title: Factors affecting illness in the developing world: chronic disease, mental health and traditional medicine cures.
abstract: This is a case report of a 24-year-old Ethiopian woman with a medical history of hepatosplenic schistosomiasis. She suffers from chronic liver failure and portal hypertension. She has been hospitalised for 'hysteria' in the past but did not receive follow-up, outpatient treatment or psychiatric evaluation. After discontinuing her medications and leaving her family to use holy water, a religious medicine used by many Ethiopians, she was found at a nearby monastery. She was non-communicative and difficult to arouse. The patient was rushed to nearby University of Gondar Hospital where she received treatment for hepatic encephalopathy and spontaneous bacterial peritonitis. Her illness is the result of neglected tropical disease, reliance on traditional medicine as opposed to biomedical services and the poor state of psychiatric care in the developing world.
authors.affiliation: Ben Gurion University, Medical School for International Health, Be'er Sheva, Israel.
authors.forename: Nathan T
authors.initials: NT
authors.lastname: Douthit
authors.affiliation: Department of Internal Medicine, University of Gondar, Gondar, Amhara, Ethiopia.
authors.forename: Hailemariam Alemu
authors.initials: HA
authors.lastname: Astatk
mesh_terms: D003906:Developing Countries; D058625:End Stage Liver Disease / Q000469:parasitology; D005002:Ethiopia; D005260:Female; D006501:Hepatic Encephalopathy / Q000469:parasitology*; D006801:Humans; D006975:Hypertension, Portal / Q000469:parasitology; D007046:Hysteria / Q000469:parasitology; D008109:Liver Diseases, Parasitic / Q000150:complications* / Q000469:parasitology / Q000523:psychology / Q000628:therapy; D016488:Medicine, African Traditional / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000382:microbiology; D012552:Schistosomiasis / Q000150:complications* / Q000523:psychology / Q000628:therapy; D013158:Splenic Diseases / Q000150:complications* / Q000469:parasitology / Q000628:therapy; D055815:Young Adult