Date: -1/April /2008
Department community health /faculty of medicine
Benadir university
Mogadisho City
Somalia.
Prepared by senior students:- Tutor:-
1.Mohe’d Abdullahi Awale Dr:- Abdullqadir Mohe’d Hasan
2.Mohe’d Moh’ud Omar(Arab)
3.Abdullahi Abdiaziz Farah.
Contents pages
Introduction…………………………………………………………..1
Health …………………………………………………………..........2
Environment and socio-economic status in bulo marer village……...4
Traditional healers…………………………………………………….5
Subject and methods…………………………………………………..6
Table 1…………………………………………………………………7
Table 2…………………………………………………………………7
Table 3…………………………………………………………………7
Table 4………………………………………………………………….7
Table 5…………………………………………………………………..8
Table 6…………………………………………………………………..8
Table 7…………………………………………………………………..9
Table 8…………………………………………………………………..9
Results………………………………………………………………….10
Summary and acknowledgment ………………………………………11
Reference……………………………………………………………...12
Introduction
Health seeking behavior is different from community to community depending socio-economic, education and traditional believes.
In Bulo Marer over all level of literacy and education is low infrastructure (roads, public transport, water, electricity supplies etc.) is under-developed.
The population is growing fast where as gross national product is static or going down per head of population, health facilities in personal are low in rural areas where most poor people live.
Health needs become high, the existing political system of the country is disabling and volatile.
WHO and UNICEF are trying to do their best to cover health needs in kuntuwarie district to reach health for all but the steps to provide HFA is very low.
For the reasons mentioned above the people become disoriented seeking health care in different behavior.
In order to design and set national goals of health needs it’s needed to assess health seeking behavior of the community and the factors that influencing it, so the faculty of medicine and surgery of Benadir university applied this study in bulo mare area in kuntuwarie District, Lower Shabelle Region, Somalia
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Health
Is a state of complete physical, mental, and social wellbeing and not merely an absence of disease or infirmity.
Health is on one hand, a highly personal responsibility and on the other hand a major public concern. It thus involves the individual and the community.
Health is now recognized a fundamental human right, it’s essentially an individual responsibility.
Health can never be adequately protected by health services with out the active understanding and involvement of community whose health is at stake.
In bulo marer and surrounding area, the people are farmers and nomadic, they are busy in daily life.
A health can be influenced by many factors including: -
· Economic process, which reduces morbidity and increases the life expectancy and improving the quality of life.
· Education especially female Education,
· Occupation, employment produces work and promotes health, because the employment shows higher incidence of ill health and death.
Other contributions to the health of population derive from systems outside the formal health care system, i.e. health related system (e.g. food, agriculture and Education).
The standard of living in bulo population is not good other side of level of Education, employment status, food, dress, housing and sanitation. The way people live is composed of cultural and behavioral patterns and life long per ional habits.
The people in kuntuwarie district seek curative in bulo marer where HAYAT HOSPITAL is located. Kuntuwarie district is not far from the HAYAT HOSPITAL; it’s about 20km distance.
Some are 7km apart and others are >20km away from the Bulo, this shows the rate of medical problems, which exist in this district.
Health care professionals which consist mainly in nursing personal, doctors, specialist and paramedical personnel such as pharmacist and laboratory assistants could not exist enough and the levels of care is not adequate which is Primary level, corresponds to the home and health care station where a sick person can expect initial contact, oral rehydration and treatment of fever and minor injuries are associated with this level. This type of care involves the family, community and Secondary level is when sick person comes in to contact with a health care professional. Tertiary level corresponds to the hospital; this is final link in the chain of care offered to patients.
The health facilities whether local or newly established will not be able to meet medical demand. The diseases which are mainly suffer the population are: - diseases transmitted by contact such as scabies and conjunctivitis, STD such as syphilis, vector-transmitted diseases such as malaria and schistosomiasis, diseases transmitted through fecal matter –diarrhea (amebiasis and giardia, hepatitis, typhoid fever, ascariasis) and diseases transmitted through air- acute respiratory infection, Tuberculosis, measles and whooping cough.
Experience has shown that in kuntuwarie district, certain communicable diseases have a
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particularly great impact such as measles, diarrheal diseases and acute respiratory infection and malaria. Others, which are less important, are cholera, typhus and schistosomiasis.
Factors influencing the impact of Communicable Diseases in Kuntuwarie.
The risk factors listed below are numerous and the way they interact varies from case to case.
1.presence of new pathogenic agent:-
Population migration may introduce new pathogenic agents into the host region, usually it’s not a new pathogenic agent in the strict sense, but rather a different strain from the one normal found in that particular environment.
2.susceptibility of the population:-
A population’s susceptibility is reflected at two levels; the population’s immunity, which is low in some degree and it’s a consequence of long continued exposure to a particular infections.
Individuals immunity, the group of individuals usually at risk are the children under the age of four or five another factors is malnutrition, malnourished children are particularly susceptible to infections.
3.Increased Transmission:
Several factors contribute to an increase in disease transmission particularly:
ü Overcrowding-the concentration of a group of people in a restricted space presents an obvious risk of epidemics.
ü Deterioration of hygienic condition-lack of water for basic hygiene, accumulation of waste which encourage the proliferation of disease vectors and the absence of sanitation measures are all factors that help increase the transmission of communicable diseases.
4.deterioration of health services:-
The deterioration of health services affects disease transmission at all levels. For example no active vaccination are given, vector-control programmes deteriorate and little or no care is provided for the sick.
Prevalence and seriousness of medical problems
Several factors contribute to the increased prevalence and seriousness of medical problems in kuntuwarie district. Prevalence is usually a function of nutritional status, environmental and the deterioration of preventive services. One of the main reasons for the potentially greater number of serious problems in kuntuwarie is that access to medical services is impaired by the lack of the education. The combination of prevalence and seriousness leads to high mortality, this idea can be formulated as fallows: -
Prevalence×seriousness/access to medical care = Mortality
Thus, the high prevalence of medical problems, the large numbers of serious cases and the reduced access to health care services all help the particularly high mortality rates found in kuntuwarie.
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Environment and socio-economic status in bulo marer village
The term environment implies all the external factors, which surround man.
Environment includes not only the water, air, and soil that form our environment, but also the social and economic conditions under which we live.
Every country has it’s own environmental properties; in general Somalia is under tropical environment.
Bulo marer is one of the villages in kuntuwarie district, the land is classy and suitable for farming and husbandry, people are forced into crowded, un sanitary conditions which can lead to outbreak.
The season divide for the whole in to two:-
Eight months of raining season, and 4 months dry season, the dry season whether is hot, and the land become dry, while the raining season is so cold and the land is wet that is suitable for farming and animal raring.
Malaria is common for all the year but increases in the raining season.
The populations are in poor housing condition, presence of animal reservoir and insect vector which a constant treat to man’s health.
Much of the ill health in Bulo marer is due to environment sanitation that is unsafe water, polluted soil and unhygienic, disposal of human excreta.
The high death rate, infant mortality rate, sickness rate and poor standards of health are infact largely due to defective environmental sanitation.
Most of the bulo marer populations live in rural areas and the problem is poor sanitation and waste disposal.
Any change occurs the environment will affect the social behavior and damages the sanitation of the population.
About 2/3 of the population use the channel water which is risk full for many diseases such as Bilharzias and diarrheal diseases.
The economical status of bulo marer divided in to two groups:-
Group depend on farming, which is majority, while the other group depend on commercial which is minority
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Traditional medicine
Traditional medicine is an old, as man exist, which is the anxious type of treatment that human being was using before the modern medicine were discovered.
It’s different the mode of applying from community to community, the traditional healers treat different type s of diseases in different manners.
The commonest ways of treating a sick person are: -
1) Spiritual
2) Herbal
3) Others (burning, small cutting of special parts, etc.
If you think deeply and go back to the history of medicine, you will notice that it was successful to treat human being, for a long time until the modern medicine abrupt with it’s miracles, but yet traditional medicine it’s struggle in world wide not only to save it’s existing but to regain it’s superiority.
Now we would like to mention certain common diseases that are treated by traditional healers with traditional medicine.
Example of most common diseases of children and women that are treated by the traditional healers in Bulo-Marer are: -
Children
I. dhajis:
Symptoms: abdominal pain, vomiting.
The cause: when some one hungry looks you while you are eating.
The treatment: the traditional healers makes small cut over the umbilical region and suck to get out the material that causes the ill health so the patient become fit as they believe.
II. Ilkow:
Symptoms: diarrhea, vomiting.
The cause: canines
Treatment: they cut the position of canines to take out the roots of the canine, some times they burn, no matter what the age of the infant is.
III. Ab Ab:
Symptoms: fever, restlessness, insomnia.
Treatment: mixed herbs they put on the head of infant.
Women
1. umusibiyan
Symptoms: pelvic, sterility.
Causes: a living thing lives in uterus (womb) of women that eats or sucks the sperm of the male with that reason; the women do not become pregnant.
Treatment: mix different types of seeds plant (filfil+ hulbo+tun+hildid + uburo +habit sowdo ), when the women use to treat orally for days which kills the living thing in the uterus.
2. Rimi Rebka
During the pregnant, the labour becomes prolonged, so in order to facilitate they put HIRZ on her thigh.
N.B we have not any prove, whether these type of disease exist and treatment is successive.
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Subjects and methods
Area of study
Bulo-Marer/ kuntuwarie District/Lower Shabelle /Somalia was used for the study.
Sample and sampling technique
1. 200 adults (100 male and 100 female) were chosen randomly in Bulo- Marer and it’s surrounding area by the researchers, direct contact with them, the criteria of selection was according to the area they live which was inside bulo marer, 100 persons (50 male+ 50 female), and outside bulo marer 100 persons (50 male +100 female).
Aim of the Research
To know behavior of the community of bulo and its surrounding area how they seek health and factors of the influencing this behavior.