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Social and Cultural Issues
Cultural
and social factors influence Chagas' disease. Chagas'
disease is often considered from only a biomedical perspective,
with little concern for cultural and social factors
that influence behavior and values. Social behavior
and cultural beliefs or values influence the way people
respond to the parasitic
cycle of T. cruzi. For example, Andean peasants
view insects as an integral part of life and many object
to insecticide campaigns
as destructive to life. Their worldview reflects maintaining
balance with nature. Peasants love their animals and
protect them in their houses, so it is difficult to
have them keep them in corrals. They believe that their
ancestors are connected to abandoned buildings, so they
resist removing unused buildings, even though they are
infested with vinchuchas.
Others believe that vinchucas are signs of fertility.
Their children play
with them, racing the adults and gathering their eggs.
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Culture
Context Model
Chagas'
disease presents many culturally related concerns. Because
symptoms of chagas may appear years after the initial
infective bite, people rarely associate its symptoms
of heart disease, volvulus, and constipation with vinchucas.
Latin Americans posit the symptoms of illnesses with
more immediate causes, such as improper diet or an imbalance
of the hot, cold, wet, or dry. Parasitic cycles are
difficult to understand for traditional people with
distinct ethnomedical beliefs concerning disease and
its treatment. Ethnomedicine also provides many sources
for irradicating chagas. (See Ethnomedicine)
A
Culture Context Model of Chagas' Control attempts to
lessen the gaps in cross-cultural communication between
health workers and community members. This model triangulates
upward from three corners. Project personnel and technical
assistance, community members and participation, and
community health workers and ethnomedical practitioners
form a pyramid whose apex is prevention and treatment
of Chagas' disease. The parts converge toward common
goals, maintaining distinct identities, and operate
within a shared cultural context distinct to the community.
(See Kiss of Death: Chagas Disease in the Americas,
pages 143 through 145, for an explanation of this model.)
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