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Who is the guilty? Communication ideologies, narratives and moral narratives in the fight against tuberculosis in a Peruvian prison


KeywordsTriple Keywords
Social anthropology
Cultural anthropology
Races of man
Communication, Primitive
Mass communication


This article addresses narratives, dialogues and experiences of health inmates and staff involved in an intervention funded by the Global Fund to reduce TB rates in Peruvian prisons. The aim is to answer two main questions: how is this intervention debated and who is responsible for health care? It is based on an ethnography carried out in 2006 in Lurigancho, Peru’s most overcrowded prison. The study shows that, contrary to what the intervention claimed, many of the inmates were able to reproduce in their terms, without major problems, the biomedical versions of the disease’s aetiology. It is found that the speech of the intervention ends up holding patients solely responsible for their health status, taking care of other equally important social and economic factors. It is argued that many public health policies have become reductionist since public health has started to think using liberal economic assumptions. As a result of this process, certain diseases and types of patients or social groups may be considered morally reproachable and punishable. It was concluded that it was essential to explore communication ideology behind any public health intervention or policy.

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