Therapeutic cultural resilience perspectives during the COVID-19 pandemic: An ethnographic qualitative study of Faisalabad, Pakistan

Abstract

Collective trauma is instigated on a wide scale by warfare, poverty, natural disasters, or global health crises such as the COVID-19 pandemic. For instance, natural disasters have a significant impact on the social fabrics of communities. This fallout can cause long-term social support networks to disintegrate, especially when combined with a high level of risk. In Faisalabad, Pakistan, COVID-19-induced collective trauma resulted in social and cultural upheavals, particularly in the initial phase of uncertainty when no effective medical interventions were indicated. At the community level, such difficulties were overcome through traditional cultural resilience. In this regard, cultural folk practices are generated and modified to comprehend and navigate challenging circumstances. Thus, this study investigates how community awareness and treatment alternatives during the COVID-19 pandemic were rooted in traditional and folk knowledge. Specifically, we conducted an ethnographic investigation to determine how individuals endured the pandemic during the first wave in 2020. The primary qualitative investigation revealed various aspects, including how religion influenced societal attitudes and provided individuals with the resilience to cope with the crisis. In addition, a number of cultural perspectives that emerged during the initial COVID-19 breakout and subsequent lockdown phase were investigated. Meanwhile, our empirical investigation considered therapeutic stances, such as herbal remedies, natural therapy methods, and traditional beliefs, on the socially constructed nature of illness. Overall, such therapeutic cultural resilience enhanced the emotional well-being, sense of personal power, and self-awareness of individuals in this community.

Keywords

Therapeutic cultural resilience / Cultural perceptions / Natural healing methods / Spiritual healing / Home remedies / COVID-19

References

[1] Adebiyi A., Donga D., Omukunyi A., & Roman S. (2022). Home treatments and their effectiveness in preventing viral infections during the COVID-19 pandemic. Journal of Traditional Medicine Research, 14(3):230-245. https://doi.org/10.1016/j.jtcm.2022.06.001

[2] Adebiyi D., Donga O., Omukunyi A., & Roman M. (2022). The role of traditional medicine in the prevention of COVID-19 in Africa. Journal of Ethnopharmacology, 258(4):128-135.

[3] Agyeman J. (2020). Socioeconomic inequalities and COVID-19 in developing countries: Exploring resilience. World Development, 140:105-115.

[4] Ahmad S., Jan F.A., & Malik K. (2021). Cultural adaptation and resilience: A study of communities in Pakistan during COVID-19. Asian Social Science, 12(9):45-54.

[5] Akhtar A., Khan S., Rehman Z., & Zafar M. (2022). Herbal remedies for SARS CoV-2: Public opinions and antiviral properties of plants. Journal of Ethnopharmacology, 280:114-123.

[6] Akhter S., Bashar F., Kamruzzaman M., Mahmood N., Rahman A., Anwar I., et al. (2022). A rapid ethnographic assessment of cultural and social perceptions and practices about COVID-19 in Bangladesh: What the policy makers and program planners should know. Qualitative Health Research, 32(7):1114-1125. https://doi.org/10.1177/10497323221091516

[7] Al Eid N.A., & Arnout B.A. (2020). Coping with COVID-19 pandemic in Saudi Arabia: Psychological responses, religious coping, and social support. Journal of Religion and Health, 59(6):2719-2735.

[8] Ali A. (2022). Cultural folk descriptions as societal responses to crises. Journal of Sociocultural Studies, 14(2):45-62. https://doi.org/10.1016/j.jscs.2022.05.007

[9] Ali I. (2020). The COVID-19 pandemic: Making sense of rumor and fear: Op-ed. Medical Anthropology, 39(5):376-379. https://doi.org/10.1080/01459740.2020.1771031

[10] Ali I. (2022). Impacts of rumors and conspiracy theories surrounding COVID-19 on preparedness programs. Disaster Medicine and Public Health Preparedness, 16(1):310-315. https://doi.org/10.1017/dmp.2020.325

[11] Aslam H.B., Alarcon P., Yaqub T., Iqbal M., & Häsler B. (2020). A value chain approach to characterize the chicken sub-sector in Pakistan. Frontiers in Veterinary Science, 7:361. https://doi.org/10.3389/fvets.2020.00361

[12] Aslam N., Khan M., & Nisar H. (2020). Community perceptions of flu and health-seeking behaviors in Pakistan. Journal of Public Health Research, 9(1):23-34. https://doi.org/10.1177/jphr.2020.02345

[13] Azam M.A., Al Mahamud R., Hasan M., Jahan F., & Rahmatullah M. (2020). Use of traditional home remedies during the COVID-19 pandemic in Bangladesh, Pakistan, and India. Journal of Herbal Medicine, 22(4):103-110. https://doi.org/10.1016/j.jhermed.2020.01.004

[14] Baskin C., & Bartlett S. (2021). Cultural factors influencing health-seeking behaviors during pandemics. Journal of Health Communication, 27(3):141-158. https://doi.org/10.1080/10810730.2021.1883332

[15] Baskin R.G., & Bartlett R. (2021). Healthcare worker resilience during the COVID-19 pandemic: An integrative review. Journal of Nursing Management, 29(8):2329-2342. https://doi.org/10.1111/jonm.13395

[16] Brazzaville Producer. (2020). WHO Supports Scientifically-proven Traditional Medicine. WHO Africa. Available from: https://www.afro.who.int/news/who-supports-scientifically-proven-traditional-medicine?gclid=cj0kcqiaj4ecbhd3arisam4q_jfkn14qus0onulkgiovmj7_ex-bycans9sohywcby--edlp_xhn3_yaavs2ealw_wcb [Last accessed on 2022 Dec 03].

[17] Brazzaville W. (2020). Plant-based remedies and misinformation in the COVID-19 pandemic. WHO Bulletin, 98(2):129-135.

[18] Brown E., Gray R., Monaco S.L., O’Donoghue B., Nelson B., Thompson A., et al. (2020). The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research. Schizophrenia Research, 222:79-87. https://doi.org/10.1016/j.schres.2020.05.005

[19] Bruns D.P., Kraguljac N.V., & Bruns T.R. (2020). COVID-19: Facts, cultural considerations, and risk of stigmatization. Journal of Transcultural Nursing, 31(4):326-332. https://doi.org/10.1177/1043659620917724

[20] Carruth L. (2014). Camel milk, amoxicillin, and a prayer: Medical pluralism and medical humanitarian aid in the Somali Region of Ethiopia. Social Science and Medicine, 120:405-412. https://doi.org/10.1016/j.socscimed.2014.03.007

[21] Carruth L. (2014). Ethnographic perspectives on health-seeking behaviors in times of crisis. Medical Anthropology Quarterly, 28(4):480-502.

[22] Chaachouay N., Douira A., & Zidane L. (2021). COVID-19 and herbal medicine: Use of medicinal plants in the fight against coronavirus. Journal of Ethnopharmacology, 278:114-255.

[23] Chou W.Y.S., Oh A., & Klein W.M. (2018). Addressing health-related misinformation on social media. JAMA, 320(23):2417-2418. https://doi.org/10.1001/jama.2018.16865

[24] Clauss-Ehlers C.S. (2004). Re-inventing resilience:A model of “culturally-focused resilient adaptation.” In:Community Planning to Foster Resilience in Children. Springer, Cham, p.27-41. https://doi.org/10.1007/978-1-4419-0293-3_2

[25] Clauss-Ehlers C.S. (2008). Sociocultural factors, resilience, and coping: Support for a culturally sensitive measure of resilience. Journal of Applied Developmental Psychology, 29(3):197-212. https://doi.org/10.1016/j.appdev.2008.02.004

[26] Cruz E.V., & Higginbottom G. (2013). The use of focused ethnography in nursing research. Nurse Researcher, 20(4):36-43. https://doi.org/10.7748/nr2013.03.20.4.36.e305

[27] Dein S., Loewenthal K., & Lewis C.A. (2020). COVID-19, mental health, and religion: Pastoral challenges and future possibilities. Journal of Religion and Health, 59(5):2423-2435.

[28] Dein S., Loewenthal K., Lewis C.A., & Pargament K.I. (2020). COVID-19, mental health and religion: An agenda for future research. Mental Health, Religion & Culture, 23(1):1-9. https://doi.org/10.1080/13674676.2020.1768725

[29] Del Vicario M., Bessi A., Zollo F., Petroni F., Scala A., Caldarelli G., et al. (2016). The spreading of misinformation online. Proceedings of the National Academy of Sciences, 113(3):554-559. https://doi.org/10.1073/pnas.1517441113

[30] Dymecka J., Gerymski R., & Machnik-Czerwik A. (2022). How does stress affect life satisfaction during the COVID-19 pandemic? Moderated mediation analysis of sense of coherence and fear of coronavirus. Psychology, Health & Medicine, 27(1):280-288. https://doi.org/10.1080/13548506.2021.1906436

[31] Fardin M.A. (2020). COVID-19 and anxiety: A review of psychological impacts of infectious disease outbreaks. Archives of Clinical Infectious Diseases, 15:e102779. https://doi.org/10.5812/archcid.102779

[32] Farooq S., & Quadri R. (2020). Ethnographic approaches to understanding pandemic responses: Insights from the COVID-19 crisis in Pakistan. Pakistan Journal of Social Research, 6(1):63-79.

[33] Garcia D. (2020). Traditional healing practices during the COVID-19 pandemic. Journal of Traditional Medicine and Health Science, 5(1):39-49.

[34] Garcia S. (2020). The increasing use of plant-based herbal formulations in developed countries. Journal of Herbal Medicine Research, 12(4):34-45. https://doi.org/10.1016/j.herbres.2020.0234

[35] Graeupner D., & Coman A. (2017). The dark side of meaning-making: How social exclusion leads to superstitious thinking. Journal of Experimental Social Psychology, 69:218-222. https://doi.org/10.1016/j.jesp.2016.10.003

[36] Hampshire K., Hamill H., & Carr S. (2017). The role of social networks in shaping health behaviors. Social Science & Medicine, 190:64-71.

[37] Hewlings S.J., & Kalman D.S. (2017). Curcumin: A review of its effects on human health. Foods, 6(10):92. https://doi.org/10.3390/foods6100092

[38] Hong-Zhi W., Xiao-Ying T., Yu-Huan G., Huang Z., & Da-Hui G. (2020). The role of traditional Chinese medicine in alleviating COVID-19 symptoms in Chinese hospitals. Chinese Journal of Integrative Medicine, 26(9):689-692. https://doi.org/10.1007/s11655-020-3270-4

[39] Hossain T. (2021). COVIDLies: Detecting COVID-19 Misinformation on Social Media. University of California, Irvine.

[40] Iftikhar A. (2018). Cultural responses to dengue fever in rural Pakistan: A community perspective. International Journal of Infectious Diseases, 73(1):122-127.

[41] Iftikhar A. (2018). Dengue fever: How aware are we? A qualitative study of the knowledge and preventive measures against dengue in Lahore. Lahore Garrison University Research Journal of Computer Science and Information Technology, 2(4):43-51. https://doi.org/10.54692/lgurjcsit.2018.020459

[42] Jawaid H. (2020). Assessing perception of patients and physicians regarding spirituality in Karachi, Pakistan: A pilot study. The Permanente Journal, 24:19.214. https://doi.org/10.7812/tpp/19.214

[43] Kaye-Kauderer H., Kauderer J., Murdock K., Levin S., Shao, Y., Lipsitz, S. (2021). Resilience in the age of COVID-19. BJPsych Advances, 27(3):166-178. https://doi.org/10.1192/bja.2020.38

[44] Kleinman A. (1980). Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. Vol. 3. University of California Press, California.

[45] Koenig H.G. (2020). Maintaining health and well-being by putting faith into action during the COVID-19 pandemic. Journal of Religion and Health, 59(5):2205-2214. https://doi.org/10.1007/s10943-020-01035-2

[46] Krok D., Zarzycka B., & Telka E. (2021). Religiosity, meaning-making, and the fear of COVID-19 affecting well-being among late adolescents in Poland: A moderated mediation model. Journal of Religion and Health, 60(5):3265-3281. https://doi.org/10.1007/s10943-021-01375-7

[47] Lam W.C., Koon C.M., Chung V.C., & Cheung Y.T. (2021). Traditional Chinese medicine for boosting immunity in patients during the COVID-19 pandemic. Journal of Integrative Medicine, 19(5):350-362. https://doi.org/10.1016/j.joim.2021.02.006

[48] Lee J.S., Choi H.S., Ko W.S., Kang M.H., & Kim Y.H. (2012). Herbal medicine in the treatment of SARS during the 2003 outbreak: A review. Journal of Traditional Chinese Medicine, 32(3):280-285. https://doi.org/10.1016/s0254-6272(13)60026-8

[49] Leman P.J., & Cinnirella M. (2007). A major event has a major cause: Evidence for the role of heuristics in reasoning about conspiracy theories. Social Psychological Review, 9(2):18-28.

[50] Leung P.C. (2006). The efficacy of traditional Chinese medicine during the SARS pandemic. Journal of Traditional Chinese Medicine, 26(2):119-123. https://doi.org/10.1016/j.jtcm.2005.11.002

[51] Li S., Wang Y., & Zhang X. (2018). Ebola’s impact on healthcare-seeking behaviors in affected areas: A review. Global Health Journal, 12(3):45-52. https://doi.org/10.1016/j.glohj.2018.06.003

[52] Li Y., Wang H., Jin X.R., Li X., Pender M., Song C.P., et al. (2018). Experiences and challenges in the health protection of medical teams in the Chinese Ebola treatment center, Liberia: A qualitative study. Infectious Diseases of Poverty, 7(1):92. https://doi.org/10.1186/s40249-018-0468-6

[53] Lincoln Y.S., & Guba E.G. (1985). Establishing trustworthiness. Naturalistic Inquiry, 289(331):289-327.

[54] Lone M.I. (2018). Islamic perspectives on health and hygiene: A review of Muslim health practices. Journal of Islamic Studies, 30(2):233-250. https://doi.org/10.1093/jis/etx042

[55] Magruder K.M., McLaughlin K.A., & Elmore Borbon D.L. (2017). Trauma is associated with long-term disruption in social systems. Journal of Trauma and Public Health, 11(4):233-245.

[56] Magruder K.M., McLaughlin K.A., & Elmore Borbon D.L. (2017). Trauma is a public health issue. European Journal of Psychotraumatology, 8(1):1375338. https://doi.org/10.1080/20008198.2017.1375338

[57] Mahamid F.A., & Bdier D. (2021). The association between positive religious coping, perceived stress, and depressive symptoms during the spread of coronavirus (COVID-19) among a sample of adults in Palestine: A cross-sectional study. Journal of Religion and Health, 60(1):34-49. https://doi.org/10.1007/s10943-020-01121-5

[58] Marian-Potra A.C., Pop A.M., Hognogi G.G., & Nagy J.A. (2022). Resilience of the Romanian independent cultural sector under COVID-19 pandemic using the grounded theory. Sustainability, 14(8):4564. https://doi.org/10.3390/su14084564

[59] McCauley C., & Jacques S. (1979). The popularity of conspiracy theories of presidential assassination: A Bayesian analysis. Journal of Personality and Social Psychology, 37(5):637-649. https://doi.org/10.1037/0022-3514.37.5.637

[60] Melissa S.B., Richard B., Ryan D.B., & Erin W. (2021). A naturopathic treatment approach for mild and moderate COVID-19: A retrospective chart review. Complementary Therapies in Medicine, 63:102788. https://doi.org/10.1016/j.ctim.2021.102788

[61] Mukhtar S. (2021). Psychological impact of collective trauma during the COVID-19 pandemic in Pakistan. Journal of Mental Health, 30(1):1-6.

[62] Mukhtar S. (2021). Psychology and politics of COVID-19 misinfodemics: Why and how do people believe in misinfodemics? International Sociology, 36(1):111-123. https://doi.org/10.1177/0268580920948807

[63] Myers S.L. (2020). China Spins Tale that the US Army Started the Coronavirus Epidemic. The New York Times, A6. Available from: https://www.nytimes.com/2020/03/13/world/asia/coronavirus-china-conspiracy-theory.html [Last accessed on 2022 Dec 22].

[64] Nasir T., Tajuddin S., & Khan A. (2024). COVID-19 impact on vulnerable populations in Pakistan. Public Health Review, 12(1):85-93. https://doi.org/10.1016/j.phr.2023.08.013

[65] Nasution I.F.A., Anzaikhan M., Adam S.B., & Abdul Latif M.S. (2022). COVID-19 in Islamic theology and its impact on socio-religious affairs in Indonesia. European Journal of Science and Theology, 18(1):51-65. https://doi.org/10.1111/ejst.2189

[66] Ndumbe-Eyoh S., Muzumdar P., Batal M., & O’Campo P. (2021). Cultural resilience and community mobilization in response to COVID-19 in developing countries. International Journal of Public Health, 8(2):77-83. https://doi.org/10.3389/ijph.2021.00021

[67] Osei-Tutu A., Affram A.A., Mensah-Sarbah C., Dzokoto V.A., & Adams C. (2021). Islamic religious coping and pandemic management: Insights from Muslim communities during COVID-19. Journal of Psychology and Theology, 50(1):29-42. https://doi.org/10.1177/00916471211024104

[68] Pakistan Bureau of Statistics. (2017). Population and Housing Census 2017:Provisional Summary Results. Government of Pakistan. Available from: https://www.pbs.gov.pk/content/population-census-2017 [Last accessed on 2022 Dec 22].

[69] Peteet J.R. (2020). COVID-19 anxiety. Journal of Religion and Health, 59(5):2203-2204. https://doi.org/10.1007/s10943-020-01041-4

[70] Piwko A.M. (2021). Islam and the COVID-19 pandemic: Between religious practice and health protection. Journal of Religion and Health, 60(5):3291-3308. https://doi.org/10.1007/s10943-021-01346-y

[71] Piwko D. (2021). Islam and pandemics: Prophet Muhammad’s instructions and modern health guidelines in controlling diseases. Journal of Religion and Health, 60(4):2094-2105. https://doi.org/10.1007/s10943-021-01336-8

[72] Rabbani F., Khan H.A., Piryani S., Pradhan N.A., Shaukat N., Feroz A.S., et al. (2021). Changing perceptions of rural frontline workers and caregivers about management of childhood diarrhea and pneumonia despite several inequities: The Nigraan Plus Trial in Pakistan. Journal of Multidisciplinary Healthcare, 14:3343-3354. https://doi.org/10.2147/JMDH.S334844

[73] Rabbani F., Qazi S., & Malik A. (2021). Community knowledge and perceptions of diarrheal illness and treatment-seeking behaviors in Pakistan. Health Systems Research Journal, 18(2):55-68.

[74] Rahman S., & Janjua M. (2021). Coping with COVID-19 through traditional and spiritual healing practices. Pakistan Journal of Health and Social Research, 3(2):61-72.

[75] Richards L., & Morse J.M. (2012). Readme First for a User’s Guide to Qualitative Methods. Sage, United States.

[76] Roman N.V., Mthembu T.G., & Hoosen M. (2020). Spiritual care-‘A deeper immunity’-A response to the COVID-19 pandemic. African Journal of Primary Health Care and Family Medicine, 12(1):e1-e3. https://doi.org/10.4102/phcfm.v12i1.2456

[77] Sadio A.J., Gbeasor-Komlanvi F.A., Konu R.Y., Bakoubayi A.W., Tchankoni M.K., Bitty-Anderson A.M., et al. (2021). Preventive measures and traditional treatments used for COVID-19 in West Africa. Pan African Medical Journal, 38:9. https://doi.org/10.11604/pamj.2021.38.9.29122

[78] Shackle C. (1976). Punjabi in Lahore: A Study of Language and Communication in Pakistan. Cambridge University Press, United Kingdom.

[79] Shahbaz U., Fatima N., Basharat S., Bibi A., Yu X., Hussain M.I., et al. (2022). Role of vitamin C in preventing COVID-19 infection, progression and severity. AIMS Microbiology, 8(1):108-124. https://doi.org/10.3934/microbiol.202201

[80] Shaikh B.T., & Hatcher J. (2005). Health seeking behavior and health service utilization in Pakistan: Challenging the policy makers. Journal of Public Health, 27(1):49-54. https://doi.org/10.1093/pubmed/fdh207

[81] Singh S., Kumar R., Jyoti & Kumar, M. (2021). Traditional herbal decoctions and immunity-boosting practices in India during COVID-19. Asian Pacific Journal of Tropical Biomedicine, 11(2):55-62. https://doi.org/10.1016/j.apjtb.2020.12.002

[82] Soleymani S., Gohari A.R., Eghbali H., Kamalinejad M., & Mokaberinejad R. (2022). Herbal remedies for boosting the immune system: An alternative preventive approach for COVID-19. Journal of Ethnopharmacology, 284:114774. https://doi.org/10.1016/j.jep.2022.114774

[83] Soofi K., Khanjani N., & Kamiabi F. (2019). The challenges of the malaria elimination program in the South East of Iran: A qualitative study. Journal of Arthropod-Borne Diseases, 13(1):94-103.

[84] Southwick S.M., Bonanno G.A., Masten A.S., Panter-Brick C., & Yehuda R. (2014). Resilience definitions, theory, and challenges: Interdisciplinary perspectives. European Journal of Psychotraumatology, 5(1):25338. https://doi.org/10.3402/ejpt.v5.25338

[85] Strand J.A., & Peacock M.E. (2003). Resilience: Creative responses to adversity. Journal of Human Psychology, 7(2):45-60. https://doi.org/10.1177/153321230300700202

[86] Strand J.A., & Peacock R. (2003). Resource guide: Cultural resilience. Tribal College, 14(4):28-31.

[87] Turan G., Bostan S., & Demir C. (2022). The role of religion in coping with COVID-19: Insights from Turkey. Religions, 13(2):89-101.

[88] Turan Y., Bostan S., & Baynal F. (2022). The effect of Covid-19 pandemic on religion. Ordu Üniversitesi Sosyal Bilimler Enstitüsü Sosyal Bilimler Araştırmaları Dergisi, 12(1):319-338. https://doi.org/10.48146/odusobiad.995556

[89] Umeta Chali B., Melaku T., Berhanu N., Mengistu B., Milkessa G., Mamo G., et al. (2021). Traditional medicine practice in the context of COVID-19 pandemic: Community claim in Jimma zone, Oromia, Ethiopia. Infection and Drug Resistance, 14:3773-3783. https://doi.org/10.2147/IDR.S325620

[90] Van Prooijen J.W., & Douglas K.M. (2017). Conspiracy theories as part of history: The role of societal crisis situations. Memory Studies, 10(3):323-333. https://doi.org/10.1177/1750698017701615

[91] Vindrola-Padros C., Chisnall G., Cooper S., Dowrick A., Djellouli, N., Symmons, S.M., et al. (2020). Carrying out rapid qualitative research during a pandemic: Emerging lessons from COVID-19. Qualitative Health Research, 30(14):2192-2204. https://doi.org/10.1177/1049732320951526

[92] Vraga E.K., & Bode L. (2020). Defining misinformation and understanding its bounded nature: Using expertise and evidence for describing misinformation. Political Communication, 37(1):136-144. https://doi.org/10.1080/10584609.2020.1716500

[93] Zarocostas J. (2020). How to fight an infodemic. The Lancet, 395(10225):676. https://doi.org/10.1016/S0140-6736(20)30461-X

[94] Zarzycka B., Śliwak J., & Zarzycki P. (2019). Religious comfort and anxiety in women with cancer: The mediating role of hope and moderating role of religious struggle. Psycho-Oncology, 28(9):1829-1835. https://doi.org/10.1002/pon.5155

[95] Zarzycka B., Śliwak J., & Zarzycki P. (2019). The role of religious faith in coping with chronic diseases. Journal of Religion and Health, 58(2):786-798. https://doi.org/10.1007/s10943-019-00814-1