Concepts of illness and the utilization of health-care services in a rural Malian village.

This paper discusses the concepts of illness and the utilization of alternative medical resources in a rural Malian village, including self-care and the services of cosmopolitan medicine, folk medicine and Islamic medicine. The main concepts of causation are described. Special emphasis is given to the explanatory models for the illnesses mara and nyènkènè bilènkè (red urine). The study presents a hierarchy of classification and analyses the determinants associated with pluralistic medical behavior. Case studies are used to illustrate how the villagers cope with severe illnesses. Finally, it is argued that indigenous illness concepts should be taken into consideration in the design of health-care projects. The research for this paper was conducted in the district of Baguineda, Republic of Mali.