Competency CM 2.1 Describe the steps and perform clinico-socio-cultural and demographic assessment of the individual, family and community.
Culture is defined as “the learned behaviour, which has been socially acquired”. Culture stands for customs, beliefs, laws, religion, moral precepts, arts and other capabilities, and skills acquired by a man as a member of the society. These are transmitted from one generation to another through formal and informal learning processes.
Aetiology and Cure
Environmental Sanitation
Food habits
Mother and Child
Personal hygiene
Sex and Marriage
Wrath of gods and goddesses - e.g. ‘Badi Mata’ and ‘Choti Mata’ i.e. Chicken pox and Measles. Instead of giving medication to the patient, pujas and offerings are made to appease the goddess.
Evil eyes - Children are considered more susceptible to evil eyes. Parents make the children wear charms and amulets, put kajal dot on face etc.
Spirit or ghost intrusion - Diseases like hysteria and epilepsy are considered due to intrusion of ghosts. The exorcist drives away the evil spirit and ghost by ‘mantras’.
Past sins - Diseases such as leprosy and tuberculosis are believed to be due to past sins.
Breach of taboo - sexually transmitted disease are believed to be due to illicit sexual intercourse with a woman of low caste, or a woman during menstruation.
Physical causes
Impure blood - Skin diseases, viz. boils and scabies are considered to be due to impure blood.
Cure
Eating neem leaves and flowers are considered to purify blood.
Branding of skin with hot iron for abdominal pain.
Adding turmeric to milk and drinking for cough.
Disposal of human excreta - ignorant about infectiousness of faeces and how it pollutes the soil/water and affects the health.
Disposal of wastes - Water is allowed to flow into the streets where water accumulates and serves as a breeding site for mosquitoes.
Well Water - Bathing, washing clothes, bathing animals etc near the well which results in contamination of the well water.
River water sacred - Water of rivers are considered ' holy water' that are bottled and carried over long distances for distribution among friends and relatives.
The Brahmins eat only vegetarian food.
Some religions like Jain do not take onion and garlic.
Amongst meat eaters, Muslim’s abhor pork as it is considered dirty and Hindu’s abhor beef as cow is a sacred animal for Hindus.
Women eat leftover food of the family or are the last ones to eat in the family, which makes her malnourished.
Foods such as meat, fish, eggs, and jaggery are considered to generate heat in the body.
Foods such as curd ,milk, vegetables and lemon are considered to cool the body.
If pure milk is boiled, the milk secretion of the donor animal may dry up. So water is added to the milk.
Fasting on several occasions for religious reasons.
Ganja, bhang and charas are frequently consumed by sadhus.
Eating and drinking from common utensils is considered as a sign of brotherhood among Muslims.
Some people do not eat unless they have taken a bath.
Male Child - A family is considered incomplete without the birth of a male child.
Dietary practices in Pregnancy
Avoid certain foods like spicy or “heat-inducing” foods.
Consumption of specific foods like ghee.
Avoid papaya due to the belief that it may cause abortion.
Eating almonds to have an intelligent child.
Drinking milk to have a fair-skinned baby.
Eating less food so the baby is not big and delivery will be easy.
Eating nourishing food during the postpartum period.
Care after pregnancy
After childbirth, adequate rest is given to women, during which they are cared for by family members.
Oil massages, especially abdominal massages are given to the mother.
Religious Rituals and Ceremonies
Rituals like baby showers in the seventh month of pregnancy.
Breastfeeding Practices
Prelacteal feeds given.
Colostrum is discarded. Breastfeeding is initiated after few days.
Prolonged breast feeding
Care of baby
Oil massage, exposure to sun etc. are good practices in Indian culture.
Putting oil into ear and nose.
Administration of opium and drastic purgatives to newborns.
Application of oil or a paste of turmeric on the anterior fontanelle .
Applying kajal or black soot to ward off the effects of "evil eye"
Taboos and Beliefs
Pregnant women avoid certain activities or visiting specific places during eclipses or certain lunar phases due to beliefs about their harmful effects on the unborn child.
Others
First delivery usually at Mother’s place.
Family and societal pressure to bear a child. Preference for delivery at home by untrained dais.
Ear and nose piercing
Baby shower in the seventh month of pregnancy
Oral hygiene - Twigs of neem tree, ashes, charcoal used for brushing teeth.
Eating pan leaves smeared with lime with or without tobacco is a common social custom.
Bathing - Oil bathing, bath using paste consisting of bengal gram/chana dal,mustard oil and turmeric powder.
Smoking - Smoking hookah is a social custom in some parts of the country.
Reverse smoking - Smoking with the burning end of the cigar in the mouth, common in Andhra Pradesh, is associated with oral cancer.
Purdah - Muslims and some high caste Hindu women observe purdah - Vitamin D deficiency.
Walking barefoot - transmission of hook-worm disease.
Circumcision, a prevalent custom among Muslims - protects them from penile cancer.
Masheri (smokeless tobacco) used by women to avoid constipation ,but it can lead to oral cancer.
Marriage is a sacred institution and it’s a custom in India for early marriage.
Menstruation is considered dirty and women are forbidden to enter the kitchen, pray, visit temple or have intercourse.
Usual practice is monogamy, but polygamy and polyandry are prevalent in certain parts of the country.
Sex before marriage is forbidden.
Pregnancy before marriage is accepted in certain tribes while in some societies it is considered a taboo.