Academic journal article Human Organization

Indigenization of Illness Support Groups in Haiti

Academic journal article Human Organization

Indigenization of Illness Support Groups in Haiti

Article excerpt

This paper examines the process of indigenization within peer support groups for Haitian women living with the chronic physical impairment of lymphatic filariasis. Five support groups established in a coastal community were studied over a period of three years to understand the adaptation of the Western illness support group model to the local cultural milieu. Unlike most support groups in affluent settings, the Haitian women showed minimal interest in talking about illness-related issues. The groups developed a distinctly Haitian style characterized by emphasis on religion and spirituality, artistic and expressive components, and acquisition of practical skills that offer income-generating opportunities. Members directed the greatest energy toward developing microenterprise activities. This pattern of adaptation is discussed in terms of indigenous traditions of mutual aid in rural Haiti, the compelling material needs of families living in stark poverty, and the ongoing challenge of coping with political and economic insecurity. Results are framed within a theoretical discussion of contextual factors that lead self-help groups into social action beyond the groups' original purposes. The analysis also addresses the conditions needed for long-term sustainability of support groups, and the way in which fundamental needs shape group activity.

Key words: indigenization, support groups, Haiti, lymphatic filariasis, women


Social scientists describe indigenization as the process of transformation that often occurs when social institutions developed in one social context are transplanted into a totally different social context (Kleinman 1980, Atal 1981, Gareau 1988, Etkin et al. 1990, Bar-on 1999, Ho et al. 2001). As globalization transforms the cultural landscape near and far, observers are paying increasing attention to the process of indigenization of social forms and institutions. Cultural borrowing has intensified in pace and degree, in many directions, taking both predictable and surprising paths. No longer do we think of culture change as homogenizing and unidirectional; the post-colonial paradigm recognizes multiple sources of influence as well as the emergence of unique, localized patterns of cultural expression (Appadurai 1996; Sahlins 1999). A dialectical conception of development incorporates not only technological dimensions but individual development and social participation.

This paper examines the process of indigenization that occurred within support groups organized to provide psychosocial support and health education for women living with lymphatic filariasis (LF) in Haiti. It describes the cultural transformation of the groups into distinctly Haitian forms, and addresses the evolution of the groups to meet basic subsistence needs of members. This discussion focuses on the implications of this trajectory for theorizing indigenization of support groups.

Attention to indigenization, intended or not, is widely viewed as an essential component of directed change programs, variously labeled "local adaptation," "cultural tailoring," "cultural sensitivity," or similar notions. Yet the concept of indigenization per se has received only limited theoretical attention in the social science literature. The concept gained currency during the 1970s when developing country scholars reacted to neocolonialist domination of social science by Western disciplines, calling for the development of independent, locally meaningful theoretical frameworks and methodologies for guiding research and scientific discourse. Interest grew during the 1980s, with much attention to disciplinary adaptation, including the epistemologies and practices of psychology, social work, and sociology (Park, 1988, Adair 1999, Nimmagadda and Cowger 1999). In comparison to other social sciences, the indigenization of anthropology in non-Western settings has received little scholarly attention. Medical anthropological studies of indigenization have tended to focus on the ways in which institutions of Western Medicine have changed in response to their introduction into different cultural contexts (Kleinman 1980, Cheung 1989, Etkin et al. …

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