Guinea worm: an in-depth study of what happens to mothers, families and communities.

This paper reports on the impact of maternal morbidity due to guinea worm, dracunculiasis, on the care and health of children under 24 months old, and the way in which the mothers and the family coped with the often extended periods of disability. This qualitative study is based on observation and in-depth interviewing, supplemented by focus group discussions. Of 42 mothers with guinea worm in two hyperendemic areas of Oyo and Kwara States, 28 were either bedridden or only able to hobble short distances with the help of a stick; the average period of incapacity was almost 9 weeks. Of the four maternal roles identified (child care, self care, domestic tasks, income generation), the women gave priority to child care; 34 of the 42 mothers needed help in child care. Coping networks operated principally within the extended family, but also included women in other households, and women from beyond the community. Thus the impact of a mother's illness extended beyond her children and family to the wider community. This qualitative study thus reveals the multifaceted impact of a disease on individuals and on the community. The study stresses the need for, and availability of, effective methods for controlling guinea worm by utilizing community cooperation to provide protected water sources and other preventive measures against the disease.