Biomedical subjects
Publications and source records attributed to S R Whyte.
Since the Year of the Disabled (1981) and the Decade for Disabled Persons (1983-1992), many questions have arisen about how to understand and deal with disability in a multicultural world. To what extent can programmes developed in one place be successfully implemented elsewhere? What kinds of cultural and social differences matter and how can they be taken into account?
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The deterioration of government health services in Uganda since 1971 has been accompanied by a process of privatization which has made pharmaceuticals readily available outside of biomedical institutions. On the basis of material from eastern Uganda, the article analyses this development in terms of the 'sector model' of health care systems, with special attention to the relations between the professional and folk sectors. Folk practitioners of pharmaceutical medicine include a broad range of specialists, from government trained paramedicals in private practice to vendors bringing medicine to local markets. Like other folk specialists, they respect the customer's opinion, provide treatment by proxy and adjust their services to the customer's ability to pay. Although there are negative aspects of this development, from the local point of view there are also positive ones, which deserve the consideration of health planners.
Child malnutrition, which is an increasing problem in Western Kenya, is addressed primarily through efforts to reach the individual mother with information about proper feeding of her children. A study carried out in Siaya, Kisumu and Busia Districts showed that mothers perceived nutrition problems differently, emphasizing their embeddedness in gender and family relations. In situations of marital conflict, male labour migration, and impoverishment, women must rely on support from others; thus health education should be addressed to husbands, grandmothers and mothers-in-law as well as mothers.
The existence of therapeutic alternatives, a very widespread feature of medical systems, is to be distinguished from medical pluralism, which characterizes situations where orthodoxy and power accrue to one group of medical professionals. Local African medical systems are dynamic and inclusive and this is the basis for the ready incorporation of Western biomedical elements. Analysis of the medical perceptions, treatments and practitioners of the Nyole of Eastern Uganda reveals that new divination techniques and exotic sorcery medicines have been absorbed as well. Some of the recent changes in Nyole medicine may be indicative of a growing medical individualism. Explanations and treatments directed toward the social and ritual situation of the sufferer still bear the greatest ideological weight.