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February 24, 1989

Sanitation, Spirits, and Medicine: Health Care in the African Bush

Author Affiliations

Michigan State University East Lansing

Michigan State University East Lansing

JAMA. 1989;261(8):1201-1202. doi:10.1001/jama.1989.03420080121046

Liberia, situated on the western bulge of Africa, is that continent's oldest independent black republic. Located 480 km north of the equator and bordered by Sierra Leone, the Ivory Coast, Guinea, and the Atlantic Ocean, Liberia is nearly the size of Ohio, with an estimated population of 2 million. Most Liberians belong to 1 of 16 distinct ethnic groups, each with a separate culture and language. Two thirds of the population is rural and 50% of the population is under 15 years of age. The estimated adult illiteracy rate is 76%.1

The village of Zorzor lies in a tropical rain forest in the foothills of the Wologizi mountain range, which extends from northeast Liberia into Guinea. Zorzor, a rural village, has an estimated population of 5000 to 10 000 and is 220 km from Monrovia, the Liberian capital (Figure). Subsistence rice farming is the primary local occupation of the