Culture and Suffering

     Suffering refers to human experience of enduring specific problems, load, and wounds towards the body and mind in different forms (Kleinman, 1997). The aim of healthcare always is to alleviate suffering. Understanding suffering is essential in health care practice. The meanings of suffering are culturally different. I think the reason may be that suffering is an aspect of inner experience, a reaction to misfortune in life. The interaction between individuals and the society is influenced by cultural values, which involves subjective self-consciousness.

     I was impressed with the assumption in Dickson’s article (2003) that Korean culture affects the way in which people respond to pain, as well as face suffering. It is true, at least according to my own experience that Korean women have unusual pressure in Korean society which is male-dominated, because they are expected to look after all the families, including three generations in some cases. In addition, older age in Korean culture means respectable states and honor. All of these distinct meanings make Korean women perceive pain differently. Sometimes pain and illness become their secret, which are hided in front of their families. What’s more, they would experience through the process of struggling, striving to decrease pain, and then tolerating the pain by themselves, because they view pain as an inevitable part of aged life. In this way, physicians could improve healthcare and pain management through considering patients’ cultural beliefs.

     I also was reminded that there is a question of balance between time and effectiveness. How could healthcare practitioners provide effective service within limited time and resource? They usually have inadequate time, or money to explore the cultural characteristics of the patients. In my opinion, it is essential, at least, for health care providers to keep the culturally sensitive perception in mind. It means physicians should notice patients’ cultural background and take it into account in diagnosis and therapy.

     Human life is filled with suffering and desire, pain and joy. Suffering is unendurable since it conflicts with the desire of goodness. Thus human are usually fighting with good and evil. It is a process of resistance, bearing and struggling with the distress of pain of body and spirit. Therefore, I am thinking whether suffering could be a power that inspires people to seek human’s desire. When people are suffering a certain kind of pain or sickness, they usually struggle to reduce the pain, to pursue “good” states that is consistent with their expectation.

     Then, I was enlightened by the point that to prevent this resistance, political violence is used to create hopelessness through suffering. Undoubtedly, dominant power needs to suppress criticism in order to maintain the domination. As we mentioned earlier, suffering can produce energy to resist, as well as sense of helplessness which result in silence. That is also the way in which dominant system keeps power and control. Human trauma can lead to silence of people. Silencing exists in the context of access to power. The dominant social actors have more chance to construct the priorities of the healthcare system. On the other hand, the voices of marginalized communities always are mute, who are hard to access to the health care resources and basic materials of life. They have no access to express their voices, and as time goes by, they lose the hope and desire to shout their voices out. They are numb, and physicians and policy maker as well. However, the voices of marginalization should be heard and represented in policy to accomplish social change.

     It also reminded me that in a society which is controlled by absolute dominant actors, it is more difficult to find out and address the challenging that marginalized people encounter. Sometimes dominant power creates a “safe” atmosphere on the surface and ignores the voice of marginalization. I am thinking the problem in China. It is likely that people who are marginalized believe no one can help except themselves. What they can do is to “climb up” to “dominant society” and gain the power to change their life through higher education and all the efforts, despite many people still are struggling in the dark. Unfortunately, little research and attentions are paid in suffering of marginalized communities. It is partly caused by abnormal state of the society. The society is supposed to be “in harmony”. The poorer and marginalized people are victim of sacrifice. What do we researchers do in the context? To heal it, I think, is to figure out a balance between the center of power and marginalized individuals. What it means is to explore how the dominant policy systems influence suffering and lead to further change through the research of culture.