Life experience and resilience of individuals affected by buruli ulcer in the Bankim community in Cameroon

Life experience and resilience of individuals affected by buruli ulcer in the Bankim community in Cameroon | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Life experience and resilience of individuals affected by buruli ulcer in the Bankim community in Cameroon Raoul Djiala Tawe Nsekalhye, Etienne Kimessoukie Omolomo, Romeo Killanga Killanga, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6144522/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim Buruli ulcer significantly impacts individuals’ socioeconomic, physical, cultural, and immunological conditions, often leading to social abandonment and difficulties in community reintegration. This study aims to identify the lived experiences and resilience factors of individuals affected by Buruli ulcer in the Bankim Community, Cameroon, utilizing Cyrulnik’s resilience theory and Hurssel’s phenomenology. Subjects and methods An interpretative phenomenological analysis (IPA) was conducted, employing purposive sampling until saturation was reached. Data were collected through semi-structured interviews using an interview guide and a lifeline tool. The analysis adhered to IPA guidelines established by Smith & Osborn, involving repeated readings of transcripts, observations, and preliminary interpretations followed by general categorization. Results Eight participants (5 females, 3 males; ages 12–58) from diverse professional backgrounds (agriculture, fishing, business, and studies) were enrolled. The analysis revealed significant life events categorized as positive (e.g., belief conversion, child success, wound healing) and negative (e.g., job loss, abandonment). Participants expressed experiences of social integration characterized by support, abandonment, fear, frustration, stigma, and feelings of inadequacy. Life experience factors included family and spiritual motivation, highlighting mixed perceptions regarding social inclusion. Conclusions The study underscores the complex interplay between adversity and resilience among individuals affected by Buruli ulcer. Notably, one participant exemplified resilience—termed “A MAN OF HOPE”—who, despite experiencing reinfection and stigma, emerged determined to overcome personal and familial challenges. This research contributes to understanding the psychosocial dynamics of Buruli ulcer and emphasizes the need for supportive interventions to facilitate social integration. Life experience Resilience Buruli ulcer Individuals affected Figures Figure 1 Introduction Good health and wellbeing, reduced inequalities, are the 3rd and 10th Sustainable Development Goals (SDGs) respectively. Buruli ulcer (BU) disease is one of the most disabilities that affect individuals who are generally ranked inaccessible to health infrastructure and low income. Physically, economically, psychologically, individuals with this are affected and found themselves isolated and abandoned thereby bringing a gap (inequalities) in populations and communities. Being ranked as the third mycobacterium infection in Cameroon, BU affects individuals of all ages and have nastic effects both on the physical, biological, psychological, socio economic and cultural levels in the life of individuals infected. Some particular individuals are devastated by the fact of having the disease, which makes it very difficult for them to adapt. On the other hand, others develop a well adaptation process that enable them to stand on their feet and manage daily living moments. However, actions or strategies put in place by the affected individuals to come out from their isolated areas are still questioned. In a study carried out by Omansen et al., ( 2019 ) in order to assess the global burden and the progress on disease control, epidemiologic data were been analyzed and reported by countries to the World Health Organization during 2010–2017. During this period, 23206 cases of Buruli ulcer were reported. Globally, cases declined to 2217 in 2017 thus 1923 in Africa and 294 in West Pacific, but local epidemics seem to arise, such as in Australia and Liberia. Analyzed available data came from a total of 16 countries as 14 in the African Region and 3 in the Western Pacific Region. Other countries were excluded because some provided less information and others had not available data. Overall, the yearly case burden declined from a maximum of 4,906 cases in 2010 to 1,952 cases in 2016; in 2017, however, the number of cases increased to 2,217 cases. In Africa, BU is largely endemic in the tropics and has been reported in more than 30 countries in Africa, South America and Asia, as well as in Australia (Mosi, 2017). The greatest burden of disease is found in West and Central Africa where the highest number of cases are reported from Ivory Coast, Benin, Ghana, Cameroon and the DRC. Estimated incidence rates include 21.5 per 100 000/year in parts of Benin and 20.7 per 100 000/year in Ghana overall with up to 158.8 per 100 000/year in some affected districts. Of the 33 globally affected countries, 15 are found in Africa. Between 1978 and 1999, up to 22% of people living in communities where the disease was endemic were affected. In Africa, the disease affects mainly children with more than 50% of cases occurring in those 5 to < 15 years of age and commonly affects those living in remote areas with limited access to health care (O’Brien et al., 2019 ). In Cameroon, from a study carried out by Porten et al., ( 2009 ) with an objective to estimate the prevalence of BU in the health district of Akonolinga, describe the geographic extension of the highly endemic area within the health district, and determine the program coverage and its geographical distribution. The results gotten are as mentioned; Out of a total population of 103000 inhabitants, 26679 were surveyed within twenty quadrats. Sensitivity of the case finding strategy was estimated to be 84% (95%CI 54–97%). The overall prevalence was 0.47% (n = 105) for all cases including sequelae and 0.25% (n = 56) for active stages of the disease. Five quadrats had a high prevalence of > 0.6–0.9%, 5 a prevalence > 0.3–0.6% and 10 quadrats < 0.3%. The quadrats with the high prevalence were situated along the rivers Nyong and Mfoumou. Overall coverage of the project was 18% (12–27%) for all cases and 16% (9–18%) for active cases, but was limited to the quadrats neighboring Akonolinga Hospital. Studies on resilience in the medical field, having a direct link with pathologies have been elaborated already, but concerning BU, little or no has been said. Bringing the aspect of life experience and resilience will however be a new discovery aspect on what BU is concerned in general and specifically in a given population. A positive correlation between the proportion of MU ( Mycobacterium ulcerans )-positive mosquitoes and BU incidence in Australia, and the bacteria’s DNA has been detected on the external parts of the body (for example, the exoskeleton and legs) of adult mosquitoes. Furthermore, in Benin (Africa),it was found that terrestrial flying insects do not harbor MU DNA, contradictory results have been found in Cameroon, where terrestrial insects collected from rural and urban houses in a BU endemic region have been found to be positive for MU DNA (Combe et al., 2017 ). More still, N’krumah et al., ( 2016 )from their study reported some frequently risk factors of getting contaminated with MU which are the contact of individuals with stagnant or slow flowing surface water through swimming, fishing, laundry, washing dishes, water supply, wearing short clothes during agricultural, activities, and agricultural land use. A positive correlation between the proportion of MU-positive mosquitoes and BU incidence in Australia, and the bacteria’s DNA has been detected on the external parts of the body (for example, the exoskeleton and legs) of adult mosquitoes. The study that carried by Geard et al., ( 2018 ) which had as purpose obtaining a deeper understanding of how individuals with spinal cord injury reflect upon the efforts, strategies and agencies they perform to sustain long term resilience and wellbeing, was seen to be a qualitative exploratory study, where by deep interviews were conducted to have the needed information about the situation in question. As a result, the efforts revealed by the participants in normalizing life with a spinal cord injury required continued flexibility, persistency and solution-focused adjustment, interpreted as processes documenting resilience. The participants were marshalling personal resources to handle challenges over time. They explained that they succeeded in maintaining health and wellbeing by maneuvering between different strategies such as being self-protective and flexible as well as staying active and maintaining a positive attitude. Further, support from relational resources were of utmost importance emotionally, socially and when in need of practical assistance. When harnessing relational resources when needed, the participants underlined that balancing dependence and autonomy to remain a part of ordinary life was essential in staying emotionally stable. To describe the experiences and perspectives of children and adolescents living with juvenile idiopathic arthritis (JIA) was the main objective of the study that was been conducted by (Tong et al., 2012 ). A systematic review of qualitative study was conducted that explored the experiences of children living with JIA, by searching electronic databases and reference lists of relevant articles. Results gotten from this study showed that, aversion to being different (unrelenting and unpredictable pain, disablement, internal disfigurement, differential treatment, and forced dependency on others); striving for normality (preserving social identity, resourcefulness, sense of community, focuses on remission, and mastery over body and pain); stigma and misunderstanding (trivialization of disease, invisible pain, and discrimination); suspension in uncertainty (control versus powerlessness, hope versus disappointment); managing treatment (benefits of taking medicines, respect and involvement in health care, and motivation for physical therapy); and desire for knowledge (medical treatment and advances, lifestyle management) were the principal events that were been experienced by these individuals. On the other hand, Smith et al., ( 2017 ) from a study with the main aim to explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice while caring for these patients, in which participants took part in semi-structured interviews consisting of open-ended questions about their experiences of life with an ileostomy and their treatments and time in hospital. Points of interest were followed up. Data were collected between July-December of 2014. Their findings were presented from two clinical themes: Issues around treatment and relationships with multi-disciplinary teams. Surgical complications were common and several participants reported concerns about addiction to painkillers. Varying attitudes were found around reversal surgery. Many reported experiencing distressing, dehumanizing care, while some felt supported by excellent healthcare providers. The theories that were used for this study were the Cyrulnik's (2003) resilience theory as an explanatory model for the BU experience, and Hurssel’s phenomenology in relation to the Interpretative Phenomenological Analysis (IPA) concept by Smith in explanation of the life experience of individuals infected with BU. These particular theories were chosen due to the fact that, they elaborated and showed a pertinence and better understanding on what our research was focusing on. It brought more light to what we were observing. This study had as main objective to describe the resilience and life experience of people with Buruli Ulcer in the Bankim community in Cameroon. Methodology Study Design and Study Area The study was carried out in the Bankim community in the Adamawa region of Cameroon, where data was collected among individuals found in the community in question. The study conducted was a qualitative research. This said, we proceeded by a phenomenological interpretative qualitative approach while paying emphasis on the Interpretative Phenomenological Analysis (IPA). As it enabled the researcher to have a number of participants for the study and collect data within a short period of time, cross sectional one was of used. It ran for a period of 4 months, from September to December 2022. Study population and sampling procedures The population of study were individuals affected by BU at the Bankim community in Cameroon. Participants or the key informant were selected in the community according to the state of being, that is, those affected by BU. The purposive sampling (reasoned choice sampling) was used where by intentional selection of cases likely to show the extent of variation in the phenomenon was proceeded. The group of individuals chosen or selected were a representative of the population. “It is not the quantity of participants surveyed that matters but the quality of selected participants concerning the situation in particular.” As such, only the process of saturation determined or let the researcher know of the exact size of the sample. For our study 10 participants were interviewed and during the stage of analysis, we got a saturation point at the 8th participant. Data Collection Data was collected using a semi-structured interview guide and a lifeline/event tool. Added to this was instruments to be used for the process such as Dictaphone and tablet, a notebook, pen, pencils and eraser. The method used here was an interview. The techniques used were an individual semi-structured interview and focused group discussion. Greetings and general presentation was done by researchers to participants where by, the researcher let know each particular participants the reason for the meet up while presenting them the free and informed consent where by participants were free to accept or refuse the interview. Proper interview was done in a form of discussion, while putting the participants in confidence and comfortable. At the end, the researcher thanked the participants, and requested if possible for another meet up in other to make sure what was gotten after listening and transcription what really what was intended to be said. As for the lifeline/event tool, it was being administered to participants at the start, that is, before moving to the interview with the semi-structured interview guide. At the end, the instrument was collected from the participants and evaluated, if all the parts were filled and asked questions to make sure if what inserted on the lifeline/events is really what was intended to be say by the participants. Data Analysis The analysis was conducted in accordance with IPA guidelines (Smith & Osborn, 2003). The initial analysis involved repeated readings of each transcript and the recording of observations and preliminary interpretations. The second stage involved the identification of emerging themes for each participant, coded with key words or phrases that reflected the meaning of individual accounts. A master list of themes was then constructed for one transcript reflecting an ordering of the themes illustrated with extracts. This master-theme list was used as the basis for analyzing subsequent interviews, in which examples of the themes were recorded and any new themes identified. In order to ensure the themes remained grounded in the data, all transcripts were reread to ensure cross-referencing of themes across participants. Ethical consideration We have obtained an ethical clearance issued by the Institutional Ethics Committee for Research for Human Health (CEIRSH) of the School of Health Sciences of the Catholic University of Central Africa (ESS/UCAC) entitled [N°2022/022149/CEIRSH/ESS/MSP]. In addition, each participant was provided with a consent and/or assent form (for minors aged 15 to 18 and incapacitated adults) to be completed without any constraint to attest to their voluntary participation in the research and to guarantee their anonymity and the confidentiality of the information collected. Results Description of respondents’ characteristics The saturation point was reached about the 8 respondents. Firstly, the names of the different correspondents were coded where by each participant was given a code to be protected. In other words, the names codes given represent each participant for the research confidentiality. This will be presented at Table 1 as shown below. Table 1 Illustration of the General presentation of participants and Identifications Code Gender Age Professional status Level of education Marital status Quarter or Village BK001 Female 22 Farmer Secondary Married Bankim town BK002 Female 15 Student Secondary Single Bankim town BK003 Male 39 Farmer Primary Married Bandam BK004 Female 12 Student Primary Single Bankim rural BK005 Male 58 Farmer/fishermen Primary Married Bankim rural BK006 Female 27 Fish roaster Primary Married Bankim town BK007 Female 19 Student Secondary Single Bankim town BK008 Male 40 Farmer/fishermen Primary Married Bandam It can be seen on the table above that both genders (male and female) are concerned with the condition, showing that BU is a disease that can touch both genders without any distinguishing. Out of the 8 participants, it can be seen that 5 of them are female, which confirms what some studied says, female at a certain age are contaminated or get more easily infected by BU than male. More so, it is observed from what gotten that, BU touches individuals of all ages as the range goes from 12 years for the youngest to 58 years for the oldest. Concerning the occupation or professional status, we can see that half (4/8) of the participants are concerned with agricultural and fishing activities, 1 is concerned with business (fish roaster) and the rest (3/8) are concerned with studies. As such, this can explain the contamination process of the participants in relation the life experienced and resilience. Concerning the level of education, 5 of the participants stopped at the primary level while 3 had the ability to move on to the secondary level. This can explain the fact that, many of them could not read nor write or even understand the French and English languages. The table below is an illustration of says gotten from the verbatim of participants, which is related to our first specific objective which was to identify the significant events during the life experience of individuals living with Buruli ulcer in the Bankim community. Table 2 Illustration of the different says gotten from the verbatim of participants regarding the significant events and life experience Themes Number of participants Category Diminution of the wound 03 Positive events Conversion (Belief) 07 Hospital care 07 Children’s success 02 Delivery 01 Unemployment 06 Negative events Loss fields products 02 Abandon 02 Loss of son’s job 01 Experience of the disease as a difficulty 08 Psychological state and events with BU Experience of the disease as a suffering 08 Attributing the source of disease to be unknown 08 Actual state with the disease uncomfortably 08 Actual state with the disease in pains 08 Positive Events. Events in general in someone’s life will include what has led to a great joy for the person or what has led to a sufferance to the same individual. Positive events are what are what brought a great joy in the life experience of individuals affected by BU. In this case, we principally have; child delivery, success of children in their daily activities, health care that is done in a good way, the diminution of the wound in general despite the pains. As said by participant BK – 001; “my wound has also reduced it’s true. I feel pains but I also feel how the wound is reducing”. On the other hand, the positive events in the life of participants has a great part to play in their development (psychological development), as most of times it makes them forget about the pain and concentrate on what makes them happy and keep a smile rather than crying of pains as says participant BK – 002; “but, my sister has given birth and I’m very happy. It makes me feel less pains, I even forget I have this wound. Really there is joy in my heart.” Negative Events. Loss of fields (farm) products, unemployment, loss of child’s job, are some of the negative events that participants had in their life experience with BU. Some of them felt bad and saw all situations coming their way as a curse as says participant BK – 005; “ My son at times I feel as it is a punishment to me and to my family. And also my child loss his job at the city because every time he had to come here and take care of me, it’s painful, it makes me feel more pains and at times I feel I will not heal.” Still, “ I lost all of my farm products last year, as the disease started at the moment taking care of the products came. My wife had not great ideas on what to do.” The negative events can result in the creation of more pains to particular individuals, there by pulling their psychology down. Psychological state and evets with Bu. The event and the general state of individuals affected by BU plays a great role on their psychological stability which somehow affect their emotions. "As soon as the illness started I was on the spot. Because since the beginning I have been in great pain. There are nights when I can't sleep because of the pain. As I am even walking there, I just force. The wound is located on the bones and it does not allow me to walk, which still hurts a lot. It's really hard. Since I'm sick I can't do anything. This is the third month that goes like this and I haven't done anything (with a very sad face). This illness started in July. I think it was the 17th of July and until today I still suffer" , explained himself participant BK – 003. Having BU just once is one story, but being re-contaminated and facing back the same struggles is another story as relate participant BK – 005; “ My son it is very difficult to live in this condition. I abandoned everything, everything. I left all my duties and my wife can’t do them all. So we lost much of our products in the farm. The thing is finishing and coming back, finishing and coming back as if I did something bad to someone. When it gets well, it will start back again. Last year by August I was already well, going to the farm and trying to do my activities. But now look (while showing the wounded leg followed by some minutes of complete silence with one arm on the jaw and the other on the wounded leg).” Concerning the actual state (at that particular moment) of the disease, participants do face difficulties in controlling their emotions as revels participant BK – 002; "The disease this, really I don't know, the disease this... I can say that since this disease started, I can't control my emotions anymore. I get angry very quickly when I'm annoyed, even just a little, and I sleep a lot too. Yes, when I sleep I don't really feel the pain. It is a kind like a rest for meˮ Based on our second specific objective which was: To demonstrate the roles and consequences of social integration in the life experience of individuals living with Buruli ulcer in the Bankim community, we have the following: Esteem or Appraisal Support This category refers to the state at which individuals were been encouraged with their social milieu or surroundings, which falls in the role and consequences of social integration. Support, Abandon and Fear are the three essential elements that governed the appraisal nature of the participants. "They only pray to God for me to get well. They call me, my mother is there, my grandmother is there. All my family is there; they call me on the phone. And there are others who call me and tell me that they pray for me, so that as I heal. Especially my sister and my brothers, and my friends they pray for me. My two children and my husband, they call me and pray for me, " as says participant BK – 001 Participant BK – 004 who feels in a state of abandon, relate that; “ No, they haven’t come to visit me because they are going to school (talking about friends). I miss them and I want to go where they are (talking about family), but my mother says when I will heal she will come and take me here”. And BK – 006 who relate that; “I already told you that those who were with us left us when I got sick. I don't have any friends anymore. Sometimes the neighbours come but...”. Who seem to be in an abandoned state. Self-Esteem and Categorization. Frustration, Stigmatization, Restlessness, Unfit, Positive opinion on social implication, Positive opinion of being a social obstacle are the what govern this particular category as it comes to individuals affected by BU. "Unfit! (with a certain tuna and sure as cold) I can't do anything anymore. I can't even bend over because I can feel the pain on my back even though. If I don't do anything, what good am I? as said by participant " BK – 007. And BK – 008 ; " Yes oouuoou, before the disease I was the one who went to the field and now I can't do that. I can't drink and play checkers at the crossroads. Yes, I see myself as an obstacle since my friends have put me out of their way , who relate themselves in the listed categories on the table below. The table below gives a global illustration; Table 3 Illustration of the different says gotten from the verbatim of participants regarding the roles and consequences of social integration . Themes Number of participants Category Support 06 Esteem or appraisal support Abandon 01 Fear 01 Frustration 05 Self-esteem and categorization Stigmatization 03 Restlessness 03 Unfit 01 Positive opinion on social implication 08 Positive opinion of being a social obstacle 08 Coming to our third specific objective which is: To identify the protective factors that are found in the life experience of individuals with Buruli ulcer in the Bankim community, we have the following; Spirituality and Family In this category falls what principally motivated the participants to stand firm in their health condition which are; Family aspect for motivation and Spiritual aspect for motivation. As this lead us to the protective factors found in the life experience of individuals affected by BU. Taking into consideration what participant BK – 001 brought out; "My children. My husband. I only pray to God too, I pray to God. When I think that God is there, it gives me strength. Yes! With my children. Because I haven't seen them since. When I think of them I am strong, very much so I get up, I eat and I chat.” It can be seen that both the spiritual aspect and family aspect do take part in the motivation state and the sense of standing firm. And for BK – 005; “ My family, my wife and children because I have 4 children and they are not here in Bankim. They are a support to me. With my brother who is always there,” the family aspect is the main point. Social importance and Consequences Positive opinion on social influence, Negative opinion on social influence, Unfit, Obstacle, are the main four aspects of this category as they give a respective understanding on the state of participants. "I think that everything happens is God's doing. If I am like that now, I don't work. I don't do anything. It is God who knows everything, I do not know. I know my part that it is God who made it. Now if I overtake somebody, aahhk (shoulders raised to the sky)" reveals BK – 001 who shows a positive opinion on social influence. BK – 008 says; "No, or I would say at the moment I don't know yet. Since I'm sick, I think a lot. I would say that I am unable to do certain things." This can be summarized on Table 4 below; Table 4 Illustration of the different says gotten from the verbatim of participants regarding factors that are found in life experience. Themes Number of participants Category Family aspect for motivation 08 Spirituality and family Spiritual aspect for motivation 06 Positive opinion on social influence 03 Social importance and consequences Negative opinion on social influence 05 Obstacle 05 Being our fourth specific objective (Neo development factors found in the life experience of individuals affected by BU), here we principally focused on those events that brought the participants to develop certain reactions out of their context of being infected by BU and to see things in a different way. As such we payed attention on the resilience factors that each participant had, that was gotten from the life event tool in straight collaboration with the interviews gotten from them. Presentation of data on the resilience of individuals affected by Buruli ulcer in the Bankim community in Cameroon. A rational is based on this section which focuses on the study of the eight participants’ life experiences with BU, of whom one participant expressed the resilience factors. For this participant in question, at first, a phenomenological account of the life experience with BU was constituted. These narratives represent a brief reconstruction of the participants’ life experience, based on the verbatim (which had to deal with the significant events of the participants) and the life line/life events tool. Secondly a syntheses and interpretation of the life experience was done to bring out resilient characteristics of the participant there by bringing out the different phase and process of resilience. A title was given to the whole process, that was gotten from the syntheses done where by it was observed in the says of the participant in question. Experience of Resilience of participant BK – 005; “Man of HOPE’’ Participant BK – 005 is a male of 58 years old that lives in Bankim town. He is a farmer and also practice fishing at times. Married to a woman for years now, they have 4 children among which one is a girl and the rest are boys. He got infected by Mycobacterium ulcerans last year 2021 precisely in the month of March. It started biologically, with a small pimple that was itchy, which let in the itching process. This resulted in the burst of the pimple, liberating a watery solution which contaminated other places around. That’s how the wound started developing and finally leading to a great one. Firstly, taken to a traditional doctor by his brother, things were worsening which leaded them to the hospital. After few months of treatment, it started healing, but suddenly got infected back early this year 2022. The significant events of the participant in association with the negative events from the life tool were the main force that driven him to a state of resilience, with the main factor of resilience; transformation . This can be related to the suffering and more pains the participant felt when the events happened. For him, he was in cause with all what happened. The transformation point come in relation with the fact of stepping up, and not letting the disease condition to control what has to go on in his personal and family life situation. Resilience based on the pains, difficult moments and personal development Participant BK – 005 has undergone a lot of suffering, gone through difficult moments and hardship right from the first contact with BU passing through the recontamination process. He saw himself abandoning all his activities while putting the whole family in difficult moments, especially his wife. One of his most difficult moments was when his friends denied helping his wife with activities in the farm, he declared; “ My friends refused to help my wife in the farm. At the start some were coming to visit but I think they felt discouraged. I don’t understand, and also my child loss his job at the city because every time he had to come here and take care of me, it’s painful and at times I feel I will not heal” Thanks to his surroundings, the environment and the family in general he could stand firm and despite the re-contamination he could develop the transformation resilient factor , trying to take more positive action to be a set free from the disease in question, as he relates; I promised myself to stay strong and recover so that I can continue taking care of my home and my farm. Because I heard that people said I did something bad for this wound to finish and come again. Now I am trying to stay strong and rest for this leg to finish and never come back again. I don’t want to feel pains again because it’s very difficult. I don’t want my wife to suffer again. I don’t want my children to allow their work in the city every time to come and me meet here. I want everybody to be happy. So I will stay home, take my medication and allow this led to heal normally. Discussion It can be seen that different significant events were evolved in different participants that are affected by BU. Phenomenology developed by Edmund Husserl as an eidetic method, is concerned with attending to the way things appear to individuals in their experience. Husserl's phenomenology (1970) offers an understanding and an in-depth a deep description of a phenomenon of interest, as well as it makes possible the emergence of a pure and universal signification of the studied experience. In this particular part that had to deal with the positive events in the life experience of individuals affected by BU, the events brought a period of great joy and encouragement in their life experience, as some of the participants said to have forgotten about pains for a good period of time thanks to those events. It’s true the events did not set in them a state of resilience, that could give them a motivational impact or empowerment to come out of the situation, but it had a role to play on their psychology, and state even if it was for a short period of time. Results gotten here could not have been liked with another study, but (Kimessoukie Omolomo, 2016 ) in his study elaborated particular points and interest on the events in the life of individuals that had gone through difficulties and suffering, helping to understand our own findings. The experience of unhappiness may distance the individual from the mainstream, but at the same time bring him or her closer to a community with whom he or she shares a different experience as mentioned by Cyrulnik in his theory. The negative events in individuals affected by BU have brought more pains and suffering. This resulted in more stress and psychological instability. Some of the participants through the negative events, developed factor of transformation, as said by (Kimessoukie Omolomo, 2016 ) that had a great role to play in the improvement, amelioration and action taken, in order to come out of the particular situation of disease state, stand firm and see life in another point of view. Recent studies that could have been compared with our study where not really dealing with the significant events of individuals in a specific manner and had no information that could have been of our use. The phenomenological approach all involves detailed examination of those individuals affected with BU lifeworld; it attempts to explore their experience and is concerned with their personal perception or account of BU in question, as opposed to an attempt to produce an objective statement of the disease condition or event itself .In other to come out with the different psychological state and events with BU, the concept of Smith is taken into consideration as to have a better perception of the participants’ affected by BU situation and state. In our study, it came out from the different participants three of these that englobe their psychological state and events in which some related their state as suffering, others related to un-comfort and others were based on pains, feeling huge pains. It’s true that pains can be related to the state of being uncomfortable but some participants emphasized in the fact that, at times they feel uncomfortable without necessarily feeling the pains, while when the feel the pains in did, the nature of un-comfort will be present as well. In relation with other studies, (Tong et al., 2012 ) had similar findings with participants who were at pains and suffering due to their condition of arthritis. Similarly, (Sutanto et al., 2013 ) reveals in different ways and state of the studied population how pains and moments of difficulties were been encountered and faced. With this, it can be said that individuals in certain state of disabilities do undergo huge difficulties and faces a lot of pains which make it at times very unsuitable for them to feel comfortable. Coming to the roles and consequences of social implications of our participants, this part of our study will be focused on the external environment of participants, and their interaction with it as well as how the external environment does interact with those participants affected by BU. “Those who have been traumatized understand, while the others live their daily lives superficiallyˮ . This particular statement was brought up by Cyrulnik in one of his theories. The statement goes in direct relation with what participant affected by BU and their external world have. Such individuals who are in the state of disability will be facing a different situation compared to those surrounding them. In the course of our study it was observed that, support, abandon, and fear are what governed the esteem or appraisal support of participants affected by BU, which could be in a long or short run. For the majority of our participants the long run was dominant, as some of them felt the support constantly and in a continuous manner, either from their family or friends (but mostly from the family). While other participants felt abandoned and fear about the situation they were facing. Some expressed the sensation of being abandoned by their friends. Similarly to (Smith et al., 2017 ) whose study was based on ileostomy patients, some findings reveal that, the participants felt to be supported or had the support needed from their family most, because they were the ones that could understand and accept it, compared to friends that were a bit reluctant in their way of getting things. Still on this phrase by Cyrulnik “ Those who have been traumatized understand, while the others live their daily lives superficiallyˮ , will be elaborated the different themes that were been gotten from our participants affected by BU. Having a self-esteem that is not valuable and been categorized in one way or the other, are what the majority of the participants affected by BU got when it comes to the interaction with people around them. Frustration, restlessness, stigmatization, unfit and positive opinion on social implication are the themes that were been gotten from the participants, as some of them felt to be put apart by some people around them. Similarly, (Smith et al., 2017 ) comes in with themes of stigmatization and restlessness as some individuals with ileostomy said to have been put apart and have a different sex life with their partners. On the other hand, (Cartwright et al., 2015 ) findings don’t relate with ours, in the sense that individuals living with Juvenile Idiopathic Arthritis don’t feel unfit with their situations. The protective factors of the participants affected by BU in the present study are basically on two aspects as follows: The concepts of spirituality and family are generally what is seen and observed. In our context the participants had to be motivated, or they were certain things or people in particular that helped them to stand firm on their feet in their disabilities situation. The themes that were been brought were; Family aspect of motivation and Spiritual aspect of motivation. In the course of our study, the majority of participants said their family were their principal source of motivation. Among them mentioned the spiritual aspect which gave them strength and enabled them to have a certain confidence as time goes. Others just mentioned the spiritual aspect while others had as one and only source of motivation their family. Similarly the study by (Smith et al., 2017 ) reveals a total motivational aspect by family of those individuals having a stoma, which in most of the case is a major reason for self-abandoned and restlessness by the affected individuals. Having a disability and feeling socially accepted or important is of great importance, but individuals don’t still have that desire and ability. Affected participants by BU, had certain observations in the manner their surroundings do implicate them in situations since they in a state of disability. Just a few had negative opinions on the social influence, meaning that they felt they were less or not more implicated in situations that concerned their surrounding and in some cases, them as well. The majority had positive opinions on their implication in different aspects by their surroundings. Same as, still the majority of the participants claimed to be an obstacle for others around them. In contrast to our findings, studies from our reviewed did not mention the aspects and opinions of individuals as what been an obstacle or been influenced by the surrounding. Neo-development as the name implies, this part basically focused on the aspect that lead to the empowerment of participants affected by BU, for them to be positive minded and which enabled them decide to take certain action. To be more precised, it will be all about resilience. "The ability to succeed, to live and develop positively, in a socially acceptable way despite stress or adversity that normally carries the serious risk of a negative outcome" as said (Cyrulnik, 1999) about the concept of resilience. This resumption of a type of development after psychological agony (Cyrulnik, 2004) is a process that is possible for any individual, regardless of the severity of their trauma, because it is physiologically inscribed in them, here talking about participants affected by BU. Unhappiness provokes a personal transformation; this transformation can be positive, provided that the person prefers an active posture of struggle to a passive position of victims; this clarification leads to a better understanding of the resilience and sense of well-being developed by participants affected by BU. In the course of our research, it came to realize that among our 8 participants enrolled, just 1 was found to be in a state of resilience. He faced a recontamination process and in the course on his first infection, he came to pay less attention on the affected area when it was about finishing healing, that lead to a second contamination. He underwent much stress, pain and suffering in which all his family members including his brother was involved. Observing his family becoming a burden for him, undergoing pains were not what he intended to finish in. Coming out of his zone of comfort by deciding to take actions despite the pains is what let us include the participant in the process of being resilient. Deciding to stand up fit and fight for him and his family are the main actions that motivated our understandings in his process of resilience. Similarly, the study by (Geard et al., 2018 ), reveals state of resilience in patients that have undergone spinal cord injury, who decide to stand, and focus more on their self-development in order to acquire a certain mobility and freedom. Conclusions This original study has permitted us to validate our different objectives. Firstly, the significant events during the life experience of individuals affected by Buruli ulcer were identified and showed both positive events (conversion or belief, delivery, success of children, diminution of wound) and negative events (loss of son’s job, loss of farm products, abandon). Panic and calm manners were their reactions about the disease state, as they related to experience the disease with a lot of difficulties and suffering. Being uncomfortable and feeling pains, the infected participants had a certain hope while others were hopeless about their condition. Secondly, as what concerns the roles and consequences of social integration, support, abandon, fear, frustration, stigmatization, negative and positive opinions about social implications were gotten. Thirdly, family and spiritual aspects as support were the main factors of protection that were identified in individuals affected by Buruli ulcer in the Bankim community, where by some of them felt to be an obstacle for their surroundings. Fourthly and lastly, resilience state or factors (Transformation) was identified to a particular participant, whose story was entitled “MAN OF HOPE” as the neo-development factors was in concern. However, these results do not draw a general conclusion on what these particular individuals feel or what they are going through, as the reinfection by Buruli ulcer is very probable and may lead to another set of findings that could better understand and ameliorate their living in all the aspects needed. As such, other researchers are invited to pay an attention on those particular set of individuals that are infected by Buruli ulcer, not just for the first time or occasion. More can still be gotten and exploited from that. Abbreviations BU Buruli Ulcer DNA Deoxyribonucleic acid IPA Interpretative Phenomenological Analysis JIA Juvenile Idiopathic Arthritis MU Mycobacterium ulcerans SDGs Sustainable Development Goals WHO World Health Organization Declarations Funding Declaration: This work has not been funded. Clinical Trial Number: Clinical trial number not applicable Competing Interest Declaration: There was no competing interest Ethical approval: This study was carried out in compliance with fundamental ethical principles, in particular those relating to the protection of participants and the confidentiality of data. We have obtained an ethical clearance issued by the Institutional Ethics Committee for Research for Human Health (CEIRSH) of the School of Health Sciences of the Catholic University of Central Africa (ESS/UCAC) entitled [N°2022/022149/CEIRSH/ESS/MSP], and an administrative and local authorization was signed and granted by Adamawa Region administrative authorities. These procedures guarantee that the study was conducted ethically and in compliance with current regulations, while ensuring the safety and well-being of participants. Consent to publication : Not applicable Availability of data and materials: All data used and/or analyzed for this study are available from the corresponding author upon reasonable request. Author contributions: All the authors made a significant contribution to this research work, in terms of study design, execution, data acquisition, analysis and interpretation of results, writing, and critical revision of the article. RNDT, EKO, RKK, GRPD and DFST designed and implemented the study; RNDT collected the data; RNDT, EKO and RKK analysed and interpreted the data; RNDT initiated the manuscript; EKO, GRPD and DFST revised the initial version of the manuscript; all authors revised and approved the final version of the manuscript. Acknowledgments : Our gratitude goes to the Comité d'Éthique Institutionnel de la Recherche pour la Santé Humaine de l'Ecole des Sciences de la Santé de l'Université Catholique d'Afrique Centrale, the Legal Authorities of the Adamawa Region and Bankim Town for research authorizations. We are also grateful to FAIRMED Association and Bankim Health District staffs, whose support and collaboration were essential in data collection. References Cartwright, T., Fraser, E., Edmunds, S., Wilkinson, N., & Jacobs, K. (2015). Journeys of adjustment: The experiences of adolescents living with juvenile idiopathic arthritis. Child: Care, Health and Development, 41 (5), 734–743. https://doi.org/10.1111/cch.12206 Combe, M., Velvin, C. J., Morris, A., Garchitorena, A., Carolan, K., Sanhueza, D., Roche, B., Couppié, P., Guégan, J.-F., & Gozlan, R. E. (2017). Global and local environmental changes as drivers of Buruli ulcer emergence. Emerging Microbes & Infections, 6 (4), pp. 1–4. Geard, A., Kirkevold, M., Løvstad, M., & Schanke, A.-K. (2018). Exploring narratives of resilience among seven males living with spinal cord injury: A qualitative study. BMC Psychology, 6 (1), pp. 1–10. Kimessoukie Omolomo, É. (2016). Variabilité et modélisation phénoménologique de la résilience chez des femmes camerounaises confrontées à une forte adversité [Phd, Université du Québec à Trois-Rivières]. https://depot-e.uqtr.ca/id/eprint/7978/ Mosi, L. (s. d.). Buruli ulcer: Africa’s neglected but third most common mycobacterial disease . The Conversation. Consulté 31 mars 2022, à l’adresse http://theconversation.com/buruli-ulcer-africas-neglected-but-third-most-common-mycobacterial-disease-56522 N’krumah, R. T. A. S., Koné, B., Tiembre, I., Cissé, G., Pluschke, G., Tanner, M., & Utzinger, J. (2016). Socio-Environmental Factors Associated with the Risk of Contracting Buruli Ulcer in Tiassalé, South Côte d’Ivoire: A Case-Control Study. PLoS Neglected Tropical Diseases, 10 (1), pp. 1–3. O’Brien, D. P., Jeanne, I., Blasdell, K., Avumegah, M., & Athan, E. (2019). The changing epidemiology worldwide of Mycobacterium ulcerans. Epidemiology & Infection , 147 . pp. 1–14. Omansen, T. F., Erbowor-Becksen, A., Yotsu, R., van der Werf, T. S., Tiendrebeogo, A., Grout, L., & Asiedu, K. (2019). Global Epidemiology of Buruli Ulcer, 2010–2017, and Analysis of 2014 WHO Programmatic Targets. Emerging Infectious Diseases, 25 (12), pp. 2–6. Porten, K., Sailor, K., Comte, E., Njikap, A., Sobry, A., Sihom, F., Meva’a, A., Eyangoh, S., Myatt, M., Nackers, F., & Grais, R. F. (2009). Prevalence of Buruli Ulcer in Akonolinga Health District, Cameroon: Results of a Cross Sectional Survey. PLoS Neglected Tropical Diseases, 3 (6), pp. 2–12. Smith, J. A., Spiers, J., Simpson, P., & Nicholls, A. R. (2017). The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis. Health Psychology, 36 (2), pp. 143–151. Sutanto, B., Singh-Grewal, D., McNeil, H. P., O’Neill, S., Craig, J. C., Jones, J., & Tong, A. (2013). Experiences and Perspectives of Adults Living With Systemic Lupus Erythematosus: Thematic Synthesis of Qualitative Studies. Arthritis Care & Research, 65 (11), pp. 1752–1765. Tong, A., Jones, J., Craig, J. C., & Singh-Grewal, D. (2012). Children’s experiences of living with juvenile idiopathic arthritis: A thematic synthesis of qualitative studies. Arthritis Care & Research, pp. 64 (9), 1392–1404. Additional Declarations No competing interests reported. Supplementary Files SupplementalNOTICEINFORMATION.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6144522","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":446287477,"identity":"a448683f-d526-470f-bea4-1b443febd1ae","order_by":0,"name":"Raoul Djiala Tawe Nsekalhye","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAklEQVRIiWNgGAWjYDCCAwcbGB6AWcyNDyQqQDRzA2EtCWAWY7OBxRmQFkZCWoAYqqVNoLINzMCvhe/g4cYPCTX35PklEtsYbs6rjeZvB2r5UbENpxbJAwebJRKOFRvOnJHY9nDmtuO5Mw4zNjD2nLmNU4sB0C8SCWwJjBtuJLYbS247ltsA1MLM2IZXS/OPhH8J9kAtbdJ/5xzLnU+EljagLxISQVokJBtqcjcQ0gL0S5tFYl9C8syeh80GEscO5G4EajmIzy98N44/vvHhW4JtP3vywQcSNXW5884fPvjgRwVuLQwSB1C4h8HkAUx1SIC/AYVbh1fxKBgFo2AUjEwAAGTha26YxE8lAAAAAElFTkSuQmCC","orcid":"","institution":"Catholic University of Central Africa","correspondingAuthor":true,"prefix":"","firstName":"Raoul","middleName":"Djiala Tawe","lastName":"Nsekalhye","suffix":""},{"id":446287478,"identity":"9f30c2d5-81e3-4042-bd39-f48aac60f8df","order_by":1,"name":"Etienne Kimessoukie Omolomo","email":"","orcid":"","institution":"Catholic University of Central Africa","correspondingAuthor":false,"prefix":"","firstName":"Etienne","middleName":"Kimessoukie","lastName":"Omolomo","suffix":""},{"id":446287479,"identity":"eb050fb0-4b4a-4935-a110-5a83e0159308","order_by":2,"name":"Romeo Killanga Killanga","email":"","orcid":"","institution":"Catholic University of Central Africa","correspondingAuthor":false,"prefix":"","firstName":"Romeo","middleName":"Killanga","lastName":"Killanga","suffix":""},{"id":446287480,"identity":"5ce695c4-fe1d-4eae-8337-a3b6a5570934","order_by":3,"name":"Godfroy Rostant. Pokam Djoko","email":"","orcid":"","institution":"University of Dschang","correspondingAuthor":false,"prefix":"","firstName":"Godfroy","middleName":"Rostant. Pokam","lastName":"Djoko","suffix":""},{"id":446287481,"identity":"049090bd-7344-4e61-b4a2-ca248f736937","order_by":4,"name":"Desire Felix Sah Tatsing","email":"","orcid":"","institution":"Ministry of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Desire","middleName":"Felix Sah","lastName":"Tatsing","suffix":""}],"badges":[],"createdAt":"2025-03-03 09:08:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6144522/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6144522/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82055504,"identity":"add124e6-53f1-41a4-b235-a5c378ea34c0","added_by":"auto","created_at":"2025-05-06 10:24:27","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":112066,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eModalization of the Life experience and Resilience of individuals affected by Buruli Ulcer in the Bankim Community in Cameroon\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6144522/v1/eb55811e6bbcef1cb76363fe.png"},{"id":91000167,"identity":"a476816b-160f-4675-960c-d90c198e6168","added_by":"auto","created_at":"2025-09-10 13:32:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1166276,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6144522/v1/be6d1a78-1219-490d-bcad-446f1e9ee109.pdf"},{"id":82055505,"identity":"3a6f1ea7-3277-463d-8de0-9a483ffa4d60","added_by":"auto","created_at":"2025-05-06 10:24:27","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":17831,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalNOTICEINFORMATION.docx","url":"https://assets-eu.researchsquare.com/files/rs-6144522/v1/302db122255702935877f34e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Life experience and resilience of individuals affected by buruli ulcer in the Bankim community in Cameroon","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGood health and wellbeing, reduced inequalities, are the 3rd and 10th Sustainable Development Goals (SDGs) respectively. Buruli ulcer (BU) disease is one of the most disabilities that affect individuals who are generally ranked inaccessible to health infrastructure and low income. Physically, economically, psychologically, individuals with this are affected and found themselves isolated and abandoned thereby bringing a gap (inequalities) in populations and communities. Being ranked as the third mycobacterium infection in Cameroon, BU affects individuals of all ages and have nastic effects both on the physical, biological, psychological, socio economic and cultural levels in the life of individuals infected. Some particular individuals are devastated by the fact of having the disease, which makes it very difficult for them to adapt. On the other hand, others develop a well adaptation process that enable them to stand on their feet and manage daily living moments. However, actions or strategies put in place by the affected individuals to come out from their isolated areas are still questioned.\u003c/p\u003e \u003cp\u003eIn a study carried out by Omansen et al., (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) in order to assess the global burden and the progress on disease control, epidemiologic data were been analyzed and reported by countries to the World Health Organization during 2010\u0026ndash;2017. During this period, 23206 cases of Buruli ulcer were reported. Globally, cases declined to 2217 in 2017 thus 1923 in Africa and 294 in West Pacific, but local epidemics seem to arise, such as in Australia and Liberia. Analyzed available data came from a total of 16 countries as 14 in the African Region and 3 in the Western Pacific Region. Other countries were excluded because some provided less information and others had not available data. Overall, the yearly case burden declined from a maximum of 4,906 cases in 2010 to 1,952 cases in 2016; in 2017, however, the number of cases increased to 2,217 cases.\u003c/p\u003e \u003cp\u003eIn Africa, BU is largely endemic in the tropics and has been reported in more than 30 countries in Africa, South America and Asia, as well as in Australia (Mosi, 2017). The greatest burden of disease is found in West and Central Africa where the highest number of cases are reported from Ivory Coast, Benin, Ghana, Cameroon and the DRC. Estimated incidence rates include 21.5 per 100 000/year in parts of Benin and 20.7 per 100 000/year in Ghana overall with up to 158.8 per 100 000/year in some affected districts. Of the 33 globally affected countries, 15 are found in Africa. Between 1978 and 1999, up to 22% of people living in communities where the disease was endemic were affected. In Africa, the disease affects mainly children with more than 50% of cases occurring in those 5 to \u0026lt;\u0026thinsp;15 years of age and commonly affects those living in remote areas with limited access to health care (O\u0026rsquo;Brien et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Cameroon, from a study carried out by Porten et al., (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2009\u003c/span\u003e) with an objective to estimate the prevalence of BU in the health district of Akonolinga, describe the geographic extension of the highly endemic area within the health district, and determine the program coverage and its geographical distribution. The results gotten are as mentioned; Out of a total population of 103000 inhabitants, 26679 were surveyed within twenty quadrats. Sensitivity of the case finding strategy was estimated to be 84% (95%CI 54\u0026ndash;97%). The overall prevalence was 0.47% (n = 105) for all cases including sequelae and 0.25% (n = 56) for active stages of the disease. Five quadrats had a high prevalence of \u0026gt;\u0026thinsp;0.6\u0026ndash;0.9%, 5 a prevalence\u0026thinsp;\u0026gt;\u0026thinsp;0.3\u0026ndash;0.6% and 10 quadrats\u0026thinsp;\u0026lt;\u0026thinsp;0.3%. The quadrats with the high prevalence were situated along the rivers Nyong and Mfoumou. Overall coverage of the project was 18% (12\u0026ndash;27%) for all cases and 16% (9\u0026ndash;18%) for active cases, but was limited to the quadrats neighboring Akonolinga Hospital.\u003c/p\u003e \u003cp\u003eStudies on resilience in the medical field, having a direct link with pathologies have been elaborated already, but concerning BU, little or no has been said. Bringing the aspect of life experience and resilience will however be a new discovery aspect on what BU is concerned in general and specifically in a given population.\u003c/p\u003e \u003cp\u003eA positive correlation between the proportion of MU (\u003cem\u003eMycobacterium ulcerans\u003c/em\u003e)-positive mosquitoes and BU incidence in Australia, and the bacteria\u0026rsquo;s DNA has been detected on the external parts of the body (for example, the exoskeleton and legs) of adult mosquitoes. Furthermore, in Benin (Africa),it was found that terrestrial flying insects do not harbor MU DNA, contradictory results have been found in Cameroon, where terrestrial insects collected from rural and urban houses in a BU endemic region have been found to be positive for MU DNA (Combe et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). More still, N\u0026rsquo;krumah et al., (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e)from their study reported some frequently risk factors of getting contaminated with MU which are the contact of individuals with stagnant or slow flowing surface water through swimming, fishing, laundry, washing dishes, water supply, wearing short clothes during agricultural, activities, and agricultural land use. A positive correlation between the proportion of MU-positive mosquitoes and BU incidence in Australia, and the bacteria\u0026rsquo;s DNA has been detected on the external parts of the body (for example, the exoskeleton and legs) of adult mosquitoes.\u003c/p\u003e \u003cp\u003eThe study that carried by Geard et al., (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) which had as purpose obtaining a deeper understanding of how individuals with spinal cord injury reflect upon the efforts, strategies and agencies they perform to sustain long term resilience and wellbeing, was seen to be a qualitative exploratory study, where by deep interviews were conducted to have the needed information about the situation in question. As a result, the efforts revealed by the participants in normalizing life with a spinal cord injury required continued flexibility, persistency and solution-focused adjustment, interpreted as processes documenting resilience. The participants were marshalling personal resources to handle challenges over time. They explained that they succeeded in maintaining health and wellbeing by maneuvering between different strategies such as being self-protective and flexible as well as staying active and maintaining a positive attitude. Further, support from relational resources were of utmost importance emotionally, socially and when in need of practical assistance. When harnessing relational resources when needed, the participants underlined that balancing dependence and autonomy to remain a part of ordinary life was essential in staying emotionally stable.\u003c/p\u003e \u003cp\u003eTo describe the experiences and perspectives of children and adolescents living with juvenile idiopathic arthritis (JIA) was the main objective of the study that was been conducted by (Tong et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). A systematic review of qualitative study was conducted that explored the experiences of children living with JIA, by searching electronic databases and reference lists of relevant articles. Results gotten from this study showed that, aversion to being different (unrelenting and unpredictable pain, disablement, internal disfigurement, differential treatment, and forced dependency on others); striving for normality (preserving social identity, resourcefulness, sense of community, focuses on remission, and mastery over body and pain); stigma and misunderstanding (trivialization of disease, invisible pain, and discrimination); suspension in uncertainty (control versus powerlessness, hope versus disappointment); managing treatment (benefits of taking medicines, respect and involvement in health care, and motivation for physical therapy); and desire for knowledge (medical treatment and advances, lifestyle management) were the principal events that were been experienced by these individuals.\u003c/p\u003e \u003cp\u003eOn the other hand, Smith et al., (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) from a study with the main aim to explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice while caring for these patients, in which participants took part in semi-structured interviews consisting of open-ended questions about their experiences of life with an ileostomy and their treatments and time in hospital. Points of interest were followed up. Data were collected between July-December of 2014. Their findings were presented from two clinical themes: Issues around treatment and relationships with multi-disciplinary teams. Surgical complications were common and several participants reported concerns about addiction to painkillers. Varying attitudes were found around reversal surgery. Many reported experiencing distressing, dehumanizing care, while some felt supported by excellent healthcare providers.\u003c/p\u003e \u003cp\u003eThe theories that were used for this study were the Cyrulnik's (2003) resilience theory as an explanatory model for the BU experience, and Hurssel\u0026rsquo;s phenomenology in relation to the Interpretative Phenomenological Analysis (IPA) concept by Smith in explanation of the life experience of individuals infected with BU. These particular theories were chosen due to the fact that, they elaborated and showed a pertinence and better understanding on what our research was focusing on. It brought more light to what we were observing. This study had as main objective to describe the resilience and life experience of people with Buruli Ulcer in the Bankim community in Cameroon.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Study Area\u003c/h2\u003e \u003cp\u003eThe study was carried out in the Bankim community in the Adamawa region of Cameroon, where data was collected among individuals found in the community in question. The study conducted was a qualitative research. This said, we proceeded by a phenomenological interpretative qualitative approach while paying emphasis on the Interpretative Phenomenological Analysis (IPA). As it enabled the researcher to have a number of participants for the study and collect data within a short period of time, cross sectional one was of used. It ran for a period of 4 months, from September to December 2022.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy population and sampling procedures\u003c/h3\u003e\n\u003cp\u003eThe population of study were individuals affected by BU at the Bankim community in Cameroon. Participants or the key informant were selected in the community according to the state of being, that is, those affected by BU. The purposive sampling (reasoned choice sampling) was used where by intentional selection of cases likely to show the extent of variation in the phenomenon was proceeded. The group of individuals chosen or selected were a representative of the population. \u0026ldquo;It is not the quantity of participants surveyed that matters but the quality of selected participants concerning the situation in particular.\u0026rdquo; As such, only the process of saturation determined or let the researcher know of the exact size of the sample. For our study 10 participants were interviewed and during the stage of analysis, we got a saturation point at the 8th participant.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eData was collected using a semi-structured interview guide and a lifeline/event tool. Added to this was instruments to be used for the process such as Dictaphone and tablet, a notebook, pen, pencils and eraser. The method used here was an interview. The techniques used were an individual semi-structured interview and focused group discussion. Greetings and general presentation was done by researchers to participants where by, the researcher let know each particular participants the reason for the meet up while presenting them the free and informed consent where by participants were free to accept or refuse the interview. Proper interview was done in a form of discussion, while putting the participants in confidence and comfortable. At the end, the researcher thanked the participants, and requested if possible for another meet up in other to make sure what was gotten after listening and transcription what really what was intended to be said. As for the lifeline/event tool, it was being administered to participants at the start, that is, before moving to the interview with the semi-structured interview guide. At the end, the instrument was collected from the participants and evaluated, if all the parts were filled and asked questions to make sure if what inserted on the lifeline/events is really what was intended to be say by the participants.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe analysis was conducted in accordance with IPA guidelines (Smith \u0026amp; Osborn, 2003). The initial analysis involved repeated readings of each transcript and the recording of observations and preliminary interpretations. The second stage involved the identification of emerging themes for each participant, coded with key words or phrases that reflected the meaning of individual accounts. A master list of themes was then constructed for one transcript reflecting an ordering of the themes illustrated with extracts. This master-theme list was used as the basis for analyzing subsequent interviews, in which examples of the themes were recorded and any new themes identified. In order to ensure the themes remained grounded in the data, all transcripts were reread to ensure cross-referencing of themes across participants.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical consideration\u003c/h3\u003e\n\u003cp\u003e We have obtained an ethical clearance issued by the Institutional Ethics Committee for Research for Human Health (CEIRSH) of the School of Health Sciences of the Catholic University of Central Africa (ESS/UCAC) entitled [N\u0026deg;2022/022149/CEIRSH/ESS/MSP]. In addition, each participant was provided with a consent and/or assent form (for minors aged 15 to 18 and incapacitated adults) to be completed without any constraint to attest to their voluntary participation in the research and to guarantee their anonymity and the confidentiality of the information collected.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003eDescription of respondents\u0026rsquo; characteristics\u003c/h2\u003e\n \u003cp\u003eThe saturation point was reached about the 8 respondents. Firstly, the names of the different correspondents were coded where by each participant was given a code to be protected. In other words, the names codes given represent each participant for the research confidentiality. This will be presented at Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e as shown below.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eIllustration of the General presentation of participants and Identifications\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"7\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCode\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eProfessional status\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLevel of education\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eQuarter or Village\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBankim town\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBankim town\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBandam\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBankim rural\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFarmer/fishermen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBankim rural\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFish roaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBankim town\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBankim town\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBK008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFarmer/fishermen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBandam\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eIt can be seen on the table above that both genders (male and female) are concerned with the condition, showing that BU is a disease that can touch both genders without any distinguishing. Out of the 8 participants, it can be seen that 5 of them are female, which confirms what some studied says, female at a certain age are contaminated or get more easily infected by BU than male. More so, it is observed from what gotten that, BU touches individuals of all ages as the range goes from 12 years for the youngest to 58 years for the oldest. Concerning the occupation or professional status, we can see that half (4/8) of the participants are concerned with agricultural and fishing activities, 1 is concerned with business (fish roaster) and the rest (3/8) are concerned with studies. As such, this can explain the contamination process of the participants in relation the life experienced and resilience. Concerning the level of education, 5 of the participants stopped at the primary level while 3 had the ability to move on to the secondary level. This can explain the fact that, many of them could not read nor write or even understand the French and English languages.\u003c/p\u003e\n \u003cp\u003eThe table below is an illustration of says gotten from the verbatim of participants, which is related to our first specific objective which was to identify the significant events during the life experience of individuals living with Buruli ulcer in the Bankim community.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eIllustration of the different says gotten from the verbatim of participants regarding the significant events and life experience\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eThemes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber of participants\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiminution of the wound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive events\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eConversion (Belief)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHospital care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChildren\u0026rsquo;s success\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDelivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnemployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative events\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLoss fields products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbandon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLoss of son\u0026rsquo;s job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExperience of the disease as a difficulty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003ePsychological state and events with BU\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExperience of the disease as a suffering\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAttributing the source of disease to be unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eActual state with the disease uncomfortably\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eActual state with the disease in pains\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cstrong\u003ePositive Events.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eEvents in general in someone\u0026rsquo;s life will include what has led to a great joy for the person or what has led to a sufferance to the same individual. Positive events are what are what brought a great joy in the life experience of individuals affected by BU. In this case, we principally have; child delivery, success of children in their daily activities, health care that is done in a good way, the diminution of the wound in general despite the pains. As said by participant BK \u0026ndash; 001; \u003cem\u003e\u0026ldquo;my wound has also reduced it\u0026rsquo;s true. I feel pains but I also feel how the wound is reducing\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eOn the other hand, the positive events in the life of participants has a great part to play in their development (psychological development), as most of times it makes them forget about the pain and concentrate on what makes them happy and keep a smile rather than crying of pains as says participant BK \u0026ndash; 002; \u0026ldquo;but, \u003cem\u003emy sister has given birth and I\u0026rsquo;m very happy. It makes me feel less pains, I even forget I have this wound. Really there is joy in my heart.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNegative Events.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eLoss of fields (farm) products, unemployment, loss of child\u0026rsquo;s job, are some of the negative events that participants had in their life experience with BU. Some of them felt bad and saw all situations coming their way as a curse as says participant BK \u0026ndash; 005; \u0026ldquo;\u003cem\u003eMy son at times I feel as it is a punishment to me and to my family. And also my child loss his job at the city because every time he had to come here and take care of me, it\u0026rsquo;s painful, it makes me feel more pains and at times I feel I will not heal.\u0026rdquo;\u003c/em\u003e Still, \u0026ldquo;\u003cem\u003eI lost all of my farm products last year, as the disease started at the moment taking care of the products came. My wife had not great ideas on what to do.\u0026rdquo;\u003c/em\u003e The negative events can result in the creation of more pains to particular individuals, there by pulling their psychology down.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePsychological state and evets with Bu.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe event and the general state of individuals affected by BU plays a great role on their psychological stability which somehow affect their emotions.\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;As soon as the illness started I was on the spot. Because since the beginning I have been in great pain. There are nights when I can\u0026apos;t sleep because of the pain. As I am even walking there, I just force. The wound is located on the bones and it does not allow me to walk, which still hurts a lot. It\u0026apos;s really hard. Since I\u0026apos;m sick I can\u0026apos;t do anything. This is the third month that goes like this and I haven\u0026apos;t done anything (with a very sad face). This illness started in July. I think it was the 17th of July and until today I still suffer\u0026quot;\u003c/em\u003e,\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003eexplained himself participant BK \u0026ndash; 003.\u003c/p\u003e\n \u003cp\u003eHaving BU just once is one story, but being re-contaminated and facing back the same struggles is another story as relate participant BK \u0026ndash; 005; \u0026ldquo;\u003cem\u003eMy son it is very difficult to live in this condition. I abandoned everything, everything. I left all my duties and my wife can\u0026rsquo;t do them all. So we lost much of our products in the farm. The thing is finishing and coming back, finishing and coming back as if I did something bad to someone. When it gets well, it will start back again. Last year by August I was already well, going to the farm and trying to do my activities. But now look (while showing the wounded leg followed by some minutes of complete silence with one arm on the jaw and the other on the wounded leg).\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eConcerning the actual state (at that particular moment) of the disease, participants do face difficulties in controlling their emotions as revels participant BK \u0026ndash; 002;\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;The disease this, really I don\u0026apos;t know, the disease this... I can say that since this disease started, I can\u0026apos;t control my emotions anymore. I get angry very quickly when I\u0026apos;m annoyed, even just a little, and I sleep a lot too. Yes, when I sleep I don\u0026apos;t really feel the pain. It is a kind like a rest for meˮ\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003eBased on our second specific objective which was: To demonstrate the roles and consequences of social integration in the life experience of individuals living with Buruli ulcer in the Bankim community, we have the following:\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003eEsteem or Appraisal Support\u003c/h2\u003e\n \u003cp\u003eThis category refers to the state at which individuals were been encouraged with their social milieu or surroundings, which falls in the role and consequences of social integration. Support, Abandon and Fear are the three essential elements that governed the appraisal nature of the participants. \u003cem\u003e\u0026quot;They only pray to God for me to get well. They call me, my mother is there, my grandmother is there. All my family is there; they call me on the phone. And there are others who call me and tell me that they pray for me, so that as I heal. Especially my sister and my brothers, and my friends they pray for me. My two children and my husband, they call me and pray for me, \u0026quot;\u003c/em\u003eas says participant BK \u0026ndash; 001\u003c/p\u003e\n \u003cp\u003eParticipant BK \u0026ndash; 004 who feels in a state of abandon, relate that; \u0026ldquo;\u003cem\u003eNo, they haven\u0026rsquo;t come to visit me because they are going to school (talking about friends). I miss them and I want to go where they are (talking about family), but my mother says when I will heal she will come and take me here\u0026rdquo;.\u003c/em\u003e And BK \u0026ndash; 006 who relate that; \u003cem\u003e\u0026ldquo;I already told you that those who were with us left us when I got sick. I don\u0026apos;t have any friends anymore. Sometimes the neighbours come but...\u0026rdquo;.\u003c/em\u003e Who seem to be in an abandoned state.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-Esteem and Categorization.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eFrustration, Stigmatization, Restlessness, Unfit, Positive opinion on social implication, Positive opinion of being a social obstacle are the what govern this particular category as it comes to individuals affected by BU. \u003cem\u003e\u0026quot;Unfit! (with a certain tuna and sure as cold) I can\u0026apos;t do anything anymore. I can\u0026apos;t even bend over because I can feel the pain on my back even though. If I don\u0026apos;t do anything, what good am I? as said by participant \u0026quot;\u003c/em\u003eBK \u0026ndash; 007. And BK \u0026ndash; 008 ; \u0026quot;\u003cem\u003eYes oouuoou, before the disease I was the one who went to the field and now I can\u0026apos;t do that. I can\u0026apos;t drink and play checkers at the crossroads. Yes, I see myself as an obstacle since my friends have put me out of their way\u003c/em\u003e, who relate themselves in the listed categories on the table below.\u003c/p\u003e\n \u003cp\u003eThe table below gives a global illustration;\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eIllustration of the different says gotten from the verbatim of participants regarding the roles and consequences of social integration\u003c/em\u003e.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eThemes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber of participants\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSupport\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eEsteem or appraisal support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbandon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrustration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"6\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-esteem and categorization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStigmatization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRestlessness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnfit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePositive opinion on social implication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePositive opinion of being a social obstacle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eComing to our third specific objective which is: To identify the protective factors that are found in the life experience of individuals with Buruli ulcer in the Bankim community, we have the following;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eSpirituality and Family\u003c/h2\u003e\n \u003cp\u003eIn this category falls what principally motivated the participants to stand firm in their health condition which are; Family aspect for motivation and Spiritual aspect for motivation. As this lead us to the protective factors found in the life experience of individuals affected by BU. Taking into consideration what participant BK \u0026ndash; 001 brought out; \u003cem\u003e\u0026quot;My children. My husband. I only pray to God too, I pray to God. When I think that God is there, it gives me strength. Yes! With my children. Because I haven\u0026apos;t seen them since. When I think of them I am strong, very much so I get up, I eat and I chat.\u0026rdquo;\u003c/em\u003e It can be seen that both the spiritual aspect and family aspect do take part in the motivation state and the sense of standing firm. And for BK \u0026ndash; 005; \u0026ldquo;\u003cem\u003eMy family, my wife and children because I have 4 children and they are not here in Bankim. They are a support to me. With my brother who is always there,\u0026rdquo;\u003c/em\u003e the family aspect is the main point.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eSocial importance and Consequences\u003c/h2\u003e\n \u003cp\u003ePositive opinion on social influence, Negative opinion on social influence, Unfit, Obstacle, are the main four aspects of this category as they give a respective understanding on the state of participants. \u003cem\u003e\u0026quot;I think that everything happens is God\u0026apos;s doing. If I am like that now, I don\u0026apos;t work. I don\u0026apos;t do anything. It is God who knows everything, I do not know. I know my part that it is God who made it. Now if I overtake somebody, aahhk (shoulders raised to the sky)\u0026quot;\u003c/em\u003e reveals BK \u0026ndash; 001 who shows a positive opinion on social influence. BK \u0026ndash; 008 says; \u003cem\u003e\u0026quot;No, or I would say at the moment I don\u0026apos;t know yet. Since I\u0026apos;m sick, I think a lot. I would say that I am unable to do certain things.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eThis can be summarized on Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e below;\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eIllustration of the different says gotten from the verbatim of participants regarding factors that are found in life experience.\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eThemes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber of participants\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFamily aspect for motivation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpirituality and family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpiritual aspect for motivation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePositive opinion on social influence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial importance and consequences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNegative opinion on social influence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eObstacle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eBeing our fourth specific objective (Neo development factors found in the life experience of individuals affected by BU), here we principally focused on those events that brought the participants to develop certain reactions out of their context of being infected by BU and to see things in a different way. As such we payed attention on the resilience factors that each participant had, that was gotten from the life event tool in straight collaboration with the interviews gotten from them.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePresentation of data on the resilience of individuals affected by Buruli ulcer in the Bankim community in Cameroon.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA rational is based on this section which focuses on the study of the eight participants\u0026rsquo; life experiences with BU, of whom one participant expressed the resilience factors. For this participant in question, at first, a phenomenological account of the life experience with BU was constituted. These narratives represent a brief reconstruction of the participants\u0026rsquo; life experience, based on the verbatim (which had to deal with the significant events of the participants) and the life line/life events tool. Secondly a syntheses and interpretation of the life experience was done to bring out resilient characteristics of the participant there by bringing out the different phase and process of resilience. A title was given to the whole process, that was gotten from the syntheses done where by it was observed in the says of the participant in question.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eExperience of Resilience of participant BK \u0026ndash; 005; \u0026ldquo;Man of HOPE\u0026rsquo;\u0026rsquo;\u003c/h2\u003e\n \u003cp\u003eParticipant BK \u0026ndash; 005 is a male of 58 years old that lives in Bankim town. He is a farmer and also practice fishing at times. Married to a woman for years now, they have 4 children among which one is a girl and the rest are boys. He got infected by \u003cem\u003eMycobacterium ulcerans\u003c/em\u003e last year 2021 precisely in the month of March. It started biologically, with a small pimple that was itchy, which let in the itching process. This resulted in the burst of the pimple, liberating a watery solution which contaminated other places around. That\u0026rsquo;s how the wound started developing and finally leading to a great one. Firstly, taken to a traditional doctor by his brother, things were worsening which leaded them to the hospital. After few months of treatment, it started healing, but suddenly got infected back early this year 2022. The significant events of the participant in association with the negative events from the life tool were the main force that driven him to a state of resilience, with the main factor of resilience; \u003cem\u003etransformation\u003c/em\u003e. This can be related to the suffering and more pains the participant felt when the events happened. For him, he was in cause with all what happened. The transformation point come in relation with the fact of stepping up, and not letting the disease condition to control what has to go on in his personal and family life situation.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eResilience based on the pains, difficult moments and personal development\u003c/h2\u003e\n \u003cp\u003eParticipant BK \u0026ndash; 005 has undergone a lot of suffering, gone through difficult moments and hardship right from the first contact with BU passing through the recontamination process. He saw himself abandoning all his activities while putting the whole family in difficult moments, especially his wife. One of his most difficult moments was when his friends denied helping his wife with activities in the farm, he declared; \u0026ldquo;\u003cem\u003eMy friends refused to help my wife in the farm. At the start some were coming to visit but I think they felt discouraged. I don\u0026rsquo;t understand, and also my child loss his job at the city because every time he had to come here and take care of me, it\u0026rsquo;s painful and at times I feel I will not heal\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eThanks to his surroundings, the environment and the family in general he could stand firm and despite the re-contamination he could develop the \u003cem\u003etransformation resilient factor\u003c/em\u003e, trying to take more positive action to be a set free from the disease in question, as he relates;\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e\u003cem\u003eI promised myself to stay strong and recover so that I can continue taking care of my home and my farm. Because I heard that people said I did something bad for this wound to finish and come again. Now I am trying to stay strong and rest for this leg to finish and never come back again. I don\u0026rsquo;t want to feel pains again because it\u0026rsquo;s very difficult. I don\u0026rsquo;t want my wife to suffer again. I don\u0026rsquo;t want my children to allow their work in the city every time to come and me meet here. I want everybody to be happy. So I will stay home, take my medication and allow this led to heal normally.\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIt can be seen that different significant events were evolved in different participants that are affected by BU.\u003c/p\u003e \u003cp\u003ePhenomenology developed by Edmund Husserl as an eidetic method, is concerned with attending to the way things appear to individuals in their experience. Husserl's phenomenology (1970) offers an understanding and an in-depth a deep description of a phenomenon of interest, as well as it makes possible the emergence of a pure and universal signification of the studied experience. In this particular part that had to deal with the positive events in the life experience of individuals affected by BU, the events brought a period of great joy and encouragement in their life experience, as some of the participants said to have forgotten about pains for a good period of time thanks to those events. It\u0026rsquo;s true the events did not set in them a state of resilience, that could give them a motivational impact or empowerment to come out of the situation, but it had a role to play on their psychology, and state even if it was for a short period of time. Results gotten here could not have been liked with another study, but (Kimessoukie Omolomo, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) in his study elaborated particular points and interest on the events in the life of individuals that had gone through difficulties and suffering, helping to understand our own findings.\u003c/p\u003e \u003cp\u003eThe experience of unhappiness may distance the individual from the mainstream, but at the same time bring him or her closer to a community with whom he or she shares a different experience as mentioned by Cyrulnik in his theory. The negative events in individuals affected by BU have brought more pains and suffering. This resulted in more stress and psychological instability. Some of the participants through the negative events, developed factor of transformation, as said by (Kimessoukie Omolomo, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) that had a great role to play in the improvement, amelioration and action taken, in order to come out of the particular situation of disease state, stand firm and see life in another point of view. Recent studies that could have been compared with our study where not really dealing with the significant events of individuals in a specific manner and had no information that could have been of our use.\u003c/p\u003e \u003cp\u003eThe phenomenological approach all involves detailed examination of those individuals affected with BU lifeworld; it attempts to explore their experience and is concerned with their personal perception or account of BU in question, as opposed to an attempt to produce an objective statement of the disease condition or event itself .In other to come out with the different psychological state and events with BU, the concept of Smith is taken into consideration as to have a better perception of the participants\u0026rsquo; affected by BU situation and state. In our study, it came out from the different participants three of these that englobe their psychological state and events in which some related their state as suffering, others related to un-comfort and others were based on pains, feeling huge pains. It\u0026rsquo;s true that pains can be related to the state of being uncomfortable but some participants emphasized in the fact that, at times they feel uncomfortable without necessarily feeling the pains, while when the feel the pains in did, the nature of un-comfort will be present as well.\u003c/p\u003e \u003cp\u003eIn relation with other studies, (Tong et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) had similar findings with participants who were at pains and suffering due to their condition of arthritis. Similarly, (Sutanto et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) reveals in different ways and state of the studied population how pains and moments of difficulties were been encountered and faced. With this, it can be said that individuals in certain state of disabilities do undergo huge difficulties and faces a lot of pains which make it at times very unsuitable for them to feel comfortable.\u003c/p\u003e \u003cp\u003eComing to the roles and consequences of social implications of our participants, this part of our study will be focused on the external environment of participants, and their interaction with it as well as how the external environment does interact with those participants affected by BU.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Those who have been traumatized understand, while the others live their daily lives superficiallyˮ\u003c/em\u003e. This particular statement was brought up by Cyrulnik in one of his theories. The statement goes in direct relation with what participant affected by BU and their external world have. Such individuals who are in the state of disability will be facing a different situation compared to those surrounding them. In the course of our study it was observed that, support, abandon, and fear are what governed the esteem or appraisal support of participants affected by BU, which could be in a long or short run. For the majority of our participants the long run was dominant, as some of them felt the support constantly and in a continuous manner, either from their family or friends (but mostly from the family). While other participants felt abandoned and fear about the situation they were facing. Some expressed the sensation of being abandoned by their friends.\u003c/p\u003e \u003cp\u003eSimilarly to (Smith et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) whose study was based on ileostomy patients, some findings reveal that, the participants felt to be supported or had the support needed from their family most, because they were the ones that could understand and accept it, compared to friends that were a bit reluctant in their way of getting things.\u003c/p\u003e \u003cp\u003eStill on this phrase by Cyrulnik \u0026ldquo;\u003cem\u003eThose who have been traumatized understand, while the others live their daily lives superficiallyˮ\u003c/em\u003e, will be elaborated the different themes that were been gotten from our participants affected by BU. Having a self-esteem that is not valuable and been categorized in one way or the other, are what the majority of the participants affected by BU got when it comes to the interaction with people around them. Frustration, restlessness, stigmatization, unfit and positive opinion on social implication are the themes that were been gotten from the participants, as some of them felt to be put apart by some people around them.\u003c/p\u003e \u003cp\u003eSimilarly, (Smith et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) comes in with themes of stigmatization and restlessness as some individuals with ileostomy said to have been put apart and have a different sex life with their partners. On the other hand, (Cartwright et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) findings don\u0026rsquo;t relate with ours, in the sense that individuals living with Juvenile Idiopathic Arthritis don\u0026rsquo;t feel unfit with their situations.\u003c/p\u003e \u003cp\u003eThe protective factors of the participants affected by BU in the present study are basically on two aspects as follows:\u003c/p\u003e \u003cp\u003eThe concepts of spirituality and family are generally what is seen and observed. In our context the participants had to be motivated, or they were certain things or people in particular that helped them to stand firm on their feet in their disabilities situation. The themes that were been brought were; Family aspect of motivation and Spiritual aspect of motivation. In the course of our study, the majority of participants said their family were their principal source of motivation. Among them mentioned the spiritual aspect which gave them strength and enabled them to have a certain confidence as time goes. Others just mentioned the spiritual aspect while others had as one and only source of motivation their family.\u003c/p\u003e \u003cp\u003eSimilarly the study by (Smith et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) reveals a total motivational aspect by family of those individuals having a stoma, which in most of the case is a major reason for self-abandoned and restlessness by the affected individuals.\u003c/p\u003e \u003cp\u003eHaving a disability and feeling socially accepted or important is of great importance, but individuals don\u0026rsquo;t still have that desire and ability. Affected participants by BU, had certain observations in the manner their surroundings do implicate them in situations since they in a state of disability. Just a few had negative opinions on the social influence, meaning that they felt they were less or not more implicated in situations that concerned their surrounding and in some cases, them as well. The majority had positive opinions on their implication in different aspects by their surroundings. Same as, still the majority of the participants claimed to be an obstacle for others around them. In contrast to our findings, studies from our reviewed did not mention the aspects and opinions of individuals as what been an obstacle or been influenced by the surrounding.\u003c/p\u003e \u003cp\u003eNeo-development as the name implies, this part basically focused on the aspect that lead to the empowerment of participants affected by BU, for them to be positive minded and which enabled them decide to take certain action. To be more precised, it will be all about resilience.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"The ability to succeed, to live and develop positively, in a socially acceptable way despite stress or adversity that normally carries the serious risk of a negative outcome\"\u003c/em\u003e as said (Cyrulnik, 1999) about the concept of resilience. This resumption of a type of development after psychological agony (Cyrulnik, 2004) is a process that is possible for any individual, regardless of the severity of their trauma, because it is physiologically inscribed in them, here talking about participants affected by BU. Unhappiness provokes a personal transformation; this transformation can be positive, provided that the person prefers an active posture of struggle to a passive position of victims; this clarification leads to a better understanding of the resilience and sense of well-being developed by participants affected by BU.\u003c/p\u003e \u003cp\u003eIn the course of our research, it came to realize that among our 8 participants enrolled, just 1 was found to be in a state of resilience. He faced a recontamination process and in the course on his first infection, he came to pay less attention on the affected area when it was about finishing healing, that lead to a second contamination. He underwent much stress, pain and suffering in which all his family members including his brother was involved. Observing his family becoming a burden for him, undergoing pains were not what he intended to finish in. Coming out of his zone of comfort by deciding to take actions despite the pains is what let us include the participant in the process of being resilient. Deciding to stand up fit and fight for him and his family are the main actions that motivated our understandings in his process of resilience.\u003c/p\u003e \u003cp\u003eSimilarly, the study by (Geard et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), reveals state of resilience in patients that have undergone spinal cord injury, who decide to stand, and focus more on their self-development in order to acquire a certain mobility and freedom.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis original study has permitted us to validate our different objectives. Firstly, the significant events during the life experience of individuals affected by Buruli ulcer were identified and showed both positive events (conversion or belief, delivery, success of children, diminution of wound) and negative events (loss of son\u0026rsquo;s job, loss of farm products, abandon). Panic and calm manners were their reactions about the disease state, as they related to experience the disease with a lot of difficulties and suffering. Being uncomfortable and feeling pains, the infected participants had a certain hope while others were hopeless about their condition. Secondly, as what concerns the roles and consequences of social integration, support, abandon, fear, frustration, stigmatization, negative and positive opinions about social implications were gotten. Thirdly, family and spiritual aspects as support were the main factors of protection that were identified in individuals affected by Buruli ulcer in the Bankim community, where by some of them felt to be an obstacle for their surroundings. Fourthly and lastly, resilience state or factors (Transformation) was identified to a particular participant, whose story was entitled \u003cem\u003e\u0026ldquo;MAN OF HOPE\u0026rdquo;\u003c/em\u003e as the neo-development factors was in concern. However, these results do not draw a general conclusion on what these particular individuals feel or what they are going through, as the reinfection by Buruli ulcer is very probable and may lead to another set of findings that could better understand and ameliorate their living in all the aspects needed. As such, other researchers are invited to pay an attention on those particular set of individuals that are infected by Buruli ulcer, not just for the first time or occasion. More can still be gotten and exploited from that.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eBU\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBuruli Ulcer\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eDNA\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDeoxyribonucleic acid\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eIPA\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInterpretative Phenomenological Analysis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eJIA\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eJuvenile Idiopathic Arthritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eMU\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMycobacterium ulcerans\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eSDGs\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSustainable Development Goals\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eWHO\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work has not been funded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical trial number not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest Declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no competing interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval:\u003c/strong\u003e This study was carried out in compliance with fundamental ethical principles, in particular those relating to the protection of participants and the confidentiality of data.\u0026nbsp;We have obtained an ethical clearance issued by the Institutional Ethics Committee for Research for Human Health (CEIRSH) of the School of Health Sciences of the\u0026nbsp;Catholic University of Central Africa (ESS/UCAC) entitled [N\u0026deg;2022/022149/CEIRSH/ESS/MSP],\u0026nbsp;and an administrative and local authorization was signed and granted by Adamawa Region administrative authorities. These procedures guarantee that the study was conducted ethically and in compliance with current regulations, while ensuring the safety and well-being of participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publication\u003c/strong\u003e: Not applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e All data used and/or analyzed for this study are available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e All the authors made a significant contribution to this research work, in terms of study design, execution, data acquisition, analysis and interpretation of results, writing, and critical revision of the article. RNDT, EKO, RKK, GRPD and DFST designed and implemented the study; RNDT collected the data; RNDT, EKO and RKK analysed and interpreted the data; RNDT initiated the manuscript; EKO, GRPD and DFST revised the initial version of the manuscript; all authors revised and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments :\u0026nbsp;\u003c/strong\u003eOur gratitude goes to the Comit\u0026eacute; d\u0026apos;\u0026Eacute;thique Institutionnel de la Recherche pour la Sant\u0026eacute; Humaine de l\u0026apos;Ecole des Sciences de la Sant\u0026eacute; de l\u0026apos;Universit\u0026eacute; Catholique d\u0026apos;Afrique Centrale, the Legal Authorities of the Adamawa Region and Bankim Town for research authorizations. We are also grateful to FAIRMED Association and Bankim Health District staffs, whose support and collaboration were essential in data collection.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCartwright, T., Fraser, E., Edmunds, S., Wilkinson, N., \u0026amp; Jacobs, K. (2015). Journeys of adjustment: The experiences of adolescents living with juvenile idiopathic arthritis. Child: Care, Health and Development, \u003cem\u003e41\u003c/em\u003e(5), 734\u0026ndash;743. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/cch.12206\u003c/span\u003e\u003cspan address=\"10.1111/cch.12206\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCombe, M., Velvin, C. J., Morris, A., Garchitorena, A., Carolan, K., Sanhueza, D., Roche, B., Couppi\u0026eacute;, P., Gu\u0026eacute;gan, J.-F., \u0026amp; Gozlan, R. E. (2017). Global and local environmental changes as drivers of Buruli ulcer emergence. Emerging Microbes \u0026amp; Infections, \u003cem\u003e6\u003c/em\u003e(4), pp. 1\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGeard, A., Kirkevold, M., L\u0026oslash;vstad, M., \u0026amp; Schanke, A.-K. (2018). Exploring narratives of resilience among seven males living with spinal cord injury: A qualitative study. BMC Psychology, \u003cem\u003e6\u003c/em\u003e(1), pp. 1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKimessoukie Omolomo, \u0026Eacute;. (2016). \u003cem\u003eVariabilit\u0026eacute; et mod\u0026eacute;lisation ph\u0026eacute;nom\u0026eacute;nologique de la r\u0026eacute;silience chez des femmes camerounaises confront\u0026eacute;es \u0026agrave; une forte adversit\u0026eacute;\u003c/em\u003e [Phd, Universit\u0026eacute; du Qu\u0026eacute;bec \u0026agrave; Trois-Rivi\u0026egrave;res]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://depot-e.uqtr.ca/id/eprint/7978/\u003c/span\u003e\u003cspan address=\"https://depot-e.uqtr.ca/id/eprint/7978/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMosi, L. (s. d.). \u003cem\u003eBuruli ulcer: Africa\u0026rsquo;s neglected but third most common mycobacterial disease\u003c/em\u003e. The Conversation. Consult\u0026eacute; 31 mars 2022, \u0026agrave; l\u0026rsquo;adresse \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://theconversation.com/buruli-ulcer-africas-neglected-but-third-most-common-mycobacterial-disease-56522\u003c/span\u003e\u003cspan address=\"http://theconversation.com/buruli-ulcer-africas-neglected-but-third-most-common-mycobacterial-disease-56522\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eN\u0026rsquo;krumah, R. T. A. S., Kon\u0026eacute;, B., Tiembre, I., Ciss\u0026eacute;, G., Pluschke, G., Tanner, M., \u0026amp; Utzinger, J. (2016). Socio-Environmental Factors Associated with the Risk of Contracting Buruli Ulcer in Tiassal\u0026eacute;, South C\u0026ocirc;te d\u0026rsquo;Ivoire: A Case-Control Study. PLoS Neglected Tropical Diseases, \u003cem\u003e10\u003c/em\u003e(1), pp. 1\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO\u0026rsquo;Brien, D. P., Jeanne, I., Blasdell, K., Avumegah, M., \u0026amp; Athan, E. (2019). The changing epidemiology worldwide of Mycobacterium ulcerans. \u003cem\u003eEpidemiology \u0026amp; Infection\u003c/em\u003e, \u003cem\u003e147\u003c/em\u003e. pp. 1\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOmansen, T. F., Erbowor-Becksen, A., Yotsu, R., van der Werf, T. S., Tiendrebeogo, A., Grout, L., \u0026amp; Asiedu, K. (2019). Global Epidemiology of Buruli Ulcer, 2010\u0026ndash;2017, and Analysis of 2014 WHO Programmatic Targets. Emerging Infectious Diseases, \u003cem\u003e25\u003c/em\u003e(12), pp. 2\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePorten, K., Sailor, K., Comte, E., Njikap, A., Sobry, A., Sihom, F., Meva\u0026rsquo;a, A., Eyangoh, S., Myatt, M., Nackers, F., \u0026amp; Grais, R. F. (2009). Prevalence of Buruli Ulcer in Akonolinga Health District, Cameroon: Results of a Cross Sectional Survey. PLoS Neglected Tropical Diseases, \u003cem\u003e3\u003c/em\u003e(6), pp. 2\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith, J. A., Spiers, J., Simpson, P., \u0026amp; Nicholls, A. R. (2017). The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis. Health Psychology, \u003cem\u003e36\u003c/em\u003e(2), pp. 143\u0026ndash;151.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSutanto, B., Singh-Grewal, D., McNeil, H. P., O\u0026rsquo;Neill, S., Craig, J. C., Jones, J., \u0026amp; Tong, A. (2013). Experiences and Perspectives of Adults Living With Systemic Lupus Erythematosus: Thematic Synthesis of Qualitative Studies. Arthritis Care \u0026amp; Research, \u003cem\u003e65\u003c/em\u003e(11), pp. 1752\u0026ndash;1765.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTong, A., Jones, J., Craig, J. C., \u0026amp; Singh-Grewal, D. (2012). Children\u0026rsquo;s experiences of living with juvenile idiopathic arthritis: A thematic synthesis of qualitative studies. Arthritis Care \u0026amp; Research, pp. \u003cem\u003e64\u003c/em\u003e(9), 1392\u0026ndash;1404.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Life experience, Resilience, Buruli ulcer, Individuals affected","lastPublishedDoi":"10.21203/rs.3.rs-6144522/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6144522/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBuruli ulcer significantly impacts individuals’ socioeconomic, physical, cultural, and immunological conditions, often leading to social abandonment and difficulties in community reintegration. This study aims to identify the lived experiences and resilience factors of individuals affected by Buruli ulcer in the Bankim Community, Cameroon, utilizing Cyrulnik’s resilience theory and Hurssel’s phenomenology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSubjects and methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn interpretative phenomenological analysis (IPA) was conducted, employing purposive sampling until saturation was reached. Data were collected through semi-structured interviews using an interview guide and a lifeline tool. The analysis adhered to IPA guidelines established by Smith \u0026amp; Osborn, involving repeated readings of transcripts, observations, and preliminary interpretations followed by general categorization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEight participants (5 females, 3 males; ages 12–58) from diverse professional backgrounds (agriculture, fishing, business, and studies) were enrolled. The analysis revealed significant life events categorized as positive (e.g., belief conversion, child success, wound healing) and negative (e.g., job loss, abandonment). Participants expressed experiences of social integration characterized by support, abandonment, fear, frustration, stigma, and feelings of inadequacy. Life experience factors included family and spiritual motivation, highlighting mixed perceptions regarding social inclusion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study underscores the complex interplay between adversity and resilience among individuals affected by Buruli ulcer. Notably, one participant exemplified resilience—termed “A MAN OF HOPE”—who, despite experiencing reinfection and stigma, emerged determined to overcome personal and familial challenges. This research contributes to understanding the psychosocial dynamics of Buruli ulcer and emphasizes the need for supportive interventions to facilitate social integration.\u003c/p\u003e","manuscriptTitle":"Life experience and resilience of individuals affected by buruli ulcer in the Bankim community in Cameroon","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 10:24:21","doi":"10.21203/rs.3.rs-6144522/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"485d3042-0040-435f-b114-fd509bb42a3e","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-10T13:24:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-06 10:24:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6144522","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6144522","identity":"rs-6144522","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}