HSSM65 Sociological Perspectives Global Health Assignment Sample
Module code and Title: HSSM65 Sociological Perspectives Global Health Assignment Sample
1. Introduction& background
Buruli ulcer is becoming an “emerging infectious” illnessand stands at third position in term of mycobacterial illness of the immune competent host, just after leprosy and tuberculosis in Africa. It is caused by “Mycobacterium ulcerans” which leads to large ulcers(Wallaceet al. 2017). Buruli ulcer has acquired the third spot after leprosy and tuberculosis and caused by an environmental bacterium that secretes a toxin named “mycolactone”.
Buruli ulcer is reported in 33 countries in Africa, the Western pacific and Asia. The disease is affecting the communities of Western Africa, especially among people who are living close to lakes, ponds and swamps. The disease affects as high as 0.25% of the population in cities like Ghana, Benin and Ivory Coast that are recording nearly a thousand cases annually. In this essay, the societal aspects of Buruli ulcers are examined with “interactionism” and “conflict theory” which highlights eventual conflict regarding the acquisition of limited resources (Vanderslott, 2020).
2. Wider health determinates
According to Simpson et al. (2019), Buruli ulcer is clustered mainly in Africa, which requires proper treatment in time, otherwise it transforms into leprosy and tuberculosis. Due to this disease is caused by Mycobacterium ulcerans; hence, there are maximum chances for that person who is suffering from these diseases may further fall in great illness.
According to Gyamfi et al. (2022), this disease in initial stage does not show pain but after time passing where it is occurs it start to destruct tissues. According to van der Werfet al. (2022), general medical care, along with adequate nutrition is required; wound saline, rinsing and cleansing, absorptive material with short-stretch comprehension result in speedy healing.
Linking with theories
Conflict theory assist to analyse of resources which are limited to it must be utilised carefully to treat this disease from spread. Therefore, due introduction of latesttechnological assets will support to trace this disease in initial stage and to cure it in time (Sur and Pal, 2021). As per the conflict theory, people who have more money and power are considered as the dominant group of the society and they make decisions regarding the ways healthcare systems should run.
They ensure that they must get the healthcare coverage which as a result makes the subordinate group stay out of access to the healthcare facilities due to lack of money. This indicates that wealthy people get greater access to healthcare system through which they can cure buruli ulcer whereas monetarily weaker section of the society cannot cure the disease on time which eventually leads to death. On the other hand, Interactionism theory assists to communicate through those people who are suffering from this and enable to discuss about their problem.
In this theory, integrationists attempt to analyses the meanings and causes of diseases and highlight the fact that social actors are the constructors of health and illness; these difficulties need to be prevented. In this regard, social actors are required to understand the effective ways of prevention of the disease for generation of positive health outcomes.
3. Discussion
Buruli ulcer is one of the most common diseases in Africa as the country has reported 95% of the total cases in the global countries. The disease is mainly seen in rural areas where the reach of a formal health care system is restricted. Moreover, people are more inclined toward acquiring the services of “traditional healers” rather than having a “biomedical treatment” (Agbo et al. 2019).
The inclination towards seeking out the healers is mostly seen in patients with advanced stages of Buruli ulcers. However, lack of proper knowledge is increasing the rate of BU in Africa; for this reason, almost 95% of BU cases are from this continent; the most endemic countries are Côte d’Ivoire, Ghana, Benin, and Cameroon (Tabahet al. 2019).
Evident challenges are recognised in the diagnostic process and appropriate case systems for the patients at the primary care centres. In order to improve the health care system of the country, the inclusion of a proper surveillance system and improving infrastructure is the major effort that is needed from the government (Koka, 2018). Moreover, the district hospital needs to acquire adequate knowledge to fill the lack of awareness on potential vectors, transmission mechanisms and environmental reservoirs.
In accordance with the “conflict theory” of Karl Marx, a majority of the conflict occurred due to limited resources. The social structure of the country has facilitated the suppression of poor people (Olorunlana, 2022). Changes in the ecological factors are often interconnected with the water bodies and the appearance of skin lesions that are associated with the crucial factor in interacting with BU.
BU is affecting mainly the rural areas in Africa and very limited to town areas of the country. The difference in social classes is evident in the cases of BU as the poor people are often provided with mediocre treatment (Koka, 2020). The distinction between the “bourgeoisie” and the “proletariat” can be seen due to the difference in the social classification in Africa.
On the other hand, the biochemical treatment of BU has failed due to the lack of efficiencies in the healthcare staff and the perception of the positive efficacy of the herbal treatment (Ahorluet al. 2018). It refers to the cause of high rates of BU in a certain region in Africa where the poor patients have failed in gaining proper treatment during the first symptom with the appearance of large lesions.
WHO has provided three categories for the lesions that help in recognising the seriousness of the BU. Category 1 refers to the presence of small lesions below the diameter of 5cm, whereas lesions with a diameter between 5-15cm with “edematous” and “plaque” form (Coates et al. 2020) characterize category 2. Category 3 characterizes multiple lesions with a diameter of more than 15 cm in critical areas such as joints, eyes and genitalia.
The presences of the category 2 and 3 lesions are seen in remote areas where the healthcare system does not provide the people with adequate knowledge and does not have appropriate healthcare tools as well (Nichter, 2019). On the other hand, “interactionism” refers to the similar characteristics a community follows based on interaction with others.
The rural people of the country still perceive herbal treatment and traditional healers as the best way to treat the issues, as is the common norm in the society. It depicts the “constructivism” of the “interactionism theory” that delivers higher importance to the social values above all (Anagonouet al. 2021). WHO has reported a higher rate of cases of BU from 16 African countries that have added approximately 57,500 cases from 2002 to 2016. Within that period, African countries have contributed to 98% of the total cases.
In African countries, the health care system consists of three parts; each includes “care facilities” and “administrative structures” (Dean et al. 2019). The technical departments of “The Ministry of Public Health” designed the tertiary level of the healthcare system and controlled the national laboratories and hospitals.
The facility of “BU-DTC” has provided African countries with the adequate infrastructure to facilitate early diagnosis and proper treatment. Moreover, with the help of the support partners those have built “physiotherapy units”, “surgical theatres”, “admission wards” and “wound dressing rooms” (Vanderslott, 2021). Most of the “BU-DTC” is provided with surveillance infrastructure and other tools to describe case detection, treatment and diagnostic activities to provide superior knowledge to the health workers.
Due to the presence of social stigma regarding BU, the facilities have focused on early detection of the disease at the community level (Kalipeniet al. 2018). It has effectively strengthened the surveillance system for community detection and facilitating communication with the inhabitants in order to increase knowledge regarding the probable causes of the disease.
The BU02 and WHO BU01has improved the case management practices by providing an infrastructure for standardized treatment and diagnostic activities. It has facilitated social mobilization, prevention of disability, and operational research in order to provide poor people with proper treatment (Guégan et al. 2018).
WHO has recommended a treatment extended for 8 weeks with oral rifampicin, antibiotic therapy and injectable streptomycin. The NBUCPs have managed to deliver free antibiotics to poor people; however, the supply of drugs and other narcotic products majorly complicated the situation(Kalipeniet al. 2018).
4. Implication for practice
Lack of proper medical care system
The absence of an appropriate medical care system for the rural inhabitants is a crucial factor that has affected public health. The diagnosis of BU is possible with a microscopic detection of the lesion that can highlight the presence of the “mycobacteria”. The sample collected from the lesion can aid in the early detection of the disease that can prevent disabilities in poor people (Ackley et al. 2021).
However, the method is not precise, as it has proved to be impaired with false detection of BU. On the other hand, the bacteria can be detected through a culture sample and DNA amplification. The PCR requires a high-tech laboratory to sustain its practice and properly trained staff.
Additionally, diagnostic tools are not available in remote areas that have led people in less believing the medical system. They are interested in gaining the service of the traditional healers resulted in low reports of the cases (Vanderslott, 2020). As a result, in recent years, the official record of BU cases has decreased; however, it does not represent the actual number. Furthermore, the negative perception of the medical staff has discouraged the people from acquiring proper care in Africa. The medical staffs are less interested in treating poor people leading to the delay in BU detection (Dean et al. 2022). On the other hand, the central care system is expensive, whereas the traditional healers cost a lot less.
Social challenges
Approximately 45% of the rural residents are not aware of the aetiology of the disease and the majority of them believed BU is caused by witchcraft.This does not allow them to access proper medication for BU. The delay in proper medication has resulted in secondary bacterial infection and additional complications (Owusu-Amponsah, 2018). The passive mentality of the medical staff has further complicated the situation, as the villager’scomfortable seeking herbal treatment.
The biochemical treatment, such as herbal and traditional healers, led patients with certain challenges that have led to permanent disability or the requirement of extensive surgery. The knowledge evaluation,can help in providing proper educational content (Vanderslott, 2019). The treatment intervention can be successful with the simultaneous deliverable with the “behaviourally-feasible prevention” method.
Lack of proper knowledge
African people do not trust on medical staff due to their belief in witchcrafts; furthermore, low knowledge about BU and untrained medical staff can not treat with this disease properly. As a result, they are more interested in alternative solutions of BU. Moreover, traditional healers initially contact patients who are admitted to the local hospital as their first choice.
It shows the lack of trust in the medical care system that is provided to the rural areas. In fact, the negligence of the medical system has delayed the detection of the BU bacteria in patients and it has created a negative impact on the people(Owusu-Amponsah, 2018).
Inadequacy of infrastructure
Surgical intervention is the main strategy in addressing Buruli ulcers in global countries. The antibiotic treatment and the oral suspension provided by WHO have provided a better option for the rural people. On the other hand, oral antibiotic therapy has made the intervention of BU easily accessible for the local people (Kalipeni et al. 2018). However, the COVID-19 pandemic has raised several challenges in creating a shortage of supply.
Furthermore, the antibiotic manufacturers have shifted toward the production of “azithromycin” and the production of “clarithromycin” and “rifampicin” has reduced significantly, as a result, the inadequate amount of antibiotics has increased the issues in the rural areas. The antibiotics were effective in treating the category 1 lesions resulting in reduced transmission of BU.
Due to the social stigma around the disease, the BU patient needs to be provided with “psychological support” (Tambo et al. 2018). Moreover, lack of medical resources and medical infrastructure in Africa increase the spread of BU. This prevents them to avoid pond swamps and wear protective clothing.
5. Recommendation
Psychological support
Psychological support is essential for the patients of BU, especially those who belong to the rural areas of Africa. Due to the social stigma regarding the disease, the patients do not seek medical treatment adequately resulting in various side effects (Iwelunmor and Grigsby-Toussaint, 2019).
The patients needed to be provided with psychological counselling that can retain their mental stability as well as awareness regarding BU. It can help in eradicating the wrong perception of the local people associating and motivate them for herbal treatment and seeking out the help of traditional healers.
Additional preventative measures
The mode of transmission of the pathogen that is responsible for spreading the disease is still unknown. As a result, the authorities have found it exceedingly difficult to conceive an appropriate preventative measure to implement. The introduction of vaccines for BU can be an effective way to stop the epidemic in African countries (Harrington et al. 2020).
The government need to deliver financial resources to facilitate research regarding the disease and establishment of the laboratories in rural areas. Moreover, permanent sensitisation of the inhabitants who are living in the endemic areas of Africa can be a proper action (de Groot et al. 2020). The local person needs to wear boots and clothes to cover their entire body, which can restrict the transmission of the environmental pathogen.
The anglers and the farmers are needed to make aware regarding the avoidance of contact with the environment that can lessen the chances of transmission significantly. Moreover, collaboration with the traditional healers is paramount for the initial period in the African continent that can aid in providing mental assurance to the local people (Weiss, 2018). The government can gain support from WHO to improve the infrastructure in the rural areas.
Improvement of the patient care
The “World Health Organization (WHO)” and NGOs such as “Médecins Sans Frontières (MSF)” is playing a critical role in spreading awareness regarding the disease. They have demonstrated simple intervention techniques to respond to the requirements of the patients (Engdaworket al. 2020). Additionally, the authorities need to investigate founding comprehensible programmes to include all skin “NTDs” such as yaws, Buruli Ulcer, leprosy and leishmaniasis can improve the operational responses.
It can increase the probability of the early detection of BU lesions in patients and decrease the need for extensive surgery (Opoku, 2021). The integration of the traditional healers can also help in increasing community interaction and assist in establishing adequate “public health programmes”.
6. Conclusion
Poor knowledge regarding the disease is the main reason for the endemic situation of BU in Africa. Additionally, the increasing stigma regarding the disease has restricted the government programmes to provide proper care for the rural inhabitants. The interactionism theory depicts the essential role of community interaction that has facilitated the misconception regarding BU.
As a result, the inclusion of traditional healers in the medical system can help in gaining the trust of the local people. It can effectively improve the perception of the rural people regarding the medical care system resulting in better detection of BU lesions. The development of the “diagnostic algorithms” in facilitating recognition of changes and establishment of the “triage criteria” can be beneficial for health workers.
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