Restoring dignity: community arts in leprosy control.

The evolution of health care is closely linked with the community arts. In Greek mythology, Asclepius, son of Apollo, is commonly referred to as the god of medicine and healing. The World Health Organization and most professional health organisations use, as the traditional symbol of healing and medicine, the staff of Asclepius, which is depicted as a single serpent encircling a staff. The serpent signifies the ideal of healing as renewal, as the serpent sheds its skin. The history of art in hospitals has been extensively documented in many European countries since the 14th century, a time when religious imagery, architecture and aesthetics were as important for healing, as the provision of medical care. Today, active hospital arts charities in the United Kingdom and Australia are focussed on providing hospital environments that enhance the therapeutic, recreational and occupational opportunities for those in medical care. Community arts projects are created through collaborative processes, and typically involve artists and non-artist members of the community with a shared sense of values and practices based on geographic location and/or identity actively participating in the making of a work of art for aesthetic, personal development, community development or educational purposes. Community arts involve an understanding of communities and how art can function as an agent of social change and enhancer of community vitality. Participatory arts projects provide opportunities for community engagement and capacity building, particularly among disadvantaged groups. Apart from its general contribution to improving health and wellbeing, community arts has been adapted to enhance the coping strategies and self-image of people affected by breast cancer and human immunodeficiency virus (HIV), as well as improve fundraising activities to control these diseases. In individual and group settings, art therapy has shown positive outcomes for women diagnosed with breast cancer, such as an increase in self-esteem and cohesion, a decrease in anxiety and depression and significant improvements in overall health and wellbeing. In community settings, campaigns such as breast cancer awareness month, utilise a wide array of community arts, symbols and murals to change adverse community perceptions towards people affected by the disease. In relation to HIV, community arts projects have played significant roles in stigma reduction, and translating research into practice. In contrast, the legacy of community arts in leprosy control is contested, with current community arts efforts largely neutralised by centuries of adverse artistic depictions of leprosy and the people affected by it. Misrepresentation of serious dermatological conditions, such as leprosy, originated from a misleading translation in the Bible of the Hebrew word ‘nega tsdra ‘ath’ as ‘a plague of leprosy’. Biblical descriptions of what was referred to as leprosy are documented in Leviticus chapter 13, which provides a crude diagnostic algorithm for ‘leprous sores’, with those diagnosed being certified as ‘unclean’. For centuries these biblical descriptions have served as an important perceptual lens and repository of knowledge for community artists depicting people living with leprosy, and have also influenced public perception of individuals affected by leprosy in the Christian world since the renaissance. The sculpture of leprosy in the Cistercian Abbaye de Cadouin exemplifies the use of