antropologi keseshatan

8/13/2019 Antropologi Keseshatan

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Kuswandewi Mutyara


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Antropologi dan sosiologimemahami manusia sebagaibagian dari suatu kelompok atau masyarakat

Mempunyai sasaran yang sama, tetapi sudut pandangyang berbeda.Antropologi lebih menekankan pada

aturan2 yang kecil (nilai/norma, unsur-unsur budaya yangmempengaruhi peranserta, pandangan dan penghayatanindividu terhadap penyakit dan proses penyembuhannya),sedangkan sosiologi lebih menekankan kepada aturan

yang besar (aturan sosial, peran serta masyarakat,struktur sosial, solidaritas kelompok)


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Studi sistematis mengenai umat manusia dengan segalakegiatannya, dahulu dan sekarang.

Melengkapi, memperluas pekerjaan ahli ekonomi, sejarah,ilmuwan politik, psikologi, sosiologi, biologi, farmasi, dll.

A/N/T/R/O/P/ O/L/O/G/I

Studi mengenai umat manusia (manusia dan perilakunya

dan untuk memperoleh pengertian yang lengkap mengenai

keanekaragaman manusia)


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Secara garis besar terbagi menjadi:

Physical anthropology

Material culture

Social & cultural anthropology



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mempelajari manusia sebagai organisme biologis,melacak perkembangan manusia menurut evolusinya,dan menyelidiki variasi biologisnya di dalam species

studi mengenai variasi umat manusia (warna kulit,

bentuk hidung, golongan darah, kepekaan terhadappenyakit tertentu, dll)

menggunakan pengetahuan genetika dan biokimia

untuk memperoleh pengertian yang lengkap mengenaivariasi umat manusia dan cara menyesuaikan diridengan lingkungannya

A/N/T/R/O/P/ O/L/O/G/I F/ I/ S/ I/ K


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M/ A/ T/ E/ R/ I/ A/ L C/ U/ L/ T/ U/ R/ E

Mempelajari mengenai seni dan artefak (obyekyang dibuat oleh manusia)

Termasuk mepelajari mengenai seni, musikinstrumen, senjata, pakaian, peralatan, ataupunberbagai aspek yang berhubungan denganteknologi manusia


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A/N/T/R/O/P/O/L/O/G/I S/O/S/I/A/L & B/U/D/A/Y/A

Menerangkan perilaku manusia berdasarkankebudayaannya

Studi perbandingan masyarakat saat ini danbagaimana sistem budaya mereka


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KESIMPULAN:

Ilmu yang mempelajari berbagai aspek dalam

kehidupan sosial manusia, misalnya biologi,ekologi, ekonomi, politik, agama, kesehatan,farmasi, dll


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ANTROPOLOGI KESEHATAN

Cabang dari antropologi sosial dan budaya

Perhatian: fenomena biologi, terutama hubungan antarasehat dan penyakit

Hasan dan Prasad (1959): cabang dari ilmu mengenaimanusia yang mempelajari aspek-aspek biologi dankebudayaan manusia dari titik tolak pandangan untukmemahami kedokteran, sejarah kedokteran, hukumkedokteran, aspek sosial kedokteran, dan masalah-masalahkesehatan manusia.

Hochstrasser dan Trapp (1970): pemahaman biobudayamanusia dan karya-karyanya, yang berhubungan dengankesehatan dan pengobatan

Lieban (1973): studi mengenai fenomena medis


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Mempelajari sosio-kultural dari semua masyarakat yang

berhubungan dengan sakit dan sehat sebagai pusat daribudaya

Berhubungan dengan kepercayaan (misfortunes)

kekuatan supernatural atau penyihir Kelompok healers ditemukan dengan bentuk yang

berbeda di setiap kelompok masyarakat

Anthropologi biasanya tertarik di kelompok yang spesial

dengan cara-cara seleksi, training, konsep, value, danorganisasinya


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Healersmempunyai peranan sebagai penyembuh Fokus: tidak secara individual, terutama ill pada

keluarga ataupun masyarakat

Tugas utama antropologi kesehatan: bagaimanaindividu di masyarakat mempunyai persepsi danbereaksi terhadap ill dan bagaimana tipe pelayanankesehatan yang akan dipilih, untuk mengetahui

mengenai budaya dan keadaan sosial di lingkungantempat tinggalnya


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Dalam bidang biologi, antropologi kesehatanmenggambarkan teknik dan penemuan ilmu-ilmukedokteran dan variasinya, termasuk mikrobiologi,biokimia, genetik, parasitologi, patologi, nutrisi, dan

epidemiologi. Hal ini memungkinkan untuk menghubungkan antaraperubahan biologi yang didapatkan dengan menggunakantekhnik tersebut terhadap faktor-faktor sosial dan budayadi masyarakat tertentu

Contoh: penyakit keturunan ditransmisikan melalui genresesif karena pernikahan di antara anggota keluarga


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ANTROPOLOGI KESEHATAN

Disimpulkan:

1. Interpretasi mengenai hubungan timbal balik budaya, antaratingkah laku manusia di masa lalu dan masa kini dengan

derajat kesehatan dan penyakit

2. Partisipasi profesional dalam program-program yangbertujuan untuk memperbaiki derajat kesehatan melaluipemahaman hubungan bio-sosial-budaya dengan kesehatan,

serta melalui perubahan tingkah laku sehat ke arah yangdiyakini akan meningkatkan kesehatan menjadi lebih baik


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Pandangan orang tentang kriteria tubuhsehat atau sakit tidak selalu obyektif.

Persepsi masyarakat sangat dipengaruhiolehunsur pengalamanmasa lalu dan unsur sosialbudaya

Petugas kesehatanmenerapkan kriteria

medis yang obyektif berdasarkan simptomyang tampak guna mendiagnosa kondisi fisik Perbedaan persepsimasalah


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1. Perkins (1937)Suatu keadaan yang tidak menyenangkan yang

menimpa seseorang sehingga menimbulkan gangguan

aktifitas sehari-hari baik aktifitas jasmani, rohani dansosial

2. ReverllyTidak adanya keselarasan antara lingkungan dengan

individu

3. New Webster DictionarySuatu keadaan yang ditandai dengan suatu perubahan

gangguan nyata yang normal.

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KONSEP PENYAKIT DAN SAKIT

Penyakit mempunyai konotasi biomedik dan sosio

kultural Disease konsep patologi (masalah kesehatan pada seseorang berdasarkan medical

expert)

Illness konsep psikologi (masalah kesehatan pada seseorang berdasarkan diri

sendiri/pasien) Sicknesskonsep sosial budaya (masalah kesehatan pada seseorang berdasarkan

masyarakat)


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Skema Schuman:1. Tahap pengalaman gejala(keputusan bahwa ada yang tidak

beres)

2. Asumsi dari keadaan peranan sakit(keputusan bahwaseseorang sakit dan membutuhkan perawatan profesional)

3. Tahap kontak perawatan medis(keputusan untuk mencariperawatan medis profesional)

4. Tahap peranan ketergantungan pasien(keputusan untuk

mengalihkan pengawasan kepada dokter dan menerimaserta mengikuti pengobatan yang ditetapkan)

5. Kesembuhan/keadaan rehabilitasi(keputusan untuk mengakhiri peranan pasien)


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PENGOBATAN DAN PERAWATAN DALAM PELAYANAN KESEHATAN

Popular, folk, profesional (menurut Kleinman)

POPULAR- Non profesional, non spesialis, tanpa konsultasi pada

ahli pengobatan tradisional atau medis


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FOLK/RAKYAT

- Dukun patah tulang

- Pengobatan spiritual

- Dukun

Pelatihan: turun temurun, kedudukan dalam keluarga (cucu laki-laki ke 7 dari anak laki-laki ke 7 (Irlandia)

tanda lahir, mengikuti pengobat yang berpengalaman)

Keuntungan: melibatkan keluarga dalam diagnosa danpengobatan


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PROFESIONAL

- Pengobatan yang terorganisir

- Kedokteran modern/barat dikenal sebagai Allopathy/Biomedicine

- Misal: dokter, bidan, perawat,dll


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The effect of any medication on an individual (its total

drug effect), in addition to its pharmacological

properties, depends on a number of elements, i.e.:

The attributes of the drugitself The attributes of the recipient

The attributes of theprescriber

The physical setting


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Macro-context

Micro-context

Drug

PhE

RecipientPrescriber

PhE : Pharmacological Effect of the drug


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The whole social, cultural, political &economic milieu, includes:

The moral & cultural values attached The prevailing socio-economic climate, e.g. levels

of poverty or unemployment The role of economic forces in producing,

advertising & selling the drug The social grouping, e.g. family, group of friends,members of healing cult, or a sub-culture ofheroin addicts


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= total drug effect drug

any effect of attributable to a pill, potion orprocedure, but not its pharmacodynamic or specificproperties (Wolf, 1959)

the psychological, physiological orpsychophysiological effect of any medication orprocedure given with therapeutic intent, which isindependent of or minimally related to the

pharmacologic effects of the medication or to the

specific effects of the medication or to the theprocedure, & which operates through a psychologicalmechanism (Shapiro, 1959)


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It is the beliefof those receiving (and/oradministering) a placebo substance or

procedure in the efficacy of that placebo orprocedure that can have both psychological& physiological effects (Helman, 2000)


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Other studies indicate that, dependingon peoples expectation, placebos caneven cause side effects or psychological

dependence on them Patients negative expectations of a

particular medical treatment or

procedure can seriously affect manyaspects of their mental and physicalhealth


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The placebo effect also

influenced by: The color and brand name of drugs

The attributes of the patient receiving the drug

The characteristics of the prescriber

Rapport, mutual confidence & understanding

b/w prescriber & patient

Intrinsic effect of the drug (for recreationaldrug)


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Psychological dependence on drugs:The need the patient experiences for the

psychological effects of a drug. This need can be of2 types :- the patient may crave the drug-induced symptoms or

changes in mood e.g. a feeling of euphoria or a

lessening of tension

- The patient may take the drug to stave off the

symptoms of withdrawal


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Psychotropic drug use is embedded in a matrix ofsocial values & expectations

The drug can be used to improve socialrelationship by bringing ones behavior (&emotions) into conformity with an idealizedmodel of normal behavior

As a means (both pharmacological andsymbolic) of meeting social expectations (incl.the cultures view of what constitutes normal,acceptable behavior)

Social acceptance of psychotropic drug-takingas a normal part of life can lessen the stigma ofpsychological dependence on them


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Without the drug:Id be nervy, impatient with other people

Id be nasty, jumpy, not nice to live withI wouldnt want to see people

I couldnt help those I love


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Success = Individual + Chemical

Mental

Physical

SocialSexual

Economic

e.g.:- Vitamins- Nutriceuticals- Tea- Coffee- Tobacco- Tranquilizers

- Alcohol- Marijuana- Cocaine- Heroin

- Ecstacy

The definition of success nowalso seems to include theabsence of any anxiety,worry, guilt, anger and grief -

emotions


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Medically recognized addiction is only thepathological end-part of a continuum of

drug-taking Physical addiction is not just a physical

phenomenon, it also required certain social orcultural factors


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Public health problem Incidence of alcoholism and the regular

consumption of alcohol on ritual and otheroccasions differ between cultural and socialgroups


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Normal drinking refers to the everyday use ofalcohol at mealtimes or on social and ritual

occasions Abnormal drinking, these mores are

transgressed and there is frequent andexcessive intake of alcohol with resultantuncontrolled, drunken behavior


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Tacit rules about who can drink, in whose company,

in which settings & how much can be consumed

Alcoholism:- the overuse of alcohol


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Some studies:Heavy smoking relates to- a perception of powerlessness by the smokers

- a sense of anomie & futility in the daily lives- a drop in socio economic status- experience of divorce or separation- less academically successful (for teenagers)

- family situation (for teenagers)


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A way of communicating social messages:Lets talk

Lets relax togetherI need to be aloneIm not going to tell you how Im feeling


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The way how people regard & treat their ownill-health Distribution & access The presence of hazards Medicalization

The Essential Drugs Program


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To deal with this chaotic situation, and toensure a more rational and fairly distributed

use of drugs There are a basic drugs that should be

available to any population The list excludes many of the more expensive

or exotic patented drugs


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Help member countries develop nationaldrugs policies for selecting, procuring,storing and distributing essential drugsand through training and monitoring

As well as improving the quality ofavailable drugs and reducing their price,the aim was to achieve a more rationaluse of drugs and greater coverage of theworlds population


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Opposition to this program has come notfrom pharmaceutical industries but also from

local populations Beautifully packaged imported drugs,

adorned with internationally renowned brandnames seem to offer greater healing power

than cheaper one


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In some cultural groups, hallucinogenic drugsare used to obtain states of transcendence

and fervour, and in their trance state thosewho take them are possessed


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Among the more well-known hallucinogenic Marijuana

Psilocybin Peyote cactus Morning glory seeds Jimson weed


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Blood as a vital liquid circulating within the body, &which appears at the surface at times of injury, illness,menstruation or childbirth

The human experiences of blood provides the basis fora variety of illnesses

Changes in its volume (high blood), consistency (thinblood causing anemia), temperature (hot illnessescaused by heat in the blood), quality (impurities in theblood, from constipation), or polluting power

(menstrual blood causing weakness in males) cancaused illnesses


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Belief about menstruation blood divided into 2 types The first: that the menstrual blood is bad blood &

menstruation the process by which the system ispurged of badness or excess. The menstrual process as

essential to producing & maintaining a healthyequilibrium by regular purging of badness. They havea pessimistic attitude towards the menopause

The second: believed that menstruation damaging totheir overall health & were fearful of losing their life`sblood. They wished to cease menstruating as early aspossible and much more positive about themenopause & its attendant symptoms


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Menstruating women are believed to have a

contagious pollution, which is dangerous to

other humans & to the natural world Men`s virility may be weakened by this

blood, especially if they have intercourse Women may be confined each month to an

isolated menstrual hut to protect the

community from their dangerous pollution


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Saw menstruation as a method of riding the body impurities that mightotherwise cause illness or poison the system Saw the uterus as a hollow organ that is opens up to allow the blood to

escape during the period While uterus was open, they believed themselves to be particularly

vulnerable to illness, caused by entry of external forces (cold air or water,germs, witchcraft)

Certain cold foods might clot the hot blood and interrupt the flow &can caused a stroke, cancer, sterility) Cold foodstuffs included fresh fruits, especially citrus, tomatoes, green

vegetables (caused deficient in vitamins) The fear of impeded menstruation may also lead some women to avoid

some methods of contraception


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Down in volume depending on what one eats or drinks, and thiscan cause high blood or low blood

Low blood is believed to result from eating too many acid orastringent foods (lemon juice, olives, Epsom salt, etc) and causesfatigue, lassitude, weakness

This condition should be treated by ingesting certain red foods ordrinks (grape juice, red wine, liver, red meat) High blood results from eating too much rich food especially red

meat (home remedies taking lemon juices, Epsom salt, etc) The clinical implications of this belief are the effects on health of

this type of diet and the effect on compliance with a doctor`sinstructions by one who confuses high blood pressure as highblood


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When lost through injury or disease, can

not be replaced, leaving the victim

permanently weakened In parts of Latin America: this may be one

of the reasons why blood banks are less

successful in getting donations of blood


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Blood is seen as a vital liquid that it almost impossible toreplace if lost

Debilitating sicknesses & worms make the blood dirty Blood can also be lost by having blood samples taken at

hospital or by donating blood To replace, build or purify the blood by the use of certain

foods (palm oil, spinach, potato leaves) All red medicine are considered desirable, provided they are

red, brown, even orange in color Palm oil is the favorite remedy for dirty blood so young

children until their second year fed only soft rice and palm oil

antropologi keseshatan

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