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Changing Representations of Mosquito Borne Disease Risk in Réunion

出版	University of Western Australia, 2008
URL	http://books.google.com.hk/books?id=IB5wrgEACAAJ&hl=&source=gbs_api

註釋[Truncated abstract] In March 2005, the Indian Ocean island of Réunion, a former colony and now overseas department of France, saw the first cases of what was to become a massive epidemic of the mosquito borne viral infection Chikungunya. More than 250,000 people, one third of the Island's population, were subject to high fevers, rash, and joint and muscle pains over the next 18 months, yet the public health authorities in metropolitan France were arguably slow to take the epidemic seriously. The research presented here explores attitudes underlying the management of the epidemic by examining both metropolitan and local representations of mosquito borne disease from historical, epidemiological and media perspectives. The research seeks to answer the general question Does colonial history continue to influence the representation and management of mosquito borne disease in Réunion? Three parallel approaches are taken to answering this question, using a common framework of tropicality (a Western discourse that exalts the temperate world over its tropical counterpart, and overlaps with colonialism and orientalism). ... Several factors are likely to have contributed to the persistence of tropicality in public health practice in Réunion: Othering as a universal phenomenon; the cost of administering interventions to combat tropical diseases in the remote environments of French overseas departments and territories; the denial of a serious public health risk as a cultural trait in Réunion; and the significant rôle of the colonies in forming and maintaining the French national identity. It has to be acknowledged that historically, tropicalism does appear to have played one positive role in the management of mosquito borne disease: "Top-down" public health campaigns successfully eradicated malaria and dengue fever in Réunion. However, the public health response to the Chikungunya epidemic was not as successful, and led to an exacerbation of Reunionese feelings of resentment towards the metropolitan French government. This study is original in so far as it is multidisciplinary, drawing on discourses on tropicality, public health, risk perception, and postcolonialism to interpret the findings. The approach has provided insights that might not otherwise have come to light, highlighting the value of the contribution that textual analysis can make to our understanding of public health particularly in providing information on what constitutes culturally appropriate advice and acceptable forms of public health intervention. Regardless of our understanding of the mechanisms of disease transmission in the physical space of tropical epidemics, affected populations will continue to suffer a preventable disease burden until such a time as the conceptual space of tropical Otherness is changed. Ongoing research collaboration between the Humanites and Health Sciences can only help to bring such a time closer.