Beyond constructionism and pessimism: theoretical implications of leprosy destigmatisation campaigns in Thailand.

Based on a study of leprosy destigmatisation campaigns conducted in Thailand since the 1970s, this article examines the difficulties in their implementation, the extent of their success and the degree to which they are actually needed. The findings indicate that these campaigns are doomed to fail because of problems inherent in any attempt to transmit a normalising message, and also because of stigmatisation derived from the metaphorical use of leprosy in spoken language. The study also found that educating the public about leprosy only increased the risk of stigmatisation. However, it appears that the stigma itself bears the potential for destigmatisation, since the worse the image of the disease, the less likely its identification with the patients diagnosed today, thus sparing them actual negative reactions. These conclusions serve as a basis for examining assumptions about knowledge and power underlying the constructionist analysis of destigmatisation processes. The paper calls to abandon these presuppositions, as they have led constructionism to a pessimistic view of the possibility of destigmatising diseases and disabilities. [ABSTRACT FROM AUTHOR]