Our approval or disapproval of them depends largely on our individual value premises. The traditionalist acts in accordance with institutionalized norms and practices, while emotional behavior is shaped largely by moods. Therefore social change can best be effected by bringing about new ideas and beliefs and there- by behavior. To cite just one example of this process in more detail, social and psychological factors play a greater role in connection with leprosy than with almost any other disease. A social study that we carried out in Sri Lanka in 1989 revealed that traditional beliefs about leprosy lead to feelings of guilt and shame in patients, to apathy and resignation, and even to aggressiveness toward society.
Patients try to elude social rejection by concealing themselves and their illness.
This enables the disease to progress to the point of irreversible and visible physical deformities, and also increases the likelihood of it being transmitted to others. In 1989, however, an estimated 12,000-15,000 leprosy sufferers remained untreated, many of them highly infectious. Only a few hundred cases were thus detected, and about a third of them refused to accept the diagnosis as they associated leprosy with deformities and not with the relatively harmless looking early signs on their bodies. The new approach was social marketing, and this was carried out in close collaboration by the Sri Lankan Ministry of Health, Leprosy Relief Emmaus Switzerland, and the then Ciba-Geigy Leprosy Fund . Any campaign must take these factors into consideration and also be compatible with the cultural and religious traditions of the target group or groups.