Minnesota State University, Mankato Cornerstone: A Collection of Scholarly and Creative Works for Minnesota State University, Mankato All Theses, Dissertations, and Other Capstone Theses, Dissertations, and Other Capstone Projects Projects 2020 Medical Utilization in the Context of Culture: Analyzing the Concepts, Benefits and Drawbacks of Sri Lankan Biomedical and Ayurvedic Healthcare Miriah Rajaguru Minnesota State University, Mankato Follow this and additional works at: https://cornerstone.lib.mnsu.edu/etds Part of the Public Health Commons, and the Social and Cultural Anthropology Commons Recommended Citation Rajaguru, M. (2020). Medical utilization in the context of culture: Analyzing the concepts, benefits and drawbacks of Sri Lankan biomedical and Ayurvedic healthcare [Master’s thesis, Minnesota State University, Mankato]. Cornerstone: A Collection of Scholarly and Creative Works for Minnesota State University, Mankato. https://cornerstone.lib.mnsu.edu/etds/1010/ This Thesis is brought to you for free and open access by the Theses, Dissertations, and Other Capstone Projects at Cornerstone: A Collection of Scholarly and Creative Works for Minnesota State University, Mankato. It has been accepted for inclusion in All Theses, Dissertations, and Other Capstone Projects by an authorized administrator of Cornerstone: A Collection of Scholarly and Creative Works for Minnesota State University, Mankato. Medical Utilization in the Context of Culture: Analyzing the Concepts, Benefits and Drawbacks of Sri Lankan Biomedical and Ayurvedic Healthcare By Miriah Rajaguru A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science in Applied Anthropology Minnesota State University, Mankato Mankato, Minnesota May 2020 ii May 1 st , 2020 Medical Utilization in the Context of Culture: Analyzing the Concepts, Benefits and Drawbacks of Sri Lankan Biomedical and Ayurvedic Healthcare Miriah Rajaguru This thesis has been examined and approved by the following members of the student’s committee. Dr. Kathryn Elliott ____________ Advisor Dr. Rhonda Dass_____________ Committee Member Dr. Dharshini Gonnetilleke_____ Committee Member iii Acknowledgments I would like to thank Dr. Kathryn Elliott, Dr. Rhonda Dass and Dr. Dharshini Gonnetilleke for being on my thesis committee. Special thanks to Venerable Sathindriya Peradeniye, Venerable Mihintala Kamalasiri and Triple Gem of the North for providing support, connections to informants and assisting in the preparation of this research. I want to thank my mother, husband and friends for the emotional support needed to complete this work. I would also like to thank all informants who participated in this study. I would not have finished this work if it were not for these valuable individuals. iv Table of Contents Chapter 1 Introduction 1 Chapter 2 Literature Review 5 Recent Health Trends in Sri Lanka 5 The Medical Specialists 9 Cost for Seeking Treatment in Government Hospitals 15 Health Education and Awareness 18 Trends and Education in Alcohol Consumption 23 Awareness and Attitudes Toward Mental Health 25 Anthropological Context 26 Chapter 3 Methods 35 Previous Literature 35 The Informants 36 Methods Utilized 36 Chapter 4 Demographics 42 Chapter 5 Results 51 Introduction of Informants 51 Private Biomedicine 57 Government Biomedicine 65 Ayurveda 85 The Progression of Sri Lankan Healthcare 104 v Chapter 6 Discussion 118 Anthropological Theories 118 The Sri Lankan Conceptualization of Illness 145 The Communication Between Patients and Medical Specialists 163 The Relationship Between Curing and Healing 174 Chapter 7 Sri Lankan Healthcare: Moving Forward 185 Limitations and Future Research 185 Conclusion 187 Bibliography 195 vi List of Figures and Tables Figure 1.1: Gender - Lay Informants 44 Figure 1.2: Gender - Biomedical Doctors 44 Figure 1.3: Gender - Ayurvedic Doctors 44 Figure 1.4: Gender -Total 44 Figure 2.1: Age - Lay Informants 45 Figure 2.2: Age - Biomedical Doctors 45 Figure 2.3: Age - Ayurvedic Doctors 45 Figure 2.4: Age – Total 45 Figure 3.1: Ethnicity - Lay Informants 47 Figure 3.2: Ethnicity - Biomedical Doctors 47 Figure 3.3: Ethnicity - Ayurvedic Doctors 47 Figure 4.1: Working Location - Biomedical Doctors 48 Figure 4.2: Working Location - Ayurvedic Doctors 48 Figure 5.1: Location of Origin and Upbringing – Lay Informants 49 Figure 6.1: Choice of Healthcare - Lay Informants 52 Figure 7.1: Utilization of Government Biomedicine: Comparative Graph 68 Figure 8.1: Positive Characteristics of Government Biomedicine: Comparative Graph 76 Figure 9.1: Negative Characteristics of Government Biomedicine: Comparative Graph 82 Figure 10.0: Utilization of Ayurveda: Comparative Graph 88 Figure 11.1: Positive Characteristics of Ayurveda: Comparative Graph 95 Figure 12.1: Negative Characteristics of Ayurveda: Comparative Graph 102 Figure 13.1: Future Changes in Sri Lankan Healthcare: Comparative Graph 115 Table 1: Lay Informants: Medical systems utilized 51 Table 2: Biomedical Doctors: Choice of Healthcare 53 Table 3: Private Biomedical Doctors: Choice of Healthcare 54 Table 4: Biomedical Doctors: Majority of Patients 55 Table 5: Government Ayurvedic Doctors: Choice of Healthcare 55 Table 6: Private Ayurvedic Doctors: Choice of Healthcare 56 Table 7: Ayurveda Doctors: Majority of Patients 57 Table 8: Lay Informants: Utilization of Private Biomedicine 58 Table 9: Private Biomedical Doctors: Utilization of Private Biomedicine 58 Table 10: Private Biomedical Doctors: Benefits of Private Biomedicine 59 Table 11: Lay Informants: Benefits of Private Biomedicine 60 Table 12: Private Biomedical Doctors: Benefits of Private Biomedicine for Patients 62 Table 13: Lay Informants: Drawbacks or Weaknesses with Private Biomedicine 63 Table 14: Private Biomedical Doctors: Drawbacks or Weaknesses with Private Biomedicine 64 Table 15: Lay Informants (Government Biomedical Patients): Utilization of Government Biomedicine. 66 Table 16: Lay Informants (Non-Government Biomedical Patients): Utilization of Government Biomedicine 66 Table 17: Government/Public Biomedical Doctors: Utilization of Government vii Biomedicine 67 Table 18: Government/Public Biomedical Doctors: Benefits of Government Biomedicine 69 Table 19: Lay Informants (Government Biomedical Patients): Benefits of Government Biomedicine 71 Table 20: Lay Informants (Non-Government Biomedical Patients): Benefits of Government Biomedicine 72 Table 21: Government/Public Biomedical Doctors: Benefits of Government Biomedicine for Patients 73 Table 22: Lay Informants (Government Biomedical Patients): Drawbacks or Weaknesses with Government Biomedicine. 77 Table 23: Lay Informants (Non-Government Patients): Drawbacks or Weaknesses with Government Biomedicine 79 Table 24: Government/Public Biomedical Doctors: Drawbacks or Weaknesses with Government Biomedicine 80 Table 25: Lay Informants (Ayurvedic Patients): Utilization of Ayurveda 85 Table 26: Lay Informants (Non-Ayurvedic Patients): Utilization of Ayurveda 86 Table 27: Ayurvedic Doctors: Utilization of Ayurveda 87 Table 28: Ayurvedic Doctors: Benefits of Ayurveda 89 Table 29: Lay Informants (Ayurvedic Patients): Benefits of Ayurveda 91 Table 30: Lay Informants: Benefits of Ayurveda 92 Table 31: Ayurvedic Doctors: Benefits of Ayurveda 93 Table 32: Lay Informants (Ayurvedic Patients): Drawbacks or Weaknesses with Ayurveda 96 Table 33: Lay Informants (Non-Ayurvedic Patients): Drawbacks or Weaknesses with Ayurveda 98 Table 34: Ayurvedic Doctors: Drawbacks or Weaknesses with Ayurveda 99 Table 35: Lay Informants: Progression in Sri Lankan Healthcare 105 Table 36: Biomedical Doctors: Progression in Sri Lankan Healthcare 109 Table 37: Ayurvedic Doctors: Progression in Sri Lankan Healthcare 112 viii Abstract Medical Utilization in the Context of Culture: Analyzing the Concepts, Benefits and Drawbacks of Sri Lankan Biomedical and Ayurvedic Healthcare Miriah Rajaguru Master of Science, Applied Anthropology Minnesota State University, Mankato Mankato, Minnesota May 2020 Sri Lanka is an island inhabited by a culture more than 5,000 years old. The primary medicine utilized by this culture in precolonial times is known as Ayurveda. During colonization, Sri Lanka was introduced to biomedicine and forced to negate Ayurvedic medicine. Throughout the years, rather than abandoning their indigenous medical practice, Sri Lanka incorporated biomedicine and Ayurvedic medicine into their medically plural society. Today, Sri Lankans utilized both medicines for different ailments, concerns and conditions. Utilizing a variety of anthropological methods and theories, this study gathered qualitative information from 39 Sri Lankan informants. These informants were recruited to find out the cultural dynamics and purposes of Ayurvedic medicine and biomedicine and the relationship between the two medical systems. The informants also provided valuable insight into the strength and weaknesses between the two medical systems along with explaining the concept of illness, dynamics of communication and whether the medical systems either cure or heal the patient. Informants suggested that Sri Lanka utilizes biomedicine for curative care to cure their patients while incorporating Ayurvedic medicine for preventative care to heal their patients. It appeared that the principle purpose of private biomedical clinics is to treat any non-emergency related conditions while government biomedical hospitals tend to treat emergency related conditions. Private and government Ayurvedic medicine appear to treat common ailments and conditions