Education And Debate

Treating childhood asthma in Singapore: when West meets East

BMJ 1994; 308 doi: (Published 14 May 1994) Cite this as: BMJ 1994;308:1282
  1. G J Connett,
  2. B W Lee
  1. Department of Paediatrics, National University of Singapore, 0511
  1. Correspondence To: Dr Lee.
  • Accepted 22 February 1994

Though Western medicines and ideas about asthma have become popular in many Asian nations, local beliefs about treatment prevail. The multiracial society of Singapore shows a variety of beliefs about causes of asthma attacks (for example, the balance of yin and yang) and types of treatment - herbal remedies, inhaled versus eaten medicines, the influence of Ramadan. Many of the cultural practices mentioned are probably preserved among south east Asian minorities residing in the United Kingdom. Eastern treatments typically take a holistic approach to asthma and do not ignore the psychosomatic component of the disorder.

As in most Western countries, asthma is increasingly common in many Asian nations. Its prevalence during childhood (5-17 year olds) in Singapore is 12% among Chinese communities, 19% among Malays, and 15% among Indians (unpublished data). In recent years Western medicines and ideas about asthma have become popular, but despite this trend local beliefs about treatment prevail. Some of these sound implausible, but others hint at underappreciated differences in the pathogenesis of asthma between Asians and white people.

Singapore is a multiracial society, consisting mainly of Chinese (76%), Malays (15%), and Indians (6%). These main racial groups are culturally diverse, as are their beliefs in traditional medicine. The Chinese in Singapore originate from southern China and belong mainly to the Cantonese, Fukien, and Teochew dialect groups. These dialect groups share the same written language and have common traditional beliefs about illnesses and their cures. The Malays in Singapore are also a heterogeneous community, with main origins from Javan and Bawean provinces of Indonesia. Like the Chinese, they share distinct beliefs about diseases and their cures.

This article reviews some of the local beliefs about asthma reported by the parents of children attending the respiratory clinics of the National University Hospital of Singapore. Although this report …

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