1Anthropology, University of Auckland, 2Atiu Hospital, Cook Islands Ministry of Health
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Syndemic theory allows for the identification and exploration of complex biocultural interactions between disease agents and the sociocultural conditions in which they operate. In this paper we identify the physiological interactions between tuberculosis and helminth infestation which occur both pre- and post-natally and track, through analysis of historical records, how these interactions have occurred in the context of colonial and postcolonial changes in the Pacific.
Specifically we analyse historical accounts of eradication campaigns as well as reports of TB prevalence from pre-World War II to 2000 in the nations of Tuvalu (then the Gilbert Islands) and the Cook Islands. We hypothesise that syndemic interactions between the two infectious conditions serve to explain aspects of the historical experience of tuberculosis for people in these Pacific nations, particularly the variable prevalence of TB on different islands of each group in the past, as well as the current highly varying rates between these two island groups – Tuvalu with one of the highest rates of tuberculosis among the Pacific Island Nations and Cook Islands with one of the lowest. The work emphasises how past colonial ecologies have long term legacies.
This work has been funded through a grant from the Health Research Council of New Zealand.