FILARIAL ELEPHANTIASIS AMONG HAITIAN WOMEN - SOCIAL-CONTEXT AND BEHAVIORAL-FACTORS IN TREATMENT

Few studies have addressed the social and behavioural aspects of lymph atic filariasis. The research reported here investigated the ethnograp hic context of filarial elephantiasis among women in Leogane, Haiti, a nd focused on explanatory models of the illness, the impact of the dis ease on women's lives, and the difficulties patients experienced in fo llowing a therapeutic regimen provided at a local hospital. Qualitativ e data were collected through focus group and individual interviews an d direst observation of patients enrolled in the treatment programme. Results indicate that traditional understanding and treatment for the disease are prevalent in the community, although biomedical explanatio ns are gaining credence as a consequence of long-term filariasis contr ol activities in this area. Women's lives are substantially burdened b oth socially and economically by the physical impairment of elephantia sis, most notably in the loss of income due to restrictions on mobilit y. The degree of social discrimination encountered varies by the timin g of onset of symptoms in the life course. Difficulties encountered wi th the physical therapy regimen included maintenance of the compressiv e bandage and availability of suitable foot wear. Similarities between these findings and those reported for other parts of the world are no ted. Recommendations from the study cite the need for community educat ion and peer support activities to provide a knowledge base and suppor t structure for current and future intervention programmes.