This week I would like to continue the discussion on health beliefs by introducing a few general views regarding illness. In my opinion, it is important to have an understanding of the overarching concepts behind each individual belief since the specifics will change depending on where the patient is from and what their beliefs their family holds. The broad ideas, however, tend to be fairly constant between Latino cultures. Then, in the coming weeks I will present a few of these beliefs.
Enfermedades populares, “folk illnesses”, “folk medicine”, “traditional medicine”… There are many names for illnesses and treatments which do not fall within the biomedical model. The biomedical model is “a conceptual model of illness that excludes psychological and social factors and includes only biologic factors in an attempt to understand a person´s medical illness or disorder” (according to Medilexicon). Though in the past couple of decades the United States has somewhat shifted away from this model, it is still highly prevalent, especially in comparison with other cultures. Many of these other cultures, such as those of Latin America or Asia, often hold to traditional medicine and also may have beliefs surrounding certain enfermedades populares (illnesses not recognized by scientific medicine). Traditional medicine and enfermedades populares are based on the concept that illness can come from not only biological causes but also from other factors such as spells, actions of someone or something, imbalances in temperature, etc. There is also much emphasis placed on the cause for the illness and less on the symptoms.
George Foster, a medical anthropologist, describes two main categories of enfermedades populares: the personalistic medical system and the naturalistic medical system. The personalistic medical system views illness as the result of personal, conscious acts or desires of other people towards a specific “victim” (the one who falls ill). In this system, illness is not an accident but comes from an acting agent. This agent can be a supernatural or spiritual being (deity, spirit, ancestor, demon…) or a human (a witch or a hateful, envious or unwitting other person). An example of an illness in the personalistic medical system would be mal de ojo, an illness caused by the harmful gaze of another (I´ll explain this further in another post).
In naturalistic medical system, the origin of illness is less personal and, rather than being caused by another being, is explained through the concept of “balance”. That is to say, in this model illness is believed to be induced by an imbalance that “alters the normal equilibrium between the elements of the human body, the physical environment, one´s age and one´s individual condition” (translated from Fajreldin Chuaqui 2012). A good (and rather familiar) example of this system from Asian culture would be the ying and the yang. In Latino culture, for instance, importance is placed on the balance between hot and many illnesses, symptoms, foods and treatments are labelled hot or cold. For example, menstruation and diabetes are examples of hot illnesses which should therefore be treated with cold remedies.
Understanding the origins of illness is key to understanding what the patient believes will be the best treatment plan. For example, illnesses within the personalistic medical system will typically require assistance from a curandero, abuela, sobadora, yerbera or someone who can break the spell. However, treatments in naturalistic medical system center around balancing the elements that are out of equilibrium. Though the medical professional is not likely to agree with all of the beliefs, respect for and understanding of them can help the physician to better communicate with patients in a way that reduces the patients´ anxiety and encourages them to comply with the treatment plan. In the coming weeks, I will present a few of the more common illness beliefs.
Fajreldin Chuarqui, Valentina (2012). Material Teórico Básico sobre Cultura y Salud.” University of Chile. URL: https://www.u-cursos.cl/odontologia/2012/1/OD6103/1/material_docente/previsualizar?id_material=595339
Lipson, Juliene G. (2000). “Cultura y Cuidados de Enfermería”. Index de Enfermería 28-29:19-25. URL: http://www.index-f.com/index-enfermeria/28-29revista/28-29_articulo_19-25.php?textclock1=