By Angela Li
Culture-bound syndromes are a confusing concept. The actual terminology is inaccurate, as culture bound syndrome has evolved into something that is not truly “bound” to one culture, mainly just non-Western cultures, and the term syndrome can be too all encompassing to be accurate. Most culture-bound syndromes are localized to certain cultures or regions, most often the aforementioned non-West. Broadly speaking, culture-bound syndromes are any sort of diagnoses that recognizes abnormal behavior that is cause for distress. In the Philippines, lanti is the term for when one is sick— be it from a plethora of symptoms such as crying, stomachache, or fever. Being diagnosed with lanti is tantamount to assuming one has been surprised or upset of late. In Peru, the term saladera is given to those assumed to be bewitched and consequently befallen with bad luck. In South Asia, latah is a similar predicament, where one being constantly frightened leads to peculiar, atypical behavior in response to being startled such as copying the actions of others. Mental illnesses are often assigned culture-bound syndrome titles, or certain syndromes have akin qualities to Western designations of mental illnesses (think schizophrenia or depression). However, a patient’s own understanding and perception of their syndrome can affect their symptoms, their experiences, and their behaviors themselves.
One of the major issues combatting culture-bound syndromes is the constant risk of dismissal, due to their uniqueness, a side effect of romanticizing “exotic” cultures. Non-Western cultures are often defined as rooted in traditional thought and therefore in juxtaposition to what are deemed as modern societies; but conceptualizing culture in this way can reinforce the idea of modernity and in this case, medical sciences, as only a trait of the West, reinforcing the idea that the West is obligated to save other cultures. Culture-bound syndromes exemplify that different cultures are not lesser nor less knowledgeable, but are merely different. These diagnoses are thus a good example of the necessity of respecting and acknowledging culture— cultural beliefs, practices, and environment— when treating various illnesses.
By Angela Li
The United States Department of Agriculture defines food deserts as “parts of the country vapid of fresh fruit, vegetables, and other healthful whole foods, usually found in impoverished areas.” This void is predominantly the result of limited accessibility to healthy food providers, or no accessibility at all; thus, reliance on processed foods increases. This void is, instead, filled with cheaper convenience stores and fast food restaurants. Food deserts largely hurt rural, marginalized, vulnerable, and low-income communities who do not have the financial resources to allow for healthy eating without burdening themselves. Nutritious foods often have drastically different price points than more obtainable, processed foods. Consequently, residents of food deserts have diets laden with high fat, sugar, and sodium, ultimately culminating in poor health outcomes. This lack of healthy foods affects how people choose their foods: rather than for health and nourishment, residents are restricted to only what foods are available to them, what foods are cost effective.
Additionally, food deserts cannot accommodate those with specific allergies, dietary restrictions, or a need for culturally distinct items. Low-income communities also do not have the financial ability to choose to move into areas that offer better food choices. There are also the issues of transportation, time, and travel. People living in food deserts face obstacles such as unsafe areas to travel in, poor or erratic sources of transport, minimal time to even go grocery shopping due to work, single parenthood, lack of time for constant meal preparation. Food deserts further contribute to health disparities that align with historically enabled injustices within the political, social, cultural, and economic realms. The minorities that these injustices marginalize are disproportionately negatively affected.
The development of food deserts can be contributed to development of larger chain stores, demographic changes, and land fragmentation. Large chain stores want to be in communities that have residents who can assuredly be profited off of. Economic segregation within American cities, with wealthier residents moving out of inner cities, led to a lower median income that could not sustain larger supermarkets. In some areas, land is broken up to make it easier to sell, and these smaller plots of land are unsuited for the building of large supermarkets. The growth of large chain stores, chains with better quality and variety of foods, in affluent parts outside of the inner cities can attract consumers away from smaller and independent stores, forcing their closure. Only those with reliable access to transportation are able to take advantage. However, underlying these reasonings is all the pervasive theme of racism, prejudice, and discrimination that make developers and policy unable and unwilling, respectively, for construction in low-income neighborhoods. As a result, these neighborhoods are hurt disproportionally by food deserts and inevitable mortality, morbidity, and health problems such as diabetes and heart disease, all of which are further exacerbated by the strains of poverty. Even if supermarkets and grocery stores are built in food deserts, residents often feel out of place— while residents now have greater access to nutritious food, whether they will be welcomed by these stores is another issue.
Behavioral health campaigns focused on schools— incentivizing schools to increase healthy foods served in schools and reducing food advertisements targeting children— are possible solutions to effect change early on, to change the precedent with which students view food. Food deserts also provide another crucial point in the never ending list of reasons to improve infrastructure and to better public transportation. Cities can also incentivize companies themselves through tax benefits and changed zoning codes to move into areas that need healthier foods. Communities can build community gardens and organize local farmers markets.
Increasing health education can empower residents with the awareness of the necessity of healthy food options. But on a broader fundamental socioeconomic level, combating income inequality and poverty will have the best long-term solution.
By: Angela Li, Adele Wallrich
In the short time I’ve known Adele, one of our two amazing ghU coordinators, her enthusiasm, dedication, and overall lovely personality has made her a joy to work with. She is consistently able to think of meaningful conversations and the multifaceted lenses through which we as a club can look at staggering, relevant issues in the global health field and beyond.
A conversation with Adele:
Why did you join GlobeMed?
I joined GlobeMed because during my freshman year, I started to become disillusioned with the idea of altruism in international work and whether or not it was possible to affect change in ways that were not ethically problematic. I was good friends with Barune since the beginning of my time at Berkeley, and he told me about how he wanted to found a Berkeley chapter of club called GlobeMed. I was quite skeptical at first given my existing doubts of the whole idea of "helping others," but he explained the partnership model and how GlobeMed really emphasizes sustainability in their work. The focus on grassroots change and working with people who are familiar with their respective communities stood out to me as well. I started off as Director of Community Building because I really wanted to be involved in curating how the culture of the club would develop and setting precedences that would help guide the course of the chapter.
What are you interested in that relates to GlobeMed and more broadly, global health?
In the beginning, I was actually much more interested in the community empowerment and grassroots side of GlobeMed. Over time as I started to find my academic niche at Berkeley, I realized I was interested in food systems, which of course integrates public health as well. So as I took more classes for my major, I realized my interest in GlobeMed was broadening from my initial focus on social justice to the actual public health side of it, especially since our first project was on pesticides, which is something I learn a lot about in my classes. Now that (almost) 4 years have passed, my interests are really multifaceted and include equity in public health, pollution and chemical contaminants, the US's presence in international aid/relief, and sustainability in environmental work as well as health programs/interventions.
What are you passionate about?
I'm super passionate about intersections between the environment and health! I have a growing interest in environmental health sciences and policy, but I love ecology and how biological processes affect anthropogenic systems, such as agriculture. On a totally different note, I'm also very very passionate about music! My life before UC Berkeley was mainly dedicated to my musical training in piano, and even though I don't do music at Berkeley, I'm a musician at heart and in an alternate universe, I would absolutely be a performer and do music full-time.
By: Angela Li
In 1993, photographer Kevin Carter traveled to Sudan to capture the tragedy of the famine occurring then. His subsequent photograph, “Struggling Girl,” won a Pulitzer Prize. This picture showed a young emaciated Sudanese boy, with heavily protruding ribs, bowed over, having collapsed in the dead grass and dirt. A vulture lingers dangerously from behind. There’s a haze of yellow and brown at the front, the only color available in the verdant trees at the very back. After the picture was released in The New York Times, there was rush to donate to any organization that had to do with Sudan, and the public was anxious to hear of what happened to the child. Organizations reused the photo for their own campaigns, and news outlets published it repeatedly. However, there was an incredible amount of backlash against Carter due to how he waited to take the perfect picture before helping the struggling child. Carter waited for 20 minutes to see if the bird would spread its wings. Eventually, he scared the bird off and watched as the child moved again towards the feeding center. He lit up a cigarette and conversed with God before crying, thinking about his own young daughter. Carter would later commit suicide, referencing the suffering he saw in Sudan in his suicide note.
“Struggling Girl” is one of the most notorious examples of poverty porn. Poverty porn is any form of media which exploits the impoverished and their conditions. It glamorizes the idea of being poor and in pain. The purpose of this form of media is to gain charitable donations through sympathy and shock value, or to draw attention to a specific cause— especially when the audience is a privileged group. The consent of the subject is usually disregarded for the sake of creating this shock value. These forms of media reduce people in poverty to flimsy stereotypes that are then broadly applied to entire countries. These stereotypes are used as necessary justifications to even aid the destitute. One specific stereotype is the idea that the communities depicted are completely and utterly reliant on outside sources, generally “white saviors” or the West. While the goal is arguably noble, generating attention or sympathy leading to donations, it is worth questioning whether this type of media is worth the detriment it may inadvertently cause. Oftentimes poverty porn does nothing to address the underlying causes of those suffering, or it may distort or oversimplify the reality of poverty and lead to desensitization. By appealing to people’s sympathy so as to bring in donations, the processes of the actual organization— whether they respect the cultural boundaries of whomever they’re helping, how much of their funding actually goes to those shown in the media, whether transferable skills are being taught, and whether public infrastructure is being erected— are ignored. The extreme nature of poverty porn also reveals a tendency to wait until crises get to a place of no return before those in need are actually helped. The issues prevalent in poverty porn must be so shocking that they must be addressed. Only the most striking causes are worthy of attention and solving rather than broad, systemic issues. Fundamentally, poverty porn shows a lack of decency and awareness towards global issues. However, knowing this, NGOs and the public can learn to critically readjust how they put out and consume media, respectively, so as to effect real, empowering change.
I remember clearly the frustration my friend and I felt at the dearth of global health organizations on campus. As we began to be introduced to more nuanced perspectives on the nature of global health, suddenly our already scant array of options began to look at best ineffectual, and at worst harmful for the communities they worked in. What structural factors were being overlooked in these programs that were designed to be short-term? As we saw it (and still see it), the field of global health is plagued by the remnants of colonialism and the contemporary pitfalls of oppressive global structures that are often made invisible by the very sentimentality that drives people to help. Yes, we must act because it’s right and there’s no time to lose, but we must also develop deeper understandings of the people, the place, and most importantly ourselves if we do not want to perpetuate existing dynamics of power to the detriment of the communities we hope to serve. We were searching for an organization that understood this fundamentally. We found it in GlobeMed.
GlobeMed, within its organizational foundation, represents the way in which I hope to live my life. Intensely introspective and unafraid to challenge itself to be better, I felt an understanding of – or at least the desire to understand – the complexity of reality within its spaces. Even as we collectively struggled with accepting this notion, we always found our way back to this ethos. But existing in this space between theory and practice is not easy. The bridge between the two seems vast in the abstract, and when confronted with real-world decisions it more often than not it is only visible after a course of action has already been taken. Yet GlobeMed’s dogged commitment to do better by understanding better inspires hope in me. Of course, this culture is made and shaped by the incredible members I had the privilege of working with. Though at times our work felt disconnected and unnecessarily challenging, I think with fondness of the willingness of members to be critical and push further; to see the work done with humility. I will miss the community GlobeMed provided for me, the people that kept me constantly reimagining a better world. But I know that I will never forget them; that they are my community and that they will continue to push me to be a better person. So, thank you to the people that made up GlobeMed at UC Berkeley for everything you have given me. You will quite literally change the world.
Berkeley is nestled in one of the most affluent areas in the world. But, its economic endowment is a double-edged sword.
The phenomenon that is Silicon Valley has attracted exceptionally intelligent and diverse people from all around the world to Berkeley and its surrounding area. Yet, this process has also spawned a crisis: gentrification.
Gentrification is one of those “five syllabled concepts” whose meaning and importance is most often confined to its academic origin--the classroom. However, to many, particularly in the Bay Area, gentrification is beyond a theoretical concept, and manifests itself in insidious ways on a day to day basis and its effects are all too real.
Gentrification can be broadly defined as the result of wealthy individuals moving into an “existing urban district”, consequently raising rents in the area, and displacing it existing population. Most often, the consequence of this phenomena is its ability to disrupt cultures that have taken root in certain areas. Gentrified neighborhoods, for example, feature “fusion restaurants seemingly on every block as an attempt of preserving local culture”. However, this “preservation” of culture is more accurately characterized as a perversion and distortion leading some to claim, perhaps hyperbolically, gentrification is contributing to a “cultural genocide” of sorts.
While cultural degradation is certainly a feature of gentrification that is worth a second look, the consequences of gentrification extend beyond this. Often overlooked, but equally significant, are gentrification’s implications for public health. The Center for Disease Control (CDC) notes that those displaced by gentrification are at higher risk for cancer, birth defects, and increased mortality. Often, displaced persons will be relegated to substandard living conditions and homelessness which increases their exposure to toxic chemicals such as lead paint, which can have insidious consequences especially for young children. Furthermore, related to its cultural ramifications, the CDC observes that the collapse of certain social networks can cause emotional distress that can become chronic mental health problems in displaced persons.
The trouble with gentrification in the Bay Area reveals important features of the nature of public health crises in general. First, they are ubiquitous, yet tend to have a disparate impact on a society’s most vulnerable members. In other words, wealth of a particular country or region is not an indicium of whether or not that country or region will be immune from a harmful public health crisis. Additionally, and specifically related to the issue of gentrification, while increased housing costs have begun to even have adverse impacts on middle class Americans in the Bay Area, its consequences most acutely affect the region’s poor. Second, public health crisis exists in a broader societal context and therefore, have the ability to have a ripple effect. As people get pushed out of the Bay Area housing market, many of whom work in the Bay Area, now have to commute far distances to work. Increased traffic has resulted in increased air pollution from car exhausts.
Thirdly, and perhaps most importantly, the public health crisis spawned by gentrification teaches us to think more critically, or perhaps more fully, about how will deal with and view certain phenomena.
About The Global Health Soap Box
This blog evokes the spirit of UC Berkeley -- the home of the Free Speech Movement. The Global Heath Soap Box provides a platform for GlobeMed at Berkeley chapter members to explore and discuss their thoughts on relevant public health issues. Whether it's an expansion on what we discuss in ghUs or a topic of interest--The Global Health Soap Box covers a wide range of topics.