Learning to take charge : women's experiences of living with endometriosis

This paper describes aspects of a study that was conducted to determine women's needs for information related to laparoscopy for endometriosis. Sixty-one women attended focus groups, during which they described endometriosis as a disease of multiple losses: of relationships, of career and of a sense of self-worth. The women indicated that the pathway to diagnosis and treatment had been long and unnecessarily difficult. Many women said that they had reached a point where they decided enough was enough: the medical merry-go-round had to finish. They had to become assertive, take control and decide for themselves how they were going to manage their disease and their quality of life. For all but one woman in the study, complementary therapies were vital. For some women, alternative therapies had replaced allopathic medicine completely. Complementary/alternative therapies were a mechanism for regaining control.

Sickness ruins the complexion, breeding disappears without gold: culture and the i nterpretation of illness among the Minangkabau of West Sumatra, Indonesia

The interpretation of illness and its meaning to individuals and groups is largely a product of culture and is based on shared experience, historical significance, and the social function of individuals in the community. West Sumatra, like many parts of Indonesia, has experienced rapid development and modernization since the nation achieved independence in 1945 and is currently 12 years into Regional Autonomy, a dramatic shift in national administration from a highly centralized system to one which devolved authority to the level of district or municipal government. These changes have brought Indonesians into contact with an increasingly globalized culture and have put pressure on traditional institutions and practices. This is especially significant in the area of health, where considerable tension exists between the allopathic conceptualization of health (as espoused by health care professionals in the formal sector) and traditional interpretations of health that derive from a traditional cultural and linguistic frame of reference. This paper, based on fieldwork in the Indonesian region of Tanah Datar, West Sumatra, describes the impact of cultural and linguistic factors on the interpretation of illness among rural residents and elucidates the growing impact of multiple systems of meaning in local understanding of health.