Saturday, August 24, 2013
The Dichotomy: Belief vs. Science
The discussion in class last Tuesday was quite interesting. What caught my attention the most were the entrenched social, cultural, and religious beliefs in various populations and how they affect, often adversely, health. Truthfully, these factors must be taken into consideration as the population under consideration is not likely to be persuaded that their beliefs are fanciful imaginations. How can one contend against beliefs founded in societal superstition and fables when a lack of education prevents them from understanding, and accepting, anything else? Surely an attempt to confront these beliefs would be unsuccessful and counterproductive and yet these same forces are working to undermine the health of the population. It is here, I believe, that we arrive at the dichotomy of dispelling superstitious beliefs and promoting modern science through medicine and public health. Can both be done at the same time? Can one be used to mitigate the damage done by the other? In the case of the Chinese, do you promote western medicine or do you dispel beliefs about more traditional medicine? Perhaps it is possible to gain the upper hand by promoting the former while acknowledging the purported benefits of that latter? At what point does the wall of superstition start to fall? Can you present scientific evidence to those who do not understand? I think these factors need to be thought out extensively before considering how best to approach health problems around the globe. It is reasonable to assume that harmful societal beliefs in superstition, religion, and culture will not change overnight. This may present short-term global health outreach organizations with the task of developing campaigns that uncannily manage to promote health while distancing themselves from the beliefs of the population. Surely this is a matter of great importance; one that should not be taken lightly.
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This is an excellent observation Barry. The moment I read this on Saturday, I was tempted to comment but waited to see if anyone else took the lead; but guess people are still getting used to the format. One of the readings for today addresses your points above and Nichter too!! Barry, we have to take a pause here and really examine what is the meaning of "education" and like all these health programs try to do - "educate the illiterate communities". Are people and communities "empty vessels" into which knowledge can be poured into for healthy living? Do they share the same ontology and epistemology about knowledge and education like us? Are there alternate ontologies and epistemologies? Where did the biomedical model originate? Is western medicine the ultimate cure? And as you very correctly pointed out, its a matter of great importance. And as public health professionals we should not take these lightly and engage with them. Maybe we can create a change in the field and design and implement health interventions/ campaigns that do not fail, that are sustainable and which the global communities participate willingly.
ReplyDeleteThis is a very interesting point, because often times I believe you must address and understand a culture first before you can address health or social issues. I believe that for a health program or intervention to be successful and sustainable it must in some ways fit in and flow with preexisting cultural beliefs and customs. I know this can be conflicting, as often times it is those exact cultural beliefs and customs the program or intervention is attempting to change. However, it can be successfully done and has been done in the past. I think in order to change potentially harmful cultural beliefs/customs one must first recognize the importance of those beliefs/customs to the people and search for ways to establish new beliefs or ideas without stripping them of their cultural identity. If health officials from the outside charge into a community and demand changes and criticize their way of life, then of course there will be resistance. It must be a slow change that people feel and understand that they will benefit from.
ReplyDeleteExciting post there Barry. It is interesting that when we do not understand something, we label it. I will give you an example of African herbs. There are some herbs that are very good for people's health with minimum side effects. There are also some herbs that are not very effective. Western medicine has failed to embrace this field of health. I will give kudos to the Chinese or oriental medicine because of its attempt to be inclusive of herbs. My grandfather told me stories about herbs which his dad knew that could cure poisonous snake bites. But because western medicine did not embrace these herbs, their knowledge has been lost. Most of these African herbs were part of the African Traditional Religion and so as people embraced Christianity and western medicine, this valuable knowledge was lost. Some of our African healing methods were holistic. They addressed a person's "way of life" instead of just "cure" the current ailment.
ReplyDeleteI believe it is imperative for global health to invest some time and talent in understanding local healing practices and herbs that have been developed and used for centuries. Some of the practices provided a placebo effect without any side effects. People are spiritual beings. Ignoring the spiritual aspect in global health implementation will not make them less spiritual beings. Engaging people at their level and belief system will bring better global health outcomes.
When considering how to introduce Western medicine in a non-Western culture, strategy regarding what you introduce is crucial to success. Perhaps HIV/AIDS is the most pressing burden of disease in a particular non-Western population. It would seem at first that pouring resources into that pot would be best, however if a trust in the treatment does not exist, very few will be helped. It may be wise to focus resources on a disease where the use of Western medicine is extremely well proven, simple and produces dramatic changes in health. Once people see the benefit, they will begin to develop trust in the system. As difficult as it can be to balance pressing needs and long-term plans, we must take a step back and look at the big picture.
ReplyDeleteIt is also critical to pay attention to what the culture values. If they don’t value cold hard scientific facts, we shouldn’t initially offer them that. Do they value social relationships? Perhaps a campaign for the introduction of a certain medicine should begin with personal stories of how it’s worked. Is it a patriarchial society? Finding respected leaders in the community to teach and educate will be crucial; their endorsement will go farther than you ever could.
You nailed it Kelly! Many times health workers and their funding organizations are more concerned about short term gain and numbers to show that their program is successful. Before we create intervention programs, we need to fully understand what we are intervening and the forces creating the problem. As you said Kelly, millions and millions of dollars are wasted when an intervention is not informed by in depth study of the problem.
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