Health beliefs related to diarrhea in Haitian children: building transcultural nursing knowledge.

ABSTRACT

PIP: Interviews conducted by community health workers with 83 Haitian women working in sugar cane fields in the Dominican Republic underscored the importance of understanding local health beliefs so that culturally appropriate interventions are implemented. The respondents all had at least 1 child under 5 years of age; their average age was 29 years and they had a mean parity of 4.9. The mothers identified gastrointestinal problems, chiefly diarrhea, as the greatest threat to their child's health. 82% of the mothers had at one time had a diarrheal episode among her children and 31% reported that a child currently had diarrhea; 16% said at least 1 child had died of diarrhea. Water, food, and microbes were identified as the major cause of diarrhea. Although not routinely cited as a cause of diarrhea, the evil eye (transmitted by male of female witches) was viewed by all but 1 mother as a powerful factor in child mortality. The foods mothers claimed they would give a child with diarrhea included lemonade, soups, bananas, and other fruit juices. Both cooking oil and milk were considered harmful. Of concern was the finding that 38% of mothers would discontinue breastfeeding during a diarrhea episode. None of the mothers had heard of oral rehydration; however, most were treating diarrhea with a solution prepared by pouring boiling water over herbs and leaves. This practice suggests that these mothers can be instructed to prepare oral rehydration solutions in which all ingredients are precisely measured. Since diarrhea is a major cause of child mortality in these Haitian communities in the Dominican Republic, promotion of oral rehydration could make a significant contribution to child survival. It is essential, however, that all such interventions incorporate existing beliefs and present new information in a culturally relevant framework.