ABSTRACT
INTRODUCTION Over the last two decades, a number of focused ethnographic studies have been conducted on diarrheal disease. To date, the ethnographic record on local classification of diarrheal disease has primarily been assessed in relation to the needs of oral rehydration (ORT) programs1 (Kendall 1990, Sukkary-Stolba 1988, Weiss 1988). Given the significant number of diarrheal deaths associated with dysentery (Black 1993, Chen et al. 1980, Ronsmans, Bennish, and Wierzoa 1988, Zimicki et al. 1985), it is time that this record be reassessed and formative research be conducted toward two ends: enhancing dysentery surveillance and developing a corrective to existing diarrhea rehydration messages relevant to dysentery. It is conservatively estimated that dysentery accounts for 20% of all diarrheal related deaths (Bhandari, Bhan, and Sazawal 1992).2 Translated in terms of child survival, this amounts to approximately 5% of all deaths in children less than five years old, the age group at greatest risk to this complex of diseases. An estimated 740,000 deaths due to dysentery occur each year. Virtually all of these deaths occur in less developed countries (Hermann and Black 1987).
