Continuing the fight against diarrhoea

For decades ICROSS has fought diarrhoeal infections. Here is one of the early articles of work by ICROSS in the field of malnutrition and diarrhoea. It was published in DIALOGUE ON DIARRHOEA in December 1989 It shows the long term committment of ICROSS in Kenya in its work to reduce the suffering of children using cultural beliefs and local values . http://rehydrate.org/dd/dd39.htm#page8

This was one of the early studies in the area of diarrhoea done by Michael Meegan. His MSc in Community health at Trinity College Dublin was on the beliefs of the Maasai regarding diarrhoeal illness .




Beliefs and behaviour: the Maasai in Kenya and Tanzania

Success in preventing diarrhoeal illness does not depend only on providing information. There are important lessons to be learnt by studying how communities understand diarrhoea, the believed causes of infection, and treatments and behaviour. If sanitation, hygiene and other practices relating to diarrhoea are to be improved, change must come from within the community.

In northern Tanzania and southern Kenya, our health team studied the beliefs about diarrhoea of several groups of nomadic Maasai, including causes and treatment. The study (among 231 mothers in Kenya and Tanzania) found that there were 21 believed causes of diarrhoea. Those mentioned most were stale food, dirty water, flies, badly cooked meat, malnutrition, and water holes used by domestic and wild animals. The study identified 29 different terms used for diarrhoea, depending on stool colour, composition and type. Thirty two treatments for diarrhoea, mainly medicinal plants, were found as well as a distrust of modern medicines, and a belief among some nomads that people have two stomachs. The Maasai believe that bad food and bad water is processed by the second stomach by washing the badness from the body. Animal fat is a popular treatment, as is the drinking of clean water and breastmilk (for infants).


If sanitation, hygiene and other practices relating to diarrhoea are to he improved, change must come from within the community.

The Maasai showed knowledge of common causes of diarrhoea on which Maasai health workers can build an education programme, adapting and using positive beliefs. We are now also studying the efficiency and effectiveness of traditional Maasai treatments for diarrhoea.
If sanitation, hygiene and other practices relating to diarrhoea are to he improved, change must come from within the community.


The success of Interventions relating to practical hygiene is due to the fact that many of our own community health workers are Maasai and Samburu warriors who are part of the community and who have combined what they see as 'modernism' with traditional practices.

There is an important place for building on cultural perceptions and ideas and those beliefs are essential in building and designing any community health initiative. As one of our health workers said: 'At the end of the day, a mother will listen to her mother's advice rather than to a stranger's. She'll draw on her experience from her world, not from ideas given her in another language.'

Should any DD readers wish for information about our research methods, or for more details of our ongoing research, we would be glad to share this. Ultimately, ethnomedical research is about listening carefully and learning before trying to teach. The more we listened in our research, the more we realised we had to learn.

Michael Meegan, Director, ICROSS Rural Health Programme, 507 Ngong Hills Kenya
Dec 1989