Medical anthropology for teachers of family medicine
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Transcript of Medical anthropology for teachers of family medicine
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Medical anthropology for teachers of family medicine
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AimsAt the end of this lecture
the learner will: Know the function of
medical anthropology in medical education
Know how to perform a culturally sensitive consultation
Value the anthropological approach in teaching an learning family medicine
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The challenge of emigration: Ethiopians in Israel Emigration of
Ethiopian Jews to Israel in 1984 and in 1991
Isolated population, different culture language and customs
Unique pathology and health beliefs and practices
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From Gonder to Jerusalem
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Culture shock Conflict in contact with
the dominant culture Differing expectations
of behaviour Lack of understanding
goes beyond language Need for cultural as
well as linguistic interpreters
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Uvulectomy
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The case of uvulectomy Patient request for uvulectomy Doctor’s confusion over request Recall of observation of
phenomenon Non-judgmental questioning about
the need for the procedure Negotiation of ways to cope with
request
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Focus group method Efficient means of
collecting data Allows for group
interaction Members support each
other Allows for collection of
different viewpoints Transcripts are
analyzed as in interviews
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1. Reasons for uvulectomy "We used to have the child's uvula cut. It helps the child suck better and if not
cut the child is likely to die.... Most babies undergo cutting of the
uvula and it is few that don't.... It is cut in most people. But in some people it is not cut because
there is a family drug against swollen uvula so they don't have to cut it.…”
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2. Traditional beliefs “When we were in Ethiopia I used to have
the uvula cut for my children and soon after my children were born at about the third day we used to take them to local healers and have their uvulas cut maybe because of fear of danger happening to them.”
“They used to come down with fevers, loss of appetite and changed behavior.”
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3 .Acculturation to a new society “For example soon after my last baby
was born we were very worried thinking that if we are not going to cut the uvula for him then he will die.
So we took him to a hospital and there they said he is all right.
At first we were afraid. We thought that something is lacking
for this child. But now we are happier.”
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Patient centred care (Stewart) Disease/illness Whole person
medicine Finding common
ground Use of resources Prevention
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Patient Centred Care – Explanatory Model
Fears and feelings
Ideas Function Expectations
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Kleinman's model What name do you call
your problem? What do you think is
causing your problem? Why did it start now? What does your sickness
do to you? How severe is it? How
long will it last? What do you fear most
about it? How can it be treated? What results are
expected?
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BATHE: The psychosocial context (M. Stewart)
Background Affect Trouble Handling Empathy
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Like’s ETHNIC model Explanation Treatment Healers Negotiate Intervention Collaboration
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Conclusion The anthropological
method contributes tools to medicine that help us to adopt a patient-centred view.
This view can enrich our understanding and improve our efficacy as healers and educators.