Community perceptions on diarrheal diseases: a case study in swampy lowland area of South Sumatra Indonesia.

4 investigators conducted participative observation at 4 hamlets representing 4 typical topographic regions in the area (wet or dry near the river and wet or dry far from the river) in District Rambutan South Sumatra Province Indonesia from July 1988-February 1989. The focus was the examination of community perception and practices concerning diarrheal diseases (DD). The observations were supported by focus group discussions and informal interviews. It was established that the causes of DD can be grouped according to: dirty water inappropriate food (cold hot sting) part of the growth process physical conditions (extreme heat cold wind and physical abnormalities or muscle strain) and the supernatural. The types of DD include mild without vomiting a more severe diarrhea which might include fever more severe diarrhea with severe vomiting and bloody/mucoidal stool. Some types were associated with bad water while others were with physical abnormalities. The danger connected with diarrhea was perceived to be shrinkage or emaciation. Prolonged diarrhea could result in pale and red hair. The community did not associate these conditions with fluid loss. Management included self-medication using various remedies such as tapel (a paste of herbs applied to the stomach) decoct and a solid oral preparation (cassava with raw sugar rast rice etc.). Modern medicine is available at certain times. Secondary assistance was determined by the type of disease cost distance and reputation of the providers. The prolonged type of diarrhea tended to be taken to traditional healers. It was determined that the core concept was similar in all 4 hamlets and in areas of Indonesia and other parts of Asia but the details and terminology varied. The findings were used to construct the local version of the CDD local aid manual. (authors modified)