Comparing Healthcare Behavior between American and Dominican Culture
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Various cultures have different systems of health beliefs on what causes illnesses, how to cure or treat them along with who participates in the provision of healthcare services. The extent to which the cultural setting is relevant to their normal life can have profound influence on the reception of traditional and modern health practices and their willingness to use them. Industrialized societies including the United States and other European nations perceive disease as caused by natural scientific occurrence. Consequently, they advocate for combating the microorganisms through medical treatments and using sophisticated technologies in the diagnosis and treatment of the disease. Other societies often from the less developed regions believe the illnesses result from supernatural phenomena. For such, they emphasize prayers and spiritual interventions such as deliverance to counter and avert the alleged disfavor emerging from the powerful forces. Taking the context of the industrialized and less developed societies, this article compares the behaviors linked with health and illness in American and Dominican cultures.
Seeking healthcare services varies across societies emerging from the dominant factors translated into determinant factors in the choice. The medical pluralism today leaves the society open to various treatment options including self-treatment, prescribed treatment, biomedicine and alternative medicine. For instance, an American suffering from back pain may prefer taking over-the-counter pain relievers, hot-tub soaking, or taking slight physical exercises. In addition, one may seek appointment with a massage therapist, chiropractor or orthopedic surgeon relative to the severity of the pain. Elsewhere in an environment of tribal culture such as the Bwa Mawego setting, individuals with a similar feeling may either take semi-traction rest or use medicinal herbs. Others might engage the services of a shaman who would prescribe herbal medications besides performing exorcism rites to counter the evil spirit causing the pain to the patient(Quinlan 62).
The dominant medical system used in a society traces to the leading aspect evident in the culture. This is demonstrated by the varying use of healthcare divisions including folk, professional and folk care across the two cultures. The popular sector is a dominant treatment option where regular individuals care for themselves and their immediate families. For example, the American opt for self-treatment by purchasing over-the-counter drugs(Quinlan 62). Alike the third world regions, popular sector comprise a major preoccupation of Bwa Mawegans. Although no monetary transactions are involved, the vast majority of healthcare in the rural village occurs through the popular sector(Quinlan 63). Besides self-treatment, a family member or a close friend may administer the bush medicine. However, the use of the folk sector across the two cultures has greatly declined despite its dominant use by American in the 1900s. Although the Bwa Mawegans have stuck to the bush medicine, Americans have resorted to more professional healthcare services parallel to their industrialized status.
The healthcare sector in American culture is marked by a professional set-up where the practitioners are identified with their roles and specialization. For examples, healthcare services are collectively provided by qualified practitioners with definite titles such as nurses, doctors, surgeons, pharmacists, and chemists. Furthermore, their titles are identified with their levels of specialization including advanced practice nurses, clinical nurse specialist, surgical registered nurse amongst others. This differs to the modest healthcare sector in the Bwa Mawegan bush medicine. Although the Bwa Mawega residents possess vast curative knowledge no specialized bush doctors and they perceive the title an exaggerated compliment. Referring certain people as bush doctor is perceived as not only bragging but such would likely charge for their services as witnessed amongst the Roseau village(Quinlan 65).
Accessibility of Healthcare Facilities
Access to professional healthcare differs across the societies given the variation in infrastructural development. The industrialized regions majorly occupied by the Americans are endowed with basic healthcare facilities, emergency units and referral hospitals. Besides, community healthcare clinics and emergency units are served with a fleet of ambulances thus facilitating ready access to healthcare services. Allied to the insufficient infrastructural development, Bwa Mawegans lack access to a dependable healthcare facility(Quinlan 65). Although they seek the intervention of nurses from the biomedical clinic, it is often regarded inaccessible to the patients owing to the steep path. Although opened for longer hours, the clinic frequently runs out of medical supplies. For many, they perceive it as a center for immunization and an alternative when bush medical treatment becomes ineffective in severe illnesses. Self-transport is barely an option for their impoverished lives leaving them to embrace the immediate and free bush medicine(Quinlan 65).
Misgivings on Biomedicine
Levels of information about the medical science vary in the two societies relative to the education levels. While the American society features both an educated and informed population, the Dominican residents are less informed about medical science and therefore remain reserved to seek healthcare services from the professional sector. Oppositely, the higher levels of education and easier access to information facilitate an open-attitude to seek professional healthcare amongst the Americans. The majority of Bwa Mawegans are reluctant when dealing with the biomedical professionals especially those from other communities. This degenerates into a rapport issue especially when they distrust and dislike nurses from other communities and consider them foreigners. Although liberal residents seeking biomedical care do not fear the physicians, they feel uncomfortable showing their bodies to strangers(Quinlan 65).
Americans culture associate biomedicine as breakthrough innovations in science to deliver mankind from illness. The use of tablets, injections and medical technologies are a welcome feature by patients, translated to complying with the prescriptions. In contrary, Bwa Mawegans associate biomedicine with lost control since they must submit to their interests to the prescriptions and the power of the medications. Additionally, biomedical pharmaceuticals are presumed as concentrated bush herbs in a form that one can neither tell the identity nor its strength(Quinlan 65). Some residents view doctors as greedy individuals and suspect them of viewing bush medicine as competing with their prescriptions. They fear that professional doctors would eliminate the local remedies and thereafter drum up their businesses. Where the continued use of rare herbs has left them extinct, such is interpreted as selfish motives by the medical doctors to cut down the popular bush medicine. To the villagers, anesthesia administered during surgery is linked to high science and wicked intervention whose philosophy is making biomedicine professionals and manufacturers wealthy(Quinlan 66).
Folk-sector medicine is the rarely used by the Bwa Mawego residents and therefore regarded the last resort. However, there exist three classifications of folk healers including curers, faith healers and magical doctors. While faith healers utilize their God-given powers for good purpose, magical doctors are known to use their powers to either for both good and evil intentions. Presently, Bwa Mawegans only seek the services of priests and obeahmen given that no resident has replaced the last midwife(Quinlan 67). This emerges from the standard rationale that becoming an expert competing directly with biomedical doctors poses great risk of elimination. The older residents reveal that the biomedical doctors killed the last midwife through poison tablets for her powerful healing as residents would overlook the physicians for her services(Quinlan 68). The priest is regarded more trustworthy than physicians and obeahmen as conduit of Gods power. Secondly, visits to the priest are associated with more secrecy as the violator is directly condemned to hell. However, a considerable population in the village considers the obeahmen stronger than priests for identifying the evildoers and revering the curse to them. Equally, they are preferred for informing what patients should do to cure themselves(Quinlan 67). This differs greatly with the American culture where use of fork-sector is inversely proportional to the widespread biomedicine.
Self-treatment through over-the-counter pharmaceutical is a persistent practice amongst the Americans given the ease of accessing drugstores, chemists and pharmacists. Currently, purchasing over-the-counter pharmaceuticals is infrequently used by rural Dominicans. Pharmacists are scarcely located in the region necessitating long walking distances. This process is perceived uncomfortable and inconvenient by a majority of the Bwa Mawegans(Quinlan 69). This leaves most residents preferring the bush medicine unlike in the American environment where individuals have acculturated to incorporate the over-the-counter drugs within the popular scope of healthcare.
Many individuals drawn from various societies including the industrialized Western cultures trust that leading well-balanced lifestyles translates to healthier minds and body. They commit to balanced diets and establishing work and play harmony through exercising. this position resembles the humoral medicine concept where wellness is accomplished by striking the balances between opposing forces including dryness and wetness alongside hot and cold situations(Quinlan 70). Although the two societies hold a converging view of the symbolic value in the concept the hot-cold humoral system in America is associated with mental and physical states. For example, North Americans associate indifferences with coldness oppositely to anger judged as hot-headedness. This differs to the Dominicans hot-cold humoral system where only certain illnesses and plants fit the opposing classification (Quinlan 71).
Hot and Cold Humoral System
Bwa Mawegans humoral system conclude whether the plants are either cold, hot or neutral from the perceived effect they have on their bodies. Consequently, the use of the plant in either of the status emerges from its predetermined effect it has on the internal logic of ones ethnomedical system. In particular, Dominicans consider constipation as hot therefore would use plants with laxative results for its coldness to overcome the hot condition (Quinlan 74). The assignment of the humoral quality in the plant rarely conforms to the human physiological use and reaction to it. This is affirmed by Puerto Ricans living in New York in their classification of white beans as hot while the kidney beans are regarded hot. This contradicts the Dominicans system where the hot and cold values are assigned often citing a reason (Quinlan 74).
Furthermore, where the Americans make distinctions between cooked versus raw, processed versus uprocessed, wild and domestic, Bwa Mawegans have contrasting views. This is translated to strengthen their humoral system where considerable population of plants and animals are assigned the neutral status. Similarly, most illness are considered neutral in their own humoral right. For example, Dominicans view cuts and wounds alongside the treatment as neither hot nor cold but neutral. However, an infected would turn the condition hot thus necessitating cold treatment. This perception is widely observed where most illnesses are considered neutral given that the treatments merely focus on imbalances emerging from causes beyond the hot and cold values (Quinlan 75).
The circulatory system is treated with utmost respect in both the American and Dominican cultures. Specifically, the heart is considered a muscular pump receiving blood and later squeezing the blood in a threefold exit including the head, right and left sides of the body. Besides, the blood quality is considered by the Dominicans as mainly the cause and indicator of illnesses and health(Quinlan 79). However, blood quality is judged using the basic criteria of viscosity, purity and quantity. Blood thickness varies with temperatures, activities and emotions. Prolonged warm temperatures lead to thin blood that circulates on its own, but may cause anemia. When the blood becomes cold following exposure to cold temperatures, it thickens making clotting easier. This is alleged to inhibit circulation leading to stifle joints and sudden death(Quinlan 80).
While the industrialized regions of the American societies adopt the description provided by cardiologists, Bwa Mawegans interpret blood pressure constitute a hot condition. They allege that the condition is caused by imbalanced diets, digestion and emotional stress. It results in inflammation that causes swelling thus restricting blood circulation. Eventually, the hot blood cooks thus turning concentrated and thick to circulate freely in the compromised veins leading to pressure build up. Alike the medical doctors, the residents regards pressure resulting from emotional stress emerges from overworking the brain. Equally, Americans and the Dominicans share in the view that dietary pressure arises from increased consumption of alcohol and processed starches(Quinlan 81). Expectant women in both cultures are cautiously treated to protect the unborn. For instance, Dominicans alike the Americans restrict pregnant women to eating healthier foods and avoiding processed starches(Quinlan 82). Likewise, they regard the most health challenges arise from pollutants that find their way into the body. The residents of Bwa Mawego village view that internal dirt irritates the body internally thus prevent efficient circulation(Quinlan 86).
Treatments of Cold Illness
Presence of local concepts in the diagnosis and interpretation of illness affect the overall treatment behavior assumed by the residents across the cultures. Americans may seek curative, preventive or pain relievers. In the contrary, bush medicine center on curative treatment rather than protecting and strengthening the individual defense mechanism to withstand the causes of evolving illnesses. As such, the Dominicans classify the common illnesses into hot illnesses, stomach infections, external problems and cold illnesses. The classification is loudly rationalized on their causes, symptoms, effects on the body, and potential treatments options(Quinlan 91).
It is evident that most illnesses affecting the Bwa Mawegan are classified on basis of the humoral theory of cold and hot elements. Unlike the Americans who perceive common cold as a viral infection, the residents link it with the exposure to cold temperatures including rain, quick penetration of cold through the pores and swimming in cold temperatures(Quinlan 92). The villagers hold that treating common cold involves exposing the mucus-producing areas to humoral and thermal heat. Although they consider the colds and coughs as different, similar herbs are used in treating those using indifferent processes. Nevertheless, the note that one can develop coughs without exposure to cold, but by breathing cold air(Quinlan 92).
Bwa Mawegans hardly welcome the quest for preventative medicine. They will often prohibit healthy individuals from taking plants identified as hot especially when one is healthy and not suffering from coldness. Foremost, healthier residents should avoid consuming hot herbs during high-temperature days. Taking hot bush tea when the drinker is cold is perceived as causing shock in the system, therefore destabilizing the humoral equilibrium(Quinlan 94), Much like the cough, Asthma have twofold weaknesses leading to more cold in the lungs. Here, the residents assume that asthmatic people have thin lungs that allow more cold to the body. Equally, the asthmatic patients have sensitive nerves affected by emotional fright. This concurs with the biomedical studies that established that stress induces breathing complications translated into asthmatic attacks. The treatment seeks on delivering relaxation perceived as missing warmth in the lungs thereby use cannabis sativa and Tabak Zombi plants. The former is medically tested for its calming, anti-inflamatory and pain-relieving effects on asthma treatment(Quinlan 97).
Rheumatism like the fright and something that hurts the emotional equilibrium emerges from cold and chilled blood that causes joints to become cold when blood flows. Although a cold illness, treating rheumatism targets to generate warmth and movement of the affected joints. Rubbing bay oil and other types including castor oil and snake oil creates the heat the affected joints(Quinlan 101). Headaches are described a neutral condition that can either emerge from hot and cold conditions. Bwa Mwagans consider headaches as the body sign revealing an imbalanced metabolism. Furthermore, the individual may be already sick or engaging in activities that cause the headache. Unlike the use of aspirins in biomedical practices, such are simply painkillers contrasting the Bwa Mawegans remedies of reversing what might be causing the headache(Quinlan 102).
Treatment of Hot Illnesses
Individuals suffering from cold conditions experience continue body heating to regulate the imbalanced internal temperatures. The body may occasionally overheat thereby causing fever identified as hot illness(Quinlan 103). Nevertheless, fever may also strike as a cold illness therefore mandating the residents to treat the symptom rather than their bodies. Herbal treatments such as lime leaf tea to resolve the fever, cold and cough illnesses. The lime tree just as bathing with cool water and applying rum, facilitate evaporation thereby cooling the body temperatures. This approach is utilized by the Jamaican and Montserrat as infusion for common codes(Quinlan 104).
Although sore throats emerge as hot illnesses, they fit better when classified as neutral given its overlap with hot and cold illness. They are however, treated as hot illnesses given the high temperatures in the inflamed areas. The Dominicans eat fresh and cooked tomatoes to numb the inflammation and eliminate the sickness feeling by gargling the strained liquid(Quinlan 105). Although inflammation occurs from other biomedical conditions, it comprises a hot illness that may restrict the blood flow. The treatment approach requires using laxatives and refreshments to cool and clean out the dirt from the body systems. Other American residents such as Caribbean and Jamaicans use koukouli for its cooling effect on the inflamation (Quinlan 106).
Most people will often prioritize trying home treatment before visiting medical specialists for their advice. Individuals leaving in the developing regions result to heavy reliance on self-treatment for a multiplicity of factors deterring them from seeking biomedical treatment. Often, such facilities are scarcely located breaking the quest already de-motivated by the relatively higher cost in biomedicine. In contrast, the self-treatment using bush medicine is free and easily accessible. Additionally, cultural variations and socioeconomic deprivations emerging between the host Bwa Mawegans and the physicians adversely erodes doctor-patient relationships. This translates to a reserved attitude leaving the residents to prioritize their bush medicine. Although the two cultures have different assignments in the humoral theory of cold and hot elements, they converge at overcoming the illnesses. Lastly, though biomedicine is gradually growing to break into the conservative Bwa Mawegans, the village still suffers isolation, undependable transport network, and scarce pharmaceutical yet inadequately stocked unlike in the developed American regions.
Quinlan, Marsha B. From the Bush: The Front Line of Health Care in a Caribbean Village. Belmont, CA ;: Wadsworth/Thomson Learning, 2004.