Attitudes Toward Clinical and Traditional Treatment for the Buruli Ulcer in the Ga District, Ghana

Background: Buruli ulcer (BU) is the third most common mycobacterial disease in the world, following tuberculosis and leprosy, and has many serious consequences. In 1998 the World Health Organization (WHO) established the Global BU Initiative to encourage research about the disease and its treatment.
Method: HART conducted research on BU during the summer of 2001 in rural villages in the Ga district, about a forty-five-minute drive northwest of Accra, Ghana. Researchers used participant observation combined with open-ended interviews to collect data on basic demographics, social beliefs, cultural knowledge, and attitudes towards BU exhibited by the Ga people.
Result: Most indigenous people believe the disease is caused by supernatural factors (i.e. witchcraft), environmental factors (i.e. water, suggested by health educators), or both. More than 80 percent of villagers first seek traditional treatment because of its convenience, its low cost, and the reasonably high success rate of traditional cures for BU. Satisfaction with clinical treatment is not higher than with traditional medicine; people tend to turn to clinical medicine after traditional treatments fail. Few social stigmas result from the disease other than avoidance of the unsightly ulcer and the unpleasant smell, and among children, some teasing. The major concern expressed by villagers is the economic impact of the disease from reduced productive capacity.
Conclusions: The strong preference for traditional cures and their relatively high success rate coupled with the fact that traditional cures are not effective for advanced cases suggests that close cooperation between traditional healers and clinical staff might contribute to a better control of the disease.