Balancing Needs and Wants

Jan 07, 2016

By: Kimberly Kamara, Director, Programs

Typically in public health there is a consistent concern that the needs and wants of the community are not always aligned. Much of this is because the work is focused on prevention, when people do not always feel sick. Although pictures and people in the community suffering provoke certain emotions, many people see those affected and disassociate themselves from the potential risk. This often creates a resistance to taking advantage of preventative treatment and medication. As a public health professional, my favorite part of my work is talking to members of the community and getting them motivated to take charge of their own health. 


In my recent visit to Côte d’Ivoire, I was delighted to see the residents of Boku tremendously excited to receive their yearly treatment to prevent intestinal worms, river blindness, and lymphatic filariasis. In every home we visited, men, women, and children were lining up to receive their tablets.

The local doctor supervising the activities informed us that everyone wanted to take their deworming medication because they believed it increased their sexual prowess. In effect, one man took the medication and claimed it improved his sexual performance. Essentially, he felt the worms were slowing him down physically, just like any debilitating illness. Therefore, by taking the medication, his sexual performance was strengthened. His experience spread like wildfire and everyone in Boku eagerly wanted to receive his or her anti-parasitic medication. 


Having a local community member advocate for prevention is a vital public health tool as it is important to ensure that a community is empowered to be involved in their own healthcare. People are always more motivated to adopt new health practices when those they can relate to support the change. But this success can also bring forth a potential public health concern. 

If treatment is thought to increases virility, then perhaps there are members of the community that believe an increased dosage could have an even greater benefit, resulting in people wanting to take more than one dose of the deworming pills. To alleviate this risk in the future, the supervising team determined that this potential over-excitement can be addressed with indelible ink on a fingernail to show who already ingested the medication, just as in an election. This will ensure that everyone receives their annual treatment only once in the year, finding a perfect balance between a community’s needs and wants.


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