Abstract
Scabies is a skin Neglected Tropical Disease (SNTD) caused by infestation with human itch mite. It is estimated that scabies affects more than 300 million people globally, with an estimated prevalence ranging from 0.2 to 71%. However, it has been a truly neglected health problem largely absent from the global health agenda. Several large scabies outbreaks have occurred in the Amhara region of Ethiopia since 2015, all of them predominantly managed via hygiene-focused educational interventions and mass drug administration. Locally known as meshe mekeraye (the agony of the night‘), because its itchiness worsens in the evening, scabies has become a normal aspect of life in the Amhara region. My study explores people‘s everyday life in relation to scabies in Debre Elias district of the Amhara region, with a focus on how people living in Debre Elias understands and seek to manage scabies.I collected data via a rapid ethnographic approach. Fieldwork was conducted from February to July 2022 and included 57 semi-structured interviews with people with and at risk of having scabies, local health workers, traditional healers, and government officials. It also included participant and non-participant observations and document analysis.
Research findings indicate that scabies is so common in Debre Elias that it is often conceptualized as a trivial illness people simply learn to live with. Scabies, however, disrupts the everyday life of people in Debre Elias by affecting their social interactions, ability to work and education. Although scabies is believed to affect anyone regardless of their socio-economic status, children, breast feeding women, and religious students are highly vulnerable due to their living conditions, gender roles, lack of access to healthcare, and other contextual factors such as poverty and disempowerment. Together with uneasy relations with healthcare workers, cultural beliefs, and agricultural work needs, these factors also influence people‘s responses to scabies. Most people with scabies initiate their scabies treatment either by self-medicating or using traditional treatments (holy water and herbal medicine) and often seek biomedical treatment as a last resort. People manage health issues, including scabies, by commonly navigating biomedical and traditional healing systems, but this is done informally, as traditional health practices are seen with disdain by government officials and healthcare workers. Showing how current biomedical interventions are not sufficient to prevent and mitigate scabies in Debre Elias, I demonstrate that the existence of pluralistic scabies treatments should be seen as an opportunity (instead of a liability) for scabies control. I also suggest the need to develop contextually and culturally adequate interventions that consider the social, ecological, and economic dimensions of scabies.
| Date of Award | Apr 2025 |
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| Original language | English |
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| Supervisor | Mei Trueba (Supervisor), Dr Anne Roemer-Mahler (Supervisor), Prof Getnet Tadele (Supervisor) & Dr Kibur Engdawork (Supervisor) |