Onging Project
1. Determinants of Health (completed)
Team member : Dr. Bechu Ram Mondal, (RA)
Anthropology and Human genetics unit, Indian Statistical Institute.
Health culture is one of the main components of the total way of
life of human being.
Cultural factors influencing health of a community,
cultural meaning of health problems and the overall health seeking
behaviour of the community comprises its health culture. This change with
the dynamic change of the culture of a community.
Each community has its own cultural identity. With the development
of various health institutions bring about changes in health culture of
a community. Access to health services and health care delivery system
determine the cultural responses of the community.
A same community is sometimes found at different culture complex
(from remote rural village to the industrial and
further to stressful city). Thus there is a change
in health culture at different social milieu.
Thus the question arises what is the outcome of the
interaction of the preexisting health culture of the community
and the new health institutions in the midst of different
social milieu?
The degree of interaction and affiliation with these institutions
which shape the present health culture of the community is
the prime factor of the present study.
It is obvious that health problems and health practices can
be studied only in the context of the overall culture of a community.
The composite of (a) cultural perception and cultural meaning of health
problems, (b) the various cultural devices that are available
and accessible to members of a community for dealing with
health problems and the (c) consequent behaviours of
the community in response to these health problems.
The culture of a community indirectly influences its health culture
because certain cultural practices such as child rearing, child caring,
birth control, pregnancy, child birth, food and drinking habits, personal
hygienic practices are directly related to the generation of some community
health problems.
This holistic concept of health culture provides a valuable framework
for analysing the interaction of the health culture of a
community with that of the recent health institutions
(e.g. PHC, dispensary, hospitals, etc.) as a process
of purposive intervention.
The aim of the study is to the objective measure of health in addition
to the perceived well-being of different communities living in different
cultural and or physical milieu as well as the factors affecting the health
status of the community. The goal is to identified the intervention point
and ultimately help in realistic community based health planning in future.
With the above end in view, in addition to the Hindu and Muslim
Slums dwellers of Calcutta city, the migrant transplanted Tibetan refugees
in exile, India as well as the Kora and Mahali tribes of Midnapore district
have been selected for this study.
The migrant group has been chosen as they are exposed to a totally
new diseases ecology as well as cultural milieu. It endeavors to investigate
into how this population (i.e. Tibetan) is coping new and alien environment
and the survival strategy of refugee community in a changing habitat as
the health status reflects the degree of adaptation to an environment.
The evaluation of health status will also be assessed objectively
in terms of infant mortality, anthropometric measurements, haematological
and clinical as well as lipid profile studies.
2. Health status of Tibetan Refugees in India.
(A study of a High-Altitude
Population, migrated to low altitudes)
Team menmbers : 1.
Vikal Tripathy
, JRF, Anthropology and Human Genetics Unit, Indian Statistical
Institute.
2. Kanhu
Charan Satapathy, Jr. Lecturer in Anthropology, S. M. Govt. Women’s
Jr. College,
Phulabani, Orissa.
Adaptations to high altitude has attracted
a great deal of interest under the IBP. The three major areas in the world
where people are found living at high altitude are:
(i) Andean Mountains in South America
(ii) Ethiopian plateau in Africa
(iii) Tibetan plateau and Himalayan Mountains in
Asia.
According to Cruz-Coke (1978) the present highlanders must have invaded
the highlands after the last glaciation ended and so the time period is
short for a possible micro-evolution and development of genotype diversity.
“At first sight one must therefore conclude that it would have been difficult
for these people to develop adaptive genes in order to establish a distinctive
set of genotypes for living at high altitudes”. The period may even
be earlier as stone tools have been found which are datable to a period
between 100,000 and 20,000 years ago (Gupta and Ramchandran 1995, Bellezza
2001, Weiwen 2001)
Cruz-Coke’s review of the genetic description of high altitude populations
has not provided any evidence to support the idea of a specific genetic
adaptation to altitude; comparison of the polymorphic similarities and differences
between the three high-altitude groups shows that there are distinct differences
in the pattern of genetic polymorphisms.
Quite common acclimatizational responses to hypoxia have been reported
from different regions and experimental conditions. Gupta et al (1989)
found in their study that high altitude Himalayan populations differ from
Andean highlanders in their strategy for combating the environmental constraints.
The different populations at high altitude have adapted to its environment
in a different way both biologically as well as culturally though quite
a many similarities may be observed. Weitz (1984) on the other hand
believes that at this stage it is not reasonable to make definitive statements
about the state of their adaptation relative to that of the Andean groups.
Beall et al (1994) reported the use of statistical genetical approach
to analyse quantitative oxygen transport variables in a high-altitude
(4850-5450 m) native Tibetan population and demonstrated for the first
time the presence of a major gene, influencing %O2 saturation of arterial
hemoglobin.
One of the well-employed method in study of the adaptation studies
has been the intra-group comparison studies. Though both the high to low
and low to high altitude migrations have been studied, the studies for
low altitude to high are quite more in number than high to low, due to the
interest and attention it gets for sports and mountaineering training and
also because of the hill stations being a major tourist spots for the lowlanders.
The most elaborate research design was made by Haas (1976); which contained
multiple intra-population comparisons. He was able to fill only eight
of the twelve sample cells projected. In fact it may not be possible
to find populations migrating according to the requirements of a research
design. So multiple studies on different populations are required.
In Asian highland region the possibility of microevolution may be
quite high compared to the American highland because of the much earlier
inhabitation of Asia by Humans than America, and also due to the more
severe environmental condition. Isogenicity is rare in the Asian
highland populations and in every of polymorphism all types of alleles
are present, including all antigens of the HLA system (the only common thing
in all the high altitudes in the world is the absence of sickle cell anaemia
and thalesimia).
Tibetan plateau represents the world’s largest and highest land mass.
The average elevation is more than 4500 mts. As a country Tibet has
been quite isolated from the rest of the world because of both the climate/geographical
and the cultural reasons. In fact their capital was called ‘the
forbidden city’ (Bell 1928 and Harrer 1953). Because of this and
later due to the occupation of Tibet by the Chinese forces access to much
of the region has been restricted and so very few anthropological studies
have taken place on the populations of Tibet.
The present Dalai Lama with many of his followers fled Tibet in 1959
and entered India. The Government of India gave them asylum and were
settled at different parts of the country. They number more than
110,000 (1999) in India. The different parts of India offer them
different climatic and cultural environments, to which they had earlier
been alien to (web page of department of Home, The Government of Tibet in
Exile, 1996). Their settlements in Leh/Ladakh are more or less similar
to the climatic environment in Tibet. In contrast the settlements/colonies
in Himachal Pradesh, Arunachal Pradesh, Karnataka, Orissa, Delhi, and elsewhere
offer them different climatic setting which range from moderate high altitude
to low altitudes which is quite in contrast to the climate of Tibet (cold,
low humidity and hypoxic).
A study of Physiology and health status of the Tibetans at different
climates and altitudes will give a further insight into understanding mechanism
of adaptation to high altitude. It will also be worth studying their adaptive
strategies to the different set of stresses, which includes new climate,
exposure to new forms of parasites, psychological stress and strain, cultural
shock, social maladjustment etc.
Health status of the individuals and the populations as a whole is
a very good indicator of the degree of adaptation of the individuals and
the populations respectively to its environment (this environment includes
both the physical and as well as the cultural aspect). Apart from
this Health status is a very good indicator of the overall development of
a community or a nation. Assessing the Health status of the Tibetans
settled in India will make us understand how well the Tibetans have adaptated
to the new environment, which is quite different climate wise, and cultuarlly
highly diverse.
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