Cultural factors in health and disease

Cultural factors in health and diseasePeople 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 diseaseWhere 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 causesWrath of gods and goddesses:There are many people even among the educated who believe that certain diseases are due to.Smallpox and chickenpoxBari Mata and Choti mata.,Administration of drug is considered harmful.

Supernatural causesCases 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 causesPhysical causes are considered to be responsible for certain diseasesEffects of weather: exposure of heat during summer is responsible for an attack of heat strokeLoo., 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 sanitationDisposal 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 sanitationThus 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 drinkThese 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 habitsFood 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 habitsThe 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 bodyThese concepts are encountered by the modern physician when treating diseaseAdulteration of milk is a common practiceMotive 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 habitsMuslims 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 sadhusSpreading to the general population.,Eating and drinking from common utensils is considered as a sign of brotherhood among Muslims.,

Food habitsHindu women often take food left over by their husbands in some societies men eat first and women last and poorlyBias towards male childSome people take food only after taking a bathFood is thus a subject of widespread custom habit and belief which vary from region to region.,

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

Mother and child healthGood: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 healthBad: 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 waterBranding of the skin administration opium and drastic purgatives are bad custom.,Net result is high infant mortality.,

Mother and child healthUnimportant: certain customs are considered viz punching the ear and nose application of oil or a paste of turmeric on the anterior fontanelleUncertain: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 hygieneIndians 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 charcoalEating palm leaves smeared with lime with or without tobacco is a common social custom

Personal hygieneBathing : bathing naked is tabooApart 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 hygieneWomenfolk 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 IndiaHe does not sterilize the instruments as he does not have any idea about micro organisms.,

Personal hygieneSmoking : 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 PTPatients 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 hygienePurdah: Muslims and high caste Hindus wear purdahs incidence of tuberculosis is reported to be high they are deprived of beneficial effects of sunraysSleep:Wearing shoes:

sex and marriageSexual 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 marriageMarriage is a sacred institution it is a usual custom in India to have marriage early at about the age of pubertyConsidered 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 marriageThere are difference in marriage age by caste females of the depressed class have a low mean marriage ageChild marriage has almost disappeared., monogamy and polygamyPolyandry 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.,