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Background material by Professor Omar Hasan Kasule Sr. for Year 1 Semester 1 Biomed PPSD on 15th October 2008
Background
Hannah Cook, an 18-year old native Australian, arrived in Brunei accompanying her petroleum engineer husband. This was the first time for her to travel out of her home in the interior of the Northern Territory. She experienced alternating period of boredom and anxiety while staying alone at home. He husband got her a secretarial job at UBD in the hope that it will keep her busy and make her forget her anxieties. On her first week at the job she was very anxious and made many embarrassing mistakes. A cleaner noticed her anxiety and offered to take her to a traditional healer despite strong objections by the husband. The traditional healer diagnosed the condition as attack by the spirit of the previous owner of the rented house in which Hannah and her husband stayed. The owner died the day he was due to enter the house and missed his house. Some offerings would have to be made to appease the spirit. On the same day under strong pressure from her husband, Hannah agreed to see a general practitioner. The practitioner easily made the diagnosis of thyroid disease and wanted to prescribe medication. Hannah refused to accept the diagnosis and the treatment. She said that neck swelling was part of normal growth in her area experienced in early adulthood by her grandmother, mother, and sister. Many others in the area had swollen necks and there was no accompanying anxiety. She also refused to accept the physician’s explanation that iodine deficiency in the interior was a cause of many people having swollen necks. She wanted to return to the traditional healer for treatment because he seemed to understand her better.
Discussion issues
- Explain how normal changes due to growth /senescence can be distinguished from pathological changes
- Explain why patients would prefer seeing traditional healers despite availability of scientific medicine?