In the developed nations of the North, people do not often question the assumption that vaccines are both necessary and essential. In fact, vaccinations are often mandated by law, such as in the case of children entering new schools.
Culture and Patient-Doctor Communication in Bolivia
When biomedical practitioners encounter non-Western traditions, they often deplore patients who refuse basic treatments such as vaccinations. What they may fail to consider is that their patients have often come of age operating under an entirely different set of assumptions about the nature of disease and healing. They are not inclined to change these assumptions any more than the average citizen of the United States or Canada would suddenly give up vaccinating their children.
Miscommunication between practitioners trained in the Western biomedical system and indigenous patients can lead to tragic consequences, especially when the existing medical infrastructure is stretched too thin. For example, in rural Bolivia, up to 441,000 infants die annually from neonatal tetanus – a disease which vaccinations can easily prevent (Bastien 1995: 77).
Aymara Interpretation of Tetanus
Indigenous Bolivians often interpret the symptoms of tetanus according to their own worldview. For example, the Aymara believe that if a baby is left unattended, owls can steal one of the infant’s souls (the Aymara believe humans have three souls) and cause an ailment known as jinchukañu. Often, neonatal tetanus is interpreted as jinchukañu, and the Aymara first consult an ethnomedical healer, who performs a ceremony exchanging animal sacrifices or food for the soul of the infant. Only if this is unsuccessful do they consult a nurse or doctor, by which time it is usually too late for the infant. Although the Aymara understand the value of vaccinations for other diseases, the connection between inoculation and tetanus prevention “is not clear because [neonatal tetanus] is perceived in relation to culturally complex symbols” (Bastien 1995: 81-82).
Tetanus in Rural Cochabamaba
The Quechua people of Cochabamba often interpret neonatal tetanus as a curse someone has placed on the infant. Babies are given to native healers, or curanderos, to remove the curse. Because of the social stigma and fear surrounding sorcery, Quechua women often do not report the deaths of their infants in such cases to medical personnel, with the result that doctors have the impression that tetanus is not prevalent in the countryside (Bastien 1995: 78-79).
Cross-Cultural Communication Strategies
Simply explaining the value of tetanus vaccines as a protection against sorcery, in the case of the Quechua, or owls, in the case of the Aymara, could help curtail this problem. The use of protective amulets and remedies is quite well known to both groups. Practitioners who want to increase the rate of tetanus vaccinations could simply describe the vaccine as a type of protective amulet, or consult local ethnomedical practitioners and involve them in vaccination campaigns.
Source: Bastien, Joseph. Cross-cultural communication of tetanus vaccinations in Bolivia. Social Science and Medicine 41(1), 1995: 77-86.
Colin Forsyth - Colin Forsyth's interests range from butterfly gardening to studying disease prevention in Bolivia to writing fiction for young adults. He ...
