THE YORUBA FARM MARKET AS A COMMUNICATION CHANNEL IN GUINEA WORM DISEASE SURVEILLANCE

Disease eradication programmes are by definition lime bound and requir e strategies that Facilitate timely intervention. Surveillance, which undergirds eradication, also requires timely strategies. Finding such strategies is especially challenging when the target disease is endemi c in remote areas, e.g. guinea worm disease, the focus of this study. A strategy of market based surveillance was pilot tested in Ifeloju Lo cal Government Area (LGA) of Oyo State, Nigeria. The project gaol was to design a surveillance system that both fit into the natural communi cation network of rural people, and also enlisted their active involve ment. Ethnographic research methods were employed to learn about marke t location, structure, catchment area and attendance pattern. Four lar ger farm markers (serving 164 hamlets with 17,000 population) were cho sen. Each hamlet was visited and a volunteer 'reporter' was recruited. Reporters were trained on case recognition and detection, first aid a nd prevention, with a sensitivity to distinguishing indigenous and cli nical perceptions of guinea worm. The market cycle was based on the tr aditional four-day week. Field workers visited every second market 16 times between October 1990 and February 1991. The reporter was expecte d to identify correctly the first case of the season and thus label th e village as endemic for the season. Reporters gave oral reports, and positive indications were followed up within 48 hr by field workers, w ho verified the case and administered first aid. All hamlets were visi ted once a month to verify negative reports. Reporter attendance was m onitored. Those who had a formal role in the market, e.g. sales agents , had better attendance than ordinary farmers who came only to sell th eir own produce. Knowledge of market structure and attender roles offe rs a guide for adapting this surveillance approach to other cultural s ystems and health issues.