Cultural factors in health and

disease

Cultural factors in health and

disease
People have their own beliefs and
practices concerning health and disease.
Cultural factors are deeply involved in all
affairs of man.
Some are based on trial and error and
have positive values.
Others are useless and positively harmful.
Stood in the way of implementing health
programmes.

Cultural factors in health and

disease
Where a change of behaviour was
required the resistance of people was
maximum in accepting new programmes.
Information about these factors i.e.,
customs, cultural mores, habits, beliefs,
and superstition is still woefully lacking.

Concepts of etiology and cure.

The causes of disease as understood by
the vast majority of rural people fall into
two groups.,
supernatural and physical.,

Supernatural causes
Wrath of gods and goddesses:
There are many people even among the
educated who believe that certain
diseases are due to.
Smallpox and chickenpox
Bari Mata and Choti mata.,
Administration of drug is considered
harmful.

Supernatural causes
Cases are notified and pujas are made to
appease the gods.,
Breach of taboos:
breach of taboos is believed by some
people to be the cause of disease.
Eg venereal disease are believed to be due
to illicit sexual intercourse with a women of
low caste.,

 Supernatural causes
Or a woman with menstruation.,
Past sins:
diseases such as leprosy and
tuberculosis are believed to be as a result
of past sins.,
Evil eye:
widely held belief, throughout the
country, is the effect of the evil eye.

 Supernatural causes
Children are considered to be more susceptible.,
In order to ward off the evil eye , charms and
amulets are prescribed and incantations recited
by the exorcist.
spirit or ghost intrusions:
some diseases such as hysteria and epilepsy
are regarded as due to a spirit or ghost intrusion
into the body.

Physical causes
Physical causes are considered to be
responsible for certain diseases
Effects of weather:
exposure of heat during summer is responsible
for an attack of heat stroke
Loo., the folk remedies consists of application of oil
and ghee on the soles,
and keeping unripe mangoes under hot ash for a
few minutes., and extracting the pulp with a
pinch of salt.

 Physical causes
Water: impure water is associated with
diseases.
Impure blood :
skin diseases viz boils and scabies are
considered to be due to impure blood.,
Eating neem leaves and flowers are
considered to purify the blood.,

Environmental sanitation
Disposal of human excreta:
98% of people in rural areas use open fields for
defecation.
This practice is time honoured and considered
harmless .
The average Indian villager is averse to the idea
of latrines.
He considers that latrines are meant for city
dwellers, where there is no fields for defecation.,

Environmental sanitation
Thus the problem of excreta is bound with
numerous beliefs and habits based on
ignorance.,
Disposal of wastes:
the average villager is not aware that
mosquitoes breed in collection of waste
water.
It is permitted to flow in the streets.,

 Environmental sanitation
The solid waste is refuse is invariably thrown in
front of the houses where it is permitted to
accumulate and decompose.,
Periodically it is removed to the fields and used
as manure.,
The animal dung (cow dung ) is allowed to
accumulate it is used as manure and often
times pressed into cakes , sun dried and used
as fuel.

 Water supply:
the well occupies a pivotal place in the
cultural environment of villages.,
it is the common meeting place for men and
women
it is a place where people bathe and wash
their clothes.,
it is a place where animals are washed and
given a drink
These cultural practices lead to the
pollution of well water.,

 Tanks and ponds:

tanks and ponds are used for washing bathing
ablution and sometimes even as a source of
drinking water.
Some rivers are considered holy and people go on
a pilgrimage to these rivers have a dip.
They not only have a dip but drink the raw water
which they consider sacred.
Samples of holy water are bottled and carried
over long distances for distribution among
friends and relatives.
Epidemics of cholera and gastroenteritis have
been due to these cultural practices.

 Housing:
rural housing are practically the same thro
out the country,
usually katcha , and damp ill-ventilated
for reasons of security there is no windows
if at all one is provided, which is a mere
hole.
Absence of separate kitchen, latrine,
bathroom and drainage are characteristic
of rural house.

 Animal keeping is very common in villages

Infrequently animals and human live under
one roof.
Houses are generally kept clean inside
white washed and plastered with mud and
cow dung.

Food habits
Food habits have deep psychological roots and
are associated with love affection warmth self
image and social prestige.
The diet is influenced by local conditions eg soil
climate, religion customs and beliefs.,
Vegetarianism is given a place of honour in
Hindu society,
Some do not take onions and garlic on religious
grounds
Muslims abhor pork and Hindus beef these have
religious sanctions from early days.

Food habits
The concept of hot and cold are prevalent widely
in the country.
meat egg jaggery are considered to generate
heat in the body
curd milk vegetables are considered cool to the
body
These concepts are encountered by the modern
physician when treating disease
Adulteration of milk is a common practice
Motive is economic gain a deep rooted belief is
also responsible for the practice.,
If pure milk is boiled then the donar animal will
become dry.,

Food habits
Muslims observe fast during Ramzan and Hindus
on several occasions.,
drinks and drugs are among the food habit of the
people alcoholic drinks are tabooed by Muslims
and high cast Hindus
ganja bhang and charas are frequently consumed
by sadhus
Spreading to the general population.,
Eating and drinking from common utensils is
considered as a sign of brotherhood among
Muslims.,

Food habits
Hindu women often take food left over by
their husbands
in some societies men eat first and women
last and poorly
Bias towards male child
Some people take food only after taking a
bath
Food is thus a subject of widespread custom
habit and belief which vary from region to
region.,

Mother and child health

Mother and child health is surrounded by
wide range of customs and beliefs all over
the world
Marriages is universal in Indian society.,
and the family is incomplete without the birth
of a male child
This has obvious implications in the context
of the countrys population problems.
various customs are considered good bad
and uncertain.,

Mother and child health

Good:
Customs such as prolonged breast feeding
oil bath, massage, and exposure to sun
are considered good.,
Bad:
These vary from society to society e.g.,
some foods egg meat fish meat leafy
vegetables are forbidden during
pregnancy

Mother and child health

Bad:
in rural areas delivery is conducted by traditional
untrained dai or birth attendant
whose methods of conducting delivery are far
from safe.
the villagers have great faith in her
In some parts of the country the child is not put to
the breast for 3 days of birth because of the
belief that colostrum is harmful.,
Instead the child is put on sugar and water
Branding of the skin administration opium and
drastic purgatives are bad custom.,
Net result is high infant mortality.,

Mother and child health

Unimportant:
certain customs are considered viz
punching the ear and nose application of
oil or a paste of turmeric on the anterior
fontanelle
Uncertain:
applying kajal or black soot mixed with oil to
the eye lid for beautification and partly for
warding of evil eye
Blamed for transmitting trachoma

Personal hygiene
Indians have an immense sense of personal
cleanliness much of which is interwoven with the
ideas of ritual purification.,
Oral hygiene:
in country side people use twigs of neem to brush
the teeth some use ashes some charcoal
Eating palm leaves smeared with lime with or
without tobacco is a common social custom

Personal hygiene
Bathing :
bathing naked is taboo
Apart from regular baths of which Indians
are fond of there are bathing on special
occasions,
The women after menstruation should have
a purifying bath.,
After child birth there may be two or three
ceremonial bath
The practice of oil bath is a good custom.,

Personal hygiene
Womenfolk in the country side use apaste
of turmeric mustard oil and rub it on the
body before a bath thus bathing is aritual
in India.,
Shaving :
This is done by a barber in India
He does not sterilize the instruments as he
does not have any idea about micro
organisms.,

Personal hygiene
Smoking : smoking hubble bubble is asocial custom in
some parts of India it can spread tuberculosis
smoking with the burning end of the cigar is seen in
Andhra Pradesh associated with oral cancer.,
Chronic bronchitis, Ca lung, Coronary artery occlusion,
angina pectoris ca of mouth larynx oesophagus, ca of
bladder and PT
Patients with peptic ulcer have a very high death rate.,
A mother smoking during pregnancy will have a baby with
retarded growth of the foetus.,

Personal hygiene
Purdah:
Muslims and high caste Hindus wear
purdahs incidence of tuberculosis is
reported to be high
they are deprived of beneficial effects of
sunrays
Sleep:
Wearing shoes:

sex and marriage

Sexual customs varies among different
social religious and ethnic groups;
Menstruation is a time of uncleanliness and
women are not allowed to pray or have
intercourse.,
Orthodox Jews are forbidden to have
intercourse for 7 days after menstruation
which has an important bearing on family
planning.,

sex and marriage

Marriage is a sacred institution
it is a usual custom in India to have marriage
early at about the age of puberty
Considered a sound and desirable practice.,
Because late marriages have problems in
adjustments.,
Because marriage is universal there is no problem
of unwed mothers or illegitimate births.,
Mean age of marriage is 24 for males and19 for
girls.,

sex and marriage

There are difference in marriage age by
caste females of the depressed class
have a low mean marriage age
Child marriage has almost disappeared.,
monogamy and polygamy
Polyandry is found among Todas of
Nilgris., inhabitants of jaunsar Bawar in UP
and nayers in Malabar coast.,
High rate of venereal diseases in HP due to
local marriage customs.,