This article examines the impact of permanent disability on households, based on a 1987 field study in highly endemic areas of onchocerciasis (river blindness) in Guinea (Conakry). Preliminary results are used to model the interaction of the blinding form of the disease with a young household over a 15‐year period, revealing a process of household impoverishment often overlooked when the unit of analysis is the individual. This identifies effects on different household members and those most in need. Similar analysis could help foresee social and economic effects of the growing problem of AIDS.