Abstract
This thesis examines the lived experiences of refugees affected by scabies to understand their perceptions of their condition and the effects of community scrutiny on their well-being. The study was conducted in a refugee camp where overpopulation promotes the spread of scabies. To grasp the complexity of living with scabies in a refugee camp, I explored the cultural, social, economic, and political factors that influence the individual suffering of refugees affected by scabies in their natural context. I used qualitative research methodologies, including in-depth interviews, illness narratives, observations, key informant interviews, and focus group discussions.Respondents held a negative view towards scabies, believing, for example, that scabies skin rashes were indicators of human immunodeficiency virus opportunistic diseases or that they would attack the impoverished. Scabies was seen as a manifestation of substandard living conditions characterised by a lack of nourishing food, including milk, meat, and various vegetables, which were customary in their community's previous way of life in the Democratic Republic of Congo. Following scabies outbreaks, in which people of all social and economic strata contracted scabies, the stigma shifted as people realised that anyone could contract scabies, not just the most impoverished. However, the stigma associated with scabies persisted. Despite the free provision of biomedicine, the only available treatment for scabies, benzyl benzoate, did not receive a positive reception due to its unpleasant odour.
I argue that refugees' suffering is explained by the structural violence inherent in their global governance structures. Despite the long history of conflicts leading to this population's exile, which began with the border delimitation of African countries during the Berlin Conference of 1884–1885, the current political dialogue does not address its root causes. The United Nations High Commissioner for Refugees lacks the influence to actively engage in political discussions aimed at preventing the war that led to the displacement of these people. Additionally, the UNHCR's aid is inadequate for sustenance and does not enable the refugees to leave the camp. The structural constraints faced by this population lead to a higher vulnerability to disorders like scabies.
This thesis demonstrated, using ethnographic methods, that scabies is a manifestation of structural violence. It also makes an original contribution to the multidimensional stigma associated with visible skin diseases, the unintended consequences of humanitarian assistance for refugees, and the role the popular medical system could play to improve overall medical practice.
| Date of Award | Jul 2024 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Shahaduz Zaman (Supervisor) & Gail Davey (Supervisor) |