MODERN HEALTH CARE IN ANGOLA

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CHAPTER 2 Literature review

INTRODUCTION

The researcher conducted a literature review on the influence of culture in health care to familiarise himself with what has been written on the topic. A literature review is a systematic organisation of scientific knowledge accumulated on a particular topic.
For this study, the literature review covered books, newspaper and journal articles, radio and television programmes and the Internet. The aim of the literature review was to provide a general perspective on the taboos, beliefs and practices based on cultural traditions and their impact within the communities, especially with regard to individuals’ choices as far as health care services are concerned.

CULTURE

In order to discuss the effect of culture on health issues, the term first needs to be defined.

Definition

Culture is “the total of the inherited ideas, beliefs, values, and knowledge, which constitute the shared bases of social action; the total range of activities and ideas of a group of people with shared traditions, which are transmitted and reinforced by members of the group” (Collins English Dictionary 1991:387).
Culture includes the customs and traditions transmitted from generation to generation and therefore shapes people’s identity, and affects their behaviour. People’s social environment influences their world-view and behaviour as well. Culture can have a positive or negative influence on people and their behaviour. Positive effects include the preservation of their own identity. Negative effects include beliefs and practices, such as superstitions and witchcraft that can harm people Freud, Jung and other psychologists hold that individuals have beliefs that make them envision their personal and collective experience. These beliefs are related to the past, the future, what must be valued or what must be done. Some of these beliefs are subconscious (Guimarães & Tavares [Sa]). The phenomenon of hypnotic suggestion shows how changes in beliefs can change individuals’ perceptions and feelings, even to the point of making them “see”, “hear” and “feel” objects or people who are not present. Ultimately, people’s way of “perceiving”, “feeling” and “experiencing” reality is highly conditioned by their deep-rooted beliefs, mainly the collective paradigmatic beliefs. In turn, these beliefs are positively affected by the way in which they react in terms of reality, based on their points of reference, which reinforces the beliefs and the paradigm (Guimarães & Tavares [Sa]).
In Angola, superstition-related witchcraft continues to exist in some areas. It is still fairly common to find parents who believe that their children are involved in witchcraft or possessed by evil spirits or demons.

 Impact of culture on death and dying in Angola

Every society has basic suppositions that form the collective way of thinking and constitute a set of theoretical references which generally determine who they are, the type of universe they live in and what is important or not important for them. Those suppositions are evident in the existing institutions and cultural customs, ways of thinking and value systems; are taught indirectly through the social context in which people live, and are hardly ever questioned (Guimarães & Travares [Sa]).
In Angola, the news of a person’s death is passed on to all the family members, near and far. Then the family members begin mourning, crying, screaming and dancing incessantly, in a paced and monotonous rhythm. They grieve for the lost person, call his/her name, thank him/her for kindness, praise his/her virtues, curse the causer of the death and express their wishes of happiness for the deceased. Family and friends take part in all the actions with gestures, contortions and dancing. In this manner they demonstrate to their ancestors the kindness of the deceased, whom they try to please so he/she does not return laden with malign influences. Besides, the festivities entertain and give courage to the deceased while he/she waits for his/her transformation into an ancestor. The solemnity of the rites is in proportion to the social prestige and especially to the vital influence of the deceased. Chiefs are awarded special, solemn honours, including the gathering of the whole community.
As far as burial is concerned, the grave is generally placed near the village or along a pathway so the living can pay the deceased homage every time they go past the grave, by bowing their heads, observing silence or placing an offering at the grave.
In Quibala, an area in the Province of Cuanza Sul, the ‘quibala’ people place the bodies of their chiefs over rocks and cover them with rocks placed in a specific way to form a rectangular sarcophagus. The corpses are submitted to a type of mummification. Using a funnel, they pour boiling palm oil through the mouth into the body. This operation continues until the bowels disintegrate and are expelled through the rectum.
Cemeteries and graves hold an important position in community life. The ancestors are there, and the mystic causality that strengthens or weakens comes from them; through them vertical solidarity is strengthened. These are also places that instil awe, and where fear and mystery remain. After the burial those who came into contact with the corpse, those who transported it, and the people who accompanied it, have to bathe or to wash their hands in a river “to take away the smell of the dead” (Kota [Sa]).
The wearing of mourning clothes starts after the burial. Women usually paint their faces with black stripes, cut their hair or leave their hair loose, or even shave off their hair. Mourning forces the spouse of the deceased to do away with all luxury clothing and to wear humble clothes. It is common for women to uncover their upper bodies, because if they wore a normal dress, the deceased could recognize them and torment them. Everything that is touched becomes impure and is in danger of being taboo. Their meals are limited as well as their activities. Usually they remain in their houses or in other houses built for that purpose where they receive visitors and their food. They are not allowed to cook and their sexual activities are strictly limited. The aim is to prevent the contamination of the deceased, as they have with them the “smell of the deceased” (Niboji [Sa]).

Chapter 1 Orientation to the study
1.1 INTRODUCTION
1.2 CONTEXT AND BACKGROUND
1.3 PROBLEM STATEMENT
1.4 OBJECTIVES OF THE STUDY.
1.5 ASSUMPTION
1.6 SIGNIFICANCE OF THE STUDY.
1.7 LIMITATION OF THE STUDY FIELD
1.8 RESEARCH DESIGN AND METHODOLOGY
1.9 DEFINITION OF TERMS.
1.10 ETHICAL CONSIDERATIONS
1.11 OUTLINE OF THE STUDY.
1.12 CONCLUSION.
Chapter 2 Literature review
2.1 INTRODUCTION.
2.2 CULTURE
2.3 HEALTH CARE
2.4 CONCLUSION
Chapter 3 Research design and methodology
3.1 INTRODUCTION.
3.2 RESEARCH OBJECTIVES
3.3 RESEARCH DESIGN.
3.4 RESEARCH METHODOLOGY
3.5 ASSUMPTION.
3.6 POPULATION
3.7 SAMPLE..
3.8 DATA-COLLECTION INSTRUMENT
3.9 PRE-TESTING THE DATA COLLECTION INSTRUMENT
3.10 PERMISSION TO CONDUCT THE STUDY
3.11 DATA COLLECTION
3.12 DATA ANALYSIS
3.13 ETHICAL CONSIDERATIONS
3.14 CONCLUSION
Chapter 4 Data analysis and interpretation
4.1 INTRODUCTION
4.2 DATA ANALYSIS
4.3 DATA PRESENTATION
4.4 CONCLUSION
Chapter 5 Findings, conclusions and recommendations
5.1 INTRODUCTION
5.2 OBJECTIVES
5.3 RESULTS
5.4 CONCLUSIONS
5.5 LIMITATIONS OF THE STUDY
5.6 RECOMMENDATIONS
5.7 CONCLUSION.
BIBLIOGRAPHY
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