Putting healthcare under a cultural lens

by Nicole Findlay

Carleton University medical anthropologist Jen Pylypa is looking beyond the latest advances in drug therapies to cultural interpretations of health and illness, and initiatives for prevention and treatment in communities around the world.

In one project, the government of Thailand introduced clinics intended to screen for cervical cancer. Pylypa examined the reactions of women accessing the clinics and the nurses who conducted the tests. While the medical practitioners were focused on cancer screening, their patients interpreted unrelated symptoms as precursors to cancer and wanted treatment. Due to differences in status within the culture, women were reluctant to discuss their health concerns with nurses. As a result, patients’ reproductive disorders would remain untreated unless they exhibited obvious symptoms.

Pylypa’s research team worked with both clinics and communities on a variety of strategies intended to improve communication between the health workers and their patients.

In another Thai project, Pylypa discovered that differing perceptions held by health workers and the communities they served regarding the risk to infectious diseases undermined a government education campaign intended to protect villagers.

The villages Pylypa studied had high rates of dengue fever. Despite their vulnerability to the disease and an intense government education campaign, villagers were reluctant to take the precautions that would eliminate the breeding sites of the disease-carrying mosquito. Even families whose children had experienced life-threatening dengue could not be convinced to take preventative measures.

To reconcile these two contradictory perceptions, Pylypa interviewed community members. Repeatedly she was told that dengue was not prevalent in the community.

“Dengue fever actually has two different levels of severity. There is mild dengue, or dengue fever, and there’s more severe dengue, or dengue hemorrhagic fever,” said Pylypa. “It is interesting because it is embedded in the language they use to talk about dengue. In English we have these two terms, but in Thai they only use one term – bleeding fever.”

The education initiatives undertaken by the government emphasised the bleeding symptoms associated with the disease without addressing its more prevalent and less severe symptoms. So while the communities perceived the illness as extremely dangerous, they assessed their risk of infection as rare, since mild symptoms were not thought to be dengue.

The results of research conducted by anthropologists like Pylypa can assist governments to re-think disease prevention and education campaigns, while ensuring patients can access the best care available to them.