Monday 18 July 2016

Aesthetics overriding healthy practices: One's meat is another's poison; Constructivist Paradigms in cultural competence

Did you know that skin cancer is the most common form of cancer in the United States (CDC, 2011), despite that it is, arguably, the most preventable? The dangers of overexposure to the sun are well-established scientific facts, yet 30 million people in the United States—approximately 10% of the population—still visit indoor tanning salons (JAAD, 2005, p. 1038). Popular culture has even coined a term for those than who tan despite the dangers: “tanorexics”. Why do you think some people are willing to take the risk associated with a tan?

There are other examples of aesthetics overriding healthy practices. Some ancient Asian cultures used to bind young girls’ feet as a status symbol, repeatedly breaking their toes and the arches of their feet in an attempt to prevent them from growing in proportion to the rest of their bodies (Lim, 2007).


An example of aesthetics overriding healthy practices of an ancient Asian cultures which used to bind young girls’ feet as a status symbol, is one of so many other practices which may be meat to some and poison to others. 

I know of two African examples. One is drinking the menstrual blood from cows and the other is growing large size testicles. I have visited two African tribes whose men are encouraged to grow testicles up to 70-80 centimeters in diameter are the Baganda and Bubal Tribe reached puberty. For the Bubal tribe, this happens on account of drinking the hormone-rich menstrual secretion of the cattle. Which causes irreversible hormone changes, and this is what causes the testicles to grow. Among the Baganda the hydrocele was a status symbol and many men who had big testicles would show them off. A hydrocele is a painless buildup of watery fluid around one or both testicles that causes the scrotum or groin area to swell. This swelling is usually not painful and generally not dangerous. However, with involvement of cultural leaders these practices are dying away. Unless is prepared for such scenarios, it may be impossible to practice effective health promoting services in such situations.

The medical model would call for dismissal of such practices perhaps with long jail sentences for culprits and ridicule in one or two journals. It can be filed away as indicating abnormal behavior, itself a result of physical problems and should be treated medically. A medical model set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and prognosis with and without treatment. The medical model is highly successful and even indispensable in many contexts. But, what can explain lack of or very low turn up by given demographies at health facilities even with medical insurance provided at the gate. Appealing to the health belief of given demographies is perhaps one way of motivating participation. This can come about when providers gain a linguistic and cultural competence.

Understanding or competence in asking why other cultures do what they do can help health care providers recruit people who will meaningfully engage in practices which promote better health outcomes. 

References:

African Bubal Tribe-`The Giant Testicles`. Retrieved from: http://mindsparker.com/cultures/african-bubal-tribe-the-giant-testicles/. Retrieved on July 18th 2016.

Centers for Disease Control and Prevention. (2011). Skin cancer. Retrieved from http://www.cdc.gov/cancer/skin/ [2005, 53(6):1038–44].

Levine, J., Sorace, M., Spencer, J., & Siegel, D. (2005). The indoor UV tanning industry: A review of skin cancer risk, health benefit claims, and regulation. Journal of the American Academy of Dermatology, 53(6), pp. 1038–1044. 


Lim, L. (2007). Painful memories for China's footbinding survivors. National Public Radio. Retrieved fromhttp://www.npr.org/templates/story/story.php?storyId=8966942


Maria Mies. 2005. Patriarchy and accumulation on a world scale – revisited (Keynote lecture at the Green Economics Institute, Reading, 29 October 2005). 

Roscoe, John. 1911. The Baganda : an account of their native customs and beliefs. Cornell University.

What is a hydrocele?. Retrieved from: http://www.webmd.com/parenting/baby/tc/hydrocele-topic-overview. Retrieved on July 18th 2016. 

Laing, Ronald. 1971. The Politics of the Family and Other Essays. Routledge.

Amélie Blanchet Garneau and Jacinthe Pepin. 2014. Cultural Competence: A Constructivist Definition. J Transcult Nurs January 2015 26: 9-15, first published on July 17, 2014 doi:10.1177/1043659614541294.


Hydrocele and Manhood among African men. Source: Wikimedia Commons

Hydrocele and Manhood among African men. Source: Wikimedia Commons