Exploring health risks and Resilience in a Rural Population in the Context of Environment-Related Diseases, Ngara, Tanzania

Abstract

Public health ‘expert’ knowledge and technical ‘solutions’ to environment-related diseases are often embedded in biomedical perspectives that emphasise objectivity and rationality. However, such perspectives tend to sidestep the ways in which knowledge and solutions are shaped by social and cultural contexts. Public health interventions have therefore been evaluated in terms of the ‘failure’ of their intended recipients to ‘comply’ with them and in relation to public ‘misperceptions’ of risks to their health. This research was developed in an attempt to understandhow social and cultural beliefs and perceptions mediate health and the way that they contribute to, escalate or reduce risks to health. The study explores these attributes in the context of two issues: firstly, environment-related health risks pertaining to malaria and diarrheal diseases, and secondly residents’ perceptions and views of public health interventions and programmes. The research was carried out in two villages in rural northern Tanzania to explore the complexities of villagers’ behaviours in their everyday lives in order to help understand common public health concerns such as: why do some public health programmes succeed and others fail? Why do some individuals who know how to protect themselves against a particular disease choose not do so? And why are control and prevention of preventable infectious diseases problematic? The study employed an ethnographic approach based on a socio-cultural perspective. Focus groups and interviews were the main tools for data collection, and analysis was done inductively through development of key themes. Research findings show that social and cultural values, especially in relation to social capital, frame health-related risks in such a way as to shape the vulnerability and resilience of citizens to environment related illnesses. The thesis demonstrates a number of ways in which adherence to socio-cultural norms and practices takes precedence over potential concerns about risks to individual health.