according to foster, in a naturalistic etiology, religion can play what role in illness?

Sashur Henninger-Rener, University of LaVerne and the Los Angeles Community Higher District

What does it mean to be "good for you"? Information technology may seem odd to ask the question, merely wellness is not a universal concept and each culture values different aspects of well-being. At the most bones level, health may be perceived as surviving each solar day with enough nutrient and h2o, while other definitions of health may be based on beingness free of diseases or emotional troubles. Complicating things further is the fact that that each civilisation has a dissimilar causal explanation for disease. For instance, in ancient Hellenic republic health was considered to be the product of unbalanced humors or bodily fluids. The four humors included black bile, phlegm, yellow bile, and blood. The ancient Greeks believed that interactions among these humors explained differences not only in health, but in age, gender, and general disposition. Diverse things could influence the balance of the humors in a person's body including substances believed to exist nowadays in the air, changes in diet, or fifty-fifty temperature and weather. An imbalance in the humors was believed to cause diseases, mood problems, and mental illness.^[1]

The Earth Wellness Organisation (WHO) recognizes that the health of individuals and communities is affected by many factors: "where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family."^[2] Research conducted by the WHO suggests that these characteristics play a more pregnant role in affecting our health than any others, including having access to wellness care. For this reason, anthropologists who are interested in issues related to health and illness must use a broad holistic perspective that considers the influence of both biology and civilisation. Medical anthropology, a singled-out sub-specialty within the discipline of anthropology, investigates human being health and health intendance systems in comparative perspective, because a wide range of bio-cultural dynamics that affect the well-being of human populations. Medical anthropologists written report the perceived causes of illness as well equally the techniques and treatments developed in a club to accost health concerns. Using cultural relativism and a comparative approach, medical anthropologists seek to understand how ideas almost health, illness, and the torso are products of item social and cultural contexts.

ETHNOMEDICINE

Figure one. Traditional Tibetan medicine poster.

Ethnomedicine is the comparative study of cultural ideas well-nigh wellness, affliction, and healing. For the bulk of our existence, human beings have depended on the resources of the natural environment and on health and healing techniques closely associated with spiritual beliefs. Many such practices, including some herbal remedies and techniques like acupuncture, have been studied scientifically and plant to be effective.^[three] Others accept non necessarily been proven medically effective by external scientific evidence, but proceed to exist embraced past communities that perceive them to exist useful. When because cultural ideas most health, an important place to commencement is with ethno-etiology: cultural explanations about the underlying causes of wellness problems.

In the United states of america the dominant approach to thinking about health is biomedical. Illnesses are thought to be the effect of specific, identifiable agents. This tin can include pathogens (viruses or bacteria), malfunction of the body'south biochemical processes (weather condition such as cancer), or physiological disorders (such as organ failure). In biomedicine equally it is practiced in the U.s. (Western biomedicine), wellness is divers as the absenteeism of disease or dysfunction, a perspective that notably excludes consideration of social or spiritual well-being. In non-Western contexts biomedical explanations are often viewed as unsatisfactory. In his analysis of ideas about health and affliction in non-Western cultures, George Foster (1976) concluded that these ideas could be categorized into two main types of ethno-etiology: personalistic and naturalistic.^[4]

Ethno-Etiologies: Personalistic and Naturalistic

Personalistic ethno-etiologies view disease every bit the result of the "active, purposeful intervention of an agent, who may exist man (a witch or magician), nonhuman (a ghost, an antecedent, an evil spirit), or supernatural (a deity or other very powerful being)."^[5] Illness in this kind of ethno-etiology is viewed as the result of assailment or penalisation directed purposefully toward an individual; at that place is no accident or random chance involved. Practitioners who are consulted to provide treatment are interested in discovering who is responsible for the illness—a ghost, an ancestor? No one is specially interested in discovering how the medical condition arose in terms of the anatomy or biology involved. This is considering treating the illness volition require neutralizing or satisfying a person, or a supernatural entity, and correctly identifying the being who is the root cause of the problem is essential for achieving a cure.

The Heiban Nuba people of southern Sudan provide an interesting example of a personalistic etiology. Every bit described by, South.F. Nadel in the 1940s, the members of this society had a potent belief that affliction and other misfortune was the result of witchcraft.

A certain magic, mysteriously appearing in individuals, causes the death or illness of anyone who eats their grain or spills their beer. Fifty-fifty spectacular success, wealth too chop-chop won, is suspect; for it is the piece of work of a spirit-double, who steals grain or livestock for his human twin. This universe full of malignant forces is reflected in a bewildering array of rituals, fixed and occasional, which mark almost every activity of tribal life.^[6]

Because sickness is thought to be caused by spiritual attacks from others in the community, people who become sick seek supernatural solutions. The person consulted is oftentimes a shaman, a person who specializes in contacting the world of the spirits.

In Heiban Nuba civilization, as well as in other societies where shamans be, the shaman is believed to be capable of entering a trance-like state in order to cross between the ordinary and supernatural realms. While in this state, the shaman can identify the private responsible for causing the illness and sometimes the spirits can be convinced to cure the disease itself. Shamans are common all around the world and despite the proverbial saying that "prostitution is the oldest profession," shamanism probably is! Shamans are religious and medical practitioners who play important social roles in their communities as healers with a transcendent ability to navigate the spirit world for answers. In improver, they often have a comprehensive noesis of the local ecology and how to utilize plants medicinally. They can address illnesses using both natural and supernatural tools.

In naturalistic ethno-etiologies, diseases are idea to be the result of natural forces such as "common cold, rut, winds, dampness, and to a higher place all, by an upset in the balance of the basic body elements."^[7] The ancient Greek idea that health results from a balance between the iv humors is an case of a naturalistic caption. The concept of the yin and yang, which correspond opposite but complementary energies, is a similar thought from traditional Chinese medicine. Achieving balance or harmony betwixt these two forces is viewed as essential to physical and emotional health. Unlike personalistic explanations, practitioners who care for illness in societies with naturalistic ethno-etiologies are interested in understanding how the medical condition arose so that they tin can choose therapeutic remedies viewed equally most appropriate.

Emotional difficulties tin can be viewed every bit the cause of illness in a naturalistic ethno-etiology (likewise known every bit an emotionalistic caption). 1 example of a medical problem associated with emotion is susto, an illness recognized by the Mixe, an indigenous grouping who live in Oaxaca, Mexico, besides as others throughout central America. The symptoms of susto include difficulty sleeping, lack of energy, loss of ambition and sometimes nausea/airsickness and fever. The status is believed to be a consequence of a "fright" or shock and, in some cases at least, information technology is believed to begin with a shock so strong that it disengages the soul from the body.^[eight] The status is usually treated with herbal remedies and barrida (sweeping) ceremonies designed to repair the harm acquired past the shock itself.^[9] Although physicians operating inside a biomedical ethno-etiology have suggested that susto is a psychiatric affliction that in other cultural contexts could be labeled anxiety or depression, in fact susto does not fit hands into any one Western biomedical category. Those suffering from susto see their condition as a malady that is emotional, spiritual, and physical.^[10]

In practice, people assess medical issues using a variety of explanations and in any given club personalistic, naturalistic, or even biomedical explanations may all apply in unlike situations. It is likewise important to keep in mind that the line between a medical business concern and other kinds of life challenges can be blurry. An disease may be viewed as just one more instance of full general misfortune such as crop failure or thwarting in love. Among the Azande in Central Africa, witchcraft is idea to exist responsible for almost all misfortune, including illness. E.E. Evans-Pritchard, an anthropologist who studied the Azande of n-primal Africa in the 1930s, famously described this logic by describing a situation in which a granary, a building used to store grain, collapsed.

In Zandeland sometimes an former granary collapses. There is nothing remarkable in this. Every Zande knows that termites swallow the supports in course of time and that even the hardest woods decay after years of service. Now a granary is the summerhouse of a Zande homestead and people sit beneath it in the estrus of the day and chat or play the African hole-game or work at some craft. Consequently information technology may happen that there are people sitting beneath the granary when it collapses and they are injured…Now why should these particular people have been sitting under this item granary at the item moment when it collapsed? That information technology should collapse is easily intelligible, but why should it have collapsed at the particular moment when these item people were sitting beneath information technology…The Zande knows that the supports were undermined by termites and that people were sitting below the granary in order to escape the oestrus of the sunday. Just he knows likewise why these two events occurred at a precisely like moment in fourth dimension and space. It was due to the action of witchcraft. If there had been no witchcraft people would take been sitting under the granary and it would not take fallen on them, or it would have complanate but the people would non take been sheltering under it at the time. Witchcraft explains the coincidence of these 2 happenings.^[xi]

According to this logic, an illness of the body is ultimately caused by the same force as the collapse of the granary: witchcraft. In this instance, an appropriate handling may not even exist focused on the body itself. Ideas most wellness are often inseparable from religious beliefs and full general cultural assumptions about misfortune.^[12]

Is Western Biomedicine An Ethno-Etiology?

The biomedical approach to wellness strikes many people, specially residents of the United states, as the best or at least the nearly "fact-based" arroyo to medicine. This is largely because Western biomedicine is based on the application of insights from science, especially biological science and chemical science, to the diagnosis and treatment of medical conditions. The effectiveness of biomedical treatments is assessed through rigorous testing using the scientific method and indeed Western biomedicine has produced successful treatments for many dangerous and complex atmospheric condition: everything from antibiotics and cures for cancer to organ transplantation.

However, it is of import to remember that the biomedical approach is itself embedded in a distinct cultural tradition, just like other ethno-etiologies. Biomedicine, and the scientific disciplines on which it is based, are products of Western history. The primeval Greek physicians Hippocrates (c. 406–370 BC) and Galen (c. 129–c. 200 Advertisement) shaped the evolution of the biomedical perspective by providing early insights into anatomy, physiology, and the relationship between surroundings and health. From its origins in aboriginal Greece and Rome, the knowledge base that matured into gimmicky Western biomedicine developed as part of the Scientific Revolution in Europe, slowly maturing into the medical profession recognized today. While the scientific method used in Western biomedicine represents a distinct and powerful "manner of knowing" compared to other etiologies, the methods, procedures, and forms of reasoning used in biomedicine are products of Western civilisation.^[13]

Figure 2: The Taiyang float meridian, one of several meridians recognized in traditional Chinese medicine. From Shou Hua'due south Jushikei Hakki, 1716, Tokyo.

In matters of wellness, as in other aspects of life, ethnocentrism predisposes people to believe that their own culture's traditions are the most effective. People from non-Western cultures do non necessarily agree that Western biomedicine is superior to their own ethno-etiologies. Western culture does not even accept a monopoly on the concept of "science." Other cultures recognize their own forms of science carve up from the Western tradition and these sciences take histories dating back hundreds or fifty-fifty thousands of years. One instance is Traditional Chinese Medicine (TCM), a set of practices developed over more than 2,500 years to address physical complaints holistically through acupuncture, practice, and herbal remedies. The tenets of Traditional Chinese Medicine are non based on scientific discipline as it is divers in Western culture, simply millions of people, including a growing number of people in the U.s.a. and Europe, regard TCM as credible and effective.

Ultimately, all ethno-etiologies are rooted in shared cultural perceptions near the way the world works. Western biomedicine practitioners would correctly observe that the forcefulness of Western biomedicine is derived from utilise of a scientific method that emphasizes objectively observable facts. Nonetheless, this this would not be particularly persuasive to someone whose civilisation uses a different ethno-etiology or whose understanding of the world derives from a different tradition of "science." From a comparative perspective, Western biomedicine may exist viewed as i ethno-etiology in a world of many alternatives.

Techniques for Healing

Western biomedicine tends to conceive of the human body as a kind of biological machine. When parts of the machine are damaged, defective, or out of balance, chemical or surgical interventions are the preferred therapeutic responses. Biomedical practitioners, who tin can be identified by their white coats and stethoscopes, are trained to detect observable or quantifiable symptoms of illness, often through the use of avant-garde imaging technologies or tests of actual fluids like blood and urine. Problems detected through these ways will be addressed. Other factors known to contribute to wellness, such as the patient's social relationships or emotional state of listen, are considered less relevant for both diagnosis and treatment. Other forms of healing, which derive from non-biomedical ethno-etiologies, reverse this formulation, giving priority to the social and spiritual.

In Traditional Chinese Medicine, the body is thought to be governed by the same forces that animate the universe itself. One of these is chi (qi), a vital life force that flows through the body and energizes the body and its organs. Disruptions in the period or rest of chi can lead to a lack of internal harmony and ultimately to health problems so TCM practitioners utilise treatments designed to unblock or redirect chi, including acupuncture, dietary changes, and herbal remedies. This is an case of humoral healing , an approach to healing that seeks to treat medical ailments past achieving a residuum between the forces or elements of the body.

Communal healing, a second category of medical treatment, directs the combined efforts of the community toward treating illness. In this approach, medical care is a collaboration betwixt multiple people. Among the !Kung (Ju/'hoansi) of the Kalahari Desert in southern Africa, energy known equally north/um can be channeled by members of the community during a healing ritual and directed toward individuals suffering from illness. Richard Katz, Megan Bisele, and Verna St. Davis (1982) described an example of this kind of anniversary:

The central event in this tradition is the all-nighttime healing trip the light fantastic toe. Four times a month on the average, night signals the start of a healing dance. The women sit around the fire, singing and rhythmically clapping. The men, sometimes joined by the women, trip the light fantastic toe effectually the singers. As the dance intensifies, n/um, or spiritual free energy, is activated by the healers, both men and women, but mostly among the dancing men. As n/um is activated in them, they begin to kia , or experience an enhancement of their consciousness. While experiencing kia , they heal all those at the dance. ^[14]

While communal healing techniques often involve harnessing supernatural forces such as the num , it is likewise truthful that these rituals help strengthen social bonds betwixt people. Having a strong social and emotional support organisation is an important chemical element of wellness in all human cultures.

Faith and the Placebo Effect

Humoral and communal approaches to healing, which from a scientific perspective would seem to have little potential to address the root causes of an illness, nowadays an of import question for medical anthropologists. What role does faith play in healing? Sir William Osler, a Canadian physician who was i of the founders of Johns Hopkins Hospital, believed that much of a physician's healing ability derived from his or her ability to inspire patients with a faith that they could be cured.^[15] Osler wrote:

Faith in the Gods or in the Saints cures one, organized religion in lilliputian pills another, proposition a third, faith in a evidently mutual doctor a fourth…If a poor lass, paralyzed apparently, helpless, bed-ridden for years, comes to me having worn out in listen, body, and manor a devoted family; if she in a few weeks or less past faith in me, and faith lone, takes up her bed and walks, the Saints of one-time could not have washed more.^[16]

In fact, at that place is a considerable amount of enquiry suggesting that there is a placebo effect involved in many different kinds of healing treatments. A placebo issue is a response to treatment that occurs considering the person receiving the treatment believes it will work, not because the handling itself is effective.

In Western biomedicine, the placebo consequence has been observed in situations in which a patient believes that he or she is receiving a certain drug treatment, only is really receiving an inactive substance such as water or carbohydrate.^[17] Research suggests that the body often responds physiologically to placebos in the aforementioned way it would if the drug was real.^[eighteen] The simple deed of writing a prescription can contribute to the successful recovery of individuals because patients trust that they are on a path that volition pb to health.^[xix] If we consider the office of the placebo issue in the examples in a higher place, we should consider the possibility that humoral and communal healing are perceived to "piece of work" considering the people who receive these remedies have faith in them.

An interesting example of the complication of the mind-body connection is institute in studies of intercessory prayer: prayers made to asking healing for some other person. In one well-known written report, researchers separated patients who had recently undergone heart surgery into 2 groups, one containing people who know they would be receiving prayers for their recovery and some other grouping who would receive prayers without being enlightened of it. Those patients who knew they were receiving prayers really had more complications and health problems in the month following surgery.^[20] This reflects an interesting relationship between faith and healing. Why did the patients who knew that others were praying for them experience more than complications? Perhaps it was because the knowledge that their doctors had asked others to pray for them made patients more than stressed, perceiving that their health was at greater hazard.

Figure three: A botánica shop selling herbal folk medicines

However, information technology can also exist a lack of faith that drives people to look for alternative treatments. In the United States, alternative treatments, some of which are drawn from humoral or communal healing traditions, take become more than popular among patients who believe that Western biomedicine is failing them. Cancer research facilities have begun to suggest acupuncture equally a treatment for the intense nausea and fatigue caused by chemotherapy and scientific studies propose that acupuncture can be effective in relieving these symptoms.^[21] Marijuana, a drug that has a long recorded history of medical use starting in aboriginal China, Egypt, and Bharat, has steadily gained acceptance in the United States as a handling for a variety of ailments ranging from anxiety to Parkinson's disease.^[22] Equally growing numbers of people place their organized religion in these and other remedies, information technology is important to recognize that many alternative forms of healing or medicine lack scientific evidence for their efficacy. The results derived from these practices may owe as much to faith as medicine.

MENTAL HEALTH

Different other kinds of illnesses, which present relatively consistent symptoms and clear biological testify, mental wellness disorders are experienced and treated differently cross-culturally. While the discipline of psychiatry within Western biomedicine applies a disease-framework to explain mental disease, there is a consensus in medical anthropology that mental health conditions are much more complicated than the biological illness model suggests. These illnesses are not simply biological or chemical disorders, only complex responses to the surround, including the web of social and cultural relationships to which individuals are connected.

Medical anthropologists practise not believe there are universal categories of mental illness.^[23] Instead, individuals may express psychological distress through a variety of concrete and emotional symptoms. Arthur Kleinman, a medical anthropologist, has argued that every civilisation frames mental health concerns differently. The pattern of symptoms associated with mental health atmospheric condition vary greatly between cultures. In Cathay, Kleinman discovered that patients suffering from low did not describe feelings of sadness, but instead complained of colorlessness, discomfort, feelings of inner pressure, and symptoms of pain, dizziness, and fatigue.^[24]

Mental wellness is closely connected with social and cultural expectations and mental illnesses tin ascend every bit a upshot of pressures and challenges individuals face in particular settings. Rates of depression are college for refugees, immigrants, and others who have experienced dislocation and loss. A sense of powerlessness also seems to play a role in triggering anxiety and low, a miracle that has been documented in groups ranging from stay-at-dwelling mothers in England to Native Americans affected past poverty and social marginalization.^[25]

Schizophrenia, a condition with genetic as well equally environmental components, provides another interesting example of cross-cultural variation. Unlike anxiety or depression, there is some consistency in the symptom patterns associated with this status cross culturally: hallucinations, delusions, and social withdrawal. What differs, yet, is the way these symptoms are viewed by the community. In his research in Indonesia, Robert Lemelson discovered that symptoms of schizophrenia are oftentimes viewed by Indonesian communities equally examples of communication with the spirit world, spirit possession, or the effects of traumatic memories.^[26] Documenting the lives of some of these individuals in a picture show serial, he noted that they remained integrated into their communities and had meaning responsibilities as members of their families and neighborhoods. People with schizophrenia were not, as often happens in the United States, confined to institutions and many were living with their condition without any biomedical treatments.

In its multi-decade study of schizophrenia in 19 countries, the World Health Organization ended that societies that were more culturally accepting of symptoms associated with schizophrenia integrated people suffering from the condition into community life more completely. In these cultures, the disease was less severe and people with schizophrenia had a higher quality of life.^[27] This finding has been controversial, but suggests that stigma and the resulting social isolation that characterize responses to mental disease in countries like the United States affect the subjective experience of the disease as well equally its outcomes.^[28]

THE Experience OF ILLNESS IN Identify

Social Construction of Illness

As the above examples demonstrate, cultural attitudes affect how medical conditions will be perceived and how individuals with wellness problems will be regarded past the wider community. There is a divergence, for instance, between a illness, which is a medical status that can be considerately identified, and an illness, which is the subjective or personal feel of feeling unwell. Illnesses may exist acquired by disease, but the experience of beingness ill encompasses more than only the symptoms acquired by the illness itself. Illnesses are, at least in part, social constructions: experiences that are given meaning by the relationships betwixt the person who is ill and others.

The grade of an illness tin can worsen for instance, if the dominant order views the sickness equally a moral failing. Obesity is an splendid instance of the social construction of affliction. The condition itself is a result of culturally induced habits and attitudes toward food, merely despite this strong cultural component, many people regard obesity as a preventable circumstance, blaming individuals for becoming overweight. This attitude has a long cultural history. Consider for example the religious connotations inside Christianity of "gluttony" as a sin.^[29] Such socially synthetic stigma influences the subjective experience of the illness. Obese women have reported avoiding visits to physicians for fear of judgment and as a effect may not receive treatments necessary to help their condition.^[xxx] Peter Attia, a surgeon and medical researcher who delivered a TED Talk on this subject, related the story of an obese woman who had to have her pes amputated, a common upshot of complications from obesity and diabetes. Even though he was a physician, he judged the woman to be lazy. "If you had simply tried even a piffling bit," he had thought to himself before surgery.

Subsequently, new research revealed that insulin resistance, a precursor to diabetes, often develops as a result of the backlog sugars used in many kinds of processed foods consumed commonly in the The states. As Attia observes, high rates of obesity in the United States are a reflection of the types of foods Americans have learned to swallow as role of their cultural environment.^[31] In improver, the fact that foods that are loftier in sugars and fats are cheap and abundant, while healthier foods are expensive and unavailable in some communities, highlights the economical and social inequalities that contribute to the disease.

Figure 4: AIDS prevention art, Mozambique. The text reads "recollect of the consequences, alter behavior, prevent HIV/AIDS".

The HIV/AIDS virus provides another instance of the style that the subjective experience of an disease can be influenced by social attitudes. Research in many countries has shown that people, including healthcare workers, make distinctions between patients who are "innocent" victims of AIDS and those who are viewed as "guilty." People who contracted HIV through sex activity or intravenous drug use are seen equally guilty. The aforementioned judgment applies to people who contracted HIV through same-sexual activity relationships in places where societal disapproval of same-sex relationships exists. People who contracted HIV from blood transfusions, or equally babies, are viewed as innocent. The "guilty" HIV patients often find information technology more than difficult to access medical care and are treated with disrespect or indifference in medical settings compared with superior handling provided to those regarded every bit "innocent." In the wider community, "guilty" patients suffer from social marginalization and exclusion while "innocent" patients receive greater social acceptance and practical assistance in responding to their needs for support and care.^[32]

The stigma that applies to "guilty" patients too ignores the socioeconomic context in which HIV/AIDS spreads. For instance, in Indonesia, poor women can make considerably more coin as sexual practice workers than in many other jobs: $10 an hour equally a sex worker compared to 20 cents an hour in a factory.^[33] In a similar style, poverty and a lack of other choices contribute to a decision to engage in sex work in other societies, including in sub-Saharan Africa where rates of HIV infection are among the highest in the earth. Poverty itself is one of the greatest "risk factors" for HIV infection.^[34] The clear relationship between poverty, gender, and HIV infection has been the topic of a bully deal of research in medical anthropology. One instance is Paul Farmer's classic volume, AIDS and Accusation: Republic of haiti and the Geography of Blame (1992), which was one of the primeval books to critically evaluate the connection between poverty, racism, stigma, and neglect that allowed HIV to infect and kill thousands of Haitians. Projects like this are critical to developing holistic views of the entire cultural, economic, and political context that affects the spread of the virus and attempts to care for the affliction. Partners in Health, the non-profit medical system Paul Farmer helped to found, continues to pursue innovative strategies to prevent and care for diseases like AIDS, strategies that recognize that poverty and social marginalization provide the environment in which the virus flourishes.

Culture-Bound Syndromes

A culture-jump syndrome is an illness recognized only within a specific culture. These weather, which combine emotional or psychological with physical symptoms, are not the consequence of a illness or any identifiable physiological dysfunction. Instead, civilization-bound syndromes are somatic, meaning they are physical manifestations of emotional pain. The existence of these conditions demonstrates the profound influence of culture and society on the experience of illness.

Anorexia

Anorexia is considered a civilisation bound syndrome because of its strong association with cultures that place a loftier value on thinness as a measure of health and dazzler. When we consider concepts of dazzler from cultures all over the world, a common view of dazzler is 1 of someone with additional fatty. This may be because having additional fatty in a place where food is expensive means that one is likely of a college status. In societies like the Usa where nutrient is abundant, it is much more than difficult to become sparse than it is to become heavy. Although anorexia is a complex condition, medical anthropologists and physicians accept observed that it is much more mutual in Western cultural contexts among people with high socioeconomic status.^[35] Anorexia, as a class of self-deprivation, has deep roots in Western civilization and for centuries practices of self-denial accept been associated with Christian religious traditions. In a contemporary context, anorexia may address a similar, simply secular want to assert self-command, particularly amidst teenagers.^[36]

During her inquiry in Fiji, Anne Becker (2004) noted that young women who were exposed to advertisements and idiot box programs from Western cultures (like the United States and Australia) became self-conscious near their bodies and began to change their eating habits to emulate the thin ideal they saw on tv. Anorexia, which had been unknown in Fiji, became an increasingly common problem.^[37] The aforementioned design has been observed in other societies undergoing "Westernization" through exposure to foreign media and economic changes associated with globalization.^[38]

Swallowing Frogs in Brazil

In Brazil, there are several examples of culture-leap syndromes that affect children as well as adults. Women are particularly susceptible to these atmospheric condition, which are connected to emotional distress. In parts of Brazil where poverty, unemployment, and poor physical health are common, there are cultural norms that discourage the expression of strong emotions such equally anger, grief, or jealousy. Of course, people go along to experience these emotions, just cannot limited them openly. Men and women deal with this trouble in unlike ways. Men may cull to drink alcohol heavily, or even to express their anger physically by lashing out at others, including their wives. These are not socially adequate behaviors for women who instead remark that they must suppress their feelings, an deed they describe as having to "swallow frogs" (engolir sapos).^[39]

Nervos (nerves) is a culture-bound syndrome characterized past symptoms such every bit headaches, trembling, dizziness, fatigue, stomach pain, tingling of the extremities and even partial paralysis. It is viewed equally a result of emotional overload: a state of constant vulnerability to shock. Unexplained wounds on the trunk may be diagnosed equally a different kind of affliction known as "claret-humid bruises." Since emotion is culturally defined as a kind of energy that flows throughout the body, many believe that as well much emotion can overwhelm the body, "boiling over" and producing symptoms. A person tin get so aroused, for instance, that his or her blood spills out from under the skin, creating bruises, or and so angry that the blood rises upward to create severe headaches, nausea, and dizziness. A 3rd form of culture-spring disease, known as peito aberto (open chest) is believed to be occur when a person, most often a woman, is carrying too much emotional weight or suffering. In this state of affairs, the centre expands until the chest becomes spiritually "open." A breast that is "open up" is unsafe because rage and anger from other people tin can enter and make a person ill.^[40]

In stressful settings like the communities in impoverished areas of northeastern Brazil, information technology is common for people to be afflicted with culture-bound illnesses throughout their lives. Individuals can endure from i condition, or a combination of several. Sufferers may consult rezadeiras/rezadores, Catholic organized religion healers who will treat the condition with prayer, herbal remedies, or healing rituals. Considering these practitioners do non distinguish between illnesses of the torso and mind, they treat the symptoms holistically as evidence of personal turmoil. This approach to addressing these illnesses is consistent with cultural views that it is the suppression of emotion itself that has caused the physical problems.

BIOMEDICAL TECHNOLOGIES

In the history of human being health, technology is an essential topic. Medical technologies take transformed human life. They have increased life expectancy rates, lowered child mortality rates, and are used to intervene in and oft cure thousands of diseases. Of course, these accomplishments come with many cultural consequences. Successful efforts to intervene in the body biologically also have implications for cultural values and the social arrangement of communities, as demonstrated by the examples beneath.

Antibiotics and Immunizations

Infectious diseases caused past viruses and bacteria have taken an enormous cost on human populations for thousands of years. During recurring epidemics, tens of thousands of people have died from outbreaks of diseases like measles, the flu, or bubonic plague. The Black Death, a pandemic outbreak of plague that spread across Europe and Eurasia from 1346–1353 AD, killed as many as 200 meg people, as much every bit a 3rd of the European population. Penicillin, discovered in 1928 and mass produced for the first time in the early 1940s, was a turning point in the human fight against bacterial infections. Chosen a "wonder drug" by Fourth dimension magazine, Penicillin became available at a time when bacterial infections were oftentimes fatal; the drug was glorified as a catholicon.^[41] An important factor to consider near the introduction of antibiotics is the change to an understanding of disease that was increasingly scientific and technical. Before scientific discipline could provide cures, personalistic and naturalistic ethno-etiologies identified various root causes for sickness, but the invention of antibiotics contributed to a strengthening of the Western biomedical prototype too every bit a new era of profitability for the pharmaceutical manufacture.

The effects of antibiotics take not been completely positive in all parts of the world. Along with other technological advances in areas such as sanitation and access to clean water, antibiotics contributed to an epidemiological transition characterized past a sharp drop in mortality rates, especially among children. In many countries, the immediate effect was an increment in the man population as well as a shift in the kinds of diseases that were nigh prevalent. In wealthy countries, for instance, chronic conditions like heart illness or cancer have replaced bacterial infections as leading causes of decease and the boilerplate lifespan has lengthened. In developing countries, the outcome has been mixed. Millions of lives have been saved by the availability of antibiotics, merely high poverty and lack of access to regular medical care hateful that many children who now survive the immediate dangers of infection during infancy succumb later in childhood to malnutrition, aridity, or other ailments.^[42]

Effigy 5: Women and children waiting to enter a medical dispensary in Somalia. The clinic is open 2 days each calendar week and treats 400-500 people each day.

Another difficulty is the fact that many kinds of infections have become untreatable as a result of bacterial resistance. Medical anthropologists are concerned with the increase in rates of infectious diseases like tuberculosis and malaria that cannot be treated with many existing antibiotics. According to the World Health Organization, there are nearly 500,000 cases of drug resistant tuberculosis each twelvemonth.^[43] New research is now focused on drug resistance, every bit well as the social and cultural components of this resistance such every bit the relationship between poverty and the spread of resistant strains of bacteria.

Immunizations that tin can provide immunity against viral diseases have also transformed human health. The eradication of the smallpox virus in 1977 following a concerted global try to vaccinate a large percentage of the world'south population is one example of the success of this biotechnology. Earlier the development of the vaccine, the virus was killing one–2 million people each twelvemonth.^[44] Today, vaccines exist for many of the world'due south well-nigh dangerous viral diseases, simply providing access to vaccines remains a challenge. The polio virus has been eliminated from well-nigh of the world following several decades of near universal vaccination, but the disease has made a comeback in a handful of countries, including Afghanistan, Nigeria, and Islamic republic of pakistan, where weak governments, inadequate healthcare systems, or war accept made vaccinating children impossible. This instance highlights the global inequalities that still be in access to bones medical care.

Because viruses have the ability to mutate and to bound between animals and people, man populations around the earth besides face the constant threat of new viral diseases. Flu has been responsible for millions of deaths. In 1918, a pandemic of the H1N1 flu infected 500 million people, killing well-nigh 5 percent of the human population.^[45] Non all influenza strains are that deadly, but it remains a unsafe affliction and one that vaccines can only partially address.^[46] Each year, the strains of the influenza virus placed in the annual "flu shot" are based on predictions about the strains that will be near common. Because the virus mutates oft and is influenced past interactions betwixt homo and animal populations, in that location is always uncertainty virtually future forms of the virus.^[47]

Reproductive Technologies

Today, the idea of "contraception" is linked to the technology of hormone-based birth command. "The pill" as we now know it, was not available in the United States until 1960, but attempts to both foreclose or bring about pregnancy through technology date back to the primeval homo communities. Techniques used to control the birthrate are an of import subject for medical anthropologists because they have meaning cultural implications.

Many cultures utilise natural forms of birth command practices to influence the spacing of births. Among the !Kung, for instance, babies are breastfed for many months or fifty-fifty years, which hormonally suppress fertility and decrease the number of pregnancies a woman can have in her lifetime. In Enga, New Guinea, men and women do not live with i some other post-obit a birth, another practice that increases the fourth dimension between pregnancies.^[48] In contrast, cultures where in that location are social or religious reasons for avoiding birth control, including natural birth spacing methods, accept higher birth rates. In the United States, the Comstock Act passed in 1873 banned contraception and even the distribution of information about contraception.

Although the Comstock Act is a thing of the past, efforts in the United states to limit admission to birth command and related medical services like abortion are ongoing. Many medical anthropologists report the ways in which access to reproductive technologies is affected by cultural values. Laury Oaks (2003) has investigated the manner in which activists on both sides of the ballgame argue attempt to culturally ascertain the idea of "gamble" equally information technology relates to women's health. She notes that in the 1990s anti-abortion activists in the United states of america circulated misleading medical material suggesting that abortion increases rates of breast cancer. Although this claim was medically false, information technology was persuasive to many people and contributed to doubts about whether abortion posed a wellness risk to women, a concern that strengthened efforts to limit admission to the procedure.^[49]

Other forms of reproductive technology accept emerged from the want to increment fertility. The world of "assisted reproduction," which includes technologies such as in vitro fertilization and surrogate pregnancy, has been the subject of many anthropological investigations. Marcia Inhorn, a medical anthropologist, has written several books most the growing popularity of in vitro fertilization in the Middle E. Her book, The New Arab Human (2012), explores the style in which infertility disrupts traditional notions of Arab masculinity that are based on fatherhood and she explores the ways that couples navigate conflicting cultural messages about the importance of parenthood and religious disapproval of assisted fertility.^[50]

CONCLUSION

As the global population becomes larger, it is increasingly challenging to address the health needs of the earth's population. Today, ane in 8 people in the world exercise not have admission to acceptable nutrition, the near basic element of good health.^[51] More than half the homo population lives in an urban environment where infectious diseases tin spread rapidly, sparking pandemics. Many of these cities include dumbo concentrations of poverty and healthcare systems that are not adequate to meet demand.^[52] Globalization, a process that connects cultures through merchandise, tourism, and migration, contributes to the spread of pathogens that negatively bear upon human being health and exacerbates political and economical inequalities that make the provision of healthcare more difficult.

Human health is complex and these are daunting challenges, but medical anthropologists have a unique perspective to contribute to finding solutions. Medical anthropology offers a holistic perspective on human evolutionary and biocultural adaptations as well as insights into the human relationship between wellness and culture. As anthropologists study the ways people think about wellness and illness and the socioeconomic and cultural dynamics that impact the provision of health services, in that location is a potential to develop new methods for improving the health and quality of life for people all over the world.

Word QUESTIONS

This chapter describes several examples of diseases that outcome from interactions between biology and civilisation such every bit obesity. Why is it important to consider cultural factors that contribute to illness rather than placing blame on individuals? What are some other examples of illnesses that take cultural as well as biological causes?
Many cultures have ethno-etiologies that provide explanations for affliction that are not based in scientific discipline. From a biomedical perspective, the not-scientific medical treatments provided in these cultures have a low likelihood of success. Despite this, people tend to believe that the treatments are working. Why do you think people tend to exist satisfied with the effectiveness of the treatments they receive?
How does poverty influence the wellness of populations around the world? Do you see this in your own community? Who should be responsible for addressing health care needs in impoverished communities?

GLOSSARY

Biomedical: an approach to medicine that is based on the awarding of insights from science, especially biological science and chemistry.

Communal healing: an approach to healing that directs the combined efforts of the customs toward treating disease.

Culture-leap syndrome: an disease recognized only within a specific culture.

Emotionalistic explanation: suggests that illnesses are caused by potent emotions such as fear, anger, or grief; this is an example of a naturalistic ethno-etiology.

Epidemiological transition: the abrupt drop in mortality rates, peculiarly amongst children, that occurs in a guild as a upshot of improved sanitation and admission to healthcare.

Ethno-etiology: cultural explanations about the underlying causes of health problems.

Ethnomedicine: the comparative study of cultural ideas nearly wellness, affliction, and healing.

Humoral healing: an approach to healing that seeks to treat medical ailments by achieving a balance betwixt the forces, or elements, of the body

Medical anthropology: a singled-out sub-specialty within the discipline of anthropology that investigates human wellness and wellness care systems in comparative perspective.

Naturalistic ethno-etiology: views affliction as the issue of natural forces such as cold, heat, winds, or an upset in the residue of the basic body elements.

Personalistic ethno-etiology: views affliction as the result of the actions of homo or supernatural beings.

Placebo effect: a response to treatment that occurs considering the person receiving the treatment believes it volition work , not because the treatment itself is constructive.

Shaman: a person who specializes in contacting the world of the spirits.

Somatic: symptoms that are concrete manifestations of emotional pain.

Zoonotic: diseases that accept origins in animals and are transmitted to humans.

ABOUT THE Author

Sashur Henninger-Rener is an anthropologist with research in the fields of comparative faith and psychological anthropology. She received a Main of Arts from Columbia University in the Urban center of New York in Anthropology and has since been researching and teaching. Currently, Sashur is teaching with The University of LaVerne and the Los Angeles Community College District in the fields of Cultural and Biological Anthropology. In her free time, Sashur enjoys traveling the globe, visiting archaeological and cultural sites along the way. She and her hubby are actively involved in animal rescuing, hoping to eventually found their ain animal rescue for animals that are waiting to discover homes.

NOTES

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