Culture Specific Diseases
There are some diseases that have very limited
distributions around the world due to the fact that they are caused by unique
combinations of environmental
circumstances and cultural practices. These are generally referred to as
culture specific diseases or culture bound syndromes. Some cause relatively minor
health problems
while others are very serious and can even be fatal. An example of a
relatively harmless culture specific medical condition was "rave rash" in
England during the late 1990's. This afflicted young women who went to "raves", or
large-scale pop music dance parties that went on all night long.
Aggressive dance motions without wearing a bra sometimes led to a painful rash on their
nipples--hence "rave rash." Another more recent culture bound
syndrome is "toasted skin syndrome". This is a result of excessive use
of laptop computers resting on the lap. The heat from these devices
over time can cause a mottled discoloration of the skin on the legs.
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Kuru
is a fatal culture specific disease
of the brain and nervous system that was found among the South Foré
people of the eastern New Guinea Highlands. Until recently, it was
thought that kuru is caused by a virus with a prolonged incubation
period. Evidence now points to
prions as being the cause. The symptoms
include palsy, contracted face muscles, and the loss of motor control
resulting in the inability to walk and eventually even eat. Kuru victims
become progressively emaciated. The South Foré called this disease "trembling
sickness" and "laughing sickness." The latter description was due to the
fact that the face muscles of victims were constricted in a way that looked
like a smile. Death almost always occurs within 6-12 months of the onset
of symptoms.
Kuru was first recorded among the South Foré at the beginning of the 20th century and it progressively became more common up through the 1950's. At its peak, it mostly afflicted women in their 20's and 30's. This caused major social problems. Normally, men had several wives and children were taken care by women. Now, however, there were too few marriageable women, and men were left with the child care duties. Men were resentful and confused by their situation. Since the South Foré had a personalistic explanation for illness, they logically assumed that Kuru was the work of witches who used contagious magic. As a result, people became very careful at cleaning up their house sites to make sure that witches could not obtain any of their hair, fingernail clippings, feces, or personal belongings. Witch hunts were organized and former witches were forced to confess and then join anti-witch cults. None of these steps slowed the rate of increase in the number of Kuru victims.
In the early 1950's, a team of Australian doctors began working to discover what caused kuru in hopes of finding a cure. Anthropologists traced cases of the disease in family lines to see if it was hereditary. Other field workers collected water, soil, plant, and animal specimens to test for environmental toxins. All of these attempts failed to discover the cause. In the late 1950's, an American pediatrician named Carleton Gajdusek came to Papua New Guinea to try to solve the problem. Through the microscopic examination of tissue from people who died of kuru, he discovered that the disease organism was carried in the blood and was concentrated in brain tissue. The means of transmission was cannibalism. The South Foré ate their dead relatives as part of their funerary practices. Women butchered the corpses and were the main cannibals. They also gave this meat to their children. Men generally thought that it was unmanly. They had pigs to eat, while the diet of women and children was normally animal protein poor.
In the early 1960's, cannibalism was outlawed in Papua New Guinea. Since then, the kuru rate has dropped off significantly but has not yet disappeared because of the very long incubation period for this disease. Between 1996 and 2004, 11 people were diagnosed with kuru. Apparently, all of them were born before 1950 and had contracted kuru before the end of cannibalism. This meant that the incubation period was 34-41 years in these cases.
NOTE: Kuru is closely related
to two other well known fatal diseases that affect the brain
and nervous system. They are scrapies
in sheep
and goats and Kreutzfeld-Jacob
disease in humans. The latter disease is now popularly referred to as "mad
cow disease" since it is a variant of the disease in cattle (bovine
spongiform encephalopathy
).
Beginning in 1986, there was a
minor epidemic of it among cattle and people in
Western Europe, especially in Britain. More recently, there were
several cases among cattle in Western Canada. The human form of "mad cow
disease" has been
connected to eating beef from cattle that had acquired the disease as a result
of eating food supplements made from ground up dead sheep and perhaps other farm
animals. The official response has been the isolation and slaughter of
several hundred thousand cattle and other farm animals in Europe and Canada. This drastic
measure apparently has prevented a widespread epidemic. Variants of "mad
cow disease" are known to exist in at least 10 wild mammal species including
deer, elk, bison, kudu, oryx, mink, and cats. In these species, the
disease is commonly referred to as "chronic wasting disease."
Culture Specific Mental Disorders
Apparently, mental illness is present in all societies. However, the frequencies of different types of mental illness vary as do the social connotations. What is defined as a mild form of mental illness in one culture may be defined as normal behavior in another. For instance, people in western societies who regularly carry on animated conversations with dead relatives or other supernatural beings are generally considered mentally ill. The same behavior is likely to be considered healthy and even enviable in a culture that has an indigenous world-view. Such a person would be thought fortunate for having direct communication with the supernatural world. Traditionally among many Native American societies, dreams and the visionary world were, in a sense, more real and certainly more important than the ordinary world of humans.
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Among the Saora
tribe of
Orissa State in India, young men and
women sometimes exhibit abnormal behavior patterns that western trained mental
health specialists would likely define as a mental disorder. They cry
and laugh at inappropriate times, have memory loss, pass out, and claim to
experience the sensation of being repeatedly bitten by ants when no ants are
present. These
individuals are usually teenagers or young adults who are not attracted to the
ordinary life of a subsistence farmer. They are under considerable psychological
stress from social pressure placed on them by their relatives and friends.
The Saora explain the odd behavior of these people as being due to the actions
of supernatural beings who want to marry them. The resolution to this
situation is to carry out a marriage ceremony in which the disturbed person is
married to the spirit. Once this marriage has occurred, the abnormal
symptoms apparently end and the young person becomes a shaman responsible for curing
people. In the eyes of the society, he or she changes status from a peculiar
teenager to a respected adult who has valuable skills as a result of
supernatural contacts. This Saora
example suggests that some minor mental illnesses could be better viewed as
ways of dealing with impossible social situations. In other words, they
are coping mechanisms.
What a culture defines as abnormal behavior is a consequence of what it defines as a modal personality. People who exhibit abnormal behavior in western societies are usually labeled as being eccentric, mentally ill, or even dangerous and criminal. Which label is assigned may depend on the subculture, gender, and socioeconomic level of the individual exhibiting abnormal behavior. In North America, the public acts of poor mentally ill males are sometimes seen as being criminal. This is especially true if they are ethnic minorities or living on the streets. In contrast, similar abnormal behavior by rich males is likely to be viewed as being only eccentric. In the former Soviet Union, important people who publicly opposed government policy were sometimes considered mentally ill and were placed in mental institutions where they were kept sedated "for their own good."
The standards that define normal behavior for any
culture are determined by that culture itself. Normalcy is a nearly
meaningless concept cross-culturally. For instance, in the Yanomamö
Indian culture of South America, highly aggressive, violent men are
considered normal and such individuals are often respected community leaders.
In contrast, the same behavior among the Pueblo Indians
of the Southwestern United States was considered abnormal and dangerous for
society. People who exhibited these traits were avoided and even
ostracized.
Many psychological anthropologists believe that the most meaningful criterion for defining mental illness is the degree of social conformity by an individual. People who are so severely psychologically disturbed and disoriented that they cannot normally participate in their society are universally defined as being mentally ill. For instance, individuals who have difficulty relating to other people because of their intense hallucinations, paranoia, and psychotic defenses will very likely be defined as mentally ill and potentially a danger to others in all cultures.
While mental illness is found in most, if not all,
societies, there are unique culture influenced forms that these
illnesses can take. They are culture bound syndromes.
An example is Windigo psychosis
. This condition was reported
among the Northern Algonkian
language group of Indians (Chippewa
, Ojibwa
, and
Cree
) living around the Great Lakes of Canada and the United States. Windigo psychosis usually developed in the winter when families were isolated
by heavy snow for months in their cabins and had inadequate food supplies.
The initial symptoms of this form of mental illness were usually poor appetite, nausea, and vomiting.
Subsequently, the individual would develop a
characteristic delusion of being transformed into a Windigo monster.
These supernatural beings eat human flesh. People who have Windigo
psychosis increasingly see others around them as being edible. At the
same time, they have an exaggerated fear of becoming cannibals. A modern
medical diagnosis of this condition might label it
paranoia because of the irrational perceptions of being persecuted.
In this case, it is the Windigo monsters who are the persecutors--they are
trying to turn people into Windigo monsters like themselves. In
contemporary North American culture, the perceived persecutors of paranoids are more
likely to be other people or, perhaps, extra terrestrial visitors. Victims of Windigo
psychosis experienced extreme anxiety and sometimes attempted suicide to
prevent themselves from becoming Windigo monsters.
Another example of a culture bound mental syndrome
is koro
in China and areas of Southeast Asia where Chinese
culture has diffused (especially Vietnam, Malaysia, and Singapore). Koro is an irrational perception that one's prominent sexual body parts are withdrawing into
the body and subsequently being lost. In the case of men, the concern is that their penis and testes
are shrinking. For women, the focus is on the perceived shrinking of the
vulva and breasts. In both cases it is a fear of the loss of masculinity or
femininity followed by premature death. Koro is traditionally believed to be
caused by "unhealthy sex" (e.g., masturbation or sex with prostitutes).
It also thought to be caused by "tainted" foods. An example of the latter
occurred in Singapore in 1967. A newspaper reported that koro had
resulted from eating pork that had come from a pig that was given a
vaccination against swine fever. This sparked an epidemic of hundreds of
cases of koro. More recently, another epidemic occurred in
coastal Vietnam when some mothers were shocked to see that the penis and
testes of their children had shrunk after swimming. This created a
widespread panic among mothers in a number of coastal communities. In
some cases, the mothers tried to pull out the penis and testes with their
hands and even hooks in order to make them larger. This resulted in the
penis being torn off some of the boys.
Many culture bound syndromes have been reported around the world by anthropologists and medical professionals. The following list includes the commonly reported ones:
Latin America and Latin derived cultures of Europe:
ataque de nervios (Latin America and the Latin cultures of the Mediterranean)
mal de ojo (evil eye) (Latin America and the Latin cultures of the Mediterranean)
mal de pelea (Puerto Rico)
Africa and African origin cultures of the Americas:
- Ashanti psychosis (Ashanti of Ghana)
- boufée deliriante (Haiti and West Africa)
- brain fag or brain fog (West Africa)
- falling out or blacking out (Afro-Caribbean and the Southern United States)
- rootwork (Haiti and some parts of sub-Saharan Africa)
- sangue dormido (Cape Verde Islands)
- spell (Southeastern United States)
Middle East:
- zar (Northeast Africa and Southwest Asia--especially Egypt, Sudan, Somalia, Ethiopia, and Iran)
South and East Asia:
- amok (running amok) or mata elap (Indonesia, Malaysia, and the Philippines)
- dhat (India)
- hsieh-ping (Taiwan)
- hwa-byung or wool-hwa-bung (anger syndrome) (Korea)
- koro, shook yang, suo yang, jinjinia bemar, or rok-joo (China and Southeast Asia)
- latah (Malaysia and Indonesia)
- p'a leng (wind illness) (China)
- qi-gong psychotic reaction (China)
- shen kui (China)
- shin-byung (Korea)
- shinkeishitsu (Japan)
- taijin kyofusho (Japan)
- sudden death syndrome (Hmong people of Laos and Vietnam)
South Pacific Ocean:
- cafard or cathard (Polynesia)
- gururumba (wild man episode) (New Guinea)
Native America:
- ghost sickness (some Native American cultures)
- grisi siknis (Moskito Indians of Nicaragua)
- hi-wa itck (Mohave Indians of southeastern California)
- iich'aa (Navaho Indians of the American Southwest)
- pibloktoq (arctic hysteria) (Eskimo or Inuit of the North American sub-arctic)
- wacinko (Oglala Sioux Indians of the Northern Plains of the United States)
- windigo or witiko psychosis (Chippewa, Cree, and Ojibwa Indians of Eastern Canada and the Northeastern United States)
To learn about the symptoms and presumed causes of these culture bound syndromes, go to the Related Internet Sites section of this tutorial.