This is a presentation on medical anthropology

1. MSB 102: Behavioral Sciences
Medical Anthropology
Part 1
Lecturer: Violet Naanyu, PhD.
Period: March-April 2010
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2. History of Medicine ?
2002 BC Here, eat this root
1000 AD That root is heathen
Here, Say this prayer
1850 AD That prayer is superstitious
Here, drink this potion
1940 AD That portion is snake oil
Here, swallow this pill
1985 AD That pill is ineffective
Here, take this antibiotic
2000 AD That antibiotic doesn’t work
Here, take this root..Now what?! 2
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3. What is Anthropology ?
 A Greek word meaning “the study of man”
 It aims at holistic study of humankind by
seeking an understanding of specific
societies and cultures
 Has many branches. Medical Anthropology is
one of them
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4. What is Medical Anthropology? 1
 The study of medical phenomena as culture
 Medical phenomena here implies:
– Illness
– Response to illness
– Health care
 It seeks to understand how different cultures
and social groups explain:
– Causes of illness
– Types of treatment
– To whom they turn to for help when ill
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5. What is Medical Anthropology? 2
 Seeks to understand how beliefs & practices
relate to biological, psychological, & social
changes in people when in health & disease
 It is a bio-cultural discipline because it draws
from
– Social-cultural anthropology
• Beliefs & practices relating to health & illness:
– Perceptions
– Reaction to illness
– Types of healthcare
– Biological sciences
• Draw on techniques & findings of medical sciences
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6. History of Anthropology
 Began with travelers
 We had arm chair anthropologists
– Writing about “primitive” societies
– Criticizing their own culture
 During colonial times, it became a real
discipline because of written records from wide
travels & related experiences of “otherness”
– Soldiers
– Imperialists
– Missionaries
– Romantics/ Travelers
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7. What is Culture?
 Culture – the
values, beliefs,
behavior, and
material objects that
form a people’s way
of life.
 Nonmaterial
culture – ideas
created by members
of a society.
 Material culture –
tangible things
created by members
of a society.
 Only humans rely on
culture rather than
instinct to ensure
survival.
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8. The Components of Culture
 Although cultures vary, they all have
five common components:
(1) Symbols
(2) Language
(3) Values
(4) Beliefs
(5) Norms
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9. Components of Culture
Symbols
 Symbols – anything that carries a particular
meaning recognized by people who share
culture.
 Not understanding the symbols of a culture
leaves a person feeling lost and isolated.
 Symbolic meaning may also vary within a
single society.
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10. Components of Culture
Language
 Language – a system of symbols that allows
people to communicate with one another.
 Language allows for the continuity of culture.
 Cultural transmission – the process by
which one generation passes culture to the
next.
 Every society transmits culture through
speech.
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11. Components of Culture
Values and Beliefs
 Values – culturally defined standards by
which people assess desirability, goodness,
and beauty and that serve as broad
guidelines for social living.
 Beliefs – specific statements that people hold
to be true.
 Values are abstract standards of goodness.
 Beliefs are particular matters that individuals
consider true or false.
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12. Components of Culture
Norms
 Norms – rules and expectations by
which a society guides the behavior of
its members.
 Most important norms in a culture apply
everywhere and at all times.
– Mores – norms that are widely observed
and have great moral significance.
– Folkways – norms for routine, casual
interaction.
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13. Material Culture
 Material culture – artifacts.
 Every culture includes a wide range of
tangible human creations.
 A society’s artifacts reflect underlying culture.
 Material culture also reflects a society’s
technology – knowledge that people use to
make a way of life in their surroundings.
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14. Cultural Diversity
 Cultural diversity can involve social class.
 Many cultural patterns are readily accessible
to only some members of a society.
 High culture – cultural patterns that
distinguish a society’s elite.
 Popular culture – cultural patterns that are
widespread.
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15. Subcultures
 Subculture – cultural patterns that set apart
some segment of society’s population.
 Almost everyone participates in many
subcultures without having much commitment
to any of them.
 What we view as the dominant culture – a
set of patterns favored by powerful segments
of the population.
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16. Multiculturalism
 Multiculturalism – an educational program
recognizing cultural diversity and promoting
the equality of all cultural traditions.
 Eurocentrism – the dominance of European
cultural patterns.
 Afrocentrism – the dominance of African
cultural patterns.
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17. Counterculture
 Counterculture – cultural patterns that
strongly oppose those widely accepted
within a society.
 In many cultures, counterculture is
linked with youth.
 This is the outright rejection of
conventional ideas.
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18. Cultural Change
 Change in one
dimension of culture
usually sparks
change in another.
 Cultural integration
– the close
relationships among
various elements of
a cultural system.
 Some elements of
culture change
faster than others –
cultural lag.
 Cultural change may
be spurred by
invention, discovery,
or diffusion.
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19. Ethnocentrism and Cultural
Relativism
 Ethnocentrism –
the practice of
judging another
culture by the
standards of one’s
own culture.
 A particular culture
is the basis for
everyone’s reality.
 Cultural Relativism
– the practice of
evaluating a culture
by its own
standards.
 It requires
understanding
unfamiliar values
and norms.
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20. Medical Anthropology Theories
 A theory is a statement of how & why specific
facts are related.
 Theories are based on theoretical paradigms
= sets of assumptions that guide thinking and
research.
 There are 5 theories of particular importance to
Medical Anthropology:
1. Structural Functionalism
2. Ecological Perspective
3. Transactionalist Model
4. Marxist Political Economy Model
5. Cognitive & Symbolic Approach 20
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21. 1. Structural–Functionalism
 Society is a complex system whose parts work
together (Metaphor of the body)
 Our lives are guided by social structures & each
social structure has social functions.
 Social & cultural phenomena are functionally
interconnected & basic to structural maintenance
of society
 Applying the model in Medical Anthropology:
– Illness is a ‘dysfunctioning’ of the body
– Health care contributes to maintenance of society by
‘repairing’ the sick
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22. 2. Ecological Perspective
 Culture is viewed as human adaptation to
environment
 Cultural phenomena are human solutions to
problems posed by the natural environment
(Climate, water etc)
 Health is regarded as the result of successful
adaptation to environmental challenges
 Disease is held to be an outcome of failure to
adapt
 Medicine (preventive & curative) is a cultural
device to restore optimal adaptation
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23. 3.Transactionalist Model
 Culture is seen as the outcome of competition
at an individual level
 For maximum profits, enterprising individuals
negotiate & change society including:
– Conditions of health
– Conditions of health care
 Activities of health workers may be motivated
by profit making e.g private clinics
 Patients may use health services to further
individual interests e.g specialized care &
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24. 4. Marxist Political Economy Model
 Culture is viewed as an outcome of political &
economic circumstances
 Problems in health & health care in developing
countries is linked to penetration of the
capitalist economy
 Health (or lack of it) & the quality of health
care are determined by:
– Social competition between groups of people
(social classes)
– Unequal distribution of scarce resources
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25. 5. Cognitive & Symbolic Approach
 Cognitive competence/ intelligence consists of
many capacities, skills, & adaptive responses
to the environment
 Basic thinking processes are universal, it is the
content of cultures that differs
 Cognitive anthro: Culture is largely defined as a
system of rules, meanings & classifications that
help people understand their experiences
 Thus in Medical anthropology, we ask:
– What is illness?
– How do people explain & label illness?
– How do people choose between various care givers?
– How do people communicate with health providers?
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26. Lay Theories of Illness
 There are 2 ways of looking at them:
1. Internalizing & externalizing beliefs (Young,
1983)
2. Personalistic & naturalistic systems (Foster
& Anderson, 1978)
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27. Internalizing & Externalizing Beliefs
(Young, 1983)
 Internalizing: origins & blame located
within the individual
 Externalizing: origins attributed to the
natural environment, infections, social
world or supernatural
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28. Personalistic & Naturalistic Systems
(Foster & Anderson, 1978)
 Personalistic: Purposeful intervention of
supernatural or human agents
 Naturalistic: Caused by natural forces or
imbalance in the individual
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29. What is an “Explanatory Model
of Illness?”
 A response to a particular episode
 An explanation of the origin of a condition and
its treatment
 It provides meaning to symptoms
 Held by both patients and practitioners
 The condition is best understood in the
context of the society as a whole, the physical
setting of the consultation & socio-economic
conditions of those involved
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30. Disease, Illness & Sickness 1
 Distinctions made between the three terms
stress the different perspectives of various
actors involved in the experience of ill-health
and in the healing process
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31. Disease, Illness & Sickness 2
 Disease: Definition of a health problem
by a medical expert
– ‘Something an organ has’
– Deviation from normal
– Based on scientific rationality
– Assumes diseases are universal
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32. Disease, Illness & Sickness 3
 Illness: Experience of the problem by
the patient
– ‘Something a (wo)man has’
– Can be present where disease is absent
– Includes meaning that the patient gives the
experience
– Affected by culture: provides etiology,
diagnosis, prevention & treatment regimen
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33. Disease, Illness & Sickness 4
 Sickness: The social role attached to a
health problem by the society at large
– Society has influence on illness & those
suffering from ill-health
– Society assigns roles for the ill & carers
– Society provides labels for illnesses
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34. How will I apply Medical
Anthropology in my future practice?
1. Better understanding of how different cultures and
social groups explain causes of ill-health
2. Appreciation of different types of treatment available
3. Better understanding of patients’ utilization of health
facilities (whom they turn to & why)
4. A view of health problems as explained & labeled in
accordance to cultural concepts
5. More understanding of patients’ context = better
communication during consultation
6. More understanding of patients’ context =
appreciation of diversity in the experience of an
illness episode
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35. History of Medicine ? To be continued…
2002 BC Here, eat this root
1000 AD That root is heathen
Here, Say this prayer
1850 AD That prayer is superstitious
Here, drink this potion
1940 AD That portion is snake oil
Here, swallow this pill
1985 AD That pill is ineffective
Here, take this antibiotic
2000 AD That antibiotic doesn’t work
Here, take this root..2002 BC?! 35
V.Naan
yu