Soc Sci Med. 1988 ; 27(8): 789-97.

Doctoring by go-between: aspects of health care for Malay children.

Massard J.

E.R. 297, Centre National de la Recherche Scientifique, Paris, France.

The paper is a preliminary account of the way Malay adults handle sickness episodes when they occur among their children. We first show how children are conceived of as different from adults, then give some of the reasons for their vulnerability: their 'vital principle' is weak and unstable, they react more violently to humoral variations, they are related to and attracted by the supernatural world. The second section gives a sample of common indigenous illness categories as applied to children, then summarizes a typical aetiological model including factors that are children-specific. Such factors often point to either parent as initiating the episode by disrupting the animal, symbolic or social world, or by placing the child out of harmony with the outside world. The third section provides an account of therapeutic alternatives, some of which are coherent with the aetiology, others--aiming at restoring the whole person's balance--are not specific of a particular sickness. Both types can be provided by native curers, whereas only the former is expected from urban based general practitioners; we show how Malay parents in fact partly relate to medical doctors as if they were traditional healers. To sum up, we emphasize the mediating role of adults towards sick children: not only do they provide identification and treatment but they often hold themselves responsible for the disorder. We also show the socializing, hence integrating, function of sickness for children: they are gradually taught about the world order, and introduced to the value system of the culture in which they are growing up. We also note that both aetiologies and therapies can be children-specific.(ABSTRACT TRUNCATED AT 250 WORDS)