5.2 Explanations of illness
Most people consider that disease is a defined pathological condition of the body, whereas illness is a feeling of not being normal and healthy. Illness may, in fact, be due to a disease. However, it may also be due to a feeling of psychological or spiritual imbalance. By definition, perceptions of illness are highly culture-related, while disease usually is not.
For example, someone might feel ill after visiting a certain village where they believe that there are individuals with the evil eye. This is mainly due to the feeling that the individual has of not being normal and healthy. This is one example of illness. But if the individual goes to a health centre for treatment the nurse may not find any sign of a disease — and the person may be sent back home just with reassurance. That means that there is no diagnosed disease present in the individual, but they may still feel ill.
It is important for health professionals who treat people from other cultures to understand some of the things that their patients believe can cause them to be ill, and what kind of curing methods they consider to be effective, as well as acceptable.
For example many of the rural people in Ethiopia traditionally believe that some mental disorders are caused by possession of a bad spirit and that they can be cured by holy water from the church.
Thinking about medical and traditional beliefs, which of the following health beliefs and treatment options are medical or scientific and which ones are traditional?
- Measles is caused by the evil eye
- TB is caused by cold and windy weather
- AIDS is caused by HIV infection
- Malaria infection requires drug treatment
- AIDS can be cured by holy water (tebel).
1, 2 and 5 are all traditional health beliefs. 3 and 4 are scientifically established medical beliefs.
How illness is explained often varies radically from culture to culture. For example, in some rural areas people believe that mental disorders accompanied by unusual behaviours such as shouting and being aggressive are due to possession by a bad spirit or evil eye, while in some urban areas people believe that such illnesses are due to problems in the human mind and should be treated by a psychiatrist. Similarly, the methods considered acceptable for curing illness in one culture may be rejected by another. The people who believe in the evil eye or bad spirits are most likely to refer the sick person to a Holy Spirit; while those who believe that strange symptoms are because of a problem in the mind would probably take the person to a mental hospital. These differences can be broadly generalised in terms of two explanatory traditions about the cause of illness. These are:
- Naturalistic explanation about the cause of illness
- Personalistic explanation.