Table 3 Examples of different stigma manifestations. HCW = healthcare worker.

Attitudes and judgement

“It’s often households, I felt, that you’re culpable as a family. Particularly so in bird flu, H5N1, anyway, a lot of children are affected and their families felt the impact of stigma” – Interview 9

Government, community

Family, household

Avian influenza

Language and communication

“I met some survivors from way back in Gulu outbreak. That was 2001. And one of them was telling us that he stood for some political positions and they were saying his opponents were referring to him as Ebola. This is a candidate for some position, but you’re not even using their name. They’re just saying, oh, that Ebola candidate, that Ebola candidate.” – Interview 13

Community

Recovered persons

Ebola disease

Behaviours and harm

“Again, there was geographic association… that it had come from China. So there were a lot of targeted racist attacks in London. So there was a young student from Singapore who was beat up for it. I had patients who refused to see me in the hospital. I had senior staff members say to me that it was probably better I dealt with the Covid patients because, you know, subtext, people think that you might have caused it sort of thing. So that was… that was quite tough.”  – Interview 10

Public, co-workers

Persons with associated traits

COVID-19

“My first work with cholera outbreaks, um, I remember cars being stoned. No access to certain villages because we were ‘bringing the disease in’… And we always feared when going to a cholera outbreak that without good sensitization to the community, we were going to pay the price.” – Interview 24

Community

International response workers

Cholera

“One of our colleagues was investigating the virus, investigating Nipah. And they actually locked her in a house in a village. And then we needed to go with police and other local administrator to get her back. And they locked her there because they thought she was spreading rumors about this new virus, this new thing that they’d never heard about and they were really scared.” – Interview 31

Community

Local response workers

Nipah virus disease

Unwarranted avoidance

“I think I just got ashamed when I was out of the Ebola Treatment Unit and I was home. I spent two weeks at home. I would never come out of my house because I was fearing being out for the public to see me. I was ashamed of Ebola. I felt like, how will people take it?” – Interview 30

Self, community

Recovered persons

Ebola disease

“I remember a story from a man in Indonesia who was saying he had been treated and he was no longer contagious, but nobody would be willing to pray next to him at the mosque. So he rather decided that he didn’t want to go anymore. And so you get this kind of internalized stigma kicking in, which basically means that the net effect on people’s social functioning can be quite similar as when they are ostracised.” – Interview 6

Community

Recovered persons

Leprosy

Disadvantage and exclusion

“But for the survivors, of course, it was a cost because landlords were chasing people from their houses.” – Interview 25

Providers (landlords)

Recovered persons

Ebola disease

“When we were asking for money to support people there was this rhetoric of, “Oh, we need to be careful what we do with taxpayers money”. And the point that was made time and time again was that gay, bisexual men are paying tax as well. They are. They’re not this separate entity outside of the rest of the population. They’re also funding the National Health Service. So when they need it, they should be able to benefit from it.” – Interview 8

Government, institutions

Affected communities

mpox

“And of course there are some things, like you’re exporting goods, the agriculture products that could be coming from Rwanda and some people would shy away from them. Well, this is coming from a district that has Ebola, the district that is on a lockdown. So I don’t think I want to take this.” – Interview 13

Public, consumers

Associated communities

Ebola