SOCIO ANTHROPOLOGY MEDICINE

IN THE
TROPICAL DISEASE CONTROL

By : Siti Pariani, dr,MS,MSc,Ph.D

Depart Public Health and Preventive Medicine
School of Medicine, Airlangga University
Learning objective
Glossary, basic term:
Medical Sociology
Medical Anthropology
Socio Anthropology Approach
Tropical Medicine
Medical Socio Anthropology &
Tropical Medicine

Application :
Understanding Medical Sociology
Understanding Medical Anthropology
Understanding The role Socio anthropology in
tropical disease
TROPICAL DISEASE???
SOCIOLOGY..???
ANTHROPOLOGY....???
WHAT RELATIONSHIP between
INTERACTION between HUMAN
CULTURE and the community as
well TROPICAL DISEASES ???
TROPICAL
MEDICINE
Is the branch of medicine that deals with health problems
that occur uniquely, are more widespread, or prove more
difficult to control in tropical and subtropical regions.
Many infection and infestations that are classified as
tropical diseases used to be endemic in countries located
in temperate or even cold areas. Examples of such disease
include cholera, dysentery, malaria, polio, tuberculosis,
VCT, HIV, hookworm infestation, etc. And amoebiasis,
among others.
Many of these diseases have been controlled or even
eliminated from developed countries, as a result of
improvements internal environment and extern
environment, nutrition, sanitation, and personal hygiene.
Since climate is not the main reason why those infections
remain endemic in tropical areas, there is a specially as
"Geographic Medicine" or "Third World Medicine.
[ Siti Pariani Health and Illness Behavior in Tropical Medicine - slides 23
of material propaedeutic on tropical medicine April 2010 ]
Medical
SOCIOLOGY
Sociology is concerned with the study of the
social causes and consequences of human
behavior
[ William C. Cockerham University of Illinois - fourth edition of
Medical
SociologySociology Chapter
is ] ... the science 1 1989
whose object] is to interpret the meaning of social
action and thereby give a causal explanation of the way in which the action
proceeds and the effects which it produces. By 'action' in this definition is
meant the human behavior when and to the extent that the agent or agents see
it as subjectively meaningful ... the meaning to which we refer may be either (a)
the meaning actually intended either by an individual agent on a particular
historical occasion or by a number of agents on an approximate average in a
given set of cases, or (b) the meaning attributed to the agent or agents, as
types, in a pure type constructed in the abstract. In neither case is the 'meaning'
to be thought of as somehow objectively 'correct' or 'true' by some
metaphysical criterion. This is the difference between the empirical sciences of
action, such as sociology and history, and any kind of priori discipline, such as
jurisprudence, logic, ethics, or aesthetics whose aim is to extract from their
subject-matter 'correct' or 'valid' meaning.
[ Max Weber The Nature of Social Action 1922, ] [ Weber, Max The Nature of
Social Action in Runciman, W.G. 'Weber: Selections in Translation'
Cambridge University Press, 1991. p7 ]
Medical sociology is involves the sociological analysis of medical
organizations and institutions; the production of knowledge's and
selection of methods, the actions and interactions of healthcare
professionals, and the social or cultural (rather than clinical or bodily)
effects of medical practice. The field commonly interacts with the
sociology of knowledge, science of technology studies, and social
epistemology.
Medical sociologists are also interested in the qualitative experiences of
patients, often working at the boundaries of Public Health, social work,
demography and gerontology to explore phenomena at the intersection
of the social and clinical sciences. Health disparitisies commonly relate
to typical categories such as class and race. Objective sociological
research findings quickly become a normative and political issue
Bird, Chloe E.; Conrad, Peter; and, Fremont, Allen M. (2000). Handbook of Medical Sociology
(5th ed.). Upper Saddle River, NJ: Prentice Hall. ISBN 9780130144560. OCLC 42862076.
Bloom, Samuel William (2002). The Word as Scalpel: A History of Medical Sociology. New York,
NY: Oxford University Press. ISBN 9780195072327. OCLC 47056386.
Brown, Phil (2008). Perspectives in Medical Sociology (4th ed.). Long Grove, IL: Waveland
Press. ISBN 9781577665182. OCLC 173976504.
Cockerham, William C. (2001). The Blackwell Companion to Medical Sociology. Oxford, UK;
Malden, MA: Blackwell. ISBN 9780631217039. OCLC 44039611.
Cockerham, William C.; Ritchey, Ferris Joseph (1997). Dictionary of Medical Sociology.
Westport, CN: Greenwood Press. ISBN 9780313292699. OCLC 35637576
MEDICAL SOCIOLOGY is usually taught as part of a wider
sociology, clinical psychology or health studies degree course, or on
dedicated Master's degree courses where it is sometimes combined
with the study of medical ethic / bioethics. In Britain, sociology was
introduced into the medical curriculum following the Good enough
report in 1944: "In medicine, social explanations of the etiology of
disease meant for some doctors a redirection of medical thought from
the purely clinical and psychological criteria of illness. The
introduction of social factors into medical explanation was most
strongly evidenced in branches of medicine closely related to the
community Social Medicine and, later, General Practice

Bird, Chloe E.; Conrad, Peter; and, Fremont, Allen M. (2000). Handbook of Medical
Sociology (5th ed.). Upper Saddle River, NJ: Prentice Hall. ISBN 9780130144560. OCLC
42862076.
Bloom, Samuel William (2002). The Word as Scalpel: A History of Medical Sociology. New
York, NY: Oxford University Press. ISBN 9780195072327. OCLC 47056386.
Brown, Phil (2008). Perspectives in Medical Sociology (4th ed.). Long Grove, IL: Waveland
Press. ISBN 9781577665182. OCLC 173976504.
Cockerham, William C. (2001). The Blackwell Companion to Medical Sociology. Oxford,
UK; Malden, MA: Blackwell. ISBN 9780631217039. OCLC 44039611.
Cockerham, William C.; Ritchey, Ferris Joseph (1997). Dictionary of Medical Sociology.
Westport, CN: Greenwood Press. ISBN 9780313292699. OCLC 35637576
Anthropology is the study of humanity,
Anthropology has origins in the natural sciences, the
humanities, and the social sciences
[Wolf, Eric (1994) Perilous Ideas: Race, Culture, People. Current
anthropology 35: 1-7. p.227 ]

Medical anthropology is a subfield of

social and cultural anthropology that examines
the ways in which culture and society are
organized around or impacted by issues of
health, health care and related issues.
The term "medical anthropology" has been used
since 1963 as a label for empirical research and
theoretical production by anthropologists into
the social processes and cultural
representations of health, illness and the
nursing/care practices associated with these
(Scotch, Norman A. (1963)
SOCIOLOGY
concerned
-Function
-Structure
-Roles of social institution &
processes
-Social behavior of groups
ANTROPOLOGY
Study of Human Kinds

Human Various

physic - evaluation
- Various biologist
Adaptation with - Culture manner of live
Environment - Language Communication
- kind (ethnic) differentiated
Ecological - material (environment)
approach history
Stimulus
now
Whole adaptation

Technology

Contaminated
MEDICAL SOCIOLOGY

Robert Strauss (1957)

Sociology of medicine sociology in medicine

Studying organization role studying the social factor relevant

relationship, norm, values, health disorder
beliefs human behavior of
health problem

Induction / deduction - applicable to patient care

Theory of sociology from - solving public health problems
medical environment

Sociology perspective medical problems

complex relationship social factor and health

MEDICAL SOCIOLOGY

Social facet of health & illness

Social functions of health institution & organization
The relationship of systems of health care delivery
to other social systems
The social behavior of health personnel and those
people who are consumers of health care
MEDICAL ANTHROPOLOGY
End of WW II anthropologist

socio cultural biological

medical systems

bio ecological psychosocial culture

incidence health / disease

- now
- history

research : - human evolution

- anatomy
- pediatrics etc

medical anthropology
1.BIOLOGICAL APPROACHES
2.ECOLOGICAL APPROACHES
3.ETHNOMEDICAL
APPROACHES
4.CRITICAL APPROACHES
5.APPLIED APPROACHES
Anselm Strauss (1975)

HEALTH PRACTITIONERS
Manage medical crises
Control their symptoms
Tx & cause
Adjust to change in the courses of disorder
Attempt to normalize their interaction with others
Cope with the social isolation caused by reduced contact
with others
Make independent

Chronic diseases !
MEDICAL DOCTOR SHOULD CONSIDER MEDICAL
SOCIO ANTHROPOLOGY APPROACH IN THE
TROPICAL DESEASES CONTROL

1.SOCIAL SYSTEM in the tropical areas

- SOCIAL SYSTEM is SYSTEM of ACTION between
people in the certain situation
- SOCIAL SYSTEM INFLUENCE
INCIDENCE/PREVALENCE TROPICAL DESEASES
- ROLE SOCIAL SUPPORT; SOCIAL CONTROL in the
TROPICAL DESEASES CONTROL
2. HEALTH BEHAVIOUR AND SICKNESS BEHAVIOUR
- HEALTH BEHAVIOUR IS
Activity undertaken by a person who believes him
self / her self to be healthy for purpose of pre
venting health problems

a. Health life style

- Less independent medical profession
b. Health behavior
- Direct contract with medical doctor

- As preventive care
- Reduce the risk of illness
- SICKNESS BEHAVIOUR IS

Behavior of sickness person

Who feel ill & seeking relief from it

Subjective interpretations of feeling states

becomes highly medically significant

Social pressures to use professional medical

services
3. HEALTH CARE SYSTEM

UNIVERSITALITY OF HEALTH CARE SYSTEM

- HEALTH CARE SYSTEM as a part of culture

- DESEASES INFLUENCES CULTURE
- HEALTH CARE SYSTEM have preventive part
- HEALTH CARE SYSTEM have function set

Goal :
Organize for the provision and distribution of health
cervices to those who need them and to use the resources
knowledge and technologies available to prevent and
alleviate disease, disability and suffering to the extend
possible under prevailing condition.
Models
Socialized forms
Canada, Great Britain, Sweden, Saudi
Arabia, Kenya
Decentralized National Health Program
Japan, Germany, France, Mexico
Socialist Medicine
Soviet & China
Capitalist Medicine
USA
Indonesia..?
4. DECISION MAKER PROSESS in SEEKING
TREATMENT
- WHOS are the decision maker
- WHEN ??
- COMMITMENT
- CONSISTENCY

5. ETHNO MEDICINE, COMPLEMENTARY MEDICINE

- What should medical doctors do about this?
6. SOCIAL EPIDEMIOLOGICAL APPROACH.
- SEX
- GENDER
- AGE
- RACE
- SOCIAL ECONOMIC
Than :
Soc. Condition
- health / illnesses
- development of disease
People view health problems
- societies
- cultures

threat of disease their own ways

Knowledge
Health care system
norm, value, beliefs
Health hazards
Social structures
Nature & causes of illness
Life styles
ALBRECH & LEVY (1984)

-Health illness
Social -Form (disease)
Psychological -Longer duration of illness
Cultural -Symptoms intensity
-Disability
CONCLUSION
Medical sociology concern about social condition
because of relation ship between individu in the
specific environment
Medical anthropology concern cultural condition
because of relation ship between People and
environment.
Tropical disease is..???
Physician should consider medical socio
anthropology in the controlling tropical disease