What is Biomedical Healthcare?
As per World Health Organization’s (WHO) definition, health refers to the infirmity or absence of disease and a state of complete mental, physical, and social well-being. The biomedical model of health looks at illness and disease’s biological and physical elements. Therefore, biomedical health care includes a medical model involving all the healthcare professionals, including the doctors. Usually, Biomedical Healthcare will include curing, diagnosing, and treating disease.
Evolution has been occurring in the Biomedical model of health throughout the years, which has seen improvements in technology, medical science, and increased treatments and cure. The main emphasis of biomedical health care is on illness, disease, or disability and the attempts made to ensure that the patient returns to their pre-health state. There are so many historical occurrences that have been seen in different places as humans try hard to fulfill their duty of providing medical care. Some of these historical moments in biomedical care are discussed below.
In a study by Gottlieb (2016), he explores various objections to the vaccine skeptics since extensive data shows a huge number of the United States parents do not opt to vaccine their children. This is mainly due to the outbreaks of vaccine-preventable diseases. In the article, Gottlieb sees it fit to dismiss his belief by arguing that this ideology is not backed up with any valid reasons. The data for the research was obtained from southern California, where Gottlieb (2016) looked to consider why the parents were accepting some vaccines and staying away from others.
The author then calls for the public health sector, including the physicians and other advocates of vaccines, to deeply look the main reason behind the parents’ skepticism towards vaccines. He says that there is a chance that some of the recipients of the vaccine can be truly exposed to some risks. Therefore, the author poses that the doubt in parents may be increased by the clinical and public health messages despite such messages reducing the parents’ fear. Hence, one of the significant expressions of medical resistance has, at one point, been revealed through the action of the parents in choosing to change the normal vaccine schedule or opting out of the vaccines.
Immunization is a significant aspect that is considered as humans try to fulfill their duty to provide biomedical health care. Renne (2006) opted to look at the different perspectives presented about polio and immunization in Northern Nigeria. Between 1988-and 2005, the cases of polio had hugely reduced globally. However, things were different in Northern Nigeria during this period, such that the country continued to record a high number of polio cases. In his paper, Renne (2006) looked at the various barriers against polio eradication in Northern Nigeria by collecting residents’ views from Zaria, a town in northern Kaduna State.
Renne (2006) established that some individuals believed that anti-fertility substances had contaminated the distributed vaccines. Other people were wondering if more emphasis was being placed on polio at the time, yet more harm was coming from malaria and measles. The doubt, another group of people, lied about how safe the Western biomedicine was. Through such concerns, there was a correlation on how the vertical health interventions were appropriate, especially with low routine immunization. The Western donors said that the Polio Eradication Initiative was cost-effective. However, a section of people from Zaria saw this as how primary health care was undermined. Instead, they suggested implementing a more acceptable approach that should have followed a community-based framework, collaborative and included routine immunization.
Historical Moments in Biomedical Care
In the video provided in the course materials entitled In the Shadow of Ebola, it becomes clear that Liberia was hit by the Ebola outbreak (PBS 2015). Ebola being a highly contagious disease, the disease spreads quickly within a short period. The number of people dying daily from the disease was devastating. This even led the country’s government to close schools and restrict people from traveling and working. To further contain the disease, a 9 p.m. to 6 a.m. curfew was even effected. However, evidently from the video, things do not change for the better (PBS 2015). This is hugely attributed to the post-war effect that Liberia was suffering from. Hence, there was poor public health awareness and poor public health infrastructure. This led to increased admission into hospitals due to Ebola, which forced the hospital to prevent more patients from accessing medical care.
People have always been at the forefront of ensuring that the concept of health is extensively understood and meaningfully improved. To improve their health outcomes, people always tend to utilize the technologies and infrastructures availed to them. For instance, one of the infrastructures that people have hoped to improve their health status is retail pharmacies.
Most of the recent policy debates focus on the role played by the retail sector in the control of malaria in Africa. The perspectives of owners and managers of retail drug shops and pharmacies in Dar es Salaam have proved useful in answering the question of whether the retail pharmacies are partners in health or soft targets, as far as the malaria control program in Tanzania is concerned (Kamat and Nyato 2010, 626-33). The perspective collected in the study included the various activities concerning how artemisinin-based combination therapy (ACT) was really effective in the control of malaria and how they viewed the general public health discourse. Kamat and Nyato (2010, 626-33) also focused on the social realities that faced the people that managed the retail pharmacies, the type of antimalarials they sold, how they interacted with their customers, and how they perceived the effect of the new malaria treatment guidelines on their business.
Most pharmacy owners reported that their business was not negatively affected by the introduction of ACT in public health facilities concerned (Kamat and Nyato 2010, 626-33). They also reported that the number of sales they made on the conventional antimalarials was equal to the previous ones. The major aim of their study was to assess whether pharmacy owners and managers become more socially responsible and adhere to the government’s regulations regarding health. In this case, the government of Tanzania is seen to be involving the ‘people’ in the form of the pharmacy owners and managers to try and control the malaria situation in the country. The pharmacy owners were involved in the decision-making processes concerning implementing new treatment guidelines, considering the effects of social responsibility, business, and community health. Hence, public health officers are always advised to comprehensively consider that retail pharmacies play a huge role in the country’s health care system.
Medical Resistance and Immunization
In a bid to control malaria, people have also come up with various technologies. For example, rapid diagnostic tests (RDTs) have been implemented as simple mobile technologies to standardize the parasitological diagnosis of malaria in various medical settings. A study was studied to evaluate the RTDs’ effectiveness by looking at qualitative research done over a certain period (Beisel, Rene, Hutchinson, and Clare 2016, 1-9). The evaluation was done considering various assumptions that are likely to be experienced in practice in the daily clinical settings, drug stores, health centers, and the health volunteers in the community.
Beisel, Rene, Hutchinson, and Clare (2016, 1-9) established that it is easy to make RTDs effectively work in various healthcare settings that are economically pressured. Such economically pressured healthcare settings are seen in developing nations such as Sierra Leone, Uganda, and Tanzania. This is even though using these tests as stand-alone technologies is possible. In economically pressured healthcare settings, one is likely to experience underpaid and understaffed personnel, high patent loads, and under-equipment in certain treatment and diagnostic capacities. Hence, for the RTDs to achieve maximum effectiveness, the infrastructure created to substitute them must be availed without fail(Beisel, Rene, Hutchinson, and Clare 2016, 1-9). These infrastructures include organizational capacity, medical expertise, and the treatment and diagnostic options of health systems that are functioning and well-funded. Therefore, it is evident that for health issues such as malarial to be effectively diagnosed and treated, extensive investment needs to be made for both the new technologies and the general health infrastructure (Beisel, Rene, Hutchinson, and Clare 2016, 1-9). With this, there is some green light and hope for the developing nation not to abandon the implementation of RDTs in the future.
Public Health Policy 1: Oral Health
Anthropology refers to the study of different aspects of humanity. This covers various aspects, including human biology, societies, human behavior, cultures, and linguistics, both in the past and present. Anthropologists have proved to offer important insights as far as public health is concerned.
Anthropological perspectives have been used to shed more light on the issue of oral health in the Cree communities of Northern Quebec (Shrivastava, Roxane, Yves, Jill, Felix, Bousquet, Pierre, and Elham, 2020). Oral health outcomes can be largely improved by integrating primary oral health care. In their study, Shrivastava, Roxane, Yves, Jill, Felix, Bousquet, Pierre, and Elham (2020) researched the participants’ perception regarding the culturally-based approaches and their conceptualization of primary health care, and their experiences while receiving oral care services. This research established that three main anthropological concepts influenced the integration of primary health care. These included the Cree perception of cultural safety, oral health and primary health care, and the communication between the patient and the healthcare provider (Shrivastava, Roxane, Yves, Jill, Felix, Bousquet, Pierre, and Elham 2020).
From the findings of the study of Shrivastava, Roxane, Yves, Jill, Felix, Bousquet, Pierre, and Elham (2020), it can be deduced that there is a dichotomy in the view of primary health care and important elements of care between the non-Cree professional perspective and the cultural and structural Cree perspective. While the unit of care among the Cree people was the “household,” the non-Cree people thought their units of care to be the “health care services.” Hence, based on this study’s anthropological analysis, the appreciation of both the workers and users in oral care can likely be increased by improving intercultural knowledge and communication skills.
Liberia and Ebola: Post-War Challenges
Ethnography, the anthropology discipline’s hallmark, has played a huge role in understanding how contemporary society behaves. Ethnography has a great contribution to global health (MacDonald 2017). In her study, MacDonald (2017) stresses that ethnographers always strive to understand the actions and moral worlds in cultural groups and individuals. For example, while in Malawi, she came across a woman who thought it would be effective for the traditional birth attendants to begin distributing condoms. The woman wanted to understand how she could get the traditional birth attendants to distribute condoms since she believed that they were the ideal community actors as far as her HIV prevention project was concerned.
However, MacDonald had an anthropological background and had already interacted with the women in her Monkey Bay Safe Project. She already knew that the women would not help distribute the condoms because they said they never could speak with men regarding that issue (MacDonald 2017). Despite the traditional birth attendants being imagined as part of the team dealing with ‘reproductive and sexual health, they refused the task, saying that their culture did not allow them to do that. Therefore, MacDonald noted that before trying to implement any public health strategy in any given area, it is important to first do an anthropological study in the area so that the culture and behavior of the people in that region can be understood.
The public health sector is aware that most diseases are caused by micro-organisms that are likely to be transmitted through germs. Hence, more emphasis has been placed on the maintenance of hygiene to prevent a number of diseases. The major objective of the colonial public health services during the nineteenth and early twentieth century included the utilization of quarantine and sanitation to protect the European colonists’ lives and economic interests (Hahn and Marcia 2008).
A good example of the public health program that focused on hygiene in the past is seen through the development of the Rockefeller Foundation. The first task of the Rockefeller Foundation included an emphasis on the hookworm eradication campaigns in the rural United States South (Hahn and Marcia 2008). The explicit rationale utilized by the Rockefeller Foundation to gain the trust of the foreign public health administrations was hookworm. Hookworm was chosen as a model disease since it had a chronic presence in most the tropical areas, its potential to be removed from the environment by the construction of latrines, and the fact that it could be easily removed from the body by the use of vermifuge treatments (Hahn and Marcia 2008). The Rockefeller Foundation did its role mainly via demonstrations. They said that eradicating hookworm was a means to an end rather than being the end itself (Hahn and Marcia 2008). Hence, initial inroads into foreign health services were being offered by the hookworm prevention work, depicting the Rockefeller Foundation as having effective public health methods for foreign physicians.
References
Beisel, Uli, Rene, Umlauf, Eleanor, Hutchinson, and Clare Chandler.2016. “The Complexities of Simple Technologies: Re-Imagining the Role of Rapid Diagnostic Tests in Malaria Control Efforts”. Malaria Journal 15(64): 1-9.
Gottlieb, Samantha. 2016. “Vaccine resistances reconsidered: Vaccine skeptics and the Jenny McCarthy effect”. BioSocieties 11: 152–174.
Hahn, Robert A., and Marcia C. Inhorn. 2008. Anthropology and public health: bridging differences in culture and society. Oxford University Press.
Kamat, Vinay and Nyato, D. 2010. “Soft Targets or Partners in Health? Retail Pharmacies and their Role in Tanzania’s Malaria Control Program”. Social Science and Medicine 71(3):626-633.
MacDonald, Margaret. 2017. Why ethnography matters in global health: The case of the traditional birth attendant. Journal of Global Health, 7(2).
PBS. 2015. INDEPENDENT LENS | In the Shadow of Ebola | PBS. [YouTube]. From https://youtu.be/y5z3Rb8YBC8
Renne, Elisha. 2006. “Perspectives on Polio and Immunization in Northern Nigeria”. Social Science and Medicine 63(7): 1857-1869.
Shrivastava Richa, Roxane Campeau, Yves Couturier, Jill Torrie, Felix Girar, Bousquet Marie-Pierre, and Elham Emami. 2020. “Anthropological perspectives on Miyupimaatisiiun and the integration of oral health in primary care in the Cree communities of Northern Quebec.” PLoS ONE 15(4): e0231406. https://doi.org/10.1371/journal.pone.0231406
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