The 2005–2007 Chikungunya Epidemic in Réunion: Ambiguous Etiologies, Memories, and Meaning-Making

Abstract

From March 2005 to April 2007 the French overseas department and Indian Ocean island of Réunion was significantly affected by an epidemic of chikungunya. Chikungunya is a vector-spread disease (by the aedes albopictus mosquito) that leads to painful rheumatic symptoms. The disease infected approximately one third of the island's total population of 802,000 inhabitants (Rallu 2009). This article is a discussion of local etiological accounts of chikungunya. The primary topic raised by informants was whether chikungunya was a vector- or air-borne disease. Even though informants had access to substantial biomedical information concerning the disease and its transmission, some were convinced by it and others were not. In order to make meaning of the disease, the Réunionese drew on various types of medical knowledge from different health sectors simultaneously. To understand people's experiences with chikungunya, we must account for all of their etiological explanations.

Keywords:

• chikungunya epidemic
• etiology
• meaning-making
• memories
• Réunion island

ACKNOWLEDGMENTS

This research has been approved by the Regional Ethical Committee for Medical Research in Bergen, Norway and Institut national de veille sanitaire (INSERM), France. Fieldwork has been financed by grants awarded by the Humanities Faculty at the University of Bergen and the Nordic Africa Institute, Uppsala. I would also like to acknowledge the support of DRASS, CCAS, and CLAP in St Pierre for their assistance in my research and not least the 16 individual Réunionese participants in this study. I am also grateful to Tove I. Fjell, Astrid Blystad, Anne K. Bang, and Medical Anthropology's anonymous reviewers and editor, for detailed and constructive comments on this manuscript.

Notes

Kleinman's (1980:50) classic figuring of the internal structure of a local health care system distinguishes among the popular sector, that is, lay people's perceptions, experiences, and beliefs of disease and treatments, a professional sector that is characterized by biomedicine, and a folk sector in which so-called alternative medical practices operate. However, the sectors tend to overlap, and lay people's knowledge of disease can therefore be based on information withdrawn from all three of the sectors simultaneously, which is the case for this study.

Since my first fieldwork in 2009, DRASS has undergone an organizational transition, and is now known as “Agence de santé de l'Océan Indien” or ARS. ARS is nongovernnmental whereas DRASS responded directly to the French prefect. The prefect represents the French national government at a local level. This change only took place in April 2010. As DRASS was still in operation both during the chikungunya epidemic and my main fieldwork in 2009 I will therefore still refer to DRASS and not ARS throughout the rest of this article.

The term “metropolitan” is a direct translation from the French “métropolitain,” which refers to a mother country from the perspective of a (previous) colony. The term is commonly used (both etic and emic) to describe the relationship between mainland France and the French overseas departments.

There are too many references to cite them all here.

“Creole” is commonly used to describe someone or something local, and functions as a common denominator between various ethnic and religious differences on the island. However, I support Finch-Boyer's (2010) claim that Creole should not necessarily be perceived as a contrast to French. Instead Creole represents a distinction and concurrence of identity categorizations and strategies that was encouraged by the economic and political climate of the postdepartmentalization years. Although the contents and meaning of Creole and French are constantly negotiated in various situations, they are not a priori dichotomous identities.

Although all conversations between us had been in Creole up until then, Gabrielle insisted on speaking French during this recorded interview.

Mauritius has had a booming economy after independence owing to its textile industry and tourism, and has today one of the highest gross domestic products in Africa.

Malaria spreads via the anopheles, and not aedes mosquito.

Additional information

Notes on contributors

Karine Aasgaard Jansen

KARINE AASGAARD JANSEN is a PhD candidate at the Department of Archaeology, History, Cultural Studies and Religion at the University of Bergen, Norway. Jansen holds an MSc in social anthropology and has carried out wide-ranging fieldwork in Mauritius and Réunion.