Since folk-medicine techniques ostensibly develop over many centuries, one would think its practitioners would slowly come to realize that some practices are actually harmful rather than helpful. But, alas, it turns out our species isn’t always aces at connecting cause to effect. And so we keep using treatments that are several degrees worse than doing nothing at all.
One troubling case in point is traditional birthing in Timor-Leste, where infant mortality is unusually high by regional standards. The difference appears to be due to folk-medicine techniques that inadvertently cause harm to newborns:
“It happens quite a lot that when a mother gives birth, they stay by a fire for three months,” said Macu Guterres, the coordinator of the National Breastfeeding Association for the Alola Foundation, an NGO that supports women and children in Timor-Leste.
“They make a small bed beside the fire and sleep there while the fire burns 24 hours a day,” she said, explaining that the heat from the fire is believed to help dispel “dirty” blood from the body after birth.
“This can affect the baby’s health as well as the mum. The baby can develop asthma or may find it hard to breathe because of the smoke. It happens a lot in Oecussi,” she said, referring to the Timorese enclave deep inside Indonesian territory…
Traditional birth attendants (‘dukuns’), using traditional medicines and sometimes harmful practices, are common, especially in rural areas. The Alola Foundation estimates that only 10 percent of women in Timor-Leste give birth with the assistance of a skilled birth attendant.
Harmful practices by ‘dukuns’ include encouraging the mother to push before she is ready, and placing rice or other substances in the birth canal to “lure the baby out”.
Another common belief is that colostrum, the nutrient-rich milk mothers produce in the late stages of pregnancy and immediately after birth, is bad for the baby.
“They believe using water and honey instead of colostrum will wash the baby’s stomach and intestines and remove dirty blood,” Alola Foundation’s Guterres said.
Stamping out these folkways is no mean feat, as NGOs are often suspected of having impure motives. (In fairness, of course, there are historical reasons for East Indians to be suspicious of Western interlopers.)
Microkhan is not only curious as to how NGOs might best coax these harmful practices out of existence, but also why human beings are so often incapable of recognizing when certain cherished medical techniques need to fall by the wayside. (See: trepanation.) A little more global love for the scientific method certainly wouldn’t hurt.
Jordan // May 4, 2009 at 2:39 pm
At least WRT the fire technique, when you have something that’s ongoing over a fairly long period of time, the changes should be sufficiently incremental as to be almost unnoticeable except to an outsider. When everyone’s doing the same thing, that becomes the baseline.
As a biochemist, I heartily support increased love of the scientific method. I tend to think that it’s far more important the kids be taught the scientific method in school than scientific facts. The latter helps you to be better informed. The former helps you to think more effectively.
Brendan I. Koerner // May 4, 2009 at 4:22 pm
@Jordan: Yeah, I see your point. And I guess it gives me some hope that, yes, these practices can be stamped out if good information is disseminated. Sometimes it takes the intervention of outsiders to point out that things could, indeed, be better.
Captured Shadow // May 4, 2009 at 6:59 pm
Positive Deviant health promotion is somewhat trendy now in NGOs working on improving health behaviors in a non-coercive way.
http://www.positivedeviance.org/pdf/PDMyanmar.pdf
Is a pretty typical report. The idea is to take community members with good health behaviors and results and get them to be role models in communities.
Ell // May 5, 2009 at 7:42 am
Stating the very obvious – demystifying the process of pregnancy and birth to a point where we can stop thinking about blood as being dirty would help enormously. Basic science offered up by compassionate individuals is crucial.
Marie Stopes International do some great work in the region and could always use more support.
http://www.mariestopes.org.au/cms/Timor-Leste.html