PROBLEMS, ACCEPTANCE AND SOCIAL-INEQUALITY - A STUDY OF THE DEFORMED LEPROSY PATIENTS AND THEIR FAMILIES

Though the impact of social inequality on health conditions is widely known, its impact on the chronic and stigmatized disease, leprosy, has received little attention. Deformity sometimes leads to disabilities and to handicaps causing problems to the patient and his family. In th is paper an attempt has been made to understand the impact of social i nequality, prevalent in the form of the caste system in India on the d eformed leprosy patients and on their families. This impact was examin ed in terms of the problems faced by the patients. A sample of 150 def ormed patients and their families, drawn from two districts in Tamil N adu, was selected for the study. About 57% of the deformed patients ex perienced their deformity as a handicap which caused social and econom ic problems while the rest did not. Of the three caste groups, the Low er Caste group experienced more severe economic problems while the Upp er Caste group faced more social problems. The extent of acceptance of deformed patients in their family varied significantly among those fa cing and not facing problems due to their deformity. The deformed pati ents without any handicap were accepted in a large majority of their f amilies (82%) regardless of their caste status. In contrast the deform ed but handicapped patients were accepted differentially among the thr ee caste groups with the Upper group accepting them in most of their f amilies (80%) while in the Lower group much less number of families (5 4%) did. All the families of the deformed but not handicapped patients desired to keep their patients till their death irrespective of their caste status. On the contrary, while all the families in the Upper Ca ste group expressed their willingness to keep their handicapped patien ts in the family till their death, 10% in the Middle and 22% in the Lo wer Caste groups did not want to do so. This suggests the gradual marg inalization, rejection and dehabilitation of the affected. Thus, one's caste status can be a broad indicator of the nature and the extent of handicaps and acceptance in the family. This factor needs to be appro priately taken care offer rehabilitation and disability management in leprosy control programmes.