The Kiss of Death: Chagas' Disease in the Americas


Society and Culture

The Social Costs

Social costs of Chagas' disease are huge for peoples of Latin America. It is a debilitating disease that fatigues peasants, especially those working at higher altitudes, where they often must stop farming their plots or leave the work to relatives and children. The inability to work results in decreased crops, which cause malnourishment that leads to susceptibility to Chagas' disease. Even more costly, many adult victims die during their most productive years. (This is documented as Disease Adjusted Life Years, or DALYs.) Children are left without mentors and families without breadwinners. Remaining members of the community then must assume responsibility for the survivors. For this reason, Chagas' disease is a major obstacle to development in Latin America. The World Bank considers it the fourth most serious health problem in Latin America as measured by years of life lost adjusted for disability.chart showing DALYs of Chagas' disease

Social stratification creates divisions in Latin America that are difficult to bridge. Chagas' disease is mistakenly considered a disease of peasants and Indians, as if T. cruzi respects class differences. Rich and middle classes do not recognize that vinchucas inhabit their houses, as easily as cockroaches invade ours. Argentineans call chagas "The Unrecognized Disease," being not only detected but considered something "others" suffer, especially poor people and peasants. Social stratification combines with racism in Latin America to influence the political economy that represents upper classes and whiter races and that neglects supporting chagas campaigns identified with lower classes (Indians and peasants). Because Latin America is targeted for investment and tourism, information about contagious diseases, such as chagas, might deter this.

Other social issues

Another social issue affecting chagas is the attitude of peasants that they are not in control of their destiny. Locus of control implies that an individual's general expectations about his or her ability of control the future greatly influence that individual's response to house improvement programs. People's notion of whether the future is controlled by themselves, the state, fate, or luck greatly influences their desire to act to prevent anything or improve houses. R. Briceño-León and S. González have dealt with the fatalistic attitudes of peasants. They found that, after they improved their houses, many people gained a sense of empowerment. Peasants need to rediscover a sense of empowerment through cousciousness-raising education.

Chagas' prevention depends upon community participation. Too frequently, housing projects are purely vertically structured programs. Community participation refers to community members making decisions about, accepting, and complying with certain behavioral changes necessary to combatting chagas. Obstacles to this are superior attitudes of project supervisors and technicians towards peasants, not being able to speak the language of the community, and not including community members into planning phases.


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