Cross-Cultural Medical Systems

1. Cross-Cultural Medical Systems • All societies have health-care systems • Consisting of beliefs, customs, specialists, and techniques aimed at ensuring health & diagnosing, preventing, and curing disease & illness • Ethnomedicine = cultural approaches to health, illness & healing • Embraces all cultural health systems

2. Cross-cultural Medical Systems • Ethnomedicine – culturally specific beliefs relating to the causes, symptoms & cures of disease & illness • No distinction between mind and body • Need to treat both simultaneously to be effective • Views patient as a “whole” person • Takes social, cultural, emotional factors into consideration • Based on “explanatory models” • Explains what disease is, how it comes about, why it exists, how it can be prevented/cured, & why it attacks some people but not others • Personalized care

3. Cross-cultural Medical Systems • Biomedicine – scientific based medicine • Is an ethnomedical system, inextricably tied to Western culture & values • Mind (psyche) separate from body • Fragmentation of body • Dissociation from person/patient • Impersonal

4. Perceptions of the Body • Cross-cultural variation in defining the body & its parts in relation to illness & healing

5. Emic vs. Etic Perspectives on Health Emic – what insiders do & perceive about their culture • Their perceptions of reality • Their explanations for why they do what they do • Non-western medical systems tend to adopt an emic approach Etic – an analytical framework used by outside analysts in studying culture • Biomedicine subscribes to etic perspective

6. Medical/Health Terminology • Disease – abnormalities in the structure or function (or both) of bodily organs • Illness – a person’s perceptions & experience of disease & other health threatening conditions • Curing – the treatment of disease • Healing – the alleviation of illness (which may or may not be assoc. w/a diagnosed disease) • Doctors may cure, but not nec. heal • Shamans may heal, but may not always cure

7. Disease/Illness Dichotomy • Parallels Emic/Etic understandings of health problems • Culture provides the framework within which disease & other forms of suffering become illness

8. Beyond biology Structural suffering/afflictions – devastating forces that cause suffering • War • Famine • Forced migration • Poverty Biomedicine not designed to deal with structural suffering • Can lead to cultural misunderstanding

9. Healing systems • Humoral healing systems – based on philosophy of balance among certain natural elements within the body • food & drugs have “heating” or “cooling” effects on the body • Disease is result of bodily imbalances that must be counteracted by dietary changes or medicines that will restore balance

10. Preventive Practices • Can be religious or secular in nature • If spirits believed to be cause, then supernatural intervention may be required • Cultural taboos (food, actions, thoughts) to prevent misfortune, suffering & illness

11. Cross-cultural Medical Systems All cultures have health-care specialists • Healers • In western, biomedicine, curer is doctor • Specialized training – education • Specialized tools • Only doctors/nurses have access • Remedies (i.e. medicine/drugs) must be prescribed and dispensed through medical system • Doctor viewed as holding “authoritative knowledge” about the human body & how it functions • Doctor treats the disease usually not the illness or the person

12. Cross-cultural Medical Systems • Non-western medicine, curer is shaman (who is also a religious specialist) • Specialized training – trance, rituals • Specialized tools • Often symbolic, viewed as having divine power & used only by shaman • Remedies usually naturally based (herbs, plants, special foods, etc.) & generally accessible to everyone • Shaman viewed as mediator between natural & supernatural worlds • Shaman treats illness/person, may or MAY NOT cure the disease

13. Common characteristics of healers across cultures • Selection – certain indiv. show special ability • Training – extended periods of observation, practice, training • Separated from general population • Often arduous, intense period • Certification – legal or ritual certification • Professional image – distinguished from “ordinary” people through behavior, dress & other markers • Expectation of payment – some form of compensation for services in cash or kind