Medical Illness and the Use of Medical Help
In this chapter we will deal with the ways in which the Yemenites cope with illness. We will follow the changes from Yemen to Israel, as the techniques of modern medicine replaced to a great exent those of the traditional healers.
The way people cope with illness depends on several factors. If illness is seen as a form of supernatural retribution for sin, coping with illness has a very different connotation than if the cause is understood to be a physiological derangement or a bacterial invasion. But notwithstanding the set of beliefs about health and disease that people might hold, it is apparent that certain therapeutic techniques work better than others. People who take antibiotics for pneumonia generally recover more quickly and more completely than those who do not. Thus previous experience of different therapies and therapists is also important. Furthermore, neither the patient nor his healer lives in a social vacuum. The total social environment, with its supports and its stresses, affects significantly how a person copes with illness. For example, the first report of feeling ill is generally given to immediate family, friends, or colleagues, and their response often determines the direction and speed of recourse to medical care. Medical care itself may be "popular" in the form of home remedies, "traditional" care given by folk healers, or "professional," as part of a medical institution. The social distance between the patient and his healer increases as he goes from popular care to traditional and, finally, professional care. Finally, illness is an experience. 1 In the end, whatever the overall health belief systems of the patient's community, whatever resources are available, and whatever the social implications of being ill, it is the personal significance of the illness that finally decides how the person copes. "What meaning does this illness have for this person at this time?" is the question the physician needs to ask himself if he wants to give appropriate advice and care.
There are two major difficulties in caring for patients from different cultures. The first is the danger of ethnocentricity, that is, considering the patient's atti-