How Culture Affects Health.

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Culture can simply be described as a way of life. It includes aspects such as values, beliefs, norms, language, art, rituals and practices shared by a group of people or community in a given place or time. Our cultures influences how we grow and  shape our core values, beliefs systems and behaviors. Culture has a vast impact on how we all experience health. However, some cultural manifestations are more covert and not easily noticable. Cultures influences health in the following ways. 

1. Harmful Cultural Practices.

Every culture around the world has its own unique cultural practices that have a direct influence on health. Harmful cultural practices enhance spread of diseases and lead to I'll health. 

Such practices include; 

a) FGM - Female Genital Mutilation is defined by the WHO as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. FGM leads to health issues such as facilitating the spread of HIV when using       un-sterilized instruments such as razor blades and kitchen knives. It also causes sexual and reproductive complications, infections, excessive bleeding, mental trauma and death.

b) Property and land inheritance - Disinheritance of property has become an acute problem for widows and orphans in Africa.

Disinheritance entails the unlawful appropriation of property of a widow and her children often due to the perceived low status of women across many cultures. This leaves them in poverty and significantly puts them at risk of poor health and mental distress especially those who do not have access to education and employment.

c) Unsterilized male circumcision - Traditionally this practice is undertaken as a rite of passage within many African communities. It is done by a specific traditional healer, during a particular season, and in most cases, with one unsterilized knife to circumcise an age set of boys. This can facilitate the spread of HIV and other infections.

d) Cleansing rituals - Cleansing rituals are mostly sexual acts which necessitate unprotected sex with multiple people and ejaculating inside in the belief that it will cure some sort of illness or prevent calamity. Some cleansing rituals include sex with a virgin especially a minor to cure HIV and sex to cleanse away evil spirits before an undertaking. These are often unprotected sex involving multiple partners and puts communities at the risk of STIs and causes trauma to the defiled/rape victims most of who are usually young girls.

e) Forced child marriages - This is the marrying off of young girls who are under the age of 18. Families marry off their daughters due to poverty, preserving family honor, social norms and customs, and religious beliefs. Early and forced marriage puts girls at risk of sexual and gender based violence, mental distress, family and social challenges which negatively affect their health.

2. Perceptions of etiology (cause of disease).

Cultural perceptions about origin of diseases range from natural to the supernatural causes. Supernatural causes include belief that an illness is caused by witchcraft, some as a result of committing a taboo and some as a punishment for angering a supernatural being. Example, the clinical manifestations of cerebral malaria such as convulsions/fits and seizures (violent shaking) make people of certain cultures believe it’s caused by supernatural forces such as witchcraft or demonic possession. In the early years of HIV, its symptoms such as extreme weight loss were blamed on witchcraft and taboos. To this day many people still uphold this belief despite the diffusion of information. Other beliefs are, standing long hours in the sun, working for long hours or bathing with cold water causes malaria, some attribute TB to causes such as hereditary predisposition, consumption of alcohol, smoking or cold weather. These beliefs often result in delayed care-seeking and by the time individuals decide to seek health care the disease or condition will have taken it's toll on their health.

3. Health care seeking behaviors.

Etiologic beliefs influence how people

choose to treat or be treated for their symptoms. If they believe an illness is caused by witchcraft or a supernatural being, individuals will seek treatment from traditional healers and only seek modern medical treatment if the traditional medicines fails to alleviate their suffering. By this time the illness would have spread in the body and caused a lot of damage. This puts individuals at risk of serious illness which would otherwise have been easily cured if it was diagnosed earlier and a treatment regimen prescribed. The importance of traditional medicine cannot be downplayed as it is efficient in treating many conditions and is the most trusted especially by rural communities. Traditional and modern medicine therefore work in unison in order to provide treatment for various illnesses and conditions. 

4. Gender dynamics.

Gender dynamics such as gender roles, decision making, power balance and inequality determine who is more likely to get sick. Inequality such as employment and unequal pay hinder women’s (especially in rural and informal settlements) ability to seek quality healthcare and be economically stable. Women are the primary care gives in a household and are more likely to contract diseases when caring for the family such as TB, pneumonia and cold. They also do most chores such as laundry which in some areas when done in water bodies such as rivers or lakes puts them at risk of getting schistosomiasis, malaria and cholera. In most regions in Kenya, a woman would be shamed and stigmatized for purchasing a packet of condoms from a shop and be judged as “loose” and this doesn't give them much say on sexual matters and leads them to opting to unprotected sex if the male partner also doesnt bring condoms.

5 . Negative attitudes towards health care interventions.

Negative individual and societal attitudes towards health care interventions could negatively have an influence on their health. Issues such as mistrust of healthcare workers, refrain from use of condoms (due to the belief of a hidden conspiracy to render people impotent) and mistrust of vaccines are some of the most common ones. During the COVID pandemic people shunned away from receiving the vaccine jabs due to the belief of some hidden malicious agendas by the western pharmaceutical companies to reduce Africas population. In the 2014 Ebola outbreak in West Africa, locals believed that the health care workers were deliberately killing people due to the high number of deaths in hospitals and spread of fake news. Some regions also shun chloroquine use in malaria treatment because they associate bitter substances with abortion. 

It is important that we should all embrace and preserve out cultures. However, some of the harmful cultural aspects that cause untold suffering, illhealth and make life unbearable should be abandoned in order to improve health and quality of life.