Postiquet Beach, Alicante, Spain.
The chapters in Unit II will present an overview of relevant historical and contemporary theoretical content that will help you to
1. Describe traditional aspects of HEALTH care.2
2. Describe traditional HEALTH care philosophies and systems.
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3. Discuss various forms of HEALING practices. 4. Trace your family’s beliefs and practices in
a. Health/HEALTH maintenance, b. Health/HEALTH protection, c. Health/HEALTH restoration, and d. Curing/HEALING.
5. Discuss the interrelationships of sociocultural, public health, and medical events that have produced the crises in today’s modern health care system.
6. Trace the complex web of factors that a. contribute to the high cost of health care, b. discuss ways of paying for health care services, and c. impede a person’s passage through the health care system.
7. Describe common barriers to utilization of the health care system.
8. Compare and contrast the modern and traditional systems of health/ HEALTH care.
As you proceed through this unit, you will encounter several activities that link Unit I to Unit II and will help the content resonate and come alive. These are activities in which several people may participate and share their experiences.
1. Re-answer questions 5–12 from Unit I, thinking of HEALTH rather than health. (Remember, when HEALTH is in small capital letters, it is to desig- nate it as a holistic phenomenon, rather than dualistic, as is the common way it is defined.) They are the following questions: How do you define HEALTH? How do you define ILLNESS? What do you do to maintain your HEALTH? What do you do to protect your HEALTH? What do you do when you experience a noticeable change in your HEALTH? Do you diagnose your own HEALTH problems? If yes, how do you do so? If no, why not? From whom do you seek HEALTH care? What do you do to restore your HEALTH? Give examples.
2. To whom do you turn first when you are ILL? Where do you go next?
3. You have just moved to a new location. You do not know a single person in this community. How do you find health/HEALTH care resources?
4. Visit an emergency room in a large city hospital. Visit an emergency room in a small community hospital. Spend some time quietly observing what occurs in each setting. a. How long do patients wait to be seen? b. Are patients called by name—first name, surname—or number? c. Are relatives or friends allowed into the treatment room with the
5. Determine the cost of a day of hospitalization in an acute care hospital in your community. a. How much does a room cost? How much is a day in the intensive care
unit or coronary care unit? How much is time in the emergency room? How is a surgical procedure charged?
b. How much is charged for diagnostic procedures, such as a computed to- mography (CT) scan or an ultrasound? How much is charged for equip- ment, such as a simple intravenous (IV) setup?
c. What are the pharmacy charges for medications such as “clot busters,” antibiotics, cardiac medications, and so forth?
d. How many days, or hours, are women kept in the hospital after delivery of a child? Is the newborn baby sent home at the same time? If not, why not? What is the cost of a normal vaginal delivery or cesarean section and normal newborn care?
6. Visit a homeopathic pharmacy or a natural food store and examine the shelves that contain herbal remedies and information about alternative or complementary HEALTH care. a. What is the cost of a variety of herbal remedies used to maintain HEALTH
or to prevent common ailments? b. What is the cost of a variety of herbal remedies used to treat common
ailments? c. What is the range of costs for the books and other reading and instruc-
tional materials sold in the store? 7. What does your faith tradition teach you in terms of how to maintain, pro-
tect, and/or restore your HEALTH? 8. Attend a service in a house of worship with which you are not familiar. In-
quire of the clergyperson what is taught or done within the faith tradition to maintain, protect, and/or restore HEALTH.
9. Visit a HEALER other than a physician in your community. 10. Attend a HEALING service. 11. Explore other methods of HEALING, such as massage, herbal therapy, or
prayer. 12. Explore birth and birthing practices and traditions in both your heritage
and others’ than those derived from your own sociocultural heritage. 13. Explore end-of-life beliefs and practices and mourning traditions in both
your own heritage and of people from other sociocultural heritages.
88 ■ Unit 1I
Chapter 5 HEALTH Traditions
You can do nothing to bring the dead to life; but you can do much to save the living from death.
—B. Frank School (1924)
1. Describe traditional aspects of HEALTH care. 2. Describe the interrelated components of the HEALTH Traditions Model.
a. Give examples of the traditional ways people maintain their physical, mental, and spiritual HEALTH.
b. Give examples of the traditional ways people protect their physical, men- tal, and spiritual HEALTH.
c. Give examples of the traditional ways people restore their physical, mental, and spiritual HEALTH.
3. Describe the factors that constitute traditional epidemiology. 4. Give examples of the choices that people have in health care. 5. Give examples of the traditional HEALTH care philosophies and systems. 6. Discover information available from the National Center for Complementary
and Alternative Medicine.
Figure 5–1 Figure 5–2 Figure 5–3 Figure 5–4
90 ■ Chapter 5
The opening images in the chapter opener represent various methods people may use for the HEALTH—objects that may be used to protect, maintain, and/ or restore physical, mental, or spiritual HEALTH and an example of a resource where some items may be purchased by people of many different heritages. These images contain items that are symbolic of the HEALTH Traditions Model and its themes, which will be discussed later in the chapter. Figure 5–1 is of a buck-eye with a small bead on top, red string, a red pompom, and an image of the Virgin of Guadalupe. It was purchased in a Mexican market in San Antonio, Texas. It is placed on an infant to protect his or her HEALTH. Figure 5–2 is a blue glass eye from Turkey. It may be pinned on clothing, pinned on a crib or bed, or hung in the home to protect the HEALTH of the baby, adult, or entire family. Figure 5–3, is rosary beads, symbolizes prayer and meditation methods used in both the spiritual maintenance and the maintenance and/or restoration of HEALTH. Figure 5–4 is a neighborhood health food store that sells numerous forms of HEALTH products such as herbs, tonics, and vegan items.
What are the sacred objects that you and your family may have hung in your home, placed on your bed, or worn? If you could pick four items from your heritage that are used to maintain or protect your HEALTH, what would they be? Do you know where the items can be purchased? Do you continue to use sacred objects to protect your HEALTH?
Health care providers have the opportunity to observe the most incred- ible phenomenon of life: health/HEALTH and the recovery, in most cases, from illness/HEALTH. In today’s society, the healer is primarily thought by many to be the physician, and the other members of the health team all play a significant role in the maintenance and protection of HEALTH and the detec- tion, and treatment of ILLNESS. However, human beings have existed, some sources suggest, for 2 million years. How, then, did the species Homo sapiens survive before the advent of the scientific methods and modern technology? What did the people of other times do to maintain, protect, and restore their health/HEALTH? It is quite evident that numerous forms of health/HEALTH care and healing/HEALING existed long before the technological methodologies that we apply today.
In the natural course of any life, a person can expect to experience the following set of events: He or she becomes ill/ILL; the illness/ILLNESS may be acute, with concomitant symptoms or signs, such as pain, fever, nausea, bleed- ing, depression, anxiety, or despair. On the other hand, the illness/ILLNESS may be insidious, with a gradual progression and worsening of symptoms, which might encompass slow deterioration of movement or a profound intensification of pain or desperation. Or the person may not experience symptoms, seek care for a routine ailment, and discover he or she has a near-fatal illness/ILLNESS.
If the illness/ILLNESS is mild, the person relies on self-treatment or, as is often the case, does nothing and gradually the symptoms disappear. If the illness/ILLNESS is more severe or is of longer duration, the person may consult expert help from a healer—usually, in contemporary times, a physician or nurse practitioner.
The person recovers or expects to recover. As far back as historians and interested social scientists can trace in the history of humankind, this
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phenomenon of recovery has occurred. In fact, it made very little difference what mode of treatment was used; recovery was expected and usual. It is this occurrence of natural recovery that has given rise to all forms of therapies and healing/HEALING beliefs and practices that attempt to explain a phenomenon that is natural. That is, one may choose to rationalize the success of a healing/HEALING method by pointing to the patient’s recovery. Over the generations, natural healing/HEALING has been attributed to all sorts of rituals, including trephining (puncturing the skull), cupping, magic, leeching, and bleeding. From medicine man to sorcerer, the arts of maintaining, protecting, restoring health/HEALTH, and healing/HEALING have passed through succeeding generations. People knew the ailments of their time and devised treatments for them. In spite of ravaging plagues, disasters (both natural and those caused by humans), and pandemic and epidemic diseases, human beings as a species have survived!
This chapter explores the concepts of HEALTH and ILLNESS and the HEALTH Traditions Model; the choices people have in terms of folk medicine, natural, or magico-religious medicine; complementary and alternative meth- ods of health/HEALTH maintenance, protection, and/or restoration; and other schools of health/HEALTH care in contemporary American society. Just as the understanding of health and illness is fundamental in the socialization process into the health care professions, the understanding of HEALTH and ILLNESS within the traditional context is fundamental to the development of CULTURAL COMPETENCY and the skills necessary to deliver CULTURALCARE.
■ HEALTH and ILLNESS In this section, the “steps and bricks” of HEALTH and ILLNESS are going to be explored in greater depth. Once again, HEALTH is defined as “the balance of the person, both within one’s beings—physical, mental, and spiritual—and in the outside world—natural, communal, and metaphysical, is a complex, interrelated phenomenon.” On the other hand, ILLNESS is “the imbalance of one’s being— physical, mental, and spiritual—and in the outside world—natural, communal, and meta-physical.” When the terms HEALTH and ILLNESS are used in the re- mainder of this text, they denote the preceding definitions; small capitals are used to differentiate them from the terms health and illness, as defined in Chap- ter 4. Health/HEALTH and illness/ILLNESS are used in the text when there is an overlap between the terms.
The physical aspect of the person includes anatomical organs, such as the skin, skeleton, and muscles. It is our genetic inheritance, body chemistry, gen- der, age, and nutrition. The mind, mental, includes cognitive process, such as thoughts, memories, and knowledge. This includes emotional processes as feel- ings, defenses, and self-esteem. The spiritual facet includes both positive and negative learned spiritual practices and teachings, dreams, symbols, and stories; gifts and intuition; grace and protecting forces; and positive and negative meta- physical or innate forces. These facets are in constant flux and change over time, yet each is completely related to the others and related to the context of the person. The context includes the person’s family, culture, work, community,