4 ms·

A Prayer’s Chance: The scandal of mental health in West Africa (2017)

32 points by Thevet 9y ago

allthenews 9y ago
Is it right to help people in third world countries if it effectively means we are erasing parts or all of their culture with our own? Are we meddling?
- whatshisface 9y ago
  I'm not sure what's questionable about that, we "erase" things from western culture (doctors being proud of bloodstains and never sanitizing for one example) to improve its effectiveness fairly often.
  - allthenews 9y ago
    I think there's an implicit assumption of cultural superiority in such case. This mirrors the pattern of imperialist "civilization" of "savages" that drove the European world to commandeer undeveloped nations over the last few hundred years at least. Sure, we believe that we have discovered certain truths through this concept that we call science, and, our ideas seem objectively correct; but does that justify our interference, and replacement of parts or all of their cultures with our own? There are parallels here to government sponsored gentrification, I think.
    - Parcissons 9y ago
      Some cultures you would protect do not have this quarells. They produce social dynamite that constantly attacks weak members of the culture or other neighbouring cultures. If it is western culture to vote dictators to power who send culture relativists into camps, is the preventing of this not "meddling"? Or are some 'cultures' just regression and barbarity hamered into laws, protected from discussion by some "god" who created them. Is discussing other peoples missery and supression by a culture who do not get to have a say due to the culture - not actually a privilege and meddling with theire basic rights as a individual? Is the collective always worthier of protection, than the individual?
    - Kalium 9y ago
      What alternatives do you find preferable, should one wish to avoid contamination and preserve the purity of indigenous cultures? Shall we not tell people that conditions are treatable or offer our knowledge, because it stems from a Western imperialist cultural context?
      - allthenews 9y ago
        I'm not sure, I don't mean to imply any wrongdoing with any certainty, only to give pause to people who blindly believe that they are helping. But, what about cultures that, for example, believe that pain is integral to the human experience? Or possibly those that believe that humans are better off having suffered some amount in their youth? These ideals are inconsistent even among the developed world[1]. I guess the question is, are we wrong in assuming that our ideals regarding medicine and necessity for treatment are universal? And if we are, are we wrong in stepping in and attempting to improve quality of life according to our first world notions? Then there's the question of whether we really have made things better in, say, much of Africa over the last few decades. 1. https://news.ycombinator.com/item?id=16252372 https://news.ycombinator.com/item?id=16252372
        Kalium 9y ago
        You're absolutely right! Many cultures have different attitudes than ours. Pain is an excellent example. Are you aware that it's also a cornerstone of Western Imperialist Medicine that the patient has the right to refuse any treatment, such as palliative treatment for pain? In this way, our attitudes are not forced on other cultures. Members of other cultures are offered personal choices. Though I recognize that some regard this as a cultural imperialist imposition on cultures where personal autonomy is not valued. Personally, I think that western cultural imperialism has drastically improved lives through items such as anti-retrovirual drugs, mosquito nets, and drinking water filters. But I understand that some might choose to value traditional ways of life and ways of knowing and folk beliefs - and the attendant human suffering and deaths - over imposing our cultural that values human lives and the reduction of suffering. It's just perhaps possible that, having carefully considered this issue, and aware of the historical context wherein this is not assumed but thought about, some people may have concluded that this is an acceptable imperialist imposition. Thank you very much for your kind, caring, thoughtful ideas!
    - duncan_bayne 9y ago
      > I think there's an implicit assumption of cultural superiority in such case. Actually, at least in my case, it's pretty explicit. A culture that embraces science and evidence-based medicine is objectively superior - in that respect - to one that does not. I say in that respect because obviously cultures are multifaceted. It's entirely possible for, say, a culture to have a superior approach to evidence based medicine, while having an inferior approach to aged care.
- ghostbrainalpha 9y ago
  I think we need to get much more specific in our definition of "culture" if we are going to fight to protect it. If "culture" includes every single belief or practice a community might have, regardless of whether it is factually true or if it has benefits to the community, we are going to have problems. Under the broadest possible definition you would want to protect rape culture, because that is a specific culture. A more narrow definition would allow us to keep certain untrue beliefs that didn't cause harm (i.e. Santa Claus), but eliminate destructive inaccurate beliefs. (i.e. Human Sacrifice guarantees good crop yields). It might feel arrogant to presume what beliefs are harmful, and this is where we have to be careful. But if there is anything that should be clearly immune from criticism of racism or imperialism it is the pursuit of scientific approaches to medicine.
- duncan_bayne 9y ago
  Yes, absolutely. Consider the obvious edge case: https://en.wikipedia.org/wiki/Sati_(practice) https://en.wikipedia.org/wiki/Sati_(practice) That's a "part ... of their culture" that definitely warranted erasure, and which was erased in part by colonial forces, who in that case were absolutely morally correct to exercise their power in doing so.
  - allthenews 9y ago
    But what would you say to a nation militarily imperializing your own over some cultural practice of your own? Sure, you don't think any of your practices are abhorrent, but there are major religions who would disagree over, say, eating meat, or certain animals, conflicts over early and/or late term abortion, etc What, if anything, gives someone the right to force their subjective cultural views onto others? Are any cultural morals truly universal?
sandworm101 9y ago
Those in glass houses. Faith-based healing, in paticular 12-step programs, are common in the US. I would not equate the two, but the idea of treatment through prayer isnt just an africa thing.
- deleted 9y ago
  [deleted]
- jacobush 9y ago
  And sometimes it even works.
  - echlebek 9y ago
    Is there evidence of that?
    - jacobush 9y ago
      Everyone should agree that between pure chance and the placebo effect, there must be quite a few cases. As for the rest, it's a matter of faith?
    - paulryanrogers 9y ago
      Having grown up in a faith+medicine culture I've not witnessed any proven healings (that didn't invoke medicine too) in over 20 years. It's one of the reasons I'm not a believer today.
    - duncan_bayne 9y ago
      There's plenty of evidence, but probably not for 'works' in the sense the GP meant. https://en.wikipedia.org/wiki/Regression_toward_the_mean https://en.wikipedia.org/wiki/Regression_toward_the_mean https://en.wikipedia.org/wiki/Placebo https://en.wikipedia.org/wiki/Placebo
    - Broken_Hippo 9y ago
      Evidence is mixed, and it depends on what numbers you look at unfortunately. I've personally met at least one person that credited the program with kicking drinking. Unfortunately this doesn't really make it any better than a placebo effect (Which is better than nothing, I guess). And it doesn't cure my special hatred for AA (and AA type programs), especially as a court-ordered standard of care.
RcouF1uZ4gsC 9y ago
The issue is often that even with modern medicine, the treatments for mental illness are less than ideal. The medications effectiveness can vary as can the side effects. So when people hear that at best they have a life-long condition that can at best be managed with medication that they have to take everyday (which can be expensive) and have to watch out for side effects and other health problems from the medications, of course people will look to anything that will give them hope. Even in the most modern treatment center with the most modern drugs, they will have to restrain some patients (whether chemically or physically). This goes to show that we still are still at a very early stage in our understanding and treatment of mental illness. How many times have you heard of faith healing for a torn ACL (anterior cruciate ligament in the knee)? I have never heard of it, because we have a common procedure that works very, very, well with little side effects other than the immediate pain and discomfort post-surgery. In terms of glass houses, compared to anti-vaxxers and "raw" water drinkers in the US, the people seeking faith healing are at the level of Socrates in terms of logical thinking.
robocat 9y ago
[schizophrenics] do better in Third World than in West (1996) http://www.independent.co.uk/news/mentally-ill-do-better-in-third-world-than-in-west-1320282.html http://www.independent.co.uk/news/mentally-ill-do-better-in-...

32 points by Thevet 9y ago

Is it right to help people in third world countries if it effectively means we are erasing parts or all of their culture with our own? Are we meddling?

whatshisface 9y ago
I'm not sure what's questionable about that, we "erase" things from western culture (doctors being proud of bloodstains and never sanitizing for one example) to improve its effectiveness fairly often.
- allthenews 9y ago
  I think there's an implicit assumption of cultural superiority in such case. This mirrors the pattern of imperialist "civilization" of "savages" that drove the European world to commandeer undeveloped nations over the last few hundred years at least. Sure, we believe that we have discovered certain truths through this concept that we call science, and, our ideas seem objectively correct; but does that justify our interference, and replacement of parts or all of their cultures with our own? There are parallels here to government sponsored gentrification, I think.
  - Parcissons 9y ago
    Some cultures you would protect do not have this quarells. They produce social dynamite that constantly attacks weak members of the culture or other neighbouring cultures. If it is western culture to vote dictators to power who send culture relativists into camps, is the preventing of this not "meddling"? Or are some 'cultures' just regression and barbarity hamered into laws, protected from discussion by some "god" who created them. Is discussing other peoples missery and supression by a culture who do not get to have a say due to the culture - not actually a privilege and meddling with theire basic rights as a individual? Is the collective always worthier of protection, than the individual?
  - Kalium 9y ago
    What alternatives do you find preferable, should one wish to avoid contamination and preserve the purity of indigenous cultures? Shall we not tell people that conditions are treatable or offer our knowledge, because it stems from a Western imperialist cultural context?
    - allthenews 9y ago
      I'm not sure, I don't mean to imply any wrongdoing with any certainty, only to give pause to people who blindly believe that they are helping. But, what about cultures that, for example, believe that pain is integral to the human experience? Or possibly those that believe that humans are better off having suffered some amount in their youth? These ideals are inconsistent even among the developed world[1]. I guess the question is, are we wrong in assuming that our ideals regarding medicine and necessity for treatment are universal? And if we are, are we wrong in stepping in and attempting to improve quality of life according to our first world notions? Then there's the question of whether we really have made things better in, say, much of Africa over the last few decades. 1. https://news.ycombinator.com/item?id=16252372 https://news.ycombinator.com/item?id=16252372
      - Kalium 9y ago
        You're absolutely right! Many cultures have different attitudes than ours. Pain is an excellent example. Are you aware that it's also a cornerstone of Western Imperialist Medicine that the patient has the right to refuse any treatment, such as palliative treatment for pain? In this way, our attitudes are not forced on other cultures. Members of other cultures are offered personal choices. Though I recognize that some regard this as a cultural imperialist imposition on cultures where personal autonomy is not valued. Personally, I think that western cultural imperialism has drastically improved lives through items such as anti-retrovirual drugs, mosquito nets, and drinking water filters. But I understand that some might choose to value traditional ways of life and ways of knowing and folk beliefs - and the attendant human suffering and deaths - over imposing our cultural that values human lives and the reduction of suffering. It's just perhaps possible that, having carefully considered this issue, and aware of the historical context wherein this is not assumed but thought about, some people may have concluded that this is an acceptable imperialist imposition. Thank you very much for your kind, caring, thoughtful ideas!
  - duncan_bayne 9y ago
    > I think there's an implicit assumption of cultural superiority in such case. Actually, at least in my case, it's pretty explicit. A culture that embraces science and evidence-based medicine is objectively superior - in that respect - to one that does not. I say in that respect because obviously cultures are multifaceted. It's entirely possible for, say, a culture to have a superior approach to evidence based medicine, while having an inferior approach to aged care.
ghostbrainalpha 9y ago
I think we need to get much more specific in our definition of "culture" if we are going to fight to protect it. If "culture" includes every single belief or practice a community might have, regardless of whether it is factually true or if it has benefits to the community, we are going to have problems. Under the broadest possible definition you would want to protect rape culture, because that is a specific culture. A more narrow definition would allow us to keep certain untrue beliefs that didn't cause harm (i.e. Santa Claus), but eliminate destructive inaccurate beliefs. (i.e. Human Sacrifice guarantees good crop yields). It might feel arrogant to presume what beliefs are harmful, and this is where we have to be careful. But if there is anything that should be clearly immune from criticism of racism or imperialism it is the pursuit of scientific approaches to medicine.
duncan_bayne 9y ago
Yes, absolutely. Consider the obvious edge case: https://en.wikipedia.org/wiki/Sati_(practice) https://en.wikipedia.org/wiki/Sati_(practice) That's a "part ... of their culture" that definitely warranted erasure, and which was erased in part by colonial forces, who in that case were absolutely morally correct to exercise their power in doing so.
- allthenews 9y ago
  But what would you say to a nation militarily imperializing your own over some cultural practice of your own? Sure, you don't think any of your practices are abhorrent, but there are major religions who would disagree over, say, eating meat, or certain animals, conflicts over early and/or late term abortion, etc What, if anything, gives someone the right to force their subjective cultural views onto others? Are any cultural morals truly universal?

sandworm101 9y ago

Those in glass houses. Faith-based healing, in paticular 12-step programs, are common in the US. I would not equate the two, but the idea of treatment through prayer isnt just an africa thing.

deleted 9y ago
[deleted]
jacobush 9y ago
And sometimes it even works.
- echlebek 9y ago
  Is there evidence of that?
  - jacobush 9y ago
    Everyone should agree that between pure chance and the placebo effect, there must be quite a few cases. As for the rest, it's a matter of faith?
  - paulryanrogers 9y ago
    Having grown up in a faith+medicine culture I've not witnessed any proven healings (that didn't invoke medicine too) in over 20 years. It's one of the reasons I'm not a believer today.
  - duncan_bayne 9y ago
    There's plenty of evidence, but probably not for 'works' in the sense the GP meant. https://en.wikipedia.org/wiki/Regression_toward_the_mean https://en.wikipedia.org/wiki/Regression_toward_the_mean https://en.wikipedia.org/wiki/Placebo https://en.wikipedia.org/wiki/Placebo
  - Broken_Hippo 9y ago
    Evidence is mixed, and it depends on what numbers you look at unfortunately. I've personally met at least one person that credited the program with kicking drinking. Unfortunately this doesn't really make it any better than a placebo effect (Which is better than nothing, I guess). And it doesn't cure my special hatred for AA (and AA type programs), especially as a court-ordered standard of care.

RcouF1uZ4gsC 9y ago

The issue is often that even with modern medicine, the treatments for mental illness are less than ideal. The medications effectiveness can vary as can the side effects. So when people hear that at best they have a life-long condition that can at best be managed with medication that they have to take everyday (which can be expensive) and have to watch out for side effects and other health problems from the medications, of course people will look to anything that will give them hope. Even in the most modern treatment center with the most modern drugs, they will have to restrain some patients (whether chemically or physically). This goes to show that we still are still at a very early stage in our understanding and treatment of mental illness. How many times have you heard of faith healing for a torn ACL (anterior cruciate ligament in the knee)? I have never heard of it, because we have a common procedure that works very, very, well with little side effects other than the immediate pain and discomfort post-surgery. In terms of glass houses, compared to anti-vaxxers and "raw" water drinkers in the US, the people seeking faith healing are at the level of Socrates in terms of logical thinking.

robocat 9y ago

[schizophrenics] do better in Third World than in West (1996) http://www.independent.co.uk/news/mentally-ill-do-better-in-third-world-than-in-west-1320282.html http://www.independent.co.uk/news/mentally-ill-do-better-in-...