2 - Better infection than hunger’. A study of illness perceptions with special focus on urinary schistosomiasis in Northern Tanzania
Corresponding Author(s) : Rose Mwangi
African Sociological Review,
Vol. 7 No. 1 (2003): African Sociological Review
Abstract
This paper is about how a community in Northern Tanzania experiences and reasons around urinary schistosomiasis and more specifically female genital schistosomiasis or schistosomiasis of the reproductive tract. As a disease, female genital schistosomiasis presents itself with a variety of symptoms which neither the affected woman nor the medical professionals
usually recognise as schistosomiasis. The study therefore focused on symptom recognition, the question being whether women living in an endemic area can distinguish symptoms of urinary and genital schistosomiasis from those of other diseases presenting in similar ways. Data were generated using a combination of qualitative methods including observation, individual interviews and focus group discussions with diverse categories of people. All the research participants were aware of the link between water and infection. Because the disease is associated with farming, the main livelihood, there was a strong feeling among the research participants that treatment, whether in hospital or by traditional medicine could not effect permanent cure. Re-infection was considered inevitable and as schistosomiasis was said to be less poisonous than malaria, it was felt there was little choice between being infected and having food. Making sense of the symptoms was considered moreover difficult although women and men said they could tell whether blood in urine was due to urinary schistosomiasis or other conditions such as sexually transmitted diseases which present similar symptoms. The similarity of symptoms was said to be problematic also because of the sensitivity and stigma in sexually transmitted diseases. Urinary schistosomiasis is therefore a complex health problem and for any effective control there is clearly a need to grasp this complexity.
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- Agar M. 1996. ‘Recasting the? Ethno? in ?epidemiology?’. Medical Anthropology, 16:391-403.
- Ahlberg, B M, Kiiru, K, Njau, W, Krantz, I. 2000. ‘Gender masked or self-inflicted pain: female circumcision, eradication and persistence in Central Kenya’. African Sociological Review 4(1): 35- 54.
- Amazigou, U. 1994. ‘Gender and tropical diseases in Nigeria’. In Wijeyaratine P (ed) Gender, health and sustainable development. Ottawa, Canada. IDRC.
- Annandale E. and Hunt K. (eds.) 2000. Gender inqualities in health. Buckingham- Philadelphia.Open University Press.
- Appiah-Kubi, K. 1981. Man cures, God heals: religion and medical practice among the Akans of Ghana.
- New York. Friendship Press.
- Barbour R.S. and Kitzinger J. (eds). 1999. Developing Focus group Research: Politics, theory and practice. London. Sage Publications.
- Brown P. 1995. ‘Naming and framing: The social construction of diagnosis and illness’. Journal of Health and Social Behavior (Extra Issue) 34-52.
- Bunton R, Nettleton S, Burrows R. (eds.). 1995. The sociology of health promotion: Critical analysis of consumption, lifestyle and risk. London. Routledge.
- Cant, S. and Sharma, U. 1998. ‘Reflexivity, ethnography and the professions (complementary medicine): watching you watching me watching you (and writing about both of us)’. The Editorial Board of the Sociological Review: 244-263.
- Cameron, E. and Bernades, J. 1998. ‘Gender and disadvantage in health: men’s health for a change.
- Sociology of Health and Illness, 20(5):673-693.
- Caplan, P. 2000. Risk revisited. London. Pluto Press.
- Cooke, B. and Kothari, U. (eds.) 2001. Participation: the new tyranny? London. Zed Books. Dezin, N.K. and Lincoln, Y. 2000. Handbook of qualitative research. (2ⁿᵈ ed). Thousands Oaks. Sage Publications.
- Feierman, S. 1985. ‘Struggles for control: the social roots of health and healing in Africa’. African Studies Review, 28 (2/3): 73-147.
- Feldmeier, H, Poggensee, G, Krantz I, Helling-Giese, G. 1995. ‘Female genital schistosomiasis. New challenges from a gender perspective’. Trop. Geogr. Med. 47:S2-15.
- Flick, U. 1998. ‘The social construction of individual and public health: Contributions of social representation theory to a social science of health’. Social Science Information, 37(11):639-662.
- Frohlich, K.L. Corin, E. Potvin, L. 2001. ‘A Theoretical proposal for the relationship between context and disease’. Sociology of Health and Illness. 22(6):776-797.
- Hahn, R.A. 1995. Sickness and healing: An anthropological perspective. New Haven.Yale University Press.
- Hahn, R.A. (ed.) 1999. Anthropology in public health: ridging differences in culture and society.
- New York. Oxford University Press.
- Hertz R (ed.). 1997. Reflexivity and voice. Thousand Oaks. Sage Publications. Hornby, P. and Symon, G. 1994. ‘Tracer studies’. In Cassell C. and Symon G. Qualitative methods in organizational research: A practical guide. London. Sage Publications.
- Hughes, C.C. and Hunter, J.M..1997. ‘Disease and development in Africa’. SSM 3: 443-93. Kvale. S. 1996. Interviews: An introduction to qualitative research interviewing. Thousands Oaks. Sage
- Publications.
- Lane, S.D. and Cibula, D.A. 2000. ‘Gender and health’. In Albrecht G.L, Fitzptrick R. and Scrimshaw S.C. Handbook of social studies in health and medicine. London. Sage Publications. Lorber, J. 1997.
- Gender and the social construction of illness. Thousands Oaks. Sage Publications.
- Marshall, C. and Rossman, G.B. 1999. Designing qualitative research. Thousands Oaks. Sage Publications.
- McElroy, A. and Jezewski, A. 2000. ‘Cultural variation in the experience of health and illness’. In Albrecht G.L, Fitzptrick R. and Scrimshaw S.C. Handbook of social studies in health and medicine. London. Sage Publications.
- Oakley, A. 2000. Experiments in knowing: Gender and method in the social sciences. UK. Polity Press.
- Onuaha, G.B.I. 1981. ‘Factors responsible for the under-utilisation of available health services by rural people in Nigeria’. East African Medical Journal. 58(11).
- Poggensee, G., Kiwelu, I. Weger, V. Goppner, D. Diedrich, T. Krantz, I. Feldmeier, H. 2000. ‘Female genital schistosomiasis of the lower genital tract: prevalence and morbidity in Northern Tanzania’. J. Infect.Dis. 181(3):1210-3.
- Poppen, P.J and Reisen, C.A. 1997. ‘Perception of risk and sexual self-protective behaviour: a methodological critique’. AIDS Education and Prevention, 9(4):373-390.
- Seal C. 1999. The quality of qualitative research. London. Sage Publications.
- Smith, J. H., Kamel, I. A., Elwi, A. M., von Lichtenberg, F. 1974. ‘A quantitative post mortem analysis of urinary schistosomiasis in Egypt’. American Journal of Tropical Medicine and Hygiene 23, 1054-1071.
- Tierney, K.J. 1999. ‘Towards a critical sociology of risk’. Sociological Forum, 14(2):215-242.. WHO 1998. Gender and health. Technical paper, Geneva.
- Van der Geest, S. 1995. ‘Overcoming ethnocentrism: How social science and medicine relate and should relate to one another’. Soc Sci Med. 40, 869-872.
- Yelland, J. and Gifford, S. M. 1995. ‘Problems of focus group method in cross-cultural research: a case study of beliefs about sudden infant death syndrome’. Australian Journal of Public Health 19(3):257-263.
References
Agar M. 1996. ‘Recasting the? Ethno? in ?epidemiology?’. Medical Anthropology, 16:391-403.
Ahlberg, B M, Kiiru, K, Njau, W, Krantz, I. 2000. ‘Gender masked or self-inflicted pain: female circumcision, eradication and persistence in Central Kenya’. African Sociological Review 4(1): 35- 54.
Amazigou, U. 1994. ‘Gender and tropical diseases in Nigeria’. In Wijeyaratine P (ed) Gender, health and sustainable development. Ottawa, Canada. IDRC.
Annandale E. and Hunt K. (eds.) 2000. Gender inqualities in health. Buckingham- Philadelphia.Open University Press.
Appiah-Kubi, K. 1981. Man cures, God heals: religion and medical practice among the Akans of Ghana.
New York. Friendship Press.
Barbour R.S. and Kitzinger J. (eds). 1999. Developing Focus group Research: Politics, theory and practice. London. Sage Publications.
Brown P. 1995. ‘Naming and framing: The social construction of diagnosis and illness’. Journal of Health and Social Behavior (Extra Issue) 34-52.
Bunton R, Nettleton S, Burrows R. (eds.). 1995. The sociology of health promotion: Critical analysis of consumption, lifestyle and risk. London. Routledge.
Cant, S. and Sharma, U. 1998. ‘Reflexivity, ethnography and the professions (complementary medicine): watching you watching me watching you (and writing about both of us)’. The Editorial Board of the Sociological Review: 244-263.
Cameron, E. and Bernades, J. 1998. ‘Gender and disadvantage in health: men’s health for a change.
Sociology of Health and Illness, 20(5):673-693.
Caplan, P. 2000. Risk revisited. London. Pluto Press.
Cooke, B. and Kothari, U. (eds.) 2001. Participation: the new tyranny? London. Zed Books. Dezin, N.K. and Lincoln, Y. 2000. Handbook of qualitative research. (2ⁿᵈ ed). Thousands Oaks. Sage Publications.
Feierman, S. 1985. ‘Struggles for control: the social roots of health and healing in Africa’. African Studies Review, 28 (2/3): 73-147.
Feldmeier, H, Poggensee, G, Krantz I, Helling-Giese, G. 1995. ‘Female genital schistosomiasis. New challenges from a gender perspective’. Trop. Geogr. Med. 47:S2-15.
Flick, U. 1998. ‘The social construction of individual and public health: Contributions of social representation theory to a social science of health’. Social Science Information, 37(11):639-662.
Frohlich, K.L. Corin, E. Potvin, L. 2001. ‘A Theoretical proposal for the relationship between context and disease’. Sociology of Health and Illness. 22(6):776-797.
Hahn, R.A. 1995. Sickness and healing: An anthropological perspective. New Haven.Yale University Press.
Hahn, R.A. (ed.) 1999. Anthropology in public health: ridging differences in culture and society.
New York. Oxford University Press.
Hertz R (ed.). 1997. Reflexivity and voice. Thousand Oaks. Sage Publications. Hornby, P. and Symon, G. 1994. ‘Tracer studies’. In Cassell C. and Symon G. Qualitative methods in organizational research: A practical guide. London. Sage Publications.
Hughes, C.C. and Hunter, J.M..1997. ‘Disease and development in Africa’. SSM 3: 443-93. Kvale. S. 1996. Interviews: An introduction to qualitative research interviewing. Thousands Oaks. Sage
Publications.
Lane, S.D. and Cibula, D.A. 2000. ‘Gender and health’. In Albrecht G.L, Fitzptrick R. and Scrimshaw S.C. Handbook of social studies in health and medicine. London. Sage Publications. Lorber, J. 1997.
Gender and the social construction of illness. Thousands Oaks. Sage Publications.
Marshall, C. and Rossman, G.B. 1999. Designing qualitative research. Thousands Oaks. Sage Publications.
McElroy, A. and Jezewski, A. 2000. ‘Cultural variation in the experience of health and illness’. In Albrecht G.L, Fitzptrick R. and Scrimshaw S.C. Handbook of social studies in health and medicine. London. Sage Publications.
Oakley, A. 2000. Experiments in knowing: Gender and method in the social sciences. UK. Polity Press.
Onuaha, G.B.I. 1981. ‘Factors responsible for the under-utilisation of available health services by rural people in Nigeria’. East African Medical Journal. 58(11).
Poggensee, G., Kiwelu, I. Weger, V. Goppner, D. Diedrich, T. Krantz, I. Feldmeier, H. 2000. ‘Female genital schistosomiasis of the lower genital tract: prevalence and morbidity in Northern Tanzania’. J. Infect.Dis. 181(3):1210-3.
Poppen, P.J and Reisen, C.A. 1997. ‘Perception of risk and sexual self-protective behaviour: a methodological critique’. AIDS Education and Prevention, 9(4):373-390.
Seal C. 1999. The quality of qualitative research. London. Sage Publications.
Smith, J. H., Kamel, I. A., Elwi, A. M., von Lichtenberg, F. 1974. ‘A quantitative post mortem analysis of urinary schistosomiasis in Egypt’. American Journal of Tropical Medicine and Hygiene 23, 1054-1071.
Tierney, K.J. 1999. ‘Towards a critical sociology of risk’. Sociological Forum, 14(2):215-242.. WHO 1998. Gender and health. Technical paper, Geneva.
Van der Geest, S. 1995. ‘Overcoming ethnocentrism: How social science and medicine relate and should relate to one another’. Soc Sci Med. 40, 869-872.
Yelland, J. and Gifford, S. M. 1995. ‘Problems of focus group method in cross-cultural research: a case study of beliefs about sudden infant death syndrome’. Australian Journal of Public Health 19(3):257-263.