| Issue/Objective |
Podoconiosis-a climate-sensitive neglected tropical disease affecting barefoot subsistence farmers in Ethiopia-remains a significant source of health inequity. While its clinical and economic burdens are well documented, its social consequences are less understood. In contexts of poverty, policy neglect, and limited institutional recognition, stigma operates as more than interpersonal discrimination; it functions as a structural driver of exclusion. This study examines how stigma contributes to the progressive erosion of social personhood among affected individuals. It aligns with the conference theme by highlighting how inequities are reproduced through upstream social processes, underscoring the need to reclaim health equity through structurally informed action. |
| Methodology/Approach |
This qualitative analysis is embedded within a broader mixed-methods study conducted in Southern Ethiopia. Data were collected through in-depth interviews with 30 individuals living with podoconiosis. Participants were purposively selected to capture variation in age, gender, and disease experience. Interviews explored lived experiences of stigma across social, economic, and institutional contexts. Data were analyzed using thematic analysis, with an emphasis on identifying patterns of exclusion and the processes through which stigma shapes social participation and identity over time. |
| Results |
Findings show that stigma operates as a cumulative and processual form of social exclusion. First, bodily changes are moralized, with visible symptoms interpreted as signs of impurity, leading to public humiliation and institutional exclusion, including from schools. Second, relational ties are disrupted through family distancing, marriage exclusion, and weakening of community belonging. Third, participants experience civic and economic disqualification, including exclusion from decision-making spaces, education, and livelihoods. Finally, repeated exclusion is internalized, resulting in self-withdrawal, diminished self-worth, and, in some cases, suicidal ideation. Together, these stages illustrate how stigma progressively erodes recognition, participation, and future opportunity. |
| Discussion/Conclusion |
These findings demonstrate that podoconiosis-related stigma is a structural determinant of health inequity, producing a gradual "social death" through the erosion of social, civic, and economic inclusion. Addressing this requires moving beyond biomedical approaches toward structurally informed responses that recognize stigma as a systemic barrier. Integrating psychosocial support into primary health care, strengthening stigma-reduction strategies, and improving policy recognition of neglected diseases are critical steps. By addressing these upstream drivers of exclusion, health systems can better align with equity and rights-based approaches, contributing to the conference's call for collective action to restore commitment to global health equity in marginalized settings. |
| Presenters and Affiliations |
Tesfatsion Dominiko Abiyo Telic Consulting |
