International Research Journal of Social Sciences_____________________________________ ISSN 2319–3565Vol. 2(12), 35-41, December (2013)                     Int. Res. J. Social Sci. International Science Congress Association             
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Health culture of Scheduled caste:  A Case Study of Patni in Cachar District of Assam Das Suranjan Department of Sociology, Assam University Silchar, Cachar, Assam, INDIA Available online at:
 www.isca.in, www.isca.me
Received 28th October 2013, revised 10th November 2013, accepted 3rd December 2013 Abstract  Modern western health culture is believed to be strongly influenced by modern medical model. Explanations for illness in Western society are rarely couched in religious terms due to spread of bio-medical model of health and illness. Their Culture plays an important role in their perception of good health as well as regulation of health behavior. In western world body is often treated as an intricate machine which must be kept tuned-up and illness is treated as a breakdown of the machine. Western concept contrasts with Ayurvedic concept of body, a concept prevalent in India and South Asia in which health is seen as a state of balance between the physical, social and supernatural environment and illness can results from disturbances of any of these sphere. This kind of differential concepts of health illness and health behavior varies in different socio cultural settings due to difference of traditions, social practices and role relationships. Within a great tradition of health culture numerous little traditions of health culture exist which are based on beliefs, values and health practices of this tradition. Keywords: Culture, health culture, health behaviour, illness behaviour, health status, social status, folk medicine and magico-religious practices. Introduction The term culture has a broader meaning in sociology and social anthropology. Sociologists and anthropologists define and conceptualize culture in different ways. Widely accepted definition of culture is given by E. B. Tylor in his book ‘Primitive Culture’ (1871). Tylor defines culture as ‘that complex whole which includes knowledge, belief, art, morals, law, custom and any other capabilities and habits acquired by man as a member of society’.Healthculture is a concept central to understand health status of a community. Health culture is that complex whole which includes cultural conception and meaning of health problems and health behaviour of individuals in context of available and accessible health institution. As any other cultural entity, health culture also undergoes change. Culture embraces values, belief and judgments about what is good and desirable and how people should behave. Culture defines standards of morality, beauty, tastes and health. Societies vary in their perceptions of what constitutes health and how to achieve and maintain it. Culture prescribes which food to take and which should be avoided in order to be healthy. Culture provides varying prescriptions for men and women, for puberty, pregnancy and old age (Levin and Sorenson 1984). Edward Suchman works on socio-medical variations among ethnic groups. He finds an association between illness behavior and ethnicity. Group closeness and exclusivity increases likelihood of a person responding to a health problem in a way that is consistent with his sub-cultural background. There are number of studies documenting association between culture and illness behavior. A prominent contribution on culture and mental disease is made by Horacio Fabrega. summarising crux of current research in sociology and anthropology he states that empirical studies integral to and grounded in sound clinical and epidemiological research methods have succeeded in making clear that how cultural conventions affect manifestations of disorders, aspects of diagnosis and response to treatment. Perception of physical and mental disorders varies from culture to culture. Americans have more forward perception of mental illness than Vietnamese. In contrast to Americans, Vietnamese traditional culture has a much narrower definition of mental illness. They are more tolerant of behavioural disturbance triggered by distress. Vietnamese define someone mentally ill only if the person is so disruptive that he or she threatens social order or safety of others. Person is taken to hospital if family is unable to control him or her (Rovert S Mckelvy, David L Sang and Cam T Hoang). Scholars find the fact that illness behavior typically involves a wait and see for first reaction to symptoms, followed by self medication. If problem is judged to have worsened, then only person may be prepared to seek expert advice. In this process cultural patterns of behavior may be superseded by formal education. In a comparative analysis of Chinese, Malays and Indians Stella Quahfinds that education explains practice of self medication with modern over the counter medication better than culture. There is significant difference among three groups in keeping of non-prescription and traditional medication at home. Education serves as an equaliser for self medication with modern medicines. Educated persons, irrespective of ethnic identity, are more inclined to practice self medication with modern over the counter medicines before seeking expert’s advice. Cultural phenomena 
International Research Journal of Social Sciences___________________________________________________ISSN 2319–3565Vol. 2(12), 35-41, December (2013)          Int. Res. J. Social Sci.International Science Congress Association 
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vary among groups and have impact on health care. These are environmental control, biological variations, social organisation, communication, and space and time orientation. Environmental control is capacity of a particular cultural group to control and to use nature for their necessity including health care. Biologically people of one cultural group differ from another and their health needs also differ. Social environment plays an important role in people’s access to health care (Giger and Davidhizar). Material and Methods The study is descriptive and qualitative in nature having some quantitative component. Both primary and secondary is collected for the study. Secondary data is collected from books, journals and other source materials. Primary data is collected from six Patni inhabited villages. For making a comparative analysis data is also collected from Patni dwelling in urban areas. Patni living in both rural and urban areas of Cachar district constitute the universe of study. Total three hundred sample households from village and town have been randomly selected for the study. Interview, questionnaire and participant observation are tools used for data collection from the field. Results and Discussion Patni, a scheduled caste community in Assam, is originallyknown as Patauni, Nadial and (Adi) Mahishya. Traditional occupation of Patni community was boating and fishing. But gradually over period of time, may be owing to compulsive situation created within or imposed upon them from outside, they switched over to cultivation and took fishing as secondary occupation. Patni settled in Cachar kingdom in late eighteenth or early nineteenth century mostly in river banks, started agriculture by cleaning unused land of river basin. Patni community in Assam are characterised by long tradition of poverty, illiteracy, backwardness. Their poverty, illiteracy and ignorence is due to their low caste status in this region. They are victim of severe caste discrimination10. To study culture and health of Patni community is important to study perception of Patni regarding disease and illness. How much traditional belief and value deeply rooted in them. How tradition determine their cognitive orientation to etiology of diseases. What system of medicine they prefer and reason of their preference for a particular system of medicine. All above issues concerning culture and health of Patni are discussed by analysing their faith of folk medicine.Folk medicines used in Patni community of Cachar District are both natural folk medicines and magico-religious practices. Folk healers, to whom Patni people seek treatment use herb, plants, minerals and animal substances. Magico-religious practices such as chanting of holy words, giving amulets to wear, doing some magical and religious activities are done for prevention and treatment of diseases. Patni people go to folk healers for certain selective diseases. Patni people view that there are certain diseases for which no system of medicine is effective except folk medicine. These diseases are hardly known to modern medical professionals. One of such peculiar folk disease is Displacement of Navel or Navi Dula. Etiology of displacement of navel is carrying heavy load beyond one’s capacity, long jump, high jump or sudden fall down. It can occur to any matured individual who is having capacity to carry things or can move and walk freely. Any individual may be victim of this disease irrespective of gender difference. Symptoms of this disease are pain in lower abdomen and loose motion, not so frequent but persisting for longer period of time. If someone feels this symptom he or she initially does not suspect for occurrence of displacement of nave because these symptoms are similar with symptoms of diarrhea, dysentery or any other abdominal complication. People generally seek for allopathic treatment if they suffer from such symptoms. But if the symptom does not cure after a therapy of allopathic medicine displacement of navel is suspected by patient or family members. For diagnosing displacement of navel folk healer examine patient by taking measurement of lengths his both hands up to elbow. If healer finds difference in measurement of both the hands he suspects for displacement of navel. In fact this test is regarded as dry test for diagnosis. Another test is done to be sure about this disease. A plate made of steel is attached to back of patient by folk healer. If disease is present, plate will fix in back of patient after chanting holy words and this becomes wet test for diagnosis. A folk physiotherapy is done by putting a burning candle over navel of the patient. Candle is covered by a glass pot for some time. If disease is present glass pot will tightly fix over navel and navel will come back to its original position. Apart fromphysiotherapy, root of a kind of herb is given to wear and some holy words are chanted to cure disease. Patient has to follow some restrictions in terms of taking food, coming out of house in selected time of a day and not to carry heavy loads for some days. Patient is advised to wear root of herb as many days as possible so that disease does not relapse again. There are some variations among healers in methods of diagnosis and treatment of displacement of navel. Some healers do not conduct both the tests at a time. There is difference in use of holy words by healers; all healers do not chant same words for healing this disease. Action of holy words of a healer is assessed on the basis of time taken to get rid of disease. In fact social prestige of folk healer depends upon action of his chanting. Cost of therapy is within affordable range of poor patients. Another folk disease, sexual disorder of male particularly absence of libido or erectile dysfunction is termed as gachmura by Patni. Sexual disorder can be diagnosed and its treatment is available in modern system of medicine. But gachmura is to be treated as folk disease due to perception of Patni people regarding its etiology. Patni agree on occurrence of sexual problem due to physiological disorder but gachmura is not due to physiological disorder. Male sexual organ is regarded as a gach or tree when it erects. If a gach or tree is molded or broken 
International Research Journal of Social Sciences___________________________________________________ISSN 2319–3565Vol. 2(12), 35-41, December (2013)          Int. Res. J. Social Sci.International Science Congress Association 
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it cannot grow further. Similarly erectile function of male organ of a person can be permanently stopped by his enemy through magical activity. Patni perceive that action of a magical activity can only be destroyed by counter magical activity. Therefore, gachmura cannot be cured by any other system of medicine. Folk healers with magical activity and chanting treat this disease. Some folk healers give juice of a plant (name not disclosed to researcher) to these patients along with chanting and amulets. These healers believe that juice of this plant can destroy action of all magical activity to some extent. One healer discloses its colour and said he shows neither this plat to people nor its branch from where milk like juice is produced. Ban is another magical activity which acts on lungs and chest of persons to whom it is applied. Ban is so powerful magical activity that its action can cause sudden death of a person. Death due to Ban will take place by vomiting blood or sudden attackwith chest pain. Ban is sent through air by giving a time limit. If patient does not take shelter of healer within given time period, his or her death is certain. Treatment of Ban is sending back Ban towards guni or person who has done it. Another way is to destroy its action on spot by chanting powerful holy words and performing counter magical activity.All healers do not agree to destroy action of Ban because it may attack healer instead of patient. Therefore, it is very difficult to get a healer in such situation. While a folk healer is asked how many patients of such kind he gets in a year. He replies that indeedguni or people who can do such a harmful activity are not available now like past. People hardly appreciate learning evil magic for destroying someone’s life. Perhaps no one inherits this magical activity due to social stigma. That is why such an evil guni is hardly found in society now. Another healer is of view that learning black magic is not so difficult than its maintenance and keeping patience for its application. Black magic may destroy even entire generation of a person who knows it. Therefore, gunis who knew this magical activity were reluctant to teach it to their descendents. Magical activities are still persisting in society.Thama is another magical activity although not so severe like Ban but harms people in various ways. It is a common magical activity known by many people but its effects can be destroyed easily. Thama lingers injury of any person to cure. It delays delivery of pregnant women and delays jackfruit to ripe in tree. It can be applied to animals like buffalo and cow. Effect of Thama is made inactive by chanting water. Healers easily understand during chanting of water whether effect of thama is persisting or not. Extra medicine is not required to be taken except chanted water to get relief from effect of thama. Therefore, to cure thama no money is required to be spent, it requires only one’s familiarity with healers. There are other back magic which can cause unconsciousness of a person. A person may become fit or unconscious due to its effect. But according to healers this problem is not so severe. Its treatment can be easily done.  Evil eye or najar is believed by Patni. Look of evil eye causes disease. Look of every people is not harmful but there are people whose look effects health. Food cannot be digested if it is looked by person having evil eyes. If a healthy baby is looked by evil eye, baby’s growth may be hampered. For destroying action of najar one common home remedy is to burn a dry chilly in front of the patient. In case burning of chilly is not curing the disease patient should go to folk healers who gives chanted salt to the patient. This salt is to be taken by patient to get rid of effect of evil eye. Blowing and whispering of salt is known by many people. therefore, najar is not difficult to cure.  There are numerous diseases for which Patni people prefer folk medicine. Jaundice or olmi is regarded as a disease by patni but as per medical science jaundice is a symptom of disease. Folk healers diagnose jaundice by observing physical symptoms of patient. Jaundice induced physical symptoms are loss of appetite, weakness with mild fever, yellow colour urine, yellow eyes and nails of patient. Folk etiology of jaundice is irregular life style. There are four types of folk treatment for jaundice. These are bharan, tika, mala and jhara. Bharan means putting paste of leaves of a plant over head of patient, Tika or sticky juice of a plant is attached to forehead of patient, mala is made up of stem of a small herb which patient wear on neck and jharameans chanting holy words to cure disease. Folk healers view that through jhara or chanting disease is transferred from body of patient towards earth. In all four methods of treatment diet restriction is given to patient. Patient is advised to avoid oily foods and to take boiled vegetables without using oil and turmeric. It is observed that for treatment of jaundice, Patni people prefer folk medicine than any other system of medicines. Particularly bharan along with diet restriction works wonderfully to cure jaundice. Some folk healers advise patients to take juice of sugarcane early in morning. Ripe banana, fish, meat, dry fish or fermented fish are restricted for jaundice patients. Around one month is required to cure jaundice completely. Cost of therapy is also within affordable range of patients. Post delivery complexity of women or sutika is treated by folk medicine Etiology of post delivery complexity is loss of blood and its symptoms are edema, loose motion, lack of appetite and tremendous weakness. Disease is treated by folk healers by giving folk medicine made up of leaves and roots of herbs. Some healer gives charmed amulet along with leaves and herbs. Joint pain or gatbat occurs due to old age which causes problem in movement. This disease is treated by dust of a kind of rice mixed with juice of a small living organism (name not mentioned). It is said by a healer that only three dose of medicine can completely cure joint pain. Piles or arsha is also treated with folk medicine. Etiology of piles is life style and food habit of individuals. Symptom of disease is rectal bleeding during evacuation. This disease is treated purely with herbs. One folk healer treats kidney stone. He is of the view that symptoms of kidney stone are pain in lower abdomen, backache and obstruction of urine passage. This disease is treated purely with leaves of herb. White discharge of women is treated with herb, using charms and amulet. Asthma or shwas particularly of children is treated with folk medicine. A piece of iron is purified 
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by chanting and is given to wear on neck. Instead of iron piece teeth of tiger, copper coin or bittle nut is chanted and given patient to use it. Blowing and whispering is also done to cure this disease. Hydrocele or eksirais, a problem of scrutum is treated by making a hole on ear along with chanting and incantation. Apart from above mentioned diseases, there are other diseases like chickenpox, snake bite, bite of animals like dog, cat and rat etc., dental worm, green stool of babies, diarrhea and dysentery, cough and cold are treated with folk medicines. There are bone setters who treat fracture of bone with purely herbs and leaves. These above mentioned diseases are treated mainly with herbs, roots and leaves of plant. For chicken pox different kinds of leaves are given to use. Patient is advised to take only vegetarian food without using oil. Patient is kept in a separate room and advised not to come out of room for three weeks. After three weeks goddess Shitala is worshiped. There is a common faith among Patni that goddess Shitalaprovides chicken pox and for curing this disease Shitala puja or worship of goddess is mandatory. For treating snake bite herb, roots and leaves are used but chanting is mandatory for curing snake bite. Healers with help of chanting restrict movement of snake venom throughout body. Chanting destroys venom of snake on spot and patient gets relief. Bite of animal like dog and cat is treated with herbal components along with chanting and whispering. But all healers do not chant, they treat only with medicines. Dental problems particularly dental worms are removed from site of gum by blowing and whispering with herbs and roots. Diarrhea, dysentery, cough and cold are treated with herbs and leaves. But these are commonly used by community people and known to all. These medicines are used as home remedies for diarrhea, dysentery, cough and cold.It is observed from study that elder members of family have much knowledge on home remedial medicines as compared toyounger members. Older family members have command on other members regarding use of traditional medicines for minor illness. Perception of health and illness differs among respondents under study. Perception of health and illness of respondents is recorded on the basis of their socio-economic status. From table-1 it is found that thirty three percent of (33%) of respondents, who belong to lower socio-economic status, hold that good health is gift of God and illness is caused by disgrace of God. Ghosts, devils and magical activities influence on health. Occurrence of disease depends upon of physical strength. Good quality diet and sound sleep is required to maintain it. According to this group of people, good health is acquired by birth. They believe on karma and dharma which determines one’s capacity to acquire and maintain physical strength as well good health. Around fifty one (51%) percent respondents, who are in little better social position, hold dual perceptions of health. According to them, good health although is gift of God needs maintenance by taking diet timely, having sound sleep, taking bath and taking good quality food. Disease according to them is caused by interaction between human and environment, physical and behavioural causes and old age. They believe on modern medicine for treatment of disease and illness. But they hold that there are certain diseases caused by supernatural forces which cannot be cured by medicine. For treatment of such diseases one must to healers who can to cure it. They keep faith upon these healers and respect them. Only sixteen percent (16%) respondents who are educated and economically sound do not believe on influence of supernatural forces upon health. According to them, health solely depends upon maintenance. Illness is caused by intrinsic and extrinsic factors like physical malfunction and environmental causes. For illness due to any of factors one must seek advice of medical professionals on time. Majority of respondents of this group do not have faith on traditional healers. It is observed that there are some educated middle class respondents who still have faith upon traditional medicine. Table-1 Respondent’s perception of health and illness Perception of Health Number of respondents Total 
Socio-economic status 
Illiterate Poor Literate poor and lower middle class Educated middle class 
Health is gift of god and disease caused by supernatural forces 66 33 Nil 99 
Gift of god but needs maintenance. Disease caused by both supernatural and environmental factors. 21 112 21 154 
Not gift only but needs maintenance. Disease not caused by supernatural forces.Nil 9 38 47 
Total 87 154 59 300 
Source: Field work conducted during June 2010 to August 2012 Table-2
International Research Journal of Social Sciences___________________________________________________ISSN 2319–3565Vol. 2(12), 35-41, December (2013)          Int. Res. J. Social Sci.International Science Congress Association 
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Reason for preference of folk medicine Reason for preference Number of respondents Total Percentage 
Socio-economic status 
Illiterate poor Literate poorand lower middle class Educated middle class 
Economic consideration 23 56 4 83 27.6% 
Easy accessibility 9 7 3 19 6.4% 
Effectiveness of system 11 23 8 42 14% 
Immediate relief 5 4 1 10 3.4% 
Combination of all 39 64 8 111 37% 
Disagree on all - - 35 35 11.6% 
Total 87 154 59 300 100%
Source: Field work conducted during June 2010 to August 2012 It is observed from table-2 that folk medicine is preferred by 27% respondents due to economic consideration and majority of them are poor and lower middle class. Folk medicine is comparatively cheaper than any other system of medicine. Folk medicine is easily accessible to patients but very few respondents (6.4%) prefer folk medicine due to its easy accessibility. Effectiveness of folk medicine is acknowledged by 14% of respondents. Folk medicine does not have prompt action as like as other system of medicine. Only 3.4% of respondents reported to get immediate relief from disease by using folk medicine. It is observed that 37% respondents prefer folk medicine considering its all dimension. Out of this 37% respondents majority belong to poor and lower middle class background. Majority of educated middle class respondents do not have faith upon folk medicine. Out of three hundred respondents 11.6% respondents disagree with all qualities of folk medicine. But there is good number of educated middle class respondents who keeps faith upon folk as well as other system of medicine. These respondents still hold their tradition and believe on action of folk medicine. Out of total educated middle class respondents more than forty percent of them have faith upon folk medicine and prefers it by considering various dimensions. It is observed that none of the respondents who belong to poor and lower middle class category disregard action of folk medicine. Except few respondents who are educated middle class all respondents have faith on folk medicine.  It is found from study that spread of modern education is helping people to have more faith on modern medicine instead of traditional system of medicine. Respondents who are more educated favour modern medicine instead of tradional medicine or folk medicine. Those educated people still keep faith on folk medicine have stronger link with their family members living in rural areas. From table-3 it is observed that 70% of respondent’s first preference is allopathic medicine. 22.3% of respondents prefer first folk medicine. Homeopathy is preferred for first time by 7.3% and first preference for ayurvedic medicine is negligible. Illiterate and literate poor as well as lower middle class do not prefer ayurvedic medicine. It is observed from study that first preference of system of medicine depends upon accessibility and availability of system of medicine. Majority of respondents reported that they go for second and third options also if first option is not available and affordable. In table-4 respondents second preference of system of medicine is analysed. From table-4 it is observed that allopathic medicine is second preference of 30% respondents who prefer first either homeopathic or folk medicine. 30% of respondent’s second preference is homeopathy and 35% of respondent’s second preference is folk medicine. It is observed from both 3 and 4 that first choice of medicine for illiterate poor respondents is either allopathic or folk. Poor illiterate respondents either prefer allopathic or folk medicine. Very few respondents within this group prefer homeopathic or other system of medicine. Good numbers of respondents who are literate poor and lower middle class prefer folk medicine. Homeopathic medicine is preferred as a second choice by some respondents within this group. Majority of educated middle class respondents first prefer allopathic medicine and their second preference is homeopathy. However a good number of respondents within this group prefer folk medicine as second choice. 
International Research Journal of Social Sciences___________________________________________________ISSN 2319–3565Vol. 2(12), 35-41, December (2013)          Int. Res. J. Social Sci.International Science Congress Association 
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Table-3First Preference to system of medicine Preference for system of medicine Number of respondents Total Percentage 
Socio-economic status 
Illiterate poor Literate poor and lower middle class Educated middle class 
First preferenceAllopathic 50 110 50 210 70% 
First preference Homeopathy 5 9 8 22 7.3% 
First preference Ayurvedic Nil Nil 1 1 0.4% 
First preference Folk 32 35 Nil 67 22.3% 
Total 87 154 59 300 100%
Source: Field work conducted during June 2010 to August 2012 Table-4Second preference to system of Medicine Preference To system of medicine Number of Respondents Total Percentage 
Socio-economic status 
Illiterate poor Literate poorand lower middle class Educated middle class 
Second preference allopathic 37 44 9 90 30% 
Second preference homeopathy 15 39 36 90 30% 
Second preference ayurveda Nil 10 5 15 5% 
Second preference folk 35 61 9 105 35% 
Total 87 154 59 300 100%
Source: Field work conducted during June 2010 to August 2012 Conclusion Culture plays an important role in numerous ways indetermining health of Patni in Cachar district of Assam. Traditional belief and value determines their perception of health and illness vis-ŕ-vis their choice for system of medicine. Belief on supernatural forces, ghost and magical activities still prevail among them. They prefer folk medicine and respect folk healers not only due to their economic backwardness but due to cultural backwardness also. Education plays important role in changing people’s traditional world view. This fact is true in case of Patni. Majority of educated middle class do not hold traditional belief and value as like as illiterate and little literate Patni. Scientific belief is developed among educated patnis and they keep faith upon modern scientific system of medicine. However, for rural illiterate Patni, folk medicine and folk healers play important role. Folk healers help to overcome their psychological crisis due to their deep rooted belief on magic, sorcery and witchcraft.  AcknowledgementI am thankful to all the respondent of Patni community for their heartiest cooperation in the field. I am also thankful to members of Barak valley Patni Parishad for their cooperation. I convey my thanks to Prof. Nirakar Mallick, Prof. Bijay Kumar Behera and other faculty members of department of Sociology of Assam University for their valluable guidence and necessary help for entire work without which I would not be able to complete this research article. References 1.Majumdar D.N. and Madan T.N., An Introduction to Social Anthropology, Mayoor Paperbacks, Noida, 12-29, 1986) 2.Behera Bijay Kumar, Gender, Health Status and Primitive Tribes, B and B Publishers, Bhubaneswar, 13-14 (2009) 3.Freeman Howard E., Levin Sol and Reeder Leo G., Handbook of Medical Sociology, Fourth Edition, Prentice Hall, New Jersey, 59, (1972)  4.Weiss Gregory L. and Lonnquist Lynne E., The Sociology of Health Healing and Illness, Prentice Hall, New Jersey 31-175 (2000) 5.Kokerham William C., The Blackwell Companion to Medical Sociology, (Ed) Willy Blackwell, West sussex, 20-100 (2001)  
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