Health Beliefs and Practices
Traditionally, health is considered to be related to harmony in and between the body, mind, and soul and the universe; with the latter encompassing everyday life, socioeconomic conditions, as well as spiritual circumstances. The idea of harmony is most commonly expressed as a balance of "hot" and "cold" elements or states so that illnesses or states of health may be seen as hot or cold. Treatment should then be with opposite medicines or foods. The postpartum period, for example is a cold state, hence hot foods or medicines should be taken. Despite common assertions that hot and cold states are not related to temperature, most Burmans and other Southeast Asians avoid cold drinks for people in a cold state. Photo (by Tao Sheng Kwan-Gett, MD): Karen children in a Burmese refugee camp on the Thai-Burma border. Here are several powerful sites: A Journey of the Heart and Burma: Grace Under Pressure. Also, external site on the Karen and a site on Dr. Cynthia Muang.
Changes in diet are commonly used to treat illness. Depending on the illness, an increase in or reduction of one or more of the six Burmese tastes (sweet, sour, hot, cold, salty, bitter) may be indicated. Yesah is a herbal cure-all substance used by many Burmese.
Culture bound illnesses among Burmese include spirit possession by a Nat or an ancestor and Koro. Koro is the intense fear that the genitalia will recede into the body, and that if the genitalia recede completely, death will occur (Way 1985). Among women, menstrual flow is thought to be critical to health and, depending on the flow, an indication of good or poor health - including mental health (Skidmore, 2002).
The use of betel quid by women and men is ubiquitous in Burma. The basic quid (paan) is made from the betel leaf (Piper betel), with the chopped or crushed nut from the areca palm, and a white (or pink) paste of slaked lime (calcium hydroxide). The areca nut contains psychoactive alkaloids, extracted with the lime; the betel leaf cotains phenolic compounds which probably stimulate the release of catecholamines which, in turn, stimulate parts of the nervous system. Some people add tobacco and/or other substances. The quid provides a mild "high" and helps with dental pain. However, it is associated with oral pathology, including submucosal fibrosis, oral leukoplakia, and squamous cell carcinoma (Chu, 2001; Norton, 1998).
thanaka, a pale yellow paste (from the thanaka plant) applied to the cheeks, forehead, and sometimes arms of both genders but more frequently of girls and women. Photo: Child & adult with thanaka. Courtesy of pixelina (see links below).