Ruthbeth Finerman

The burden of responsibility: Duty, depression, and nervios in Andean Ecuador

Saraguro Indian women possess relatively high status in their community. Nevertheless, they experience high rates of the culturally interpreted illness nervios. This syndrome produces symptoms characteristic of stress-induced depression and is identified by Saraguros as the product of suffering and misfortune. Descriptive and quantitative interview data indicate that episodes of nervios correlate with experiences of gender role failure, and the condition is identified as a coping mechanism for excessive responsibility and unrealistic social expectation. This syndrome also appears to serve as an effective strategy for enhancing power and social status.

Transportation vulnerability as a barrier to service utilization for HIV-positive individuals

Research suggests that transportation vulnerability can negatively impact adherence to HIV-related medical treatment. Moreover, transportation can be a barrier to accessing ancillary services which can increase positive health outcomes for HIV-positive individuals. This study examines transportation vulnerability and its impact on HIV-related health and ancillary service utilization in the Mid-South Region. Focus groups and interviews were conducted with service providers and HIV-positive individuals, and survey data were collected from HIV-positive individuals (N=309) using the five As of access to frame transportation vulnerability: availability, accessibility, accommodation, affordability, and acceptability. Study results indicate that transportation vulnerability can present significant barriers to service utilization for HIV-positive individuals, including insufficient transportation infrastructure, incompatible fit between transportation and health systems, and insensitivity to privacy issues. One consequence of transportation vulnerability is reliance upon weaving together multiple modes of transport to access care and ancillary services, creating additional barriers to service utilization and medical adherence. The research team recommends more investment in public transit systems, expanded services, and innovative approaches to solving procedural problems.

Inside out: Women's world view and family health in an Ecuadorian Indian community

Saraguro Indian women regard the home as a refuge from illness, while the outside world is considered dangerous and filled with disease. The likelihood of falling ill is thought to increase with distance from the home, so mothers employ preventive measures to guard family members leaving the house. Qualitative and quantitative data collected in the community between 1978 and 1984 suggest that world view influences therapeutic choice, by reinforcing fear of strangers and reliance on mothers for family health care.