Local perceptions of onchocerciasis in the Hawal Valley, Nigeria

Abstract

Onchocerciasis is a disease which produces skin changes and can lead to blindness. It is limited in area by its blood-sucking vector. The middle Hawal valley represents a discrete focus of the disease in north-eastern Nigeria. Data on perception were obtained from informal discussion with respondents from hyperendemic, mesoendemic and hypoendemic villages. Their understanding of what constituted onchocerciasis was amazingly accurate and complete, particularly so with informants from the hyperendemic villages. A spiritual interpretation for separate symptoms of the disease was used toexplain causation; Western information on transmission was not known. The vector of onchocerciasis, Simulium damnosum was recognised in riverain areas where it exists but not in areas away from the river. Because of onchocerciasis morbidity people outside the riverain zone avoided it for settlement and temporary farms, and women shunned marriage with men from the area. Similar feelings about morbidity were voiced by people living in the riverain zone some of whom wished to move out. The problems caused by onchocerciasis are potentiated by remoteness for which the disease itself is largely responsible. During the 1970s the more remote settlements have become slightly smaller. Attitudes of people in the middle Hawal valley shape the future for the riverain zone where onchocerciasis is hyperendemic. Prospects would not seem to be rosy for remoter areas where the disease and its consequences are seen to be serious.