ABSTRACT
Right after MSF’s inception of medical activities in the surgical ward in the hospital Abéché in Chad, problems with patients’ treatment adherence became apparent. An anthropological study should decipher the reasons behind patients’ and caretakers’ reluctance towards the medical treatment offered. Contrary to the expected result that individual ‘cultural’ perceptions of disease and the biomedical treatment were the causes for patients refusing plaster casts and other therapeutic measures, structural issues appeared to account for this outcome: the quality of treatment delivered within the cooperation between MSF and the Ministry of Health, socio-cultural differences between medical staff from the south and patients from the north of the country, the availability of traditional medicine and the hospital’s reputation. The authors analyse the multi-layered factors and describe how the findings of the study helped to forge the health promotion activities and had a wider impact on discussions about staffing and ethnic relations in other MSF projects in Chad. The chapter aims to contribute to an understanding of an ‘anthropology in humanitarian settings’ and to show the potential that lies in linking anthropology with health promotion to tailor services offered in humanitarian contexts to local needs.
