“Toupaille”, STD kits and Remedies for the “mal d’enfants” (Sterility) among the Gouro of Zuénoula (Ivory Coast)
Our work has focused on trends in the treatment of specifically feminine illnesses, for the most part diagnosed as STDs, among the Gouro people in Ivory Coast over a period of twenty years. In this study we have used the tools of the anthropology of pharmaceuticals to analyse the changes brought about in both the local pharmacocenosis and pathocenosis by the introduction of new therapeutic treatments and the emergence of a new disease (AIDS). In the present health care system in Ivory Coast, traditional remedies coexist with legal and illegal drugs, and the kits of generic products delivered by public health dispensaries for the treatment of STDs. The introduction of these new forms of treatment has occurred in the context of social and economic upheaval which, by lifting to some extent the constraints that weigh on certain women’s roles in Gouro society, has weakened the social aetiology of the diseases under study. The remedies therefore are thrown into competition with the outside treatments on offer, and are gauged according to their empirical efficacy from the users’ point of view (the STD kits are equated with treatment for fertility problems). In these circumstances, where people have recognised the validity of recourse to dispensaries for the treatment of these problems, arise the issues of diagnosis by health care personnel who are deaf to the semiological codes of their patients, and of the patients’ access to medicines under the requisite conditions of efficacy.