What is culture?
I still remember clearly this was the first question I encountered when I came
to the field of health. Basically a group of people tends to think, believe,
and behave in a shared way and pattern, which is distinct with other group. This
integrated system of behavior patterns is culture (Hoebel, 1966). Culture
controls, oppresses and forms traditional ways of knowing and meaning making,
being an important impact on human health status, hope and expectation. In the world of health, I think,
culture is like a seed, which provides individuals, a group, a population original
power of living, developing, and achieving goals. At the same time, the environment
and context around it bring sunshine or storm, illuminating or restricting
health behaviors. Also, culture is like embrace of a mother, emotionally and
cognitively upholding patients.
As we approach
more knowledge about culture from the global perspective, it is interesting to
find out that a normal phenomenon in one culture may be considered as unusual
thing. There are different even opposite cultures everywhere in the world. Dutta-Bergman
(2004) implied in the paper “Poverty, Structural Barriers, and Health” that the
Ojha, a spiritual healer, played a strong role in the Santali people’s health. Why
people there believed in a spiritual healer. I was impressed by the point that
the Ojha was trusted by the Santal, because he understood the pain of the patients,
as a member of the community. In addition, it was associated with the poverty
of the Santali people. They had no access to food and health care. How can they
survive? Who knows their struggles? The Ojha was here to help them. I think
spiritual concern is an alternative way of knowing that requires notice. Patients
who have spiritual beliefs tend to contribute healing to God or spiritual power’s
will. Spiritual values create power for them to resist the violence. Various
ways of healing and knowing bring complication to health professionals’ work. What
can we do? Without doubt we need to obtain deeper understand of people’s
religious beliefs and cultural beliefs. Then, how to be more sensitive to the
spiritual beliefs? I think we should learn appropriate ways to be perceptive of
patients’ cues; learn how to identify patients’ agenda and underlying
motivation and expectation.
When
Dutta-Bergman (2004) came to the issue of “marginalized”, I was thinking there may
be a wall between the “central populations” and the “marginalized populations”.
The central populations enjoy most of the basic resources, such as food, money,
and materials, but in the meantime, marginalized populations endure pain of inadequacy
of resources. Why? It is because they are in the other side of the thick wall,
no one sees their situation, and no one hears their voices as well. The wall is
built by the structure, the culture, and these lead to inequality in race,
gender, and socio-economic status. It seems like a vicious circle. Culture is a
constructor of meanings, values, and roles within which the community exists, and
it also can become a barrier of the existence of the community. The web of
violence that is knitted by the structure is covering over the head of the “marginalized
populations”. They are suffering, struggling, striving, and hovering. They need
support and direction, and their nature of suffering requires to be understood.
As mentioned earlier, there is a circle. Cultural difference is a start of
meaning making process, and one of the causes of inequality. To jump out of the
circle, we need to put culture in the center, recognize the differences the
structure leads to, identify potential methodology for resistance the
structural violence and make efforts to achieve social change.
Reference:
so what do the Nichter readings say about culture?
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