Perceptions and treatment of cutaneous leishmaniasis in Suriname: a medical-anthropological perspective

Cutaneous leishmaniasis is a parasitic skin infection, viewed by biomedical professionals as one of the most serious skin diseases in developing countries. It affects between 1 and 1.5 million people globally and is a growing health problem. The disease is caused by parasites that are transmitted via the bite of an infected sand fly. How do people in Suriname, where CL is common in the hinterland, perceive, explain and fight the disease? This study describes and analyses the complex health seeking trajectory of CL patients in Suriname from a medical-anthropological perspective. Using mainly qualitative methods, the author explores people’s illness experiences and treatment decisions (self-medication, herbal traditional medicine, biomedical treatment). She argues that these should be understood from the view point of patients and their direct environment, within the larger historical, social, economic, and environmental contexts. She relates the stunning variety of medicines people use in self-medication with their uncertainty about the cause of the illness, their associative style of reasoning, and the specific context of their daily life. One of the most prominent and disfiguring characteristics of the disease is its extensive ulceration and scar formation from lesions. Cutaneous leishmaniasis is therefore often associated with stigma.The most striking conclusion of the study is that - unlike in some other countries - people with CL are, in general, not stigmatized in Suriname and do not feel inhibited to seek biomedical treatment because of shame