Departamento de Ciencias Sociales, Universidad Nacional de Luján, Buenos Aires, Argentina.
Int J Equity Health. 2014 Jan 29;13:6. doi: 10.1186/1475-9276-13-6.
Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers.
Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice.
Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities.
Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when communicating with these communities about prevention and control. These research findings might also be of value to national and provincial agencies in charge of decreasing the rates of Chagas disease among indigenous populations.
阿根廷 90%的原住民社区位于恰加斯病媒介传播的地方性流行地区。这些社区的控制活动一直没有成效。本研究的目的是探索皮拉加和维奇原住民社区的信仰、习惯和做法在与福尔摩沙省当地卫生系统互动方面所起的作用。本文有助于了解影响原住民与卫生保健提供者之间沟通过程的文化障碍。
在福尔摩沙省中部的四个原住民社区（皮拉加和维奇）进行了 29 次开放式访谈。这些访谈用于描述和比较这些社区对健康和疾病的看法，以及他们对西医的看法及其在当地卫生实践中的体现，与恰加斯病有关。
提出了五个关键发现：1）这些社区的成员倾向于将疾病归因于他人或个人违反禁忌，而不是生物过程；2）虽然皮拉加更倾向于接受西医，但维奇人通常更倾向于选择原住民的医疗保健方法，而不是西医；3）这些社区的成员不将媒介与疾病传播联系起来，他们对开展媒介控制活动的认识有限；4）接受诊断测试和治疗的原住民个体往往在不完全了解和知情的情况下这样做；5）临床接触充满了卫生保健提供者和这些社区成员的期望之间的冲突。
我们的分析表明，在为阿根廷北部原住民社区制定预防和控制恰加斯病的干预措施时，需要考虑健康和疾病的文化模式的作用。当与这些社区就预防和控制进行沟通时，这一点尤为重要。这些研究结果对于负责降低原住民人口中恰加斯病发病率的国家和省级机构也可能具有价值。
