Notions of Risk and Vulnerability to Malaria

Abstract

An estimated average of 150 to 200 Filipinos developed malaria daily
in the late 1990s (Malaria Control Service, 1996 ). For the 10-year period
from 1985 to 1995 an average of PhP 100 million had been spent
annually at the national government level alone for programs against
malaria.
The primary investigator (NCC) spent ten months living in Barangay
Mangingisda (an endemic rural village) in Puerto Princesa City,
Palawan from June 1995 to April 1996. With the help of assistants and
households who acted as epidemiologic sentinels in four high and four
low prevalence puroks (hamlets), she interviewed residents to elicit
their perceptions and beliefs, practices and decision-making patterns
in relation to the perceived causation/etiology, mode of transmission,
susceptibility, signs and symptoms, case finding, treatment and
prevention of malaria.
A Triangulated Approach for Health Social Science Research on Malaria,
using both qualitative and quantitative methods (modified version
of the Qualitative Contrasting Groups Design – QCGD formulated by
Higginbotham and Proteous ) was employed. A combined medical
anthropological and epidemiological approach to the study of fever
and malaria, which included a review of the development of the
malaria control program in the Philippines as a historical process, was
used.
The concept of habituation can be used to describe the situation of the
residents in Barangay Mangingisda. Perceived risk and vulnerability to
fever and malaria, and its treatment and prevention were influenced by
interactive variables. Responses to fever and perceived malaria at the
household and community levels must be viewed within the context
of lay capacities and perceived vulnerabilities (pasma or humoral
imbalance which renders one susceptible to illness, presence of
semilya ng malaria or “seeds” of malaria”), folk perceptions of resistance
(resistensiya) and the state of being malariado (present or past
experience with malaria), coping, and prevention. People employed
diverse means to ensure the continued viability of their households
amidst the immediate threat of malaria during its acute phase as well
as its long-term threat due to the chronicity of the disease.