UCSP MODULE #7: HEALTH IN SOCIETY
mctoledo02 Uncategorized October 1, 2018 8 Minutes
MODULE #7: HEALTH IN SOCIETY
In the Philippines, people can get usog or pasma, but people in the US or Europe do not know of such.
Filipinos and Indonesians go amok, while the Inuits living in the Arctic Circle experience piblokto. The
indigenous peoples of North America could experience ghost sickness, while Filipinos may experience
sapi. The Chinese and Malay can experience koro; in the Philippines, people experience kulam.
While there are similarities in the illnesses mentioned above, they are not just local terms used to
describe one medical condition. Instead, each condition is unique, its symptoms different from culture
to culture. Only through a careful study of each illness can one say whether it is the same with other
illnesses or not.
Unfortunately, such culture-bound syndromes have been dismissed as unscientific for the longest time,
and very little literature has been written about them. Though found to have no real biochemical bases,
culture-bound illnesses cannot be readily dismissed because they lead to observable physical and
mental alterations among individuals afflicted by them. For example, a doctor treating a child with usog
might see no problem based on laboratory results, but for sure there is a problem with the child because
he or she has been crying for several hours straight. A person inflicted with kulam might show a
degradation of physical health, but all health baselines may show to be normal. In order to promote the
study of these syndromes in terms of the culture where they are found, the Diagnostic and Statistical
Manual of Mental Disorders (DSM, now on its fifth revision) of APA and the International Statistical
Classification of Diseases and Related Health Problems (ICD) added the term culture-bound syndrome
and included a list of the most common culture specific illnesses.
What is a Culture-Specific Illness?
The APA defines culture-bound syndrome as the “recurrent, locality-specific patterns of aberrant
behavior and troubling experience which may or may not be linked to a particular DSM-IV diagnostic
category. These illnesses are culture-bound because they are considered as illnesses in a particular
culture, but not anywhere else.
These are the characteristics of a culture-specific illness:
the culture categorizes the symptoms being exhibited as a disease,
individuals of the same culture are familiar with the symptoms of the illness,
individuals of other cultures misunderstand or are unfamiliar with the illness,
there is no objective biochemical or tissue abnormality that may be identified as cause of the illness, and;
the illness is recognized and treated by folk doctors of the culture using a standardized methodology.
Culture-bound illnesses exist only in their cultures because their existence have a strong relationship
with their etiology. Only in cultures that believe in ghosts and witchcraft could an illness like ghost
sickness happen.
In the same way, only in a culture that look at flesh-eating as a taboo could the symptoms of windigo be
considered as a disease. Culture-specific illnesses also have symbolic meanings for all members of the
culture. Individual cases of culture-specific illnesses are connected with wider concerns—for example, a
patient’s relationship with the community, the supernatural forces, or social conflicts that are patterned
in culture. Often, responses to illnesses may lead to the resolution of these much wider concerns. A
person who experiences kulam may wish to seek redemption for his
The Importance of Studying Culture-Specific Illnesses
The subject of culture-specific illness is controversial because it brings to the fore the very foundations
of Western medicine. It leads medical professionals to review their assumptions in dealing with
disorders that they are relatively unfamiliar with. The recognition of the existence of culture-specific
illnesses opens the medical field into relativism.
The addition of culture bound symptoms in the DSM marks the development of a globalized approach to
psychiatry where clinicians have to consider not just the cultural dimension of illnesses, but also the
possibility of utilizing non-Westernized approach to treatment. In a study of Hispanics diagnosed with
ataque de nervios (nervous breakdown), it was discovered that they also met the criteria for panic
attacks, though not all features of a panic attacks were present in an ataque episode.
Through this knowledge, psychiatrists knew were to begin—they could utilize some techniques used for
panic attacks to address ataque patients, but some modifications to the techniques were necessary due
to the differences in the features of the illnesses. From being an “exotic” topic, researchers on culturebound symptoms are now afforded with a higher degree of respectability.
The results they produce helps medical practitioners to gain a deeper understanding of these conditions,
hence, enabling Western medicine to develop new, culturally-appropriate approaches to address these
concerns. This is very important, especially since migration has also led to the spread of culturally-bound
syndromes. No longer are these illnesses solely found in the home country. The addition of culturespecific illnesses in DSM and ICD also signals that the current standards for the classification of diseases
is far from exhaustive. Because culture is dynamic, health, too, will be dynamic. illnesses. Illness may be
caused by a disease, or it could be due to emotional and spiritual factors tied to the individual’s culture
and worldview.
Health systems- refer to the systems of belief that surrounds the diagnosis, prevention, and treatment
of health issues.
Disease Theories-Medical anthropology recognizes that there are at least three ways to explain how
illnesses are developed.
According to the personalistic disease theory, an illness is due to an agent of illness; for example, a witch,
a displeased ancestor, or a supernatural entity. Treatment of illnesses that fall under this category could
only be done through supernatural means. Healing is also performed by a healer who has understands
the illness and what has caused it.
The emotionalistic disease theory looks at illness as the impact of a negative emotional experience. In
some cultures, sudden shock can lead to behavioral changes. Today, psychotherapists see that emotions
have a major role to play in physical health, and new research is being conducted on how this
understanding can be translated into the medical profession.
The third disease theory is the naturalistic theory. We are all familiar with this as this is conventional
medicine. In this theory, illnesses are due to an impersonal factor, and can be cured by impersonal
treatments.
Ethnomedicine refers to the cross-cultural study of health systems. It looks at the medicine practice of
indigenous peoples in the world and how it is impacted by globalization of health systems. Western
medicine is just one kind of ethnomedicine.
Ethno-etiology, on the other hand, refers to the cross-cultural study of the causes of health problems.
For example, it looks at how in Brazil, different types of wind causes different kinds of migraines. It looks
at factors in the culture that could lead to different health outcomes. A special focus for ethnomedicine
and medical anthropology in general is structural suffering or the social suffering caused by extreme
poverty, conflict, and displacement, among others. What are the effects of structural suffering to the
overall health of the individuals in a culture?
Through ethnomedicine, methods of diagnosis, prevention, and healing must now consider a patient’s
culture in order for the medical practitioner to become effective. This is both an advantage and a
disadvantage. On one hand, it will become much more difficult for medical professionals to apply a
routinary treatment plans.
On the other hand, ethnomedicine is a road towards holistic medicine. It ensures that doctors see their
patients as people, and that the treatments given to them ensure the highest possible well-being. The
right to health has been continuously redefined in several international conventions. Some examples
include the Universal Declaration of Human Rights, the International Covenant on Economic, Social and
Cultural Rights, and the Convention on the Rights of a Child. If we look at the definition of health as the
“state of complete physical, mental, and social well-being”, then the right to health does not only refer
to the right to access to quality and adequate health care. Instead, it also refers to the human right to be
protected from illnesses and diseases, as well as social structures that could negatively impact a
person’s well-being. It means having access to decent housing, healthy working conditions, clean
environments, and adequate food and sanitation.
Hence, in order for health care systems to become effective, they must be designed with human rights
as standards. This means that a health care system must be accessible, available, acceptable, of the
highest quality for everyone, and is equitable. The main thrust of the WHO is universal access. This
means that comprehensive health care must be affordable for everyone, especially for the marginalized
and those who live in conflict areas. Universal access also refers to gaining the right information about
health and their rights.
For example, people who contract the human immunodeficiency virus (HIV) are less likely to seek for
medical attention for fear of social stigma. But knowing that they have the right to freedom of
movement will ensure that they are not segregated, isolated, or quarantined.
Availability refers to ensuring that the latest health care infrastructure (building, equipment and trained
medical professionals), goods, and services are available whenever and wherever it is needed. For
example, in countries where citizens are unable to acquire the latest imaging technology, the
government has to be ready to provide the subsidies in order to purchase it. In places where there is a
lack of trained medical professionals, the government must create programs that will bring doctors to
far-flung areas.
Acceptability refers to the creation of health care institutions that protect the dignity of all its patients. It
is an institution that offers culturally-appropriate treatment, one that respects the unique health care
needs of every individual that comes to its doors. In Asian societies where families play a huge role in
the health outcome of patients, medical professionals must learn to explain diagnoses and treatment
plans, to the satisfaction of the immediate family. An acceptable health care institution is one that
adheres to the highest standards of medical ethics and confidentiality Even with the inclusion of culturespecific illnesses, all health care institutions must provide
high quality medical services. Quality control processes must be assured and treatments must be
patient-centered. It is this thrust that pushes many health care institutions today to adapt evidencebased practice, as new methods of healing are being developed. Age-old methods like acupuncture and
Ayurveda now has a place in medical practice. Though conventional doctors are not expected to adhere
to these practices, they must learn not to immediately dismiss these modes of healing without
adequately understanding its advantages and disadvantages.
Equitability in health care means that medical resources and services are given to those who need it,
without discrimination on the health status, age, race, gender, religion, disability, country of origin,
income or social status. It shouldn’t matter if a patient has the capacity to pay or none. If a patient is
brought to the emergency room, immediate medical attention should be given to him or her before
financial concerns are discussed.
The practice of medicine has come a long with the discovery of new, more advanced technologies. But
medical anthropology has brought the diagnosis, prevention, and healing of diseases and illnesses to an
all-new dimension. It has recognized the value of traditional healingmodalities, and in essence, affirmed
the indigenous knowledge systems.
Today, medicine is no longer just about easing the symptoms of disease. Rather, it is about alleviating
the cause of the disease in order to promote wellbeing, and in effect, productivity among people.