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When Mount Pinatubo in the province of Zambales, Philippines erupted in 1991, the Aeta communities living in the mountains were immediately evacuated to the lowlands. Caught in the massive disarray, the Aetas were displaced from their home and separated from their families and friends. As they remain encamped together with the lowland residents, successive incidents of death among the Aeta children due to measles were observed. Health practitioners attributed the principal cause of incident to the Aetas’ lack of knowledge and refusal to accept treatment through modern medicine. At a glance this seems a plausible reason, but a working knowledge of the Aeta culture can provide a more holistic explanation. The Aetas, who had lived in the highlands far from the grasp of sprawling urban life, gather together in times of distress to perform rituals and provide emotional as well as psychological support to any ill member of the community. Incorporating this salient piece of information to the analysis, the cases of death could be ascribed to not just one but a number of interrelated factors: (1) absence of immunity to the virus, (2) stress brought by the dislocation from their habitat, (3) loss of community autonomy, and (4) unavailability of healing rituals.[1]

The study of health, as I argued in my previous article, falls within the realm of social sciences as it is within the domain of biomedicine. Therefore, a disease is not always triggered solely by pathological defect, nor is ill health caused solely by social factors. This article will shed light on why there seems to be a chasm dividing the fields of biomedicine and social sciences and what can be done about it.

The effect of positivist tradition

For so many years, the wide-ranging field of science is bifurcated into the soft science pertaining to the social sciences, and the hard science referring to the natural sciences. In the wake of its inception, the social sciences were considered as ‘pseudo-science’ since they deal with the study of human behavior and society and are therefore viewed subjective (thus, the term soft); the natural sciences, on the other hand, were regarded as the ‘real science’ as they deal with the study of nature’s universal laws and are therefore deemed objective (thus, the term hard). During the Medieval period, the then-emerging social sciences were associated with philosophy, the field of study which monopolized the production of knowledge during that time but was later criticized due to deriving conclusions without empirical merit. From this stigma, the natural sciences rose into prominence and in lieu of philosophy became the instrument of knowledge generation and foundation of truth.

The positivist tradition in the social sciences paved the way for the application of scientific method, the framework used by natural scientists, in the study of social sciences. Because natural sciences enjoy more intellectual legitimacy, most social science researchers became obsessed to obtaining empirical data over intuitive data. Henceforth, the interaction of both sciences to one another was rendered very challenging if not impossible by its dichotomous relationship. The relationship of medicine, known as the applied scientific knowledge, and the social sciences suffered the same consequence.

The birth of professionalization and departmentalization

The success of physicians, notably the American Medical Association, in their campaign to have their occupation recognized not just as a job but as a profession exacerbated the growing disconnect between the two fields. Since the professionalization of medicine required extensive training by the practitioners of the field, technical knowledge as regards medicine became inaccessible to the general public. The doctors eventually gained dignified status which distinguished their job and insulated their field from most others.

The departmentalization of academic disciplines in the universities also contributed to the widening of the gap. For instance, the University of the Philippines Manila is composed of six constituent colleges which house the students of medicine and allied medical professions, and one constituent college which is home to students of liberal arts and natural sciences (College of Arts and Sciences or CAS). CAS caters to the needs of medical science students who are required to take some social science courses in said college. While the college curriculum obliges these students to complete units in social sciences, the faculty of CAS and other constituent colleges do not collaborate in terms of making the course syllabus or devising pedagogical strategies. The exclusivity of the operations of departments within the corners of their own discouraged inter-faculty engagement and reinforced the dichotomization and segmentation of knowledge.

The need for decompartmentalization

Health practitioners must be aware that a human body is not only a bundle of nerves and organ systems clumped into one single unit but also a product of change internal and external, object and subject of power (according to Michel Foucault), agent of socialization, and active participant to a complex way of life. There is no need for health scientists and social scientists to alienate each other in research and development initiatives. Health scientists become social scientists when they discuss to their underprivileged patients the nature of their health condition. Social scientists become health scientists when they discuss in a policy note, for instance, the preeminent role of power in shaping the success or failure of disease prevention strategies. The biological and social realities interlock and to treat these two as theoretically divergent is absurdity. Both health scientists and social scientists belong to a society where technical knowledge of their fields of expertise serves as requisite to an unreductionist explanation of social and political phenomena and well-thought recommendation of health policies geared towards public development.

Image Source: Universeteit Leiden

[1] Taken from L. Ignacio & A. Perlas’ From Victims to Survivors (1994), as cited in Professor Fatima Alvarez-Castillo’s essay entitled Breaking Down the Walls of Our Caves published in the anthology “Reframing Old Issues, Bridging Divides in Health.” The story as told in the introductory paragraph was taken from said essay.