When is necessary understand the cultural marks in health-disease process

This article was exclusively written for The European Sting by Ms. Isadora Moura da Silva, a fourth year Brazilian medical student. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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Faced with a theme as broad as “cultural understanding and cultural shock” I cannot help but think of my own country, formed by the miscegenation of three culturally different folks: portuguese, indians and africans. Throughout history, multiple ethnic groups have been added to the population from migratory movements, from italians to japanese. This constitution makes Brazil a multicultural country, in which there are multiple identities and cultural expressions that must be valued and understood in multiple contexts, such as social, political, economic as well in health condition. It is surprising, however, why a multicultural country such as Brazil lives daily with prejudices and difficulties in living with diversity, which keep a large part of the population in a historical process of marginalization. To make a racial cut, we have that 54.9% of the brazilian population declares to be brown or black. Although the majority of the population, afrodescendants has a higher rate of illiteracy, lower income, higher unemployment rates, higher rates of child labor, higher mortality due to infectious and parasitic diseases, including HIV/SIDA, higher mortality for external and violent causes and complications of pregnancy and childbirth. In addition to, suffer with 39% of the religious intolerance reports, who relate with afro-brazilian religions like Umbanda and Candomblé. So, when we talk about ethnic-racial groups we talk about culture. And that means discuss the identity of the human being within his social group and understand patterns of behavior, customs and moral and ethical values. It is to comprehend origin, belonging and freedom of expression. Similarly, understanding health is to perceive that the well-being of an individual will be determined by a number of factors other than the biological, such as their housing, living and working conditions, their access to education, social services and safety. Therefore, understanding culture is understanding health. It is to perceive that individuals experience the health-disease process in a particular and unique way, according to their beliefs and social conditions. It is also realize that the access to the health system and quality of assistance can be influenced by the culture manifested through the appearance and the color of the skin. It is to understand that the person needs a more global look and that public policies aimed at specific cultural groups are necessary to guarantee a fairer, more equitable and humanized service. In this aspect, to promote the discussion about the particularities of each population group and the plurality of these people, especially those most vulnerable ones, is to secure basic human rights. It is to form, more than future professionals of health or assistance, citizens better able to understand the human being and the health condition in multiple aspects. And this begins by valuing the listening, by establishing a communication that allows raising hidden cultural voices, a kind of dialogue where each interpretation of the health-disease process is valued. About the author Isadora Moura da Silva is a fourth year Brazilian medical student. She currently works as Regional Assistant on Human Rights and Peace Team (2018/19) of IFMSA Brazil and as Local Director of Publications and Research on the local comitee of Universidade Federal de Juiz de Fora – Campus Governador Valadares. She believes that voluntary work through IFMSA is essential for more humanized medical training and to promote improvements for local communities.