Impact of culture on health

Culture is deeply involved in matters of personal hygiene, nutrition, immunization, seeking early medical care, family planning -in short, the whole way of life. Different cultures are there in different societies which may or may not have positive effects on health.

1. IMPACT OF CULTURE ON HEALTH Dr. Arijit Kundu

2. What is Culture L earned behaviour which has been socially acquired. Product of human societies, and man is largely a product of his cultural environment. Lays down norms of behavior and provides mechanisms which secure an individual in his personal and social survival. Culture stands for the customs, beliefs, laws, religion and moral percept, arts & other capabilities, skills acquired by man as a member of society.

3. What is Culture Every culture has its own customs, which influences diseases. Eg . lung carcinoma & liver cirrhosis in west due to smoking & alcohol intake and oral Ca in India due to tobacco intake. Involved in matters of personal hygiene, nutrition, immunization, seeking early medical care, family planning -in short, the whole way of life. Not all customs and beliefs are bad. Some are based on centuries of trial and error and have positive values, while others may be useless or positively harmful.

4. Impact of cultural factors on health Concept of etiology and cure Environmental Sanitation Food Habits Mother and child health Personal hygiene Marriage & sexuality:

5. Concept of etiology and cure 2 groups – (a) supernatural (b ) physical. SUPERNATURAL CAUSES : ( 1) Wrath of god: E.g. Smallpox and chickenpox. Administration of drug is considered harmful. Cases are not notified and pujas are made to please the gods. (2) Breach of taboo : Venereal diseases are believed by some to be due to illicit sexual intercourse with a woman of low caste, or a woman during menstruation.

6. SUPERNATURAL CAUSES (CONTD…) ( 3) Past sins: Leprosy and tuberculosis. (4) Evil eye: Children are considered to be most prone to the effect of evil eyes. Charms and amulets are prescribed and incantations recited by the exorcist. ( 5) Spirit or ghost intrusion: Hysteria and epilepsy are regarded due to spirit or ghost intrusion into the body. The services of an exorcist are sought to drive away the evil spirit or ghost.

7. B. PHYSICAL CAUSES : ( 1) Effects of Weather : For heat stroke, application of oil and ghee on the soles of feet and administration of mango- phool with a pinch of salt . ( 2) Water : Impure water is associated with disease. ( 3) Impure blood : Skin diseases (scabies, acne, boil) are considered to be due to impure blood. Eating neem leaves and flowers is considered to purify blood.

8. 2. Environmental Sanitation DISPOSAL OF HUMAN EXCRETA: Open field defecation. No idea of latrines among villagers. Latrines are meant for city dwellers, where there are no fields for defecation. Faeces are infectious, pollutes water and soil and promotes fly breeding . Problem of excreta disposal is bound up with numerous beliefs and habits based on ignorance.

9. 2. Environmental Sanitation B. DISPOSAL OF WASTES: Not aware that mosquitoes breed in collections of waste water. The solid waste 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 fertilizer. The animal dung (cow dung) is allowed to accumulate. It is used sometimes as manure and often times pressed into cakes, sun-dried and used as fuel.

10. 2. Environmental Sanitation C. WATER SUPPLY : Ponds & Tanks → Common use for washing, bathing, drinking Some rivers are considered "holy". Epidemics of cholera, gastroenteritis have occurred due to these cultural practices .

11. 2. Environmental Sanitation D. HOUSING : Rural houses are same all over the country. Usually kuccha and damp, ill-lighted and ill-ventilated . For reasons of security, no windows are provided , and if at all one is provided, it is merely a small hole. Absence of a separate kitchen, latrine, bathroom and drainage are characteristic features of an average rural house. Animal keeping is very common in villages. Infrequently, human beings and animals live under one roof.

12. 3. Food Habits Influenced by local conditions ( e.g. soil , climate), religious customs and beliefs. Vegetarianism is given a place of honour in Hindu society. Food taboos : beef, pork Foods such as meat, fish, eggs, and jaggery are considered to generate heat in the body; Foods such as curd, milk, vegetables and lemon are considered to cool the body. Adulteration of milk is a common practice.

13. 3. Food Habits ( Contd …) FASTING- ladies → married, old, pregnant , widow ( drinking water only, fruits alone, salt/spice restricted diet, single meal/day ) Muslims observe fasts during Ramzan and Hindus on several occasions.

14. 3. Food Habits ( Contd …) Alcoholic drinks are tabooed by Muslims and high caste Hindus . Ganja , bhang and charas are frequently consumed by sadhus; these habits are now spreading into the general population, especially the younger generation. Eating and drinking from common utensils is considered as a sign of brotherhood among Muslims. In some societies, men eat first and women last and poorly. Some people do not eat unless they have taken a bath.

15. 4 . Mother and child health Marriage is universal in Indian society F amily is incomplete without a male child! Good : Prolonged breastfeeding, Oil bath, massage and exposure to sun. Bad: Some foods (e.g., eggs, meat, fish , milk, leafy vegetables) are forbidden during pregnancy in some parts. Deliveries are conducted by the traditional untrained dai or birth attendant. No breast feed during the first 3 days of birth because of the belief that colostrum might be harmful; instead the child is put on water, and sugar solution .

16. 4.Mother and child health ( Contd …) Unimportant: Piercing ear/ nose Topical application of oil on head Uncertain: - Application of surma / kajal → !Trachoma

17. 5. Personal hygiene Indians have an immense sense of personal cleanliness. (1 ) Oral Hygiene: Many people use twigs of neem tree; ashes; charcoal. Eating pan leaves with lime with or without tobacco. ( 2) Bathing: Bathing naked is a taboo. Villagers: no use of soap, use of common cloth to wipe body → cross infection Women after menstruation must have a purifying bath; After childbirth, there may be 2-3 ceremonial baths, the time for which is fixed upon the advice of the priest.

18. 5. Personal hygiene ( Contd …) ( 3) Shaving: Done by the traditional barber ( nai ). No sterilization of the instruments used; No idea of micro-organisms. (4) Smoking : Can spread tuberculosis . Burning end of the cigar in mouth- common custom among villagers in Andhra Pradesh, is associated with oral cancer. Among patients with peptic ulcer, smokers have a higher death rate. A mother's smoking during pregnancy may retard the growth of the foetus .

19. 5. Personal hygiene ( Contd …) ( 5) Purdah: High incidence of tuberculosis. Deprives the beneficial effect of the sunrays . ( 6) Sleep: Sleep on the ground for reasons of poverty Exposed to insect bites .

20. 5. Personal hygiene ( Contd …) (7) Wearing Shoes: Walking barefoot → insect bite & parasite infestation (ANAEMIA-MALNUTRITION ) (8) Circumcision: Prevalent custom among Muslims, which has a religious sanction.

21. 6. Marriage & sexuality: Sexual customs vary among different social, religious and ethnic groups. Among the Irish, there are taboos against digital exploration of the vagina. During menstruation women are forbidden to pray. Orthodox Jews are forbidden to have intercourse for seven days after the menstruation ceases .

22. 6. Marriage & sexuality( Contd …) Marriage is a sacred institution. It is the usual social custom in India to perform marriages early, at about the age of puberty . Late marriages may create many problems. Because of the universality of marriage in India there are no problems such as unmarried mothers and of illegitimate births, as in the western countries. Child marriages are fortunately disappearing .

23. 6. Marriage & sexuality( Contd …) In India mean age of marriage for boys- 24yr & for girls- 19yr. Monogamy is the most universal form of marriage. Polygamy (marriage of one man with several woman) prevails in certain communities. Polyandry (marriage of several men with one woman ) is found among the Todas of Nilgiri hills, the inhabitants of Jaunsar Bawar in Uttar Pradesh and the Nayars in Malabar coast.

24. Conclusion Cultural factors are highly involved in matters of personal hygiene, nutrition, immunization , seeking early medical care, family planning, disposal of refuse, excreta etc…… In short THE WHOLE WAY OF LIFE