In this image, what do you see? This is a
common image that illustrates two different views: one of an old woman and the
other of a young lady. It is difficult once you have seen the first image to
interchangeably identify the second image if you are not primed to visualize
the second image. This illusion similarly demonstrates the role culture plays
in the arena of health. It is difficult to for a society embedded in its
culture and customs to readily accept a different view that contradicts the
methods of health and healing that is rooted in the community’s history.
Culture is responsible for shaping the
different dimensions of belief, concepts, practices, and social organization.
Culture influences all aspects of life, and culture is what distinguishes countries
and communities from each other. These past few weeks in lecture, we have been
heavily emphasizing the different perspectives of health, illness, and healing,
and considering how a society views specific diseases in order to categorize
them. Culture, which is learned in society, influences the way in which health
is approached in an “appropriate” manner. Therefore, in a circumstance in which
an individual displays a sickness that his/her society cannot identify as an
illness, then the disease does not have any meaning, thus no clinical treatment
can be provided for the individual. This is because the legitimacy of a disease
or illness is determined within the context of the culture and society.
In Culture Behavior and Health, Scrimshaw
wrote that, “Cultures vary in their definitions of health and of illness. A
condition that is endemic in a population may be seen as normal and may not be
defined as illness. Ascariasis in young children has already been mentioned as
a perceived normal condition in many populations. Similarly, malaria is seen as
normal in some parts of Africa, because everyone has it or has had it. In
Egypt, where schistosomiasis was common and affected the blood vessels around
the bladder, blood in urine was referred to as “male menstruation” and was seen
as normal.” This quote immediately caught my attention, especially with the
mention of the life threatening malaria disease. Although malaria is not
transmittable in the United States, malaria is considered a life threatening
disease that needs immediate attention and immediate care; yet as the quote
indicated, malaria is considered “normal” for some societies. I disease readily
recognized in a particular region may not have the same meaning in a different
region because culture greatly influences the entirety of health: etiology,
diagnosis, and prescription. This is because if the community does not identify
a sign or a symptom as a disease, the illness is not valid in that community. Thus,
no treatment is available. “Health and illness
are defined, labeled, evaluated, and acted on in the context of culture”
(Scrimshaw).
If we acknowledge that culture indeed
influences health care, we acknowledge that every disease is not globally
recognized as “real.” So, when physiologically detectable abnormalities in the
body (external or internal) do not have a global unanimous identification as a
“disease,” this enabled me to think about how much more disagreement could
there be in globally recognizing diseases that do not present physiological
abnormalities. This made me think about mental health on a global scale. In Mental Health: Global Effort Sought, an
article found on the British Broadcasting Corporation (BBC), it stated, “Nearly
450 million people have mental health disorders and more than three-quarters
live in developing countries. According to the World health Organization (WHO),
eight in every 10 of those living in developing nations receive no treatment at
all.” According to the numbers stated, mental health is a huge problem, yet is
has been greatly neglected. There are numerous reasons why the statistic that
eight in every 10 individuals in developing countries do not receive any
treatment, but one certain reason why treatment may be unavailable pertains to
the culture of societies. The United States, and many other Western developed
countries primarily use biomedical technologies and resources to diagnosis
mental illnesses, however, different cultures using different forms of medicine
may not detect mental illnesses as a biological problem. So, some communities
may not recognize mental illness as legitimate. Therefore, different societies
may reference the abnormality in behavior of an individual (who would be
identified as mentally ill in the United States) as spiritually impure, etc.
(or the individual may have an imbalanced equilibrium, a religious concern, or
any other different understanding/variation of explaining the abnormality). In
a developing society, mental health most likely is not a high priority concern
compared to other issues more prominent like identifiable disease, nutrition,
sanitation, etc.
In discussing mental
health, I wanted to just briefly mention a topic discussed in class that raised
much controversy. An example of a mental health disorder that was discussed in
lecture and has proven to encompass much controversy is what the Western World
has labeled, Attention
Deficit Hyperactive Disorder (ADHD). A study conducted by the National Center for
Biotechnology (NCBI) speculated the question “is ADHD an American disorder?”
The results of the study are presented that “the prevalence of hyperactivity
reflects differences in the definition of the condition rather than real
differences in behavior between British and American children. For example,
children with hyperactive behavior may be more likely to be diagnosed as having
conduct disorder in the UK and ADHD in the USA.” This indicates that children
in different countries and regions present similar behavior, but the
identification and labeling influenced by the culture of the society determines
the legitimacy of ADHD. This study of ADHD is a good demonstration of culture influencing
health.
This leads to
the big picture outlook of why it is important to recognize that culture
influences all aspects of health and healing. Scrimshaw shares, “If you wish to
help a community improve its health you must learn to think like the people of
that community. Before asking a group of people to assume new health habits, it
is wise to ascertain the existing habits, how these habits are linked to one
another, what functions they perform, and what they mean to those who practice
them.” I personally believe in a strong scientific and biomedical approach to
medicine, but I believe that it is significant to recognize that no society’s
culture in terms of dealing with health is inferior to the other. It is easy
for the Western World to feel as if it is “saving” a society from its
“inadequate” ways because it has the resources, technology, and funds to impose
a biomedical approach to medicine, yet it does not guarantee desired results.
The goal to achieve global health is to recognize that there are different
cultures with different interpretations of health; therefore, the way to
gravitate towards progress is to work together to develop a collaboration of
approaches to provide communities with necessary treatment.
Outside Texts
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ReplyDeleteIn this post, Stella discusses how our culture shapes how we perceive illness and healthcare. Furthermore she looks at how symptoms that are perceived as an illness in one culture might be seen as illegitimate or normal by another. She explores how this issue of perception can apply to diseases such as malaria and less concrete health issues such as mental illness. Stella did an excellent job of selecting quotes and an image that made her point clear. I felt that the image was particularly effective in demonstrating to the reader how much perspective matters. When you look at something one way, it becomes extremely hard to force yourself to see it another way, which is exactly the challenge of working with different cultural perspectives.
As we’ve studied cultural differences over the past couple weeks, I feel like I’ve become increasingly aware of how my culture clouds my perspective. Not only are my believes about medicine shaped by my background, but also, how I view social issues, political issues, economic issues and how I define success, education and good health. How I’ve been raised, where I’ve lived and all of my experiences create the lens with which I look at the world. And although I can read about other perspectives and learn about them, I’m beginning to realize how far that is from truly understanding them. In many ways, whether I would like to admit it or not, my set of beliefs limits my ability to accept alternative beliefs. Because approaches to health care are so much shaped by culture, it makes sense why it can be so hard to accept different approaches to medicine. As Stella says in this post, “It is difficult to for a society embedded in its culture and customs to readily accept a different view that contradicts the methods of health and healing that is rooted in the community’s history.” This is why ethnographies and field studies are so important, because it takes living with people and being immersed in their culture for an extended period of time to truly begin to grasp their beliefs.
I agree with Stella’s conclusion, because I personally believe in a biomedical approach to healthcare, but in order to make progress, it is important that there is a collaborative effort, especially in places where biomedicine is foreign. I also appreciate her pointing out that it is not right for Western countries to try and “save” less developed countries through biomedicine, without any respect for their indigenous health systems. However, I do think that biomedicine has so much power because it has proven to be so effective and because it so effective, it is often hard to see why other medical perspectives are important. But we must look past our own cultural definitions of “good health” and recognize that there are aspects of health that biomedicine might not recognize or adequately treat. Also, since people around the world have different explanatory models, the better we understand each other’s, the more likely we will be able to apply different techniques to heal people.
In this entry, Stella intelligently connects the themes we have been discussing in class. The following quote summarizes Stella’s main point, “It is difficult to for a society embedded in its culture and customs to readily accept a different view that contradicts the methods of health and healing that is rooted in the community’s history.” The image included in the entry further reinforces this main idea. Stella elaborates on culture’s strong influence as well as its significance in shaping all aspects of life. One of those aspects is health, and that connects with what illnesses and diseases are deemed legitimate in the scope of a culture and the society that embodies the culture. Different cultures have different perspectives on health, which is why the legitimacy of illnesses and diseases vary culture to culture. Stella weaves in a quote from Scrimshaw, which explains how “a condition that is endemic in a population may be seen as normal and may not be defined as illness.” The recognition of a legitimate illness or sickness by society directly affects the path of treatment.
ReplyDeleteI agree with Stella’s following statement, “I personally believe in a strong scientific and biomedical approach to medicine, but I believe that it is significant to recognize that no society’s culture in terms of dealing with health is inferior to the other.” I think that biomedicine has science on its side, so treatments, such as antibiotics or insulin, are effective for combating diseases and illnesses. But the culture surrounding biomedicine tends to assume it is superior to all other forms of treatment, and that is the main fault of biomedicine. Biomedicine’s culture is very narrow-minded, and viewing biomedicine as the sole solution to all health related issues only limits biomedicine.
This entry got me thinking about my culture, and how it has shaped my perceptions. Growing up on the island of Guam, and embracing the Chamorro culture has shaped my perceptions of heath. My great grandmother was a well-respected Siruana, basically the Chamorro version of a witch doctor. As a child, I was very sickly, sick enough to land me in the hospital at least twice a year. After a few years, my great grandmother finally convinced my mother to allow her to give me herbal Chamorro medicine. Twice a year I would have to drink a tea-like mixture of the Chamorro medicine concocted by my grandmother. My great grandmother explained to me that I had a very weak immune system, and how her herbal medicine helped to strengthen it. I believe that her medicine did indeed work, because while I stayed on track with her treatment, I did not get sick enough for hospitalization. Despite the awfully unpleasant taste, the medicine alleviated my susceptibility to illnesses.
My great grandmother’s herbal, “alternative” medicine ended up doing more for me than biomedicine. Throughout my childhood, I continued to go to the doctor for routine visits, but I took the herbal medications. Biomedicine is seen as effective, but the Chamorro culture takes into account how biomedicine does not always have the answers, and that is when we seek help from Siruanas like my great grandmother.