Stigma at the time of an outbreak

The origin of the word stigma stems from the late 16th century. The word comes via Latin (stigmat) from Greek (stizein) translating to a mark of disgrace associated with a particular circumstance, quality, or person.1 

Quoting history’s most popular space franchise’s legendary character, Yoda – ‘Fear leads to anger, anger leads to hate and hate leads to suffering’ is a fitting statement today when the world is in the midst of a pandemic. An Outbreak such as the one we are facing today can be associated with considerable fear in the general public or in specific communities, especially when illness and deaths are substantial. This fear is the key ingredient for stigma to thrive. 

Stigma towards mental illnesses, sexually transmitted diseases, sexual orientations, physical deformities are some of the most commonly faced stigmas by people around the world. In many countries, cultural and religious beliefs define the attitude of people towards those suffering from such conditions. This can affect the person’s willingness to seek and adhere to help or treatment further pushing them towards mental stress, depression and in worst cases suicide. 

 

However, what we have seen in recent times is far more troubling. The intolerance has been fuelled by misinformation and rumours to bring about a negative and many times violent reaction towards those that are helping the stigmatised person. 

 

In recent examples, a number of health care workers were ostracized by their homeowners and neighbours who were demanding that they stop living in their community. The government was then driven to release guidelines that legally prohibit any landlord to ask a health care tenant working during the time of COVID-19 to vacate the premises. However, stigma towards health care professionals is not a new phenomenon. In some countries, studies have also highlighted that stigma, religious beliefs, distrust of the medical profession, and communication barriers may contribute to wariness of mental health services.2

 

Ostracization and stigmatization is far more deadly during an outbreak like COVID-19. In a socially close-knit country of India, the fear of being segregated lies deep within each individual. The need to be accepted into a group or a social circle is so strong that the mere thought of stigmatization will drive people to hide their symptoms or vital information of contacts or history that could help the authorities contain the spread of the virus. 

 

This negative chain of effect saw its impact during the HIV outbreak, as well as during the more recent SARS, MERS epidemics. A society known to stigmatise people will push a symptomatic person to avoid seeking medical care as well as live in denial by not following any safety measures to not spread the infection further. 

 

With new information unfolding every day about the SARS-CoV2 virus and our unpreparedness for other viruses in the coming years, a society where stigmatisation is prevalent will prove to be a friend to the virus helping it spread indirectly and causing irreparable damage to the society and its future generations. 

A recently published UN article very eloquently lists down simple measures that could be taken by the government and media houses to reduce the prevalence of stigma in the society due to a pandemic like COVID-19. It talks about how to use language to humanize the disease rather than victimize it. A simple change in the words and being more mindful of the way we communicate can alter people’s attitude towards a disease and bring down the feeling of negativity amongst the masses towards a person having COVID-193. More articles, posts, videos on social media on the personal stories will raise the emotional quotient of this equation and further work towards building compassion towards those having the disease and those treating them. 

 

As Martin Luther King, Jr. rightly said – ‘Darkness cannot drive out darkness, only light can do that. Hate cannot drive out hate, only love can do that.’ In these difficult times, we need to stand united and our actions and words need to be steered by the truth and our emotions need to be driven by compassion. 

 

References

  1. Merriam-Webster – Definition of ‘Stigma’ – https://www.merriam-webster.com/dictionary/stigma 
  2. Bailey, R.K., Milapkumar, P., Barker, N.C., Ali, S., Jabeen, S. (2011). Major depressive disorder in the African American population. J Natl Med Assoc., 103: 548-557 
  3. IFRC, UNICEF, WHO, ‘Social Stigma associated with COVID-19’, 24 Feb. 2020 -https://www.unicef.org/media/65931/file/Social%20stigma%20associated%20with%20the%20coronavirus%20disease%202019%20(COVID-19).pdf 
Dr. Madhav Bhargava is a final year Core Medical Trainee in Internal Medicine at Aster Medcity, Kerala, India. He is a part of the first batch of CMT outside the UK, in India. Prior to pursuing Internal Medicine he has also worked at Safdarjung Hospital, one of the busiest hospitals in Asia in the heart of New Delhi.
He has a keen interest in Infectious Diseases and plans to pursue the Specialty in the future.
Conflict of Interest : There are no conflicts of interest to disclose.
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