An Anthropological View regarding The Ideas on the Causation of Ill-Health Part 1

Introduction

When someone becomes ill he/she often asks "Why has this happened to me?" or "Have I done anything to deserve this?" The answer provided to this question is often determined by the person's sociocultural context. Ideas about causation are an important part of a system of health care.

Explanatory theories of medical systems include ideas about the cause of a condition. A condition usually only becomes meaningful once a cause has been identified for it. Consequently, identification of a cause is an important factor in a person's decision about coping strategies he/she should follow, such as who should be consulted and the type of treatment that should be followed. Causation is founded in a patient's socialcultural enviroment in general, and in the system of health beliefs as part of that environment in particular. Causes are abstracted from illness conditions and interpreted in terms of culture. Determining a cause for a condition is a basic part of diagnosis.

The Notion of Chance

In biomedical systems disease is generally explained by means of empirically based cause and effect sequences. This implies that all "clinical events" have a cause which can be discovered through a logical chain of causal influences that lead up to the "fact" of the disease.

For instance, an infected tseate fly bites a man and he becomes sick. This illness reveals certain symptoms according to which a medical doctor diagnoses the disease, sleeping sickness. There is no attempt to explain why the fly bit that particular man and not someone else. The doctor aims to discover what is causing the symptoms, that is, what the pathological process is at work.

If the sick person asks "Why has it happened to me?", the doctor would answer: "It was by chance."

The main focus of biomedicine is on the consequences of an illness, accident of misfortune rather than on the cause. Biomedicine is more interested in answering "what?" rather than "why?"

Sufferers often to need to "make sense" of what has happened and why. Many health-belief systems include lay ideas about which do not necessarily acknowledge the idea of chance.

These medical beliefs look for an answer to the question "Why me?"

Lay Theories of Illness Causation

Based on a cross-cultural ethnomedical study of lay ideas regarding causation, four basic areas of illness causation can be identified, namely the:

• individual body
• natural world
• the social and cultural world, and
• supernatural world

Within these areas, there are three theories for why illness occurs namely

• imbalance
• natural process, and
• as punishment

Social and supernatural causes tend to be features of traditional, pre-industrial communities, while natural or patient-centered explanations of illness are mostly found in western, industrialized countries. This is, however, not an absolute division and interactions do occur.

End of Part 1

In Part 2 we discuss the four basic lay ideas on the causation of illness and the final the theories within those ideas.

Thank you for Reading

References:

• Hammond-Tooke : 1974 (336)
• Quinian : 2011 (386)
• Helman : 1994 (121)

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