Emerging chronic illness: women and lupus in Ecuador.

This article reports on an ethnographic investigation of the experiences of urban Ecuadorian women suffering from the chronic illness, lupus. Chronic illness is "emerging" in Ecuador, and cultural models and the health care delivery system are struggling to adapt to the increasing burdens brought by life-long illness. Based on extensive qualitative interviewing of lupus patients and doctors and participant observation, we identify three areas of concern including a weak health infrastructure and unequal access to care, gender models that increase the emotional burdens, and cultural understandings about illness and morality that add to social stress.

Of butterflies and wolves: enacting lupus transformations on the Internet.

This article explores how women with lupus use the Internet to construct discourses about illness and transformation. The textual and symbolic content of Internet websites and message boards offers unique perspectives on the relationship between embodied experience and textual construction, and demonstrates the ways in which women use their participation on the Internet to communicate about themselves. Using common search engines, an array of lupus websites were identified, including message boards and personal pages, and the textual and symbolic content was analysed for reoccurring themes. Three distinct types of transformational discourses were identified: adjustment narratives; expert narratives; and transformations of personhood. These transformations are achieved and given renewed value through online participation. The article suggests that online communication provides a unique opportunity to understand embodiment but also that transformational discourses may ultimately be limiting.

Chronic pancreatitis in Jamaica

Thirty-five patients with chronic pancreatitis (CP) treated with over a 15-year period were studied. There were 29 men and 6 women with a mean age of 47 years (range 21-67). Twenty-seven (77 percent) were chronic alcoholics, two (6 percent) had gallstones, one had stenosis of the Ampulla of Vater and in five (14 percent) no obvious cause was found. Thirty patients (86 percent) presented with abdominal pain. Chronic diarrhoea was present in 8 (23 percent), and steatorrhoea was documented in 6 of these. Fifteen (43 percent) had pancreatic calcifications. Five developed pseudocysts and 16 (46 percent) developed diabeted mellitus. Twelve patients required surgery. Three continue to have severe recurrent relapses of pain but the majority (91 percent) have had a relatively stable course with medical management. (AU)