Cultural Impact: lifestyle and disease management

On 29th July, Friday, WONCA Working Party on Women and Family Medicine (WWPWFM)in association with The Spice Route India Movement (SAR) organized a webinar to discuss Influence of cultural practices on lifestyle and disease management. Family Physicians across South Asia participated with great zeal to share their experiences on the topic. Celebrating the rich culture of South Asia during South Asian Heritage Month, we took a sneak peak into how it affects our lifestyle and hence healthcare in general.

The webinar was conducted in the presence of Dr Elizabeth Reji – Chair WONCA WWPWFM, Dr Hina Jawaid – Regional lead WWPWFM, speakers and several family physicians from South Asia.

Our Speakers were: 

• Dr Anupama Menon from India
• Dr Hansika Hanthanapitiya from Sri Lanka Dr Humaira Khattak from Pakistan
• Dr Sonam Choki from Bhutan Dr Rajani Giri from Nepal
• Moderator – Dr Gunjan Jha - India


The session aimed to discuss following snippets –

• Cultural influences on lifestyle - early waking/frequent fasting/early dinner, and similar practices.

• Illness prevention and management protocol - that special kaadha or appetizer taken regularly to avoid falling sick.

• Is western medicine or surgical intervention stigmatized/avoided ? If yes...how are we trying to create acceptance?

• How is family history of illness handled - taboo/outcast/no marriage prospects - i.e. is genetic aspect a legit concept?

• Pregnancy care and immunization - any Culture puts its best effort in taking care of the upcoming generation - discussing this segment will throw major light on how evolved is our culture.
 
The session began with views of the beautiful mountain dwelling nation of Bhutan. Dr Sonam showed us several cultural practices such as wine offering ceremony, betel nut chewing, prevalence of traditional medicines and the challenges henceforth.

We moved next to the landlocked country of Nepal – Dr Rajani described the significant influence of agriculture and spiritual practices in shaping their lifestyle. Early rising, frequent fasting, sattvic food habits, regular walking, working in agriculture sector, joint family system are all a part of traditional living practice. She reminisced the use of Giloy during COVID, ginger tonic for flu and so forth. Home remedies and traditional medicine do have acceptance in rural region. Stigma towards leprosy, epilepsy or fertility issues is rampant. Community workers have a strong network working towards pregnant women and infant care. Apprehension towards institutional delivery being converted to caesarean delivery promoted home delivery. It was a wholesome insight of how healthcare functions and has created inroad in the country.

Thereafter, the speaker from India – Dr Anupama Menon, put forth the beautiful collage inscribed in Indian Culture. Owing to different demography, topography and rural-urban divide, she had a plethora of interesting aspects to cover. Early rising, meal before sunset, frequent fasting schedules, dietary regulations encouraging sattvic eating habits and lots of medicinal plants being part of household such as tulsi, neem, aloe vera etc. – were integral to core Indian culture. People prefer natural treatment in lieu of avoiding side effects as they believe alternate treatment options have no side effects. Outreach of healthcare in India works in a network of CHC, PHC, ASHA and Anganwadi workers – therefore creating a good nexus apart from private set ups and tertiary care centres – hence effective ground work is done which is now reflecting in improved infant and maternity mortality rates. Acceptance of care during pregnancy and infant care has boosted thanks to presence of local faces in healthcare. Regarding taboo aspect of diseases – epilepsy, mental disorders, skin diseases and infertility top the chart. Situation is comparatively better for men. Awareness is more in urban area than rural. Holistic wellness is the most important take home message from Indian Scenario.

Dr Humaira Khattak from Pakistan offered a picturesque view of beautiful amalgamation of Sindhi, Punjabi, Balti, Balochi, Pashtun and Kashmiri culture. Healthcare system faces challenges due to catastrophic floods, rise of Taliban in vicinity, political turmoil and recent covid pandemic. The well drafted slideshow brought up the challenges faced by folklore. Vaccination drive and awareness sessions for the local masses have been an ongoing effort. Many lifestyle diseases attribute their origin to the recent sedentary lifestyle picking up in affluent population of the country. The rise in non – communicable disease is a testimony to the change in lifestyle. The country is grappling with its challenges and hopes to have a better network of facilities via a combined effort from South Asia.

The session went on to hear the views from the country of beautiful beaches – Sri Lanka. Dr Hansika Hanthanapitiya discussed about the cultural practices influenced by the predominant agricultural background of the nation. The healthcare has similar struggles as its neighbouring countries but the robust network of healthcare workers have shown commendable improvement. Almost all patients have access and preference for institutional delivery and vaccination coverage along with healthy breastfeeding. Dietary habits were customized in lieu of health status of subject such as pregnant, sick, elderly or child. With change in lifestyle rise of non-communicable diseases has been noted. The villages have a habit of hanging medicinal leaves on their gate to have healing benefits and to notify others that infection is present in this house. Health drinks such as Koththamali comprising of local products is followed in households. The healthcare network boasts of commendable rates of breastfeeding coverage and infant and maternal mortality rates.
 
The discussion provided an insight into the boon, our cultural practices have provided and how current healthcare system has merged into it and helped to create a healthy population. It was a beautiful afternoon of camaraderie and brought the essence of similarity in terms of similar cultural practices and familiar struggles. In unison the south Asian countries reinforced their pledge to create an ecosystem for better health facilities and awareness for ample preventive measures. Dr Elizabeth Reji shared her words of wisdom and encouraged all the speakers and participants.

Hoping for many more such academic and cultural exchanges in future.

Dr Gunjan Jha
Young Doctor lead- WWPWFM
National Treasurer and FM 360 Coordinator- The Spice Route India Movement