Cultural Competency - Multicultural Health Generalizations: Folk Beliefs/Remedies/Traditional Medicine
Cambodian Health Beliefs and Practices
In general, Cambodians (or Khmer) are comfortable with western medicine and with traditional healing practices.
Some of the following traditional healings are carried out by family members and some by traditional healers or kruu Khmer. Some kruu Khmer specialize in medicinal practice with a spiritual component, while others specialize in magic with a medicinal component. Regardless of who carries out the below or other procedures, they are often accompanied by prayer and other spiritual activities.
- Koo' (rub) kchall (wind) is used to treat a variety of ailments, including fever, upper respiratory infection, nausea, weak heart, and malaise. A coin is dipped in a mentholated medicine and rubbed in one direction (away from the center of the body) in a symmetric pattern on the patient's chest, back, and/or extremities. This is referred to in western literature as "coining" or "dermabrasion."
- Jup (pinch) kchall is used to treat headache and malaise. Jup includes pinching and thus bruising the bridge of the nose, neck, or chest or the practice of "cupping" or placing a small candle on the forehead, lighting the candle, and placing a small jar over the candle. The flame consumes the oxygen and creates a vacuum, thus causing a circular contusion.
- Oyt pleung (known as "moxibustion" in the literature) is used to treat gastrointestinal and other disorders. Oyt pleung is seldom done in the U.S., but the abdomens of some Cambodian adults might have four to six 1-2 cm round scars resulting from the procedure.
- Massage or manipulation is practiced by kruu Khmer and others.
There often are both spiritual and medicinal elements in healing practices. Magico-religious articles such as amulets, strings, and Buddha images are commonly part of treatment or prevention of illness. Other spiritual or magical means of treating illness include blowing on the sick person's body in a prescribed manner and showering or rubbing with lustral water. As noted earlier, many Khmer see no conflict in practicing or using traditional or magic means of treating illness simultaneously with western medicine. Many would further see no conflict in adding Christian prayer to the mix.
Most Khmer are oriented more to illness than prevention of illness. Childhood immunizations are accepted, but adult immunizations (influenza, pneumonia) are of little interest until illness strikes. Most Khmer do not value early detection or disease screening.
As with most other cultures, respect is essential. Communication is often indirect and requests or questions may be couched in seemingly vague terms. It is unusual for older people to make a direct "no" response to a question or request.
Source: http://www3.baylor.edu/~Charles_Kemp/cambodian_health.html
Accessed October 20, 2005.
Ying & Yang - Chinese Health Practices
Chinese medicine is based on the concept that health is achieved through balance of different kinds of energy (Yin & Yang) that affect the life force (Qi or Chi) of each person.
Diagnosis of imbalance is described in terms of energy (Chi) deficiency or excess - "hot or cold", "dry or damp", or a combination of these. These conditions refer to energy properties of the body, foods, and activities - rather than actual temperatures or moisture levels.
The Chinese concept of balance, represented by Ying & Yang, is reflected in much Asian traditional healing practices. For example, foods are used as therapeutic treatments. They are either "hot or cold" - depending not on their temperatures but on their use in balancing the body's basic energies.
Source: Henry Ford Health System (1999). Ethnic Resource Guide. Workforce Development and Diversity Strategies Division, Corporate Human Resources, Henry Ford Health System. Detroit, MI.
Mexican-Americans and Folk Beliefs: Part 1
- Several Mexican-American folk beliefs are culturally associated with an imbalance between nature and the supernatural.
- It is believed that exposure of a pregnant woman to an eclipse can cause her infant to have a cleft lip or palate.
- This belief originated with the Aztecs, who thought an eclipse occurred because a bite had been taken out of the moon. Hence, if a pregnant woman viewed the eclipse, her infant would have a bite taken out of its mouth.
- As a treatment, an obsidian knife was placed on the Aztec woman's abdomen before going out at night to protect her.
- This belief remains intact among many Mexican-Americans even after hundreds of years. The only difference of today's practice is that a metal key or safety pin is used for protection.
Source:Kurzon, Vanessa R. (2000). Mexican American Culture and Antepartum Management. Graduate Research On Line Journals, volume 2, number 1, January / February 2000 http://www.graduateresearch.com/kurzon.ht
Mexican-Americans and Folk Beliefs: Part 2
Mexican-American folk beliefs include:
- "Mal de ojo" (evil eye): an illness usually affecting children, caused by excessive admiration or covetous looks by others without touching the child.
- "Caida de mollera" (fallen fontanelle): believed to be caused by handling an infant improperly, such as bouncing roughly, dropping, or removing from the breast or bottle abruptly.
- "Antojos" (cravings): the belief that an infant may have characteristics of an object that the mother craves during pregnancy if the craving is not satisfied (e.g., the infant may have strawberry spots if the mother craves but does not eat strawberries).
- "Cuarentena" (40 days): the period following birth during which certain dietary and activity restrictions are observed to allow the mother time to recover from pregnancy, to bond with the newborn, and to prevent certain illnesses from occurring later in life.
Source:Kurzon, Vanessa R. (2000). Mexican American Culture and Antepartum Management. Graduate Research On Line Journals, volume 2, number 1, January / February 2000 http://www.graduateresearch.com/kurzon.htm
Native American Healing Practices
- Many Native American healing practices come from the belief that mind, body, spirit, and emotions must be balanced to be fully healthy.
- Some Native Americans believe that spirits of plants and animals sent by the Creator are sources for healing.
- Although healing beliefs may differ from tribe to tribe, various ceremonies are similar nationwide.
- Many tribes profess the burning of cedar leaves, sweet grass, or sage chases away negative energy, summons positive forces and cleanses the mind, body, spirit and emotions.
- Spiritual ceremonies and tribal counseling can also be used to treat physical illness.
Sources:
Hall, Lori. "Health Center healing room is Michigan's first" Detroit Free Press. 11 June 1999:1.
Mehl-Madrona, Lewis, MD., Ph.D. Traditional (Native American) Indian Medicine. Center for Health and Healing Beth Israel Medical Center. http://www.healing-arts.org/mehl-madrona/mmtraditionalpaper.htm
Somalian Traditional Medicine Modalities
Three, of many, Somalian traditional medicine modalities are: fire-burning, herbal remedies and healing ceremonies.
- Fire-burning: The practice of heating a stick from a special tree until the stick glows and is then applied to the skin is believed to cure some illnesses.
- Herbal remedies: Herbs and readings from the Koran are used to treat seizures. The herb habakhedi is used to treat stomachaches and backaches, while rashes and sore throats are treated with a tea made from the herb dinse.
- Healing ceremonies: Traditional healers perform ceremonies to cure illnesses such as fever, headache, dizziness and weakness, which are thought to be caused by spirits. These ceremonies, designed to appease the spirits, involve reading from the Koran, eating special foods, and burning incense.
Source:
"Common Beliefs & Cultural Practices". The Provider's Guide to Quality & Culture. Management Sciences for Health http://erc.msh.org/mainpage.cfm?file=5.1.1.htm&module=provider&language=English
Chinese Medicine and the Rule of Five Elements (Wu-Xing)
- Traditional Chinese medicine is based on the balance of two opposite forces, Yin and Yang, and a philosophy that regards the harmony of nature and its correspondents which are intimately associated with Wu-Xing (Five Elements).
- According to this philosophy, everything (including organs of the body) corresponds with the five elements. These five elements, which are earth, wood, water, metal, and fire, are related to each other by the Rule of the Five Elements.
- The Rule of the Five Elements states that each of the elements has an effect on the others in a controlling and generative cycle.
- The balance of Yin and Yang determines the state of the body; this balance also determines the direction of the five elements' cycle.
- One of the assumptions inherent in traditional Chinese medicine is that diseases are due to an imbalance of Yin and Yang, and therefore the degeneration of the five elements' cycle.
- Although the qualities of Yin and Yang oppose each other, they complement and cannot exist without each other.
- Disease can be treated by correcting the Yin and Yang imbalance, and thereby returning the body to a healthy state, according to traditional Chinese medicine.
Source: Essential-China.net. Chinese Health http://www.essential-china.net/07_health.main.htm (disabled) (2004, Aug. 2) and an Interview with Master Wasentha Young http://www.peacefuldragonschool.com/
Alternate source:
Five Element Theory in Traditional Chinese Medicine. Internal Healers. (Online).
http://www.sacredlotus.com/theory/elements/index.cfm
Traditional Medical Practices of Vietnamese Subcultures
- The mountain dwelling Mien and H'mong subcultures of the Vietnamese culture intertwine medicine and religion.
- Sickness is believed to come from the wrath of the gods.
- The physician is a priest who negotiates with the gods to remove the sickness. These priests are considered superhuman. If they fail to alleviate the illness it is not their failure, but the will of the gods.
- Conversion to Christianity and urban living has lessened the use of shamans (even before moving to the US), but the belief in external causes of sickness remains.
- The Mien and H'mong groups often resist invasive techniques and see a physician who does not intrude on the body as the best healer.
- Traditional herbal remedies, tonics, massage, and avoidance of excess are seen as the pathways to good health.
- Western health care might be sought after traditional methods prove to be ineffective.
Source: LaBorde, P. (July 1996). Vietnamese cultural profile. (Online). EthnoMed.
http://ethnomed.org/ethnomed/cultures/vietnamese/vietnamese.html
(2001, Aug. 30).
Saudi Spiritual Healing
- Spiritual healing methods are widely practiced by Saudis for the whole spectrum of disease, with particular emphasis on conditions for which no curative medicinal treatment is known.
- These include the healing of conditions such as possession by Jinn, mal-effects of evil eye, and poisonous stings.
- The common spiritual healing practices among Saudis are the ones advised according to the teachings in the Noble Qur'an and (or) Sunnah.
- The main spiritual modality of treatment is the recitation of verses of the Qur'an and specific sayings of the Prophet Mohammad.
- Zamzam water (obtained from the Zamzam well in the Holy Mosque in Makka), honey, and black cumin (Nigella seeds) are considered healing agents.
- The use of amulets is extremely rare in Saudi culture, as this practice was discouraged by the Prophet Mohammad.
- Expression of respect toward spiritual healing practices by health care providers is likely to foster a good relationship with patients and families.
Source: Al-Shahri, M. Z. (2002). Culturally Sensitive Caring for Saudi Patients.Journal of Transcultural Nursing 13, 2, 133-138.
African Americans and Folk Healers
Many types of folk healers are found in African American communities. Some, such as the granny or herb doctor, work in their homes or have store fronts, yet others may practice in a religious setting. While some folk healers limit themselves to a specific type of illness or problem, other healers' intent is to heal every type of illness. Healers may refer to themselves as herb doctors, root doctors or root workers, readers, advisors, spiritualists, or conjurors. Healers may also prefer kinship terms such as Sister, Brother, Mother, Reverend, Prophet, Evangelist, Madam, Princess, King, or Queen when referring to themselves. Some believe that their healing power is a gift from God. For fear of disapproval, many patients who use folk healers may not admit this to their healthcare provider. Hence, when providing care, it could be helpful to ask the patient about any treatments or remedies that have been tried in order to develop an effective treatment plan. In sum, learning about patients' folk beliefs and remedies can add to the effectiveness of the healthcare received.
Source: Culture-Sensitive Health Care: African American. (Online). Diversity Resources. http://www.diversityresources.com/health2k/health/african.html (disabled) (2004, Feb. 2) Redirected to: http://www.diversityresources.com/rc_sample/african.html.
Redirected on 2/06 to: http://www.unc.edu/courses/2005spring/nurs/095/001/cultural_competence/ppts/AAfolkmed.ppt
Iraqi Traditional Medicine Practices
Some Iraqi traditional medicine practices include:
- Cumin powder dissolved in water given for stomach ache , as is green tea.
- Lemon juice or plain rice given for diarrhea.
- A heated brick, covered with a cloth and sat upon, is also used for diarrhea.
- The Karawya herb, boiled in water, is given for stomach ache, diarrhea or constipatio. This herb is also believed to ease abdominal pain, especially in children.
- To treat a cough, Iraqi patients may drink a mixture of honey and lemon juice or lemon juice and orange juice.
- To treat a cold, a steam tent is constructed where the patient can be kept covered for up to twenty-four hours.
- Boiled in water, the anise seed is used for a sore throat or laryngitis.
- Ground cumin, ninia seed, shabak seed, are all ground and mixed together as a powder and placed on the gum for toothaches.
- For a dislocated shoulder, ninia and churned butter are mixed together as an ointment and applied to the shoulder.
- To treat burns, barley is burned, mixed with butter, and applied as a poultice on the burn for 48 hours.
- For a splinter, a paste of flour and sugar is placed over the splinter or over an infected pimple or cyst.
- An infected eye with pus drainage is treated by placing a cloth, boiled in tea, over the eye.
- To treat fever, a cloth is dipped in a mixture of cumin and egg yolk heated in water, and then placed over the forehead.
Source: Iraqi Refugees. http://www3.baylor.edu/~Charles_Kemp/iraqi_refugees.htm. Retrieved on 4/2/03.
Saudi Traditional Medicine
Even with the developmental boom of medical services in Saudi Arabia, traditional medical practices are still available in some rural and urban areas.
- The main modalities of traditional medicine include:
- cauterizing: destroying abnormal tissue by burning or scarring with a hot instrument
- herbal medicines
- dietary treatments
- chiropractic
- fracture reduction: alignment of the fractured bone fragments back to their original state
- cupping: treatment in which evacuated glass cups are applied to intact or scarified skin in order to draw blood toward or through the surface
- Traditional healers are common. These healers inherit the trade from their predecessors.
- A traditional healer sometimes orders the discontinuation of all hospital medications before accepting a patient for treatment.
- Health care providers may find it helpful to inquire about a patient's use of traditional medicine in order to increase the effectiveness of a non-contradicting treatment plan.
Source: Al-Shahri, M. Z. (2002). "Culturally Sensitive Caring for Saudi Patients." Journal of Transcultural Nursing 13, 2, 133-138.
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