Amsterdam Institute for Social Science Research, University of Amsterdam, Kloveniersburgwal 48, 1012 CX Amsterdam, The Netherlands.
Soc Sci Med. 2012 Sep;75(6):1097-105. doi: 10.1016/j.socscimed.2012.04.038. Epub 2012 May 26.
Why are potentially harmful, non-biomedical chemical substances, such as battery acid, chlorine, herbicides, and insecticides, used in the treatment of cutaneous leishmaniasis (CL)? What drives people to use these products as medicine? This article is about perceptions of CL, and the quest for a cure, in Suriname, South America. It highlights the associative style of reasoning behind health seeking and discusses the use of harmful chemical substances as medicines. Cutaneous leishmaniasis, a parasitic disease, affects 1 to 1.5 million people globally. It has a spectrum of clinical manifestations, but the most prominent and disfiguring elements are extensive dermatological ulceration and scar formation from lesions. The data upon which this article is based are derived from anthropological research carried out in different parts of Suriname between September 2009 and December 2010. Data was collected through mainly qualitative methods, including interviewing 205 CL patients using structured questionnaires at the Dermatological Service in the capital Paramaribo. Almost all people with CL said they tried self-treatment, varying from the use of ethno-botanical products to non-biomedical chemical solutions. This article presents and interprets the views and practices of CL patients who sought treatment using harsh chemicals. It argues that a confluence of contextual factors - environmental, occupational, infrastructural, geographical, socio-cultural, economic, socio-psychological - leads to the use of harmful chemical substances to treat CL sores. This study is the first in Suriname - and one of the few done globally - focusing on social and cultural aspects related to CL health seeking. It aims to encourage health policy makers and health professionals to carefully initiate, provide, and evaluate CL treatment and prevention programs.
为什么会有人在治疗皮肤利什曼病（CL）时使用潜在有害的非生物医学化学物质，如电池酸、氯、除草剂和杀虫剂？是什么驱使人们将这些产品用作药物？本文探讨了在南美洲苏里南，人们对 CL 的认知以及对治疗方法的探索。它强调了健康寻求背后的关联式推理风格，并讨论了有害化学物质作为药物的使用。皮肤利什曼病是一种寄生虫病，影响全球 100 万至 150 万人。它有多种临床表现，但最突出和毁容的特征是广泛的皮肤溃疡和病变引起的疤痕形成。本文所依据的数据来自于 2009 年 9 月至 2010 年 12 月在苏里南不同地区进行的人类学研究。数据主要通过定性方法收集，包括在首都帕拉马里博的皮肤科服务处使用结构化问卷对 205 名 CL 患者进行访谈。几乎所有 CL 患者都说他们尝试过自我治疗，从使用民族植物学产品到非生物医学化学溶液不等。本文介绍并解释了寻求使用刺激性化学物质治疗 CL 的患者的观点和做法。它认为，一系列环境、职业、基础设施、地理、社会文化、经济和社会心理等因素导致了有害化学物质在治疗 CL 溃疡中的使用。这项研究是苏里南首次——也是全球少数几次之一——关注与 CL 健康寻求相关的社会和文化方面。它旨在鼓励卫生政策制定者和卫生专业人员谨慎地发起、提供和评估 CL 治疗和预防方案。
