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Kingsuk Sarkar, MD,
Asst. Prof,
Dept. of Community
Medicine
DSMCH
1
- Cause of disease:
a) Supernatural causes:
- Wrath of god
- Small pox, chicken pox
- Breaking social taboos
- Past sins
- Evil eye
- Ghost/spirit
b) Physical causes:
 Extremity of weather: heat stroke, frost bite
 Contaminated Water:
 Impurity of blood: scabies, acne, boils
2
 Disposal of Human Excreta:
- Open field defecation
 Disposal of waste:
- Stagnation of eater
- Indiscriminate throwing of refuse
 Water supply:
- Ponds & Tanks → Common use for
washing, bathing, ablution, drinking
- Store wells
- Pilgrimage →Holy dip
3
- Influenced by→ climate, soil
type, custom, belief, religion
- Deep psychological root
- Related to
affection, warmth, self-
image, social prestige
- Food taboos:beef,pork,alcohol
- Concept of hot & cold food
- Veg & non-veg
- Adulteration
- Fasting
4
- Universality of marriage
- Male child preference
- Built up on a foundation of Customs
 Beneficial:
- Breast feeding, oilbath, exposure to sun
 Harmful/Bad:
- Restriction of food intake during pregnancy
- Home delivery by untrained dais
- Discarding colostrum
- Pre-lacteal feed
- Skin branding
- Sedative given to infant
5
 Unimportant:
- Piercing ear/ nose
- Topical application on head
 Uncertain:
- Application of surma/ kajal→!Trachoma
6
:
- Defect of teeth & gums common
- Twigs of Neem,
- Ash, charcoal Rural
- Tooth powder
- With finger only
- Pan chewing smeared with lime
- Not rinsing mouth after meal
- Deposition of tartar Gingivitis Pyorrhea
& Dental Abscess, Stomatitis
- coated tongue→ improper hygiene, thrush
- Lips: excoriation at angle→VitB₁₂ def,fever,H. simplex
7
- Adequacy of space, privacy, clothing,
intelligence, religion, weather & season.
- Regular bath→ removal of dust & deposit over
body, odor of sweating
- Ritual bathing- on fixed occasions & ceremonies
- After childbirth, menstruation women must take
bath
- Villagers: no use of soap, use of common cloth to
wipe body →î cross infection
8
- Infants & children→ 8-12 hrs sleep
- Adults → 6hrs of sleep(min)
- Lack of sleep ill health & disturbed
relationship
9
- Smoking hubble-bubble→ social custom
- Spread of TB
- Reverse smoking →common among Andhra
villagers Oral Cancer
- Smoking chronic bronchitis, emhysema,
lung CA, CAD, oral cancer,cancer UGI,caUB,
pTB, IUGR
- Alcoholism broken family, gastritis, lack of
appetite → malnutrition, alcoholic cirrhosis
10
- Muslims, caste Hindu
- Î tuberculosis, deprivation of solar Vit D
- Walking barefoot → insect bite & parasite infestation
- religious, medical
- Muslims, Jews
11
- Children –play in dirty environment
- Residual dirt in skin & nail→
boil, furuncle, cuts & bruise, ringworm, septic
foci, eczema
- Nail not trimmed→ microorganism &
helminthic infestation
- Irregular combing & washing of hair
- dirty & matted hair, lice infestation
12
- Poor eye hygiene
conjunctivitis, trachoma, blephritis, corneal ulcer
- Regular examination of eyelids→ trachoma
- Conjunctiva →conjunctivitis, Bitot’s spot,anaemia
- Refractive error reading in dim
light, tailoring, needle work & handicrafts
13
- Deposition of wax→irritation→ scratching
with finger, pins →introduction of infection
- Unhygenic cleaning of the
ear→infection→discharge
- Furuncolosis, pharyngitis &
tonsilitis, eustachian tube blockage→ ear
pain…..
DEAFNESS
14
- ladies→ married, old, pregnant,widow
- old ,students & elderly
- types→ drinking water only, fruits
alone, salt/spice restricted diet, single
meal/day
15
- Alertness →level of intelligence
- Poor literacy in rural areas
- Low school enrollment, attendance, high dropout
- Î Education→ understand & adopt scientific
medical promotive measures
- Attitude of the family member toward
doctors, medical & paramedical staff
- Mental health condition & Social behavior
16
- religion, ethnicity, societal structure
- Sexual taboos
- Menstrual hygiene
- Marriage Universal & early
18
THANK
YOU
19

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Role of cultural factors in health & disease...

  • 1. Kingsuk Sarkar, MD, Asst. Prof, Dept. of Community Medicine DSMCH 1
  • 2. - Cause of disease: a) Supernatural causes: - Wrath of god - Small pox, chicken pox - Breaking social taboos - Past sins - Evil eye - Ghost/spirit b) Physical causes:  Extremity of weather: heat stroke, frost bite  Contaminated Water:  Impurity of blood: scabies, acne, boils 2
  • 3.  Disposal of Human Excreta: - Open field defecation  Disposal of waste: - Stagnation of eater - Indiscriminate throwing of refuse  Water supply: - Ponds & Tanks → Common use for washing, bathing, ablution, drinking - Store wells - Pilgrimage →Holy dip 3
  • 4. - Influenced by→ climate, soil type, custom, belief, religion - Deep psychological root - Related to affection, warmth, self- image, social prestige - Food taboos:beef,pork,alcohol - Concept of hot & cold food - Veg & non-veg - Adulteration - Fasting 4
  • 5. - Universality of marriage - Male child preference - Built up on a foundation of Customs  Beneficial: - Breast feeding, oilbath, exposure to sun  Harmful/Bad: - Restriction of food intake during pregnancy - Home delivery by untrained dais - Discarding colostrum - Pre-lacteal feed - Skin branding - Sedative given to infant 5
  • 6.  Unimportant: - Piercing ear/ nose - Topical application on head  Uncertain: - Application of surma/ kajal→!Trachoma 6
  • 7. : - Defect of teeth & gums common - Twigs of Neem, - Ash, charcoal Rural - Tooth powder - With finger only - Pan chewing smeared with lime - Not rinsing mouth after meal - Deposition of tartar Gingivitis Pyorrhea & Dental Abscess, Stomatitis - coated tongue→ improper hygiene, thrush - Lips: excoriation at angle→VitB₁₂ def,fever,H. simplex 7
  • 8. - Adequacy of space, privacy, clothing, intelligence, religion, weather & season. - Regular bath→ removal of dust & deposit over body, odor of sweating - Ritual bathing- on fixed occasions & ceremonies - After childbirth, menstruation women must take bath - Villagers: no use of soap, use of common cloth to wipe body →î cross infection 8
  • 9. - Infants & children→ 8-12 hrs sleep - Adults → 6hrs of sleep(min) - Lack of sleep ill health & disturbed relationship 9
  • 10. - Smoking hubble-bubble→ social custom - Spread of TB - Reverse smoking →common among Andhra villagers Oral Cancer - Smoking chronic bronchitis, emhysema, lung CA, CAD, oral cancer,cancer UGI,caUB, pTB, IUGR - Alcoholism broken family, gastritis, lack of appetite → malnutrition, alcoholic cirrhosis 10
  • 11. - Muslims, caste Hindu - Î tuberculosis, deprivation of solar Vit D - Walking barefoot → insect bite & parasite infestation - religious, medical - Muslims, Jews 11
  • 12. - Children –play in dirty environment - Residual dirt in skin & nail→ boil, furuncle, cuts & bruise, ringworm, septic foci, eczema - Nail not trimmed→ microorganism & helminthic infestation - Irregular combing & washing of hair - dirty & matted hair, lice infestation 12
  • 13. - Poor eye hygiene conjunctivitis, trachoma, blephritis, corneal ulcer - Regular examination of eyelids→ trachoma - Conjunctiva →conjunctivitis, Bitot’s spot,anaemia - Refractive error reading in dim light, tailoring, needle work & handicrafts 13
  • 14. - Deposition of wax→irritation→ scratching with finger, pins →introduction of infection - Unhygenic cleaning of the ear→infection→discharge - Furuncolosis, pharyngitis & tonsilitis, eustachian tube blockage→ ear pain….. DEAFNESS 14
  • 15. - ladies→ married, old, pregnant,widow - old ,students & elderly - types→ drinking water only, fruits alone, salt/spice restricted diet, single meal/day 15
  • 16. - Alertness →level of intelligence - Poor literacy in rural areas - Low school enrollment, attendance, high dropout - Î Education→ understand & adopt scientific medical promotive measures - Attitude of the family member toward doctors, medical & paramedical staff - Mental health condition & Social behavior 16
  • 17. - religion, ethnicity, societal structure - Sexual taboos - Menstrual hygiene - Marriage Universal & early 18