Medical anthropology is the study of human health and disease from a holistic bio-cultural perspective. It examines biological and socio-cultural factors that influence health and disease across cultures. The field has two approaches - ethnomedical studies which examine illness as defined by social groups, and epidemiological studies which define disease biologically. Medical anthropologists study health care systems and how individuals from different cultures perceive and respond to illness and disease.
Medical anthropology is the study of human health and disease from a holistic bio-cultural perspective. It examines biological and socio-cultural factors that influence health and disease across cultures. The field has two approaches - ethnomedical studies which examine illness as defined by social groups, and epidemiological studies which define disease biologically. Medical anthropologists study health care systems and how individuals from different cultures perceive and respond to illness and disease.
Medical anthropology is the study of human health and disease from a holistic bio-cultural perspective. It examines biological and socio-cultural factors that influence health and disease across cultures. The field has two approaches - ethnomedical studies which examine illness as defined by social groups, and epidemiological studies which define disease biologically. Medical anthropologists study health care systems and how individuals from different cultures perceive and respond to illness and disease.
Faculty of Medicine Sriwijaya University Anthropology as a Field of Knowledge • ‘Anthropology’ means ‘human study’ or ‘the study of man’. • The term ‘anthropology’ is derived from the Greek words anthropos, meaning ‘man, human being’ and logos, meaning ‘reason’ or ‘divine wisdom, or science.’ • Anthropology is the scientific study of humankind, from its beginnings, millions of years ago, to the present day and also the future.
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Anthropology (Cont. 2)
• Anthropology is not the only discipline concerned
with human beings. However, only anthropology attempts to understand the whole panorama, in time and space, of the human condition. • Distinguished from other disciplines dealing with study of human beings by its holistic approach as it is concerned with all humanity at all times and also with all dimensions of humanity.
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Anthropology (Cont. 3)
• At least ideally, it concerned to present, in
temporal perspective, a broad picture of human life, including biology, language, and culture. Thus, for example, anthropology can be contrasted with disciplines such as human biology, and political science which tend to concentrate on specific aspects of human condition.
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Anthropology (Cont. 4)
• Anthropology is different from all these other
subjects because it has three main components. • cross-cultural or comparative anthropology • holistic reasons • the relativism, which proves how the rules or norms of a culture are relative to another specific culture of human beings.
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Four major subfields of anthropology
Biological Anthropology studies the
behavior of monkeys and apes, biological differences among human populations, and the origin and evolution of the human species. Cultural Anthropology studies the life ways of communities around the world and the similarities and differences among cultures. Four major subfields of anthropology – Cont. 2
• Archaeology is the reconstruction
of societies and cultures in the past, particularly before written records, from material remains. • Linguistic Anthropology studies the nature, structure, and evolution of language, and the central role it plays in human life.
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Sub-disciplines of Anthropology (Cont. 2)
• In other words, Anthropology is the study of
human diversity - the diversity that exists amongst mankind in body and behavior, in the past, in the present and even in the future.
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Medical Anthropology • In the period since World War II, increasing number of anthropologists, both socio-cultural and biological, have undertaken studies in the field that has become known as ‘medical anthropology.’ • They interested in the cross-cultural study of medical systems and to the biological and the socio-cultural factors that influence the incidence of health and disease now and throughout human history. Mutiara Budi Azhar Medical Anthropology 9 Medical Anthropology (Cont. 2)
• Their interests have been
theoretical, sparked by the desire to understand man’s health behaviour in its widest manifestations; applied, motivated by the belief that anthropological research techniques, theories, and data can and should be used in programs designed to improve health care in developed and developing nations.
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Medical Anthropology (Cont. 3)
• Medical anthropology is viewed by its
practitioners as a bio-cultural discipline concerned with both the biological and socio- cultural aspects of human behaviour, and particularly with the ways in which the two interact and have interacted throughout human history to influence health and disease.
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…medical anthropology … • .. (a) elucidates factors and processes that play a role in or influence the way in which individuals and groups are affected by and respond to illness and disease, and (b) examines these problems with an emphasis on patterns of behaviour.
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Medical Anthropology (Cont. 5)
• Within the field of medical anthropology these are
two broad approaches to the study of medical phenomena: ethnomedical studies, emphasizes disease or illness as it is defined and acted upon by members of a particular social groups. epidemiological and ecological studies. defines disease in biomedical terms and seeks to explain its etiology and consequences. These two approaches are not mutually exclusive; they should be viewed as the end points of a continuum with most studies employing some combinations of them.
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Medical Anthropology (Cont. 6)
• Some medical anthropologists are trained
primarily in anthropology as their main discipline, while others have studied anthropology after training and working in health or related professions such as medicine, nursing or psychology. • Medical anthropologists conduct research in settings as diverse as rural villages and urban hospitals and clinics.
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Health Care System
• One of main focuses of medical anthropology
has been the cross-cultural study of health care (medical) systems.
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Three sectors of health care system: The popular sector: all the therapeutic options that people utilize, without the help of health professionals, such as self treatment or self medication, advice or treatment by relatives or family, friends and neigbours. The folk sector: constituted of spiritual healers, traditional birth attendants (TBAs), herbalists, religious healers, and so forth. The professional sector: represented by Western medical practitioners and ‘professionalized’ traditional medical systems represented by, for example, the Ayurvedic and acupuncture practitioners.
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Three sectors of health care system (Cont. 2)
• A number set of medical anthropological studies
have set out to explore the wide variation in the utilization of different sectors of the health system. • Kleinman (1980): each sector of the health care system has its own explanatory models (Ems) regarding definitions of ill-health; patients or family member’s decisions about where, when, and whom they should consult are influenced by their particular EMs. Mutiara Budi Azhar Medical Anthropology 17 Three sectors of health care system (Cont. 3)
• Fabrega (1972), amongst others, on the other
hand, suggests that attempting to explain the factors influencing the use of different types of services should invoke: socioeconomic, socio- cultural, socio-demographic and psychosocial variables. • While a few of these variables may be identified as the most important, attempting to explain the differences in health seeking behaviour must not be done by imposing a pre-existing assumption that a particular variable is more dominant.
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Explanations of Illness • In the Western World, people usually do not make a distinction between illness and disease. These two terms are often used interchangeably. • However, anthropologic and sociologic studies justify the conceptual distinction we make between disease and illness, especially they considering some non-western cultural traditions.
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Disease and Illness (Cont. 2)
• Disease is an objectively measurable pathological
condition of the body. In other words, disease in medical paradigm, is malfunctioning or maladaptation of biologic and psychophysiologic process in the individual. Tooth decay, measles, or a broken bone are examples. • Illness is a feeling of not being normal and healthy. Illness may, in fact, be due to a disease. However, it may also be due to a feeling of psychological or spiritual imbalance. • By definition, perceptions of illness are highly culture related while disease usually is not.
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Disease and Illness (Cont. 3)
• It is important for health professionals who
treat people from other cultures to understand what their patients believe can cause them to be ill and what kind of curing methods they consider effective as well as acceptable. Understanding a culture's perception of illness is also useful in discovering major aspects of their world view.
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What Causes Illness? • How illness is explained often varies radically from culture to culture. Likewise, the methods considered acceptable for curing illness in one culture may be rejected by another. • These differences can be broadly generalized in terms of two explanatory traditions - naturalistic and personalistic.
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Naturalistic Explanation • The Western World now mostly relies on a naturalistic explanation of illness. • This medical tradition had its beginnings in ancient Greece, especially with the ideas of Hippocrates in the 4th and 5th centuries B.C. • It did not begin to take its modern form until the 16th century A.D.
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Naturalistic Explanation (Cont. 2)
• The naturalistic explanation assumes that
illness is only due to impersonal, mechanistic causes in nature that can be potentially understood and cured by the application of the scientific method of discovery
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Naturalistic Explanation (Cont. 3)
Typical causes of illness accepted in naturalistic medical
systems include: • organic breakdown or deterioration (e.g., tooth decay, heart failure, senility) • obstruction (e.g., kidney stones, arterial blockage due to plaque build-up) • injury (e.g., broken bones, bullet wounds) • imbalance (e.g., too much or too little of specific hormones and salts in the blood) • malnutrition (e.g., too much or too little food, not enough proteins, vitamins, or minerals) • parasites (e.g., bacteria, viruses, amoebas, worms) Mutiara Budi Azhar Medical Anthropology 25 Naturalistic Explanation (Cont. 4)
• Students learning to be doctors or nurses in medical
schools throughout the modern world are taught this kind of naturalistic explanation. • However, there are actually several different naturalistic medical systems in use today. In Latin America, many people still also rely on humoral pathology to explain and cure their illnesses (This is especially true in rural areas among less educated people. • Naturalistic medical systems similar to European humoral pathology: in India (Ayurvedic system) and in China (acupuncture and herbal medicine).
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Personalistic Explanation • It is mostly found among people in non-western world, in small-scale societies and some subcultures of larger nations. • For them, illness is seen as being due to acts or wishes of other people or supernatural beings and forces. • Adherents of personalistic medical systems believe that the causes and cures of illness are not to be found only in the natural world. • Curers usually must use supernatural means to understand what is wrong with their patients and to return them to health.
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Personalistic Explanation (Cont. 2)
Typical causes of illness in
personalistic medical systems include: • intrusion of foreign objects into the body by supernatural means • spirit possession, loss, or damage • bewitching Mutiara Budi Azhar Medical Anthropology 28 Personalistic Explanation (Cont. 3)
• The intrusion of foreign objects was a common
explanation among many cultures for internal body pains such as headaches and stomachaches. • The presumed foreign objects could be rocks, bones, insects, arrowheads, small snakes, or even supernatural objects. • It was believed that they were intentionally put into an individual's body by witchcraft or some other supernatural means.
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Personalistic Explanation (Cont. 4)
• The cure for this class of illness was the
removal of the object by a shaman, dukun, etc. • This usually involved a lengthy non-surgical procedure that was both medical and religious.
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Personalistic Explanation (Cont. 5)
• People who only accept a naturalistic explanation for
illness tend to reject the concept of the intrusion of foreign objects into the body by supernatural means. • This explanation is similar to the "germ theory" : both explanations require the belief in something that cannot be seen by most people. • In both cases, there is an act of faith: it was difficult for microbiologists and physicians to convince the medical profession that bacteria and other microorganisms can cause infection and disease. • It took even longer for the general public in Europe and North America to be convinced that there are harmful microscopic "germs."
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Anthropology and Nutrition
• Malnutrition lowers the body’s ability to resist
infection; it leads to chronic illnesses of many kinds, and it makes sustained hard work impossible. • The problem of malnutrition: • stems from the inability to produce enough food, • also depends on widespread but erroneous beliefs about the relationship between food and health, and on beliefs, taboos, and rituals that prevent people from making the best use of the food that are available to them.
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Anthropology and Nutrition (Cont. 2)
• it is important to distinguish between
nutriment and food: • Nutriment is a biochemical concept, a substance capable of nourishing and keeping good health the organism that consumes it. • Food is cultural concept, a statement that in effect says “This substance is suitable for our nourishment”.
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References • http://en.wikipedia.org/wiki/Medical_anthropology, Sept. 14, 2006-09-14 • Medical anthropology: the conceptual frame. http://emdb.lettere.unige.it/emdb/ethnomed/1_0medanthr.s html, Oct 1, 2006 • Explanations of Illness. http://anthro.palomar.edu/medical/med_1.htm, Sept 16, 2006 • Johnson, TM & Sargent CF (1990) Medical Anthropology: Contemporary Theory and Method. Praeger Publishers, New York. • Foster GM & Anderson BG (1978) Medical Anthropology. John Wileys and Sons, Inc, USA.
The Philosophy of Integrating Medical Anthropology & Clinical Psychology: Mental Health & Soul Health: A Quest for Solutions to Human Health, Diseases, Treatment and Prevention