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but look out! Oh, okay. Dr. Oliver Member is a left shop on the head of Department of Health Promotion and Education at the School of Public Health University of Zambia. He has a social parent's background with the master or philosophy in health promotion and international health from university Off Reglan know it on. He has a PhD in social science and health from Leeds. Better to invest it to United Kingdom Doctor member has all that 10 years research experience playing social social behavior, senses and missiles, toe complex public hills health promotion and medical interventions in Africa he is currently involved in um that's, um us in aged funded projects such as the education off implementation science approaches to assess the effectiveness off task shifted that new It's a pen to address card your metabolic complications in people living with HIV AIDS in samba. He is also a core investigator in the United States Ah, and I h funded study and that increasing the availability and acceptability off voluntary medical middle circumcision on Ellie infant know circumcision in Sandia in 2020 he was a common with professional fellow at Carb. It's natural Politan University in the United Kingdom on health communication and that had em. It's leadership on. He is currently serving on editorial board on health promotion International General on Critical Public Health journal. I hope, uh, we are going to learn something from this presentation. If you have any questions, please put them in the chat books. Will read them out at the end of the presentation, and doctor member will be able to address them over to you. Don't remember. Thank you. Thank you very much. Um, yeah. So I'm just going to share my in my screen. Um, yeah. Okay. And maybe also before I share. Let me just stop one second. Yep. Plus, when I showed my video, some people are not in, so that's our doctor Member looks so so basically a as mine dust aids a, um, in the scope up because of that. Basically scope up because is a new school A before they used to be called Department of Commitments in underscoring medicine. Yes. So So basically, in that particular school, we have a lot of people with different backgrounds and because of initial fabric care. Yeah, All right. So let me just then I think I think our sweets off the video for purposes off, connective. Itty on, then a little. Yeah. Okay, so I am about to see Yeah. Okay. Yes. So So? So I pitched my talk to a basically, with this site of critical perspectives in medicine and the earth Care and medical focusing more on the special determines off here a because basically, we will. They the Crisco perspectives in medicine is quite a whole range of mental of things. But of course, A This is just a moment of health. A, it's been six is is one of prominent things that there are many other aspect healing back, which includes some testicles taking swell, and they sew something to be perfect for them. Ethically good indication technology dependent on a particular intervention that mean in this area involved technology It may be, it was the social legal implications, or it's difficult off maybe advances in a things like genomics grease age. Okay, Mr T, do I put the title is to try to and to put something that is I catching. So hopefully that it'll attract people. Teacher agrees. Look for just to hear what we say. But as you see later. What will be talking about things? We we are aware and I think it's just about to bring them on the table to discuss it further because I think even if you are aware about them today, I think they still quite a lot. We have not done on day. So we need to think how we can work around then. My, my, my have been leverage for this talk is to go for about eight minutes and 10 minutes. Ah, Discussion, Eh? So So let me, then maybe just start with some few things and then we will keep the momentum will be getting strong as we go. Okay, So so so in terms of the arthritis. So Okay, I was just such a really basically talk about two models, so I would talk about the traditional more they'll which we sometimes go back, maybe see a, which we call also Beth PathoGenesis a approach. It has many other names, of course. So basically they talk about the the turn on that is more trying to actually talk about how basically it evolved on day, particularly with the understanding off biological sciences, and helped contribute it to understand more medicine. How about your logic? So basically, after today traditional medicine perspective, they're still likely influence by A They're little bit statements, a pill. So I would say something like that, but I know that A You know, they put that what I put traditional do this. Actually, you has shifted even within medical training and medical practice across the growth. I mean, some country. So So I'm actually too late for purpose of this discussion discussing probably what I can go and ashes positions because it has actually vote and try to It'll bring out allergic. Send some of the could seasons that have been raised again inside. And why if it, if it get more silly, is close to your assistant, we still more. It's like four back to religion small than actually other models. So they talk about the subcutaneous cyst more than which sometimes before such more diverse on, then a little bit to come. Some ideas on social determinants of girls Just maybe it makes a stations on how we can incorporate a fugitive more deer in healthcare practice. So I think the the position over position is not to actually really argue that this ultra cardiogenic model should replace the pathogenesis, but actually, it's your supplements. So because we we actually need both respected particular for for medical doctors, for people with care nations and all. But they still need to understand it because depressions is Balaji. But basically, I think the argument with the subject matter is that a is not enough. We need to we'll be on that. Actually consider context rich. Actually, patients come from, and then you need to actually do all these medical cultures. So after Genesis or bam, it's in which you go the traditional. So it's also known as a lot of medicine, so off course over the yes it has become dominant often is considered a rare event aspect of medical systems and the healthcare problem. So it's dominating a in terms off a busy guy reach and also in terms off ah, power and basically, even in terms of the number of people like employed in there, is that for most ticks, that's all. But of course, I think you would like to know that in our context, for example, the biggest, even if the medicine is that a student meeting, the biggest sector still, the bones they were because those medications they popular sex on don't even We still have 20% of people use only, for example, still actually a modest juggling between the hospital. But, um, it's in and also traditional medicine. So So there's quite a It's some kind of a mixed breed in our contact, potentially so. But of course we know because of the nature off how it came based on Western philosophy and Western Talaja and it's reached through. Of course, they can analyze in Project. It has really become so dominant such that has comes almost indigenous to our communities. A. But of course, you're allergic to the toast in front of the medical system, which to latex, and most people have to a navigate in between. Before that, I say, as there's a try to see what kind of healthy she have on how they operated, they never get between maybe occasion or tradition. It's being, oh, going to the hospital. That, and it just gets it sometimes tend to mix, even take care. So a before one aspect is for medical insiders often take their own view as object on reject, mostly long think So, as you know, this actually is a movement which actually has set in assumption that very much influenced by what we call Post Post Office stick philosophy, which I felt pretty. Um, yeah, so you're just giving me my Internet wasn't civil, but I hope you're still between us. So which I can't really? I use that. Basically, the reality is actually it is an objective reality out there. And so that's why at the end of the day, because off its ability to have been able to sure on demonstrate if you can see on the number of things it has, this positive is a subjective to allergic states. Lay or local reputations actually considered sounds anticancer makes it dangerous. So, as I say, this rotated Western science conception of reality. So which basically, it's linked to what we call post positivism and they off a day. Chris is, um, that have been leveled on science itself as it has been moved over. There are some of the criticisms it'll be labeled their departments and which actually is to more leans towards the practice that I should really is traditional. So it was. It assumes that created physical material. Nature is physical on objective knowledge can be attained. Okay? And they It's influenced by what we call one of season, which, actually just, um it is the idea of a single tooth on the model off practice. So tell Ejected and basically very rich off the stimulants. A religious, it is sort of like foreshadows Wait A you know, people because of many other reasons they have to they're they can probably say I went a traditional look for this. Under that, they have to always going there on the cover of darkness for few weeks. Communication from a cause, It off the, um It's in court. Religious movements. Okay, so they connected me. All this post their part of the product. Colonial project. Actually, they say the region, they're the same. And colonialism that from the seventies across? Yep. So I don't know why I can't move my slide this time around. Okay? All right. So because of that position, it tends to have what we call a deduction view off a sickness. Basically based on a bell. The physical boy, these then you know Minna off. What's the service? It'd still include some psychological aspect as well, that mostly just supplemental. It's to business. More understanding of biology, chemistry and the killer staff off for sickness in the traditional, you seem to be a malfunction off sales. My here's oh board I meant on the years and all that rather than actually socialization. So in this context, in microscope test tubes are more important than actually stories of sufferers with cure a more important than actually helps. So in this part of the focus is I said it was you and they it focus more on seeing a problem diagnosing. And that's really a letting that of normality in the body. Okay, I don't know why, and we just stop sharing. I'm just here again, sticking okay. Somehow it does. Okay, So as you get a critical this pathogenesis, as you know, Genesis is beginning. So why we quit PathoGenesis, But basically it's really more about touching me the pathology. So the explanation off disease begins with a pathology. So that's why you say battery genesis. And as you see on the contrary, some Tendonisis That's really a I guess, the other way around to say pathogens only thrives where social conditions around. So we need to really look at a social conditions and that that if you do with those in power outages, some extent become limited in terms of how they tell navigate on before the effect. Yeah, So one of the criticisms actually is it has been a good size. And this this criticism, which would put the material, is actually one that has also been leveled on science in general, a say, well says, actually win it a rose a week. In this particular case, I'm talking about the science for Francis Pepper A is doing the time of the night mint. Why would they? More ideal is to read about it itself from mystic authority, reject movement, which actually be able to do some of that program. So solidify position. So there's that criticism. So being dogmatic is the strong expression of opinion as if they were facts. So an example of dogmatic is insistent that a particular you is the one. I'm gonna the way to look at these, so why it has been a excess. And of course, a medical view has been accused like that is because it tends to actually, really, it doesn't like, really a modest incorporate other ways off off seeing or knowing or very off defining. And the experiencing units. So this particular one has been knighted was level and a little is a is a psychiatrist. A easy is a dose, but he's also a medical apologies at a claimant. Whatever. So he actually inside the list off dogmas live into this for you. And as you see, I I like it a lot on another claimant. Straight because he has that little lot of it is his research on alternative medicine under tentative philosophies on issues, off medicine and all that. So, yeah, Doctor, when believe cut out. Sorry. In your results and number. That's right. Exactly. So apologies were just having some connection challenges. We'll try and get Dr remember back online as soon as possible. Policies for the delay. I even see any. Yes, we can. Oh, sorry. I don't even know at what point I lost you was a red and they a dog. Mattis? Yes, That was it. Okay. At the great? Yes. So So basically a I think I was talking about the last point so that I could just run through. So one is Ah, the aspect that actually patients when they do things themselves to try to do with elements a the it's considered dangerous and then off most marriages aspects. I given prominence of the other aspects, like social sick oh, social college on then the relationship between the doctor and patient is one between an expert and when we see actually ignorant. So the doctors really most cases the surgical cases to give instructions, and the patient is expected to. But by on the used to him, like at here in I know that, and they also they sometimes say The question I always, as sometimes when I'm talking to students is like the safe. A woman is living with cancer cervical cancer for seven years on day. We have also a doctor Waas, pressurizing oncology for seven years. Who knows better about safety cancer? So force A. There's some form of knowledge in both sides, so one is more theoretical. Concept of the other one is more experiential, so it's not true that a patient's at actually going around. They may not have the language to say, Oh, I don't really talk about this thing where they experience that so force that's why I was off that Ah, that aspect of the discussion of part of it issues between health records on patients, actually is is something that people are looking about say, there is something that the doctor and also inflamed from the patient's already it is. Okay, so Okay, so it's trying to Okay, so they're the criticism. Is this study what you call mystification? Sophistication? Actually, it's a concept that comes from all a new maxis. Oh, actually, it comes from originally from Komac. So comments was a philosophy. Believe a neuro a around should be. It is a sedative. Is it the 8 18,019 century? So he's ever known person. And it was actually quite critical off the capitalistic society on day business is I give mints actually a one half, for example. Religion prevail. Oh, a role in in terms of in terms of trying to actually make a what they call the Proton. It's at that particular time they wake us. So I should really be obedient on weight within the characteristics system adults, revolutions He was able to actually say the region acted as an opium or report and they off the people on the you're you're a doctor. So you use opium sometimes to actually really a a modest treatment. But the taste of pain. Okay, so you also say is missing Blurry vision actually had a real suppressing data pain on in the process. It actually really distorts the reality we do. We have. So we when you've been telling us this is actually pressed. Oh, no, it's not. Actually, they're tend to think things are okay on in the process. We have a distorted view off reality. So this is what he called mystification. So that concept come from there, and it has been applied to They quit the seasonal medicine as well. So mystification heights that the nature of reality and saves to maintain the status score and protect those in power. That's like a regular in that. So basically this argument, I say, is that medicine doesn't do enough to try to change society. Rather, it's more confidence different. Is it particular date, the traditional view and the other end of the day? It does very true to a celebrity look at the context that I should make people see in the first place. So that's a concept of mystification. So when supply to burn, it's in the, um it's in the scene as mystifying. Okay, social, economic, political problems by making them appear individual, biological, unnatural. So it had to ignore the social issues off sickness and consumes their social being justice and sensory. So I I really and ofcourse, focusing on the individual and more off balance for them. And but it doesn't. I accused that it doesn't do much, and it actually really mystify social. All those receptor context, which I should really threats that sickness And in the process it comes. Remember this in in, um, access for years. So it comes and accomplice with there power people in society in the capitalist society, pharmacy companies and many other people who actually add a different day benefit from getting the bone. Actually, days, usually in arguments, say capitalism wakes us weak heart, and then the person get seats and then they actually really get sick with it creates a matter for us to get major savings and then tender with thing. So it's quite a whole complex discussion there. So because of that, I think it I guess that issues off social justice and people I should really get exposed to. Disease is just because of the structure society actually not look at in detail. There's also another criticism, which sometimes it's called medicalization. So it's letter to to miss deficient some extent. But basically it describes the reach that, actually medicine has really gone beyond its original a originally destruction, where something now a problems that were non medical, have been defined and treated as a medical problem. So I think we have situations like childbirth. At some point was Monday, um, it for issue. And I think we still have countries they call and that pledges to encourage home deliveries and only do it in agencies and all that kind of stuff a given on. Basically, if you look at the side where we're it was something that was done by a a road, as in the community and all that. So when it became a hospital issue, you finally has been all these back and forth. A between a woman has to really try to navigate between what the culture says and just let context. Pregnancy was a signified something that's right, so you're fine. And at the end of the day there's a pool you'll find. Some women sometimes will come to give them folic acid. Oh, those are anemic tablets. They don't take it because stay off suspicious with the healthcare system. So it's because the allergic skin some of these things have never did on day. So this has been one of the and a criticism that will be labeled. So as you see, the problem is defined in medical term, describing using medical language, understood through the adoption, off medical, from makes or treated with medical intervention. But basically the they're much more intervention that can be done at more political level that can just do it, reduce disease. That more social level that can actually reduce it is just by reorganizing else aside. Okay, so like, for example, if you look was was a viewer the famous actor, So in the cycle we have, we always a hot spots for for what about it is is like Korea. They always happen in one of the places called granuloma. All right, so so busy guy. The argument there is that they tell me more to disease because it has to do with the context in which I checked Italy. This is all housing and all that which field talk about as such a determinants of here. So medicalization transforms Aspects are very life in two pathologies on day. So the focus a dessert in intimate in this medicalization critic, is that the problem is individual rather and such and burns, and it cause for invasion, intervention and collective social solutions and also be expending the medical decision. Medication increases the amount of medical, social control, human behavior and possibly pressing, and we have a formal of control and 26 instrument beings. Of course, they're not passive followers. Sometimes they change in resistance. I think right now we're all battery relations, a vaccine hesitance, and it's all connected to a large extent. People trying to resist what sometimes they they they can call suspicious Western Medical Project. Under that, you have to actually understand the history in context of a colon of projects and helmets. No spatter of it and how that's still lingers it. Oh, I should really haunt us up to today, so this can get those under two alleged, and now I think we're living in an age where people have really lost faith a on science and actually some of the medical intervention. So it looks like we have did we have to do with the communities? And that should really kind of just wait till objects and considering the these social determinants of health becomes important, okay. And also made position increases the profitability and markets off, Um, a surgical component take more than just some of the push back we see actually comes for such a kind of thinking. Say, actually, a medicine is an agent off a capitalistic society. There's also a one does them increases. But when one more and I just talked about, plus colonias criticism particularly important for those making the context of Africa Zambian a media and no definable here. But of course, even doing the UK at the individual globe seasons, you may want to come on, Wake A Oh, you may. I should be working nice and open program. So So basically I'm living more on one of the prominent a possible in your theorists. A little has been writing on indigenous knowledge from Barcelona A Just listen again. So she's actually professor at Invisible. So and so, for example, she actually analyze how colonial discourse as actually in trains itself in those programs in a possible in your society. And I said this this medical excuse, local ways of knowing. So the time we use Muslim Proscar in a theory is as as or other things off other forms of knowledge. And it's it's a little too a concept of like one of these in thinking that the only way off actually really understanding your Ms is this way. Local is traditionalist in Islam. It's we also race that kind of like hierarchy, or sometimes altogether dismissing that. So indigenous methods are not you wanted by current business going on, particularly in the capitalistic society, you know, since October yet actually, even if some of that knowledge, like even which pharmaceutical companies are actually able to. So they came from a local knowledge so on the indigenous know it is generally Sigma ties, marginalized by rest and hegemonic. Christian based approach is in his program, so people usually ask him to actually really a it if they sort services from it. You know, they're not even say it remains a secret, and they, even when you actually talk about a students trying to get a sense of, like other forms off a healing. Under that definition, it's sometimes they may be a little resistant until off course. It is as a people confident that begin to realize this quite a law, that complaint from there as well. So then so because of that. So I can together, I guess, that health problems, privileged Western ways of going about disease and l a gated Dave to the periphery look on the Senate of disease on. We tend to actually co what people actually say. I did print about it diseases as meats and misconceptions. So those are the times you actually really use? Yeah, so, like, for example, one example is your key is basically when we when we grew up for in the village. So it's sometimes a some standard stocks off maze. They base. They are very sweet, like sugar cane. I don't know if you get a colleague from Premier um, so they it will itch. Sugar candy muskets is because they don't know it will give you married here, but basically with you, I can't really say that you took record meats and it's conceptions A But basically, if you can really soon a bit more closely by People have associate ID eating all those talks, amazed with my areas because each time the stocks of males come as a result off flats in most cases it's in those ears when they're flats and the the major not grow on, trees will be washed away and then they become yellow. And you get those on what happens with these water A that I should really a modest, inshallah, whales and oh, that mosquitoes breed. And they have seen you in a loud which one for what we call a knowledge or lay association that each time it's here. This, this is a Children are eating these we also have. We tend to have actually these symptoms off temperature and all that, so they're able to associate it disgruntlement what I can call environmental determinant of her, which actually Mrs if you look at the concept of it from its original left netting Britney feeling inside, that really has to do with more environment. So there's quite a whole range of things and they had they did a lane knowledge. He's not actually completely useless when people actually think in a particular way. If you just soon one look through your liver, try to see that there's something that they're experienced, which I shouldn't make them think that way. So they so basically, because that information is really get it. It eliminates them until allergic. Then sometimes they actually really engaged in passive resistance. And sometimes that's very actually see suspicious off other forms. Yeah, so and in this particular friend, local people are considered subjects and need to a d a genetic arrangement and expect it to change their behavior. So we use the term like we have a change. Okay, Like particulary health promotion particles, tradition probably is those times that they it's not indifferent from concepts Colonial concept like civilizing the savages. Okay. So, like mostly have always considered like they don't know, so we need to actually tell them that. So So because of that and because of the puffiness off medications to engage in passages system, sometimes they'll even tell, you know, I drank the medicine, but if you actually, if you do blood tests, you find innovative in toe on day, I think in a year's off air, it e they when people are studying issues off adherence. They actually saw that a self report and actually, actually it bled A. When you do both first baseman A, it was totally different. And it's because of all these dynamics, yes. So what? I was saying that the individual you actually see that a lot of businesses and pathogenesis that complement each other, and we're not displacing the potency or biology chemistry and old is six I it's and that on physiology, very, very important. So that way out we are actually asking, is an expansion to the understanding of disease because the body exists in context in space on So like, for example, in anthropology is what we call we distinct about surgical body and the social body. And that's when we really look at how we actually really a weight with our bodies in context, off eating in a particular social context. So if, for example, we put tattoos, we actually, for example, bleach our skin's a put something here. We are actually trying to feed that particular social countries, but some of those board out there itches have health consequences. Oh, sometimes we may takes it and drags to look in a particular way and that way. Actually, you begin to see that medicine cannot be. Actually, it did contextualized from the things that I should really create them in contests will help. So if you look at the genesis has been a basic a little lateral simplistic understanding of health, extension of dizzy and even this was written by a logical sense. And basically it's definitions were more I focusing on absence of disease, disability focus on pathology, says individual factors. Why did inferences where actually not taking instructional were 600 and the health associative, if individual body is that supposed to be? And this is physically separated from the social context. But this after Genesis actually is an extension, which I should, I guess, for a broader understanding off here. Explanation is rooted in a range of social factors. So you have it is caused by structure factors such as poor body inequalities. I'm more holistic definitional care of taking two considerations. It's a political social donation on part of the reason why it's allergic that there's been lectins to bring these because you can't measure them with traditional methods like the way we have been doing 2030 members under that decided requires bring in other ways off. Doing the research is where which also includes a participation of communities that communicates. That's about it. So I should really wait on Kobe call creators our knowledge with with a a with the diskus doctor as health workers. Yeah, As you see, I'm struggling to say with a experts because I think I did have a day. A expect is, um, is dependent. So if someone has living with cancer, and I they're actually living in for seven years and somebody has studied it was the real experts. This stuff is debatable. So and then we need to take into consideration itself. It just sticks in to consider why the interest is such as impact on remained at all. So inequalities and therefore healthy. Seen as a social constructs and subjective experience, including lasers, a knowledge is actually taken into consideration. Yeah, Okay, so therefore said just sort of genesis, focus more on upstream faking. I should try to actually look at the context and social tenants of growth on the earth. And quiet is become very, very prominent. So I think business as you see here, it focus more and closing the tab rather than actually continuing morphine off course in in a in a row, society there was to continue. Literature supports people with the washing, the and all that, too. You still have most. You need more, but basically you traces ethical. And the economic questions is, well, if we believe that runny there. So we asked where that's basically day, the whole focus. And they basically Michael moment that some of you may know him. Make moment is a I think it should be the president of the, um a World Medical Association right now. So actually in his book would the health cap he actually starts a expressed interest is why treat people and send them back to the same condition that made them sick in the first place. So basically, if you look this sciatic, I don't if it's visible, look at that. The environment that communities this is where disease gets it's actually doing well. So I did. Every day we can just be receiving cases without doing my actually context off course. At the end of the day, doctors cannot go and try to accept it as gentle that, but I think It's just as you see that on that I'm talking about is some kind of not discriminate approach. Okay, so yeah. So and I think this this things have been known for a long time, so they're not new. So if you look the this is a microbiologist in in a book man adapting 96 5 actually say the prevalence of it's micro. But this is our condition. More by the way of life a person affected than the violence and the properties of a natural estrogen. Hence they need to learn more off man and the society. We have to make sense of the patterns of disease, and this is is particularly important in public. But I think that medicine is well, okay. Have to go back. Yeah. So this is another game in, um, this is this is epidemic a social process cradling creatures. This is shaped by political economy, social relations and culture. Aids extract, for example. It's particularly community struggling 100 but in supporting pretty common percentile. And I think we even know what is happening with coffee. 19, particularly in the year is in Brazil. You France, all these more culture communities. I'm driving in the UK, where actually people off color actually being affected more. And it is quite a bit more off a understanding now on why that is. And it all goes back to understanding complex issues on how this 30 is organized and where on how it actually found itself and where we're coming from. Yeah, so and that's actually is one of these, that we're fragile. And e if you look, for example, all these numbers. So this is if you look at the trends in life expectancy, so look at substance Africa. So the person like me, who is 45 20 Hey, I'm expected to that a and it's got These are not excellent. It's because of the context. It is a life expectancy linked too many other things in society. Yeah, on the basically, it's the same thing. If you look at under five mortality, that's the 100 life base. By both caps, you can actually see the port is reporter. Somebody's they they they hired in mortality and you can actually see. It's the same, even within country and across country. So it tells us that there's something that we need to actually doing. You can't continue generally, and so the bridge. So I said, is waking with this more they'll where we actually need to contextualize there. Of course, immediate issues we can control is what we make. Homogeneous comes and say this is off social capital and then social coming position, social structures about that on the broader market economy contacts. So we need to I really a see how that can actually wait. So I think at the end of the day, the commissioner's written and so actually say, the circumstance which people are born grow leave wake and age and the systems in place to do it. It is a little important, so improving day living conditions makes a difference. These comes to that shift, by the way, the state of forces. Of course, the economy is special. Police is politics and all that, and like to responsible for health inequalities, which we had I just saw there. So now, having said this, all these are complex, deep topics and they actually raise a debate. But basically I think the best is healthy in society to actually really I think of the best because I think at the end of the day, people are continuing to try and find the best way to actually really organize yourself that we can offer it because people they actually so, suggestions on how we can incorporate it suggested any perspective in healthcare. So remember, this is a supplemental, a approach, so we're not describing the pathogenesis. We need both. So I've been for suggestions. It's, and I'm sure they can be more so. Mouth, mouth. So it's small. It is. So I would talk about units narratives and explain to them, or does which actually a cyclin has been quite a lawyer on the talk about improving health, break a patient interaction and communication and also issues off not discriminatory transistor mentally and intersect. Approach, as was indigenous knowledge and decline is a shin off your care practice and the in trying to do this something to actually respond or react to some of the criticism that has been a rebel against professional a view of hell. So Eunice narratives and experiential model. So I think in for commission is familiar with the patient, and I'm sure some of the hour in six patient who, with the patient will with whose disease has been treated successfully friend who actually often a 16 complaining off symptoms as well as patients who dropped out of present despite effective. So they're all these issues, so basically, very why this happens. And so it's twenties have been able to distinct disease and units. So I said when you talk about units were talking about this subjective experience of physical and mental state, which can be days on, and the lining disease pathology almost on can also the a out of social reactions from the search environment. So usually when you talk about patient hood Oh, really, Eunice were I should really talking about the patient is subjective feeling, and that's a different feeling is influenced by their culture on their communities and all that things like still given, for example, a day prayer on somebody's still really feel on how I feel a d l to the drug, whether they will come to the clinic and all that. So I think we weigh saw how in the early part of a chemical in the India particle, when they learned about Coffee day committed suicide, we in HIV, they one of the that was 80 stigmatized. How people that should not take drugs. So even up to the CF, people fear to taste. It's because units is very complex. It's lean toe social issues. Yeah, so because of that, human beings create what we call units mellitus and explain to them orders. And those can I really appreciate monetary can come for treatment or not so in, in it's knowledge of the story that patient tells and signature and tell us will be a problem but the retail to give coherence with distinct events and course of suffering. So these medicine, influenced by a culture and so sad on there and expensive because they're related, expensive mother's I hurt my profession's and patient, which consists of ideas about a nice sort of sickness. And it's treatment that can be played in those day if I oh, if those those involved in the clinical process So these actually very, very important asshole, three acres if you want to. I don't understand, Like try to get a sense off how how somebody big rates they're here. Nous on what they I should have the link it to society issues. You get a sense of a how probably you can work together deficient in a crib. Great way to deal with some of the issues that, at least within the context of the doctor, you may be able to. But also, weight came to and refer them to. People can help them. Yeah, so that those are expensive models and they a Basically, I think Lehman is has been treated by the Lord. Ah, So, as he says, these are notions about cause of disease, diagnostic criteria and treatment options. So they were actually have information on when, what? How course of signatures meant for patients who have their studies on division. And it's up there because of the past. If you may have, they may actually not really say everything. Yeah, so a because they fear maybe they will be will be shouted it at all that, you know, with the so There are a lot of differences, mostly between the clients and practitioners in terms off explained to murders. And so, basically, if you see my slides, they got it from one of my from a student. So I actually did a study looking at extension motors of cervical cancer among women accessing several kinds of care treatment that day, concept is hospital. So she was doing it as part of an M PS dissertation, and they she presented this week in one of the conference is So I just like, put this life. So I tell him, if you look the latest victory, for example, they perceived difficult cancer as switch craft, something that has treatment, appalls and in cure. But it is justice, maybe water vagina Eunice on even then starting off the cause. And people thought just being Bewitched. No knowledge because somewhere course of uncircumcised man eating chemicals. And four. So it's a bit of information, but also they had alternative explanation on on prevention, something know. But some say that way to position contrition, medicine, observation, so a bit of information, and they in terms of Pacific treatment. Of course, there's some more thought to cannot be done by doctors, and they all that. So These are the dynamics. And if you get a sense of the beliefs that efficient times and you allow that that narrative total really wait till camp on your table encounter with that really suppressing you're actually really do well on their courage. So I can't read that. That's quite a lot of British. So that has been then around that. So then improving health Because I have to finish improving health to a patient interaction through storm a complication skills. So a one off the people has been quite a load. A doctor skin, naturally, is a medical doctor where they basically made for sociology. A hedge is that medical language general excludes a quicker place of the social context, so health records need no need to be clipped with skills of reading. In between the lines for the marriage is that education's talk about today what they want to be it. So which is a physical. But this was a mattress is like, for example, my visits Doctor, because off very great, great great is in a tribute. She complains that partition and shortness of breathe in it great, actually interfering with Billy to do house with the doctor checks that I'm a little diagram where she exercises, changes that project me, the medicines and Congress in the air force him into in the household. So but it looks straightforward like that. But actually, if you look this is actually linked to each is a gender on issues off, actually a really ministro in a home. And it can actually even be much deeper if she actually very have shortness of breath and palpitations. May actually where, as you may know, to other my two Uti's and in process mean was that has been to another person in this study. Tell me that bigger There's a lot of bleeding in the in between like another. Any man comes to trees, Doctor. Several months after heart attack is depressed, his spirit off the day off, decided payments are expressing. His union is about to go on strike. It tells the doctor his doctor tells him that his physical able to turn away from that waking would be good for his mental. The doctor also free sprays and present and trust tranquilizer. But actually, if you look in all these ah, this is the present, actually is linked to deeper, troubling issues off survive in society. So there's quite a whole lot of things that are complex. So we have been involved in in research to try to to explore some of these, and this paper, which is actually really worked with a one of my colleagues from Vessel Colorado which would cost support or control quite a few times with something remain on male pattern involvement, HIV care during and after pregnancy. I reviewed the complex major off how a safe, accessing take care is linked to many ablation. So we need to do that. They're not really, as a general excited that really must navigate to be a general through here. It's every care Julie and after pregnant. So agenda inequities and social norms coupled with HIV stigma in That's the test a disclosure by many men, which made at the idea it's on the HIV care more challenging and does it does? Some things may wind up quiet and not dealing. Sometimes it may not even tell you that you actually see that the patient is not progressing so in this way and covered key aspect related to agenda structures, which has a certain issues in the lives of women with HIV, often four of contradictions. They enjoy it well enough, getting HIV care treatment on, but it's got after after Yeah, so I think that it was just an example, and you can actually find this paper a specialist, and I think one of the one of the people on this paper is I think it is in the department of Upset with that and gynecology. Now you quit with main hospital. That means yeah. So he has been involved in a broader Waco. So we chose a quantitative last day. Then I suggested my disciplinary. So I think that small it's like where we're actually going mostly sits now require understanding off a things in a complex way. So if you really debated medical sciences, need to be actually really a there's also need for the same behavior stances. So your sciences and this is something that has been advocated. If you look at these two doctors have a claimant, they actually really I do to maintain it once a they keep us for missing, know to diminish the rover. Um, it processes here and practice of a little, but just have remained, um, with an equal education of such a stands. Is in order to provide both a comprehensive understanding of disease and Medicare patients. Their problem is not too much science, but to know is you off sensory. That lets it. So I think I did that they need beyond that uses to actually brilliant. I'm standing on social science beyond psychology. Total bringing this on So they're million ways like, for example, in the past house, which is since I've been rebuilt week. I've been waking with doctors. I don't I'm trying to. I generally look at things from one another angle, so they had wakes. Percent subjective helps understand and do with their programs, like weeks on the Sun Body has for some condom use or mitral interventions. The fatty tissue is that here in stomach is in concert with your support. Also such a sentence and write it also subjective. But it's still studying it as a social phenomena where we analyze the some cheese and raining permits and the criticism that comes. And this come from there studying the forms off speech in Melbourne, it's in and the language, the military metaphors that I used a medicine, for example two and come away the new social meanings I invaded in diameter concept in category. I don't so demystifying medicine show that problems of medicine that problem so so side effects of the present capitalist organism set on here with and fight is, I said, it's supposed to be a little dab in and also taking that issue on the incorporation of in business on it and be colonized other forms of knowledge It is I get that indigenous noise can play a role in healthcare and health medication needs to be respected compression health care. They need to invest in beauty research series motors and process plays a little knowledge and fair to explore a million money from low communities brings the mix of suspicion resistance and the S stick expectations and complex escalations with the apartment is electing. We have seen some of these with this coffee 19 today me of people that doubted this exists that also they push back on back seats. Yeah, so I think that's way and see that some of the the books that you can actually look at some articles. There's quite a lot of rich literature in this, and they Yes. So in the interest of time, I'm not going through in of these. Yeah. Thank you. Hello. Thank you very much. For what? Ones that you want to teo up. Um, I'm just checking through the chat. If it does there any questions or if I brother is anyone who has a question for the Remember you can and mute and ask before we close. Good afternoon, Doctor. Remember we left? Yes. Thank you very much for the eye opening presentation. Hello. I can hear you. Go ahead. Yes, I have a question on mystification you you had mentioned, but, um, the current medical approach to Eunice. It doesn't take into account the environment where the patient is coming from. So on the way forward house, we How do we count? A lot. Thought we apply both more doors. Where by when we treat a patient in the as we are treating our patients in our house because as doctors, we take into account off the environment where they're coming from. I'll start to question off something like they were. We treat my nutrition in clinical practice. Usually. What about they have dessert when it's out. Comes to the hospital with the said, um a nutrition, for example who treat them a nutrition in the hospital. We treat those issues that are immediate concern When they go back into the community. You find that these Children again, they are brought back and see twice for the over the same problem when we keep one treating day the same problem over and over because you have not really taken into account off the social aspect and economic aspect in the community is they're coming from. So basically, my question is, how do we incorporate or these approaches? They're moving forward. Thank you. Yeah. Yeah. So thanks. Thanks for For that. Yes. So, basically, actually, and that's a perfect example. Ministrations is one which really is purely Ah, a social issue as much as it manifests itself as a medical issue. Yeah, So I'm basically so I think every day a doctor's This is only so much you can do a Let's try to logics. And they actually argue that some of the things you can do as doctors is play that it gets raw, okay. And if such things you see size things where a child literally comes because they have no food and then you treat them you may give them medicines. They go back where they were still not access food. You touch on raises in bale. So it was for us in that Identix, when we we actually do is to actually published those and try to which will put you stand, and that's where government needs to come in. That's where I tell you the whole system is to come in so a function government in most cases. So I think you cut too. Then within those context like, for example, nutrition, who may be vulnerable, who may need to be supported. So that's why when you talk about intersect approach and all that social has transfer, for example, which, of course has been it has been made abused by politicians and on some government or visual if they're supposed to, I should really come to me to get on such kind of things where somethings, they support the household. So try to. I should really also do with that also, as much as the doctors can do a visual patients, but also you're trying to do it at house would label. So that's why that intersect approach I talked about is very, very important, and they a like present patootie. Eight. You have a medical social worker office and I I think that that office is Reese opposed to make that s link. But of course, if I played every day this the resources being abused and all that, then probably what we need to do is more political level. And that's why I made it to solve some of the health problems we're having used to solve political questions. So So I think in this'll be the only answer. I'm sure some people may have other ways they can suggest, but basically it's all interlinked. It's all interrelated trying to identify such households. It the whole office off medical social worker is supposed to come in to try to do. And I think now the ministry has employed to their credit in a major hospitals what they call Hell's promotion practitioners who can take up on because they're trained in such kind of social psychosocial A dimensions. Those help you can actually read, Supposed to take up some of those issues and try to see what opportunities and linkages for Children what I need so that we don't get it back. You've entered again, uh, stations. Yeah, so they're not his issues by their task, but course the fact that they had half we doesn't mean we can't just ignore them. And that discount vested, great example the protein of contrition. But anybody else couldn't suggest a ways to actually do with that pushing that has been raised. Then there are did also to find out if you're going to share that. Our point resent a shin with us? Yes. I'll send it straight away to window on. Then she she'll say with you. Yeah. Thank you. Yeah. So I had mentioned that, like, for example, you know, health promotion and a great program actually developed course. Now we call it history and philosophy, science and medicine, where we do with these issues more complex way with, of course. So if you look, we actually drop quite a lot on philosophy. Crystal Social Sands, a Twitter really argue and be able to unmasked it the way our society wakes, including the healthcare system. So So basically, there is a cause that actually be just a little bit is running. It doesn't kill some people. Be interested. But it's it's It brings into quite a lot of physicians, and it's an eye opener. Two things we take for granted. All right. Thank you.