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FYI:ハンセン病対策の歴史と現状/元気が無かった私

ひょっとして以前もアップしたかも知れませんが、COVID19関係で「罰則」がつくという話がでてきているので、歴史を学んでおく必要があると思います。


ハンセン病対策の歴史と現状


−日本と世界−
森 修一
https://www.jstage.jst.go.jp/article/hansen/87/2/87_73/_article/-char/ja
【抄録】(本文は日本語です)

 

  Isolation of leprosy patients beginning in the Middle Ages of Europe was a religious isolation based on the doctrine of Christianity. It was terminal care with compassion for the purpose of protecting the patient, but the patient had to finish his life in Lazaretto. This aspect deeply engulfed people the image of leprosy as diseases isolated, diseases of fear, dark and dusky. A plague epidemic starting in the 14th century became the greatest tragedy in European history, and one third of the population died out. Pest epidemic continued until the 18th century, and cholera also became popular from the 19th century. In the epidemic of plague and cholera, in Europe, developed public health policies mainly against measures against infectious diseases and opposed it. As a result, the European public health policy was forced to sacrifice minorities with the aim of maximizing maximum happiness, and was established in the 19th century with the development of bacteriology.

  Leprosy was prevalent in the 19th century in Canada, Hawaii, Norway and Germany. It began with management as a genetic disease at the beginning, became to be considered as an infection eventually, Mycobacterium leprae (Lepidoptera) was discovered by Hansen in 1873, and then overcome by overcrowding as a public health policy I was tried. Isolation was strict, but protection was also secured by Christian missions and isolation aimed at terminal care was also done. The former strongly aimed at transition from religion to science mainly in the United States, scientific measures were taken based on the “International Conference”. The latter was centered on British Christianity mission, with the dignity and compassion of human being the center of its activities. Two isolation became the tide of the world in the modern age, eventually leading to the trial of the isolation policy based on science and compassion.

  Chemotherapy starting with Promine in 1943 changed Hansen’s disease from incurable disease to diseased disease, science learned from the spirit of religion, changed the isolation as public health policy, religion was a remedy for patients who respect scientism , Aiming to escape from the concept of isolation in the Middle Ages. Eventually, this result fruited as WHO’s measures against leprosy, isolation policy shifted to outpatient treatment, and WHO policy of multidrug therapy (MDT) began in 1981. With the progress of this policy, the number of leprosy patients worldwide has drastically decreased, and in 2010 only one country where leprosy is a public health problem became one country. It was also the end of the history of the tragedy of leprosy for thousands of years.

  The history of leprosy gave humanity a number of tragedies, but the way to overcome it has given us a lot of lessons. Today, utilizing what we learn from the history of leprosy to the future will be our mission living in the era when leprosy is about to be overcome. In this paper, while examining the process of religion and science overcoming leprosy, I will clarify the history of leprosy and I would like to think about the significance of telling the history as archives as a history.

↑の論文で世界の流れが大まかに分かったのですが、標題に「世界と日本」となっている割には、日本のことがあまり書かれていないのが残念です。(論文の最後にちらっと載っていますが、日本で外来制度が進展しなかった要因、日本の隔離政策維持の要因・・・「要因」については、まさに今後の課題なのかもしれませんが、少なくともその実態がもうちょっと詳しく書かれていたら良かったです。

・それにしてもちょっと長い論文でした。

以下日記

・本日1/29(金)は6時半起床。何か疲労感あり。ほんのちょっとだけ朝勉して、出勤。午前外来、午後回診、会議、夕方職員さん向けに呼吸管理の学習会。なんと参加者は3人も。(最初は一人だけかなと思っておりました)帰宅は18時49分。お風呂入って夕食:もつ鍋、〆はラーメン。うまかったー。アルコールを摂取したかったけど睡眠の質が悪くなるので今日はノンアルで我慢。そしてこのブログを書いております。

・先日から書いておりますが、2月からのワン・オペ外来のシミュレーション中。私は、なんとかやれると思っているのですが、今日外来の主任さんが、水曜日のシミュレーション後私が寂しそうに外来を去って行ったと。今まで、外来しながら患者さん、看護師さん達と何気ないことの言葉のやりとりを楽しんでいたのでしょうね。多分そういうことが楽しめなくて元気が無かったのでしょう。今は、コロナで仕事後、休みの日も交流できないので、ちょっとつらいですね。


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