Социальный отклик на коро во время эпидемии: изучение из Индии

NHS Trust, UK.

Социальный отклик на коро во время эпидемии: изучение из Индии

Арабинда Н. Чоудхари

Институт психиатрии, Колката, Индия

Убеждения и отношения сообщества, включая лечение людей по поводу каких-либо поведенческих аномалий, обычно влияют на частоту, течение и прогноз или исход дезадаптационного поведения. Это критически верно для психиатрической эпидемии, когда интенсивность, частота и тип распространения эпидемии происходят параллельно с убеждениями и отношениями сообщества по паритету с динамикой социального принятия/отклонения. Массивный всплеск коро имел место в СевероБенгальском регионе Западной Бенгалии (Индия) (Chowdhury et al., 1988). Анализ социальных откликов сообщества на болезнь коро показывает восприятие коро как позитивной парадигмы болезни на высоте эпидемии.

Introduction . The beliefs and attitudes of the community including the treatment people towards any behavioural abnormalities in question usually influence the incidence, course and prognosis or outcome of the maladaptive behaviour. This is critically true for a psychiatric epidemic where the intensity, incidence and the type of the epidemic spread occur parallelly with the beliefs and attitudes of the community at par with the social acceptance/rejection dynamics. A massive Koro outbreak took place in the North Bengal region of West Bengal, India (Chowdhury et al., 1988). An analysis of social responses of the community to the illness Koro shows a perception of Koro as a positive illness paradigm, during the height of epidemic.

Material and Methods .

• 1.    Study Population (n=366): The Community Group comprise 206 responses (88 rural and 118 urban family heads) from three villages and one major town of North Bengal Region, and 160 responses from four groups of treatment people (Physicians, General Practitioners, Surgeons, Paramedical Staff) of the Darjeeling district.

• 2.    Social Response Pattern Schedule: It is a simple 12-item forced choice questionnaire in local language for recording the following social responses to Koro illness from each individual. It contains: Brief Demography, Illness Paradigm of Koro, Koro etiology, Koro Treatment option and Koro Acquaintance Source.

The present paper discusses the responses of illness Paradigm of Koro only which has the following four items: a. Koro Illness type as either physi- cal/mental or nil, b. Grades of Koro Seriousness, viz. nil/mild/moderate and severe, c. Infective Potential of Koro, viz. nil/mild/moderate/severe and highly infectious, d. Risk imposition by Koro, viz. nil/life threaten-ing/risk of sexual power loss/risk of general health problems or combination of the last two. Each respondent was asked to express his best estimate of the items of his choice in each category.

l

Results . Koro illness Type: 80,6 % of the total sample viewed Koro as a form of physical illness and only 6 % discarded its illness potentialities.

Koro Seriousness: 58,5 % of the sample pre-ceived Koro as an illness with severe seriousness while 10 % endorsed its non-serious nature.

Koro Infectivity: Only 21,6 % of the sample perceived no chance of infection from Koro. Percentage distribution on the graded positive categories were: mild 3,8 % moderate 13. 7 %, severe 17,2 % and highly infections 43,7 %.

Koro Health Risk: Only 8,2 % of the sample rejected the proposition that Koro has any dangerous risk. 32,2 % perceived a life threatening risk while 38,5 % viewed loss of sexual power as the risk of Koro illness.

Discussion . This study of the social response pattern of Koro during the epidemic height reveals some interesting facts in so far the recognition of Ko-ro as an illness in the community and its consequent spread is concerned. The community responses endorsed the fact that Koro as a definite illness with profound seriousness, great risk of life and disabilities, and is having a high infective potentiality.

This positive illness cognition reinforces the acceptability of Koro in the community as an accepted illness model and thus makes Koro affection of other vulnerable individuals legitimate. Though the rural and urban populations differed in their responses to illness type or chance of infection, they showed remarkably identical responses inasmuch as the seriousness and risk of Koro is concerned. The medical opinion at the same time, which ought to have a deep influence on the ongoing social perception of the phenomenon, is also noteworthy in this context. Different professional groups of the medical community have expressed their Koro cognition, which is very similar to that of the social responses. In other words they reflect the predominant cultural expressions. In fact the treatment people have failed to offer any rational and effective scientific explanation about the illness, which would meet the social curiosity at the time of extreme demand. Their identical responses virtually reinforce further the social cognition, which in turn favour the rapid spread of Koro through milling behaviour along the different socio-communicative networks in the region.