There is widespread use of traditional healers and sometimes villagers go to the clinic or hospital only when other remedies have failed. It is part of the modernist, Western project to regard all events as controllable and all accidents as preventable (Green, 1995). In tandem, it would be essential to investigate the effects of relative national economic decline on household poverty and thence on to injury rates. Twenty informal interviews were carried out with local people at their homes; this was a purposive sample and all the respondents were women, as data were also being collected on reproductive health. (1985) Education and inequality in Botswana. The miasma theory (also called the miasmatic theory) is an obsolete medical theory that held that diseases—such as cholera, chlamydia, or the Black Death—were caused by a miasma (μίασμα, Ancient Greek for "pollution"), a noxious form of "bad air", also known as night air.The theory held that epidemics were caused by … Focus groups were carried out with 20 medical students and tape recorded. A number of ways forward are suggested. Specifically, the main learning objective of introduction to sociocultural anthropology is to familiarize students with the basic ideas, issues, concepts and principles of anthropology. So the accident has been prevented. Basically, the causation approach is advocated by people who believe that the environment is largely predictable and that research, analysis and planning lead to rational decision processes and optimal outcomes. It is a central tenet too of Yoruba belief that one can make efforts to improve one's lot in life and thus `fatalism' should not be equated with passive resignation. This site needs JavaScript to work properly. It is striking, in the accident literature, that discussion of preventive actions are based on `rational' approaches and seldom take into account people's `non-rational' explanations of causes. As countries experience the `epidemiological transition' with a relative decline in infectious diseases, accident rates tend to increase, particularly road traffic accidents. Basic to Yoruba belief is the idea of pre-destination, which has led to a belief that accidents may be pre-determined, and to the use of the babalawo to give advice about the future. Bastian has written of the complexity of ideas about roads and pathways in colonial times as well as today, and of the Nigerian fascination with the evils on the road; `Most of the people I knew agreed that night-time travel in Nigeria was tantamount to suicide because of all the dangerous forces, material and otherwise, that made their way along the darkened roads' [see Bastian, p. 102 (Bastian, 1992)]. 1995 Apr;(17):11. PhD thesis. This may be the view of researchers, but it is not one held by all lay people. All the women were petty traders and half the men were drivers by occupation. Three approaches—education, engineering and enforcement—are usually used together to prevent and reduce the effects of accidents. The positive functions of a fatalistic worldview are seldom mentioned, but, as Abimbola comments, `By shifting the responsibility for human failure or success largely from human beings, this concept frees them from any sense of guilt and dependency which usually causes psychological disturbances' [see Abimbola, p. 34 (Abimbola, 1975)]. (Davison et al., 1991). National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error, Newsl Inter Afr Comm Tradit Pract Affect Health Women Child. (1989) Survey of apprenticeship in Igbo-Ora, project report submitted to the Department of Preventive and Social medicine, University of Ibadan, 1985. Responsible for one death each (extracted verbatim from the records) were the following: thunder accident (a farmer), native poisoning, poisoning, kerosene poisoning, nail accident, cutlass accident (a butcher), fracture, drowning, burns, head injury, home accident and overdose of native medicine. These postulates enabled the germ theory of disease to achieve dominance in medicine over other theories, such as humors and miasma. Nigeria has a rich cultural heritage. R. A. Dixey, `Fatalism', accident causation and prevention: issues for health promotion from an exploratory study in a Yoruba town, Nigeria , Health Education Research, Volume 14, Issue 2, April 1999, Pages 197–208, https://doi.org/10.1093/her/14.2.197. In other words a person who believes that life's choices are governed by the vagaries of fate or determined by a conspiracy of powerful others and faceless organizations will be less likely to mobilize the personal resources needed to face a potentially threatening situation. Bunton, R., Nettleton, S. and Burrows, R. (1995) The Sociology of Health Promotion. Igbo-Ora has a well-developed system of primary health care and relatively effective systems for recording vital statistics data (Ayeni and Olayinka, 1979). Accidents and unintentional injury in developing countries, Increasing poverty and structural adjustment programmes, Health promotion discourse and accident prevention, Receive exclusive offers and updates from Oxford Academic. Likewise, the continued reliance on kerosene and other fuels for cooking is likely to continue to cause burns and poisonings. The outcome is not recorded (i.e. The efficacy of countermeasures in developed countries, they argue, may not be definitive, but also what might be effective in developed countries may not be effective in developing countries and vice versa. Recent years have seen increased willingness to incorporate lay beliefs into health promotion activity and to accept that what appears `rational' to one person or culture may not to another, but this appears to be lacking in the area of accident causation. This clearly, however, is dependent upon resources. Trading is a central part of Nigerian culture and traders travel large distances to markets, particularly to the `inter-kingdom periodic markets' (Mills-Tettey and Fadare, 1991). There is, however, a paucity of data on women's understanding of the cause of UI from a social and cultural perspective. It is fatuous to suggest that because people have a particular set of beliefs that they are satisfied with the status quo or do not `mind' accidents when explained by external forces. In Oyediran, A. Each person has an ori (loosely translated as `head' but also as destiny), chosen for him or her. [Harmful practices affecting women's health]. There are major questions regarding who carries out the research and this author is well aware of the issues in researching African culture as a non-African (Dixey, 1985). Iyang, E. E (1991) Measures of reducing accidents and improving productivity—the experience of Inyang Ette Motors Ltd. Bathing in boiling water results in many women being burned or disfigured; gishiri cut has resulted in vesicovaginal fistula in many young girls. (1995) Accidents and the risk society: some problems with prevention, in Bunton, R., Nettleton, S. and Burrows, R. (eds), The Sociology of Health Promotion. Health Education Authority, London. This paper uses a small exploratory study in a Yoruba town in Nigeria to examine these points. The latter include sorcery, witchcraft and `spirit instructions'. Legislation does not seem to be very effective. (1991) Accidents and safety in Nigeria: the way ahead. ...if individuals perceive themselves as `copers'; if they believe that they are in control of their lives and have the capacity to act logically and decisively, then their chance of adopting a given health action which they believe is sensible is that much greater than those having a different self-concept. It may be a case too, that effective treatments are not available for other types of injury. It is possible to find out what life has in store by consulting the deity Orunmila, who was present when each person's destiny was decided. This type of analysis has led to the production of the idea that health promotion is involved in a battle for the hearts and minds of the population, a struggle between a modern belief in lifestyle and an atavistic culture of `fatalism'. Like process theories, ‘mechanistic’ accounts of causation also seek to identify causation with the process by which the cause produces the effect (Glennan, 1996; Machamer et al., 2000; see Williamson, 2011 for a survey). Clipboard, Search History, and several other advanced features are temporarily unavailable. Health promotion needs to recognize its secular, modernist, individualist biases, and its pre-occupation with control and empowerment. Bolade, T. and Ogunsaya, A. Of the 54 accidental deaths, 31 (57%) were caused by RTAs. Western secular health promoters may need to recognize that some accidents are indeed Acts of God or of gods, `witchcraft', sorcery or are predestined to happen—in other words to accept the reality of a worldview based on another cosmology. certain individuals who had behaved erratically were prime candidates for an accident. In Ademuwagun, A., et al. In the meantime, some of the factors which would improve safety levels are already known and these appear to be culturally acceptable. Sahdev, P., Lacqua, M., Singh, B. and Dogra, T. (. Ironically, the petrol shortages in Nigeria may lead to a reduction in RTAs. All currently accepted theories, including Evolution, Relativity and non-Malthusian population ecology, were at one time new ideas that challenged orthodoxy. In Bolade, T. and Ogunsaya, A. Routledge, London. Conrad, P., Bradshaw, Y., Lamsudin, R., Kasniyah, N. and Costello, C. (, Davison, C., Davey Smith, G. and Frankel, S. (. Psychosocial and cultural factors associated with the management of spina bifida cystica in Nigeria. A reverse causation explanation could be that people with poor mental wellbeing are more likely to use recreational drugs as, say, a means of escapism. Many of the things we don't see are included in African belief systems, cultural and social values, philosophies, … 1995. African Press, Ibadan, p. 91. Health denotes perfect harmony and normalfunctioning of all the body system or state of completewellness whereas disease … 87–116. (1979) Yoruba Beliefs and Sacrificial Rites. TOT or training of trainers of TBAs. Patients may have symptoms that approximately match a set of symptoms that typically occur in people with a particular disease. Firstly, there is a need for further research to elicit from local people their beliefs about different types of accidents and their causation, and the acceptability and efficacy of safety measures. Udomah and Edafiogho, p. 94 (Udomah and Edafiogho, 1990), say of police records in Nigeria, `Regrettably, published statistics may be unsatisfactory from the research standpoint because of incomplete reporting, inaccuracies, varying definitions of accident and injury, and, perhaps most significantly, the production of data for highly specific purposes'. This is particularly the case for the poorest countries, many in sub-Saharan Africa; Asogwa (Asogwa, 1992) describes how even fatalities are under-reported. Different cosmologies exist outside this culture, often described as `fatalist' by Western commentators and as obstructing change. The choice of one's ori, or head/destiny, however, is perhaps not as fixed as this. Theories of disease causation..ppt 1. Discussion of preventative actions need to incorporate a wider range of factors, such as cultural beliefs and understanding, and accidents need to be placed within a social, economic and political context. 1997 Dec;2(12):1175-9. doi: 10.1046/j.1365-3156.1997.d01-219.x. Sayer and Downing (Sayer and Downing, 1981) and Jacobs and Sayer (Jacobs and Sayer, 1983) note that the `culture' of driver behaviour must also be considered and driver training (Oladiran and Pheko, 1995). Ninety-nine entries were recorded, of which 63 were injuries caused by RTAs. _Hill's Criteria of Causation It is frequently stated in the literature that many developing countries have insufficient data on accidents (Jacobs and Sayer, 1983; Mohan, 1997). World Health Day in 1993 focused on injury prevention and the Eighth General Programme of Work of the WHO (1990–95) gave accident prevention a prominent place within `Health For All'. The students held their own `rational' explanations whilst also being aware of distancing themselves from the `non-rational' beliefs of their patients. A. accident, occurrence, incident, critical incident, mishap, defence/s, failure, causation, safety Note from the Body of Knowledge Technical Panel and the authors of this chapter: The development of theories and modeling of accident causation is a dynamic field with the result that there is often a gap between the theoretical … In the Western worldview, an Act of God is a label applied only when all `rational' explanations have been exhausted. The number of vehicles in developing countries is increasing (Varma et al., 1992). healing traditions of a given culture. (1979) The concept of the inner essence in Yoruba traditional medicine. Afolabi, O. Today in Nigeria, death by accident far exceeds those by any communicable disease in the country'. Lay theories of schizophrenia: A . A., Adekole, N. M., Yusuf, Y. O., Alao, M. O., Desalu, A. When new meets old: collaborating on safer birthing methods in Nigeria. This study further underscores the need to incorporate folk theories of disease causation, gender and malaria issues into malaria control strategies in order to improve their coverage and effectiveness in different contexts. A. Although this approach has led to improvements having been made in developed countries, it can smack of paternalism. Zed Books, London. In addition to different worldviews, the different levels of development also mean that solutions formulated in richer countries do not suit poorer countries. A. In Sidell, M., Jones, L., Katz, J. and Peberdy, A. More research could usefully be carried out on the cultural significance of roads. An everyday activity in many developing countries, such as wood cutting, causes considerable eye injuries, but it is hardly practical to suggest the wearing of goggles, as in industrialized countries. Asogwa, p. 154 (Asogwa, 1992), has called for `technical know-how from advanced motorized countries where road accidents are well under control using well tested countermeasures' to be applied to Nigeria. Ogunsaya, A. From talking to local people, it is clear that Muslims and Christians may also adhere to belief in traditional African deities, and that they and believers in traditional African religion all consult babalawos. It was the medical students' view, however, that fuel shortages lead to increases in burns, due to the mixing of fuels and the use of the wrong types of fuels for certain purposes. From anecdotal evidence it would seem that there may be a tendency to treat home and farm accidents within the home, whereas road accident victims are more likely to be taken to the clinic. However, there is still a lack of recognition by some countries and funding agencies of the importance of unintentional injuries as a health problem. To do this, an Ifa priest, or babalawo, is consulted, who uses a system of verses, the Odu, and a set ritual, to communicate with the divinities and so to advise the client. Sayer, I. and Downing, A. Responsible for two admissions each were: domestic, fell from tree, broke leg and human bite. Health Promotion, Leeds Metropolitan University, Leeds LS1 3HE, UK. Lack of resources and of a co-ordinated response to the problem has been blamed for lack of progress in preventing road accidents in other African countries (Bezzaoucha et al., 1988). `Each individual's ori is his personal divinity who regulates his life in conformity with the wishes of the divinities who exist for the general public interest' [see Abimbola, p. 34 (Abimbola, 1975)]. Rogers, A., Popay, J., Williams, G. and Latham, M. (1997) Inequalities in Health and Health Promotion: Evidence from the Qualitative Literature. Safety as a Social Value. Department of Health (1992) The Health of the Nation: A Strategy for Health in England. The other main causes were snake bites (seven deaths), gun shot wounds (two deaths) and electric shock (two deaths). Awolalu, J. What then are the potential strategies for tackling accidents, presuming that it is morally indefensible simply to ignore them? Moreover, many theories have focus on individual’s behavior forgetting environment and social relations and their effects on behavior … (1990) Health Education: Effectiveness and Efficiency. Six babalwos (traditional priests) were visited and interviewed, with one taking us through the ritual of a consultation. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Again however, this is where more research would illuminate an acceptable strategy. AIMS Public Health. The Yoruba, in south west Nigeria, have a worldview with pre-destination as a central idea, i.e. Such beliefs may be useful in helping Nigerians live through a time when it appears that their living standards are controlled by outside economic forces. Locals are presumed to subscribe to alternative disease models rooted in “traditional healing,” believe in sorcery or the … Disease Causation – Henle-Koch Postulates: (1877) A set of 4 criteria to be met before the relationship between a particular infectious agent and a particular disease is accepted as causal. `Community participation' is clearly an attempt to ensure that the health promotion agenda is not simply imposed, but that people are consulted and involved to varying degrees. Hospital data only record cases which reach hospital—and these may not necessarily be the most severe. There is some evidence of the effect of SAPs on health (Onimode, 1989) but the precise relationship between SAPs, economic decline and increases in injuries requires further empirical research. These data could provide a basis upon which to frame proposals for a larger study. A health worker explained that: If you want to travel out you need to go to the babalawo first and ask, `Now I want to go to Lagos' or you might ask for your sister and...he will say `Ah! A. and Waziri, M. A. had had accidents during their training (Osinubi et al., 1985). (eds), African Therapeutic Systems. Newsl Inter Afr Comm Tradit Pract Affect Health Women Child. In Sibert, J. PIP: Nigeria has a rich cultural heritage. Longman, London. The data may under-represent particular types of accident, such as fractures, which may be taken to a bone setter. 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