context in which they were created, these structures expressed the medical culture and point of view of that age. Although very far from discovering the cause of the pathology due to their lack of scientific knowledge, the medical class sometimes knew how to effectively organize the isolation of patients. The history of such structures interweaves with the long history of Christianity and with the emerging nations of Europe and the city-states of the Italian Renaissance. Previously, in classical Greece and Imperial Rome there had also been "homes for the sick" to isolate patients. Today the world is periodically hit by epidemics. In such moments the medical profession uses its research ability and organizational capabilities but also historical memory to reduce epidemic contagion.

Catholicism↗
PubMed2004

[Hansen's disease-associated disabilities in sanatoria residents. A study of the actual situation in three sanatoria located in the Setouchi area].

PURPOSE: Clarification of details of Hansen's disease in Japan is important for obtaining an adequate understanding of the present circumstances regarding control and for formulation of specific suggestions for future measures. The average age of residents in national Hansen's disease sanatoria reached 74.9 in May 2002 and most of these suffer from serious disabilities caused by the disease. In order to implement measures facilitating their return to society or secure living in sanatoria, a proper understanding of the residents' physical situation is essential. Therefore, the present study was conducted of residents suffering from Hansen's disease in Japan. METHOD: A direct interview was conducted with all 1282 residents of three sanatoria, located in the Setouchi area: Nagashima-aiseien, Oku-komyoen, and Oshima-seishoen. An investigator visited the rooms of the residents, interviewed them using a questionnaire, which consisted of about 100 items including the OPCS scale, and filled out an answer form. The reply rate was 64%. RESULTS: The average age of the residents was found to be 72.8 years, their average age when they entered the sanatoria was 26.0 years, and the average period of residence was 52.4 years. The damage they suffer as a result of the isolation policy is physical, mental, economical and social. That is to say, their entire life is harmed as a direct result of the Leprosy Prevention Law or the Eugenic Protection Law with discrimination in society and negative effects on their families. Their physical condition features serious disabilities in the use of fingers, as well as in walking and seeing caused by peripheral nerve damage. Such disabilities are related to their age and period of residence, and in addition, these in use of their fingers are related to the work which residents were forced to do in sanatoria. The results indicate that patients' physical condition is related to their age, how long they have had the disease and their work in sanatoria. CONCLUSION: It is clear that previous Hansen's disease control in Japan has caused a great deal of harm, from which it is very difficult to recover so that residents have to live with serious problems. In order to implement measures allowing their return to society or more secure life at sanatoria, sufficient care is needed to treat progressive disabilities caused by ageing and prevent deterioration caused by peripheral nerve damage.

Aged↗
PubMed2005

[Social rehabilitation experiences of people with a history of Hansen's disease: interviews of readmitted residents in a sanatorium].

PURPOSE: This study focused on the reflections of people with a history of Hansen's disease who once experienced social life and then returned to their sanatorium again. The purpose was to clarify what they think about their experiences of social life outside of institutions. METHOD: Study participants were people with a history of Hansen's disease who had experienced social life outside of the sanatorium and are now living in a national sanatorium with good ADL. The study was based on a semi-structured interview, the data being categorized with the focus on "situations or topics affect by Hansen's disease". Thirteen people agreed to participate in the study. RESULTS AND DISCUSSION: Six categories were abstracted: "maintaining a good condition," "anxiety about relapse or illness," "medical service," "coping with Hansen's disease in social life," "relationships with others," and "means of livelihood." Hansen's disease affected their lives in 2 aspects; one was "sawagu (recurrence of the disease)" and the other "kakusu (concealing the disease)." "Sawagu" was related to "anxiety of the disease" and "intention of maintaining a good condition." "Kakusu" affected the way of "coping with the disease in social life" and "the relationship with others." "Medical service" was important for both "sawagu" and "kakusu." Patients were visiting hospitals and taking medicine to avoid "sawagu," while trying to "kakusu" when they consulted with physicians. Similarly, both "sawagu" and "kakusu" interacted with each other when the participants needed to work and earn a living. All participants looked back at their social life as a "good experience" because they were satisfied with the sense of accomplishment or fulfillment the experience had given them. CONCLUSION: Participants of the study looked back at their social life as a "good experience." Hansen's disease affected their social life in 2 aspects; "sawagu" and "kakusu." It is necessary to alleviate difficulties with both of these so that people with stigmatized disease such as Hansen's disease can maintain normal lives in society.

Adaptation, Psychological↗
PubMed2006

Between stigma and dawn of medicine: the last leprosarium in Croatia.

In an attempt to reconstruct the function of the last leprosarium in Croatia, situated in the little town of Metkovic in the Neretva valley, we used local folk tales and compared them with different data sources, such as register of deaths in the Roman Catholic parishes in Metkovic and the nearby village of Vidonje, archived local newspapers, building documents, and different artifacts from the beginning of the 20th century. We identified individuals and families who were treated in the leprosarium during its existence from 1905, when it was built, until 1925, when it was closed down. We analyzed why the Neretva river valley was chosen for the isolation of lepers. It seems that the geographical position of the region, close to the endemic seat of the disease in the neighboring Bosnia, was more important for the decision to build the leprosarium than the incidence of leprosy or some recent outbreak of the disease in Croatia. Building of leprosariums, such as this one in Metkovic, was a part of tradition of separating lepers from human community. This was considered as a socially and medically justified behavior in a time when it was not possible to identify the cause of leprosy and apply the proper treatment.

Croatia↗
PubMedDate not supplied

[Community health and national sanatoria for Hansen's disease in Japan--survey of receipts of National health insurance].

National sanatoria for Hansen's disease in Japan were special institutions that only treated in-patients. But a few sanatoria for Hansen's disease located in islands and rural districts should have other duty, namely service to community health because there was no other clinic office. New patients with Hansen's disease are very small in number and inpatients become older and older. Then the new role should be seeked to National sanatoria for Hansen's disease in Japan. Amami-wakoen, National sanatorium for Hansen's disease in Amami island started skin clinic for out-patients with skin diseases in March, 1983 because there were few skin clinics in Amami district. The number of patients with skin diseases increases year by year (from 12.3 persons every day in 1983 to 36.4 in 1989). We surveyed receipts of National health insurance for the purpose of studying the main diseases in Amami main island and the behavior of the patients with skin diseases. The results of survey are followings; 1. The percentage of patients with skin diseases in Amami main island in August, 1987 was significantly superior. 2. The percentage of patients with mental diseases and pregnant woman in hospital and patients with gastrointestinal disorders and pregnant women in clinic were significantly large in May, 1987 in Amami main island. 3. There was a tendency that the patients with skin diseases visited to the clinic near in place. It was found that we treated only 5.1 percent persons of patients with skin diseases in August, 1987.

Community Health Services↗
PubMed1989

A study into bacteriological positivity and treatment of beggar leprosy patients.

Hundred beggar leprosy patients were medically examined and skin smears were taken for bacteriological positivity for A.F.B. Information regarding their treatment was collected. 20% of them were found bacteriologically positive and 40% of the positive cases were not taking treatment. Epidemiological and operational implications of the findings are discussed.

Biopsy↗