02674nas a2200205   4500000000100000008004100001260003200042653001300074653002000087653001800107653001100125653001000136653001500146653003200161653002900193100001500222245012500237520209200362022001402454       2016                            d  bCambridge University Press 10aTanzania10aschistosomiasis10aS.haematobium10aRumour10aRiots10aResistance10aNeglected Tropical Diseases10aMass drug administration1 aHastings J00aRumours, riots and the rejection of mass drug administration for the treatment of schistosomiasis in Morogoro, Tanzania.3 a<p>In 2008 in Morogoro Region, Tanzania mass drug administration (MDA) to school-aged children to treat two neglected tropical diseases (NTDs), schistosomiasis haematobium and soil-transmitted helminths, was suspended by the Ministry of Health and Social Welfare after riots broke out in schools where drugs were being administered. This article discusses why this biomedical intervention was so vehemently rejected, including an eyewitness account. As the protest spread to the village where I was conducting fieldwork, villagers accused me of bringing medicine into the village with which to “poison” the children and it was necessary for me to leave immediately under the protection of the Tanzanian police. The article examines the considerable differences between biomedical and local understandings of one of these diseases, schistosomiasis haematobium. Such a disjuncture was fuelled further by the apparent rapidity of rolling out MDA and subsequent failures in communication between programme staff and local people. Rumours of child fatalities as well as children’s fainting episodes and illnesses following treatment brought about considerable conjecture both locally and nationally that the drugs had been either faulty, counterfeit, hitherto untested on humans or part of a covert sterilization campaign. The compelling arguments by advocates of MDA for the treatment of NTDs rest on the assumption that people suffering from these diseases will be willing to swallow the medicine, however, as this article documents, this is not always the case. For treatment of NTDs to be successful it is not enough for programmes to focus on economic and biomedical aspects of treatment; rolling out ‘one size fits all’ programmes in resource-poor settings. It is imperative to develop a biosocial approach: to consider the local social, biological, historical, economic and political contexts in which these programmes are taking place and in which the intended recipients of treatment live their lives. If they do not, the world’s poor will continue to be neglected.</p>
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