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Medical Anthropology

Mutiara Budi Azhar


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.
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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.
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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)
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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
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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.

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Thank You Very Much for Your Kind Attention

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