The Role of Anthropology: Part II

According to recent studies, the high degree of variability of arsenicosis symptoms elicits a comparably wide variety of responses in terms of treatment-seeking (Ahmed, Adams, Chowdhury, & Bhuiya, 2003; Ahmed, Petzold, Kabir, & Tomson, 2006; Edgeworth & Collins, 2006). Many of the symptoms characteristic of initial phase arsenicosis are shared with other maladies—thus, internal inflammation caused by arsenic exposure can be confused with other gastrointestinal disorders; arsenicosis-related anemia and fatigue are attributed to other common maladies. Such ailments go untreated, or they are addressed by home-treatment (Ahmed et al., 2003).

The most visible—and readily recognizable—symptoms (keratosis, melanosis, hyperpigmentation, etc.) are manifested on the hands, feet, and trunk. As noted above, many reports have indicated that such symptoms are often believed to be caused by leprosy, thus individuals exhibiting ulcerations on hands and feet are highly stigmatized. According to surveys in affected areas, these symptoms are occasionally treated by medical specialists (Paul, 2006). However, the majority of affected individuals are unaware of arsenicosis’ life-threatening potential. Consequently, few are prompted to seek health care, allowing the disease to progress to the advanced phase.

Paul & Tinnon Brock (2006) have found that, in the instances of recognized arsenic poisoning, treatment delay is most strongly influenced by three factors: 1. A tendency of waiting to see if symptoms will go away, 2. A feeling of embarrassment (or feeling burdensome) in asking for assistance, and 3. A failure to recognize the importance of the symptoms. In addition to these, socio-economic and demographic dynamics have also served to prevent and/or promote health-seeking behavior (gender, age, occupation, years of education, availability of financial resources), but reportedly to a lesser degree (Ahmed et al., 2000).

While some investigations have begun to explore the complexities of health-seeking behavior (HSB), there remains a great deal of room for expansion. The two theoretical models of health-seeking behavior could be employed simultaneously, shedding light on both the behavioral stages leading to pro-health activity (the ‘pathways model’), and the external factors that influence an individual’s health choices (the ‘determinants model’) (MacKian, Bedri, & Lovel, 2004).

It will be of further importance to examine what types of home- and alternative-treatments are being employed against arsenicosis symptoms, particularly when they are not immediately assumed to be the symptoms of arsenic poisoning. In understanding the existing systems of ethnomedicine in Bangladesh, for instance, it will be possible to assess the role of traditional practitioners in offering care for arsenicosis symptoms. Similar studies have been conducted in other parts of the world, and there have been marked successes in treatment by local health-care workers who have been trained to offer disease-specific care, either in the stead of or in conjunction with traditional methods (Amarasiri de Silva, Wijekoon, Hornik, & Martines, 2001; Marsh, Mutemi, Muturi, Haaland, Watkins, Otieno et al., 1999).


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