Medical Pluralism: Understanding Health Seeking Behaviors

Medical Pluralism 1
Medical Pluralism
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Medical Pluralism 2
Introduction
One of the questions that influenced the decision to choose the question related to
medical pluralism is: why do indigenous and mestizo populations in the Americas shy away from
a medical system designed to alleviate the afflictions and ills they suffer?
Medical pluralism is a perfect answer to this question. Medical pluralism can be
described as situation where health and illness, science and experience, ethics and aesthetics,
values and morals, economics and politics, rights and duties, public and private are intertwined
(Redvers, 2018). In medical pluralism, what is problematic is not a type of medication (the
Western one) but the legitimacy of the one who provides it (the doctor). Early historians and
anthropologists who studied medical pluralism wrote about it, as if about equal and peaceful
coexistence of medical systems, but soon realized that there was no equality. On the contrary,
subordinate medical systems exist hierarchically. For example, biomedicine is almost universally
considered the most prestigious and best, but popular and alternative forms of treatment are often
marginalized.
How concept of medical pluralism may help us understand and respond to potentially
problematic and negative health seeking behaviors?
To answer this question, it is important to demonstrate how different ethnic groups seek
and obtain medication. We will start with Western societies. In Western societies the crisis of the
bio-medicine model manifested itself in the last decades of the 20th century for reasons that are
fundamentally associated with the high costs of health and prevention systems. The profitability
imperatives require that consultations, at least in the field of public health, be increasingly brief,
which inevitably affects the patient / patient relationship (In Micozzi, 2011). On the other hand,

Medical Pluralism 3
the so-called family doctors, who knew the families and followed them for years, have decreased
alarmingly. The graduates of the universities prefer to follow more prestigious careers (research
or private sector) discarding the general medicine, not very prestigious and not very profitable.
Hence, an "art" that in the West had developed over the centuries a qualitative relationship with
patients (ability to listen on the part of the doctor, interest in the environment, familial, relational
and professional of the patient), gave way to a technology that, in the name of efficacy, leaves
aside subjective aspects of the patient, which passes from the position of subject to the object of
a clinical observation.
In Latin America, the poverty and marginalization of rural populations, the absence of
social health systems, the isolation of the peoples and the poor quality of medical care all
exacerbate the problems faced by "bio-medicine” (Bala, 2007). In most Latin American
countries, newly-received physicians must carry out a "year of provinces" that is sometimes
reduced to a few months, and settle in inhospitable areas. The majority reluctantly complies with
this obligation - I am aware of personal experience in Ecuador - and patients perceive this
discomfort, which is aggravated by the inevitable rotation of the "doctors" (Incayawar,
Bouchard, Wintrob, Bartocci & World Psychiatric Association (2010) . Rural patients are rightly
considered ill-treated by a third-category medicine, whose protocol is incomprehensible for
linguistic reasons, hence the urgency of training bilingual health personnel.
Bivins (2010) gives us an ethnography of these young doctors and shows that medicines
are not rejected because they are incompatible with traditions, but because they are expensive.
When they are given away, they are used, says Bivins (2010), referring to the Aguaruna of the
Peruvian Amazon rainforest.