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Nine rural village communities in the jungle of Brunei, Borneo were studied to ascertain possible effects of rapid social change on the health of the inhabitants. The social mores and religious beliefs of the rural tribes—Iban, Dusun, and Punan—have undergone but little change over many hundreds of years. During the past three decades, however, enormous social pressures for change have evolved from extraordinary economic prosperity of the region, due to the exploitation of large discoveries of oil and gas. Much of the money has been invested in health care, with the result that malaria, typhus and other tropical scourges have been virtually wiped out. Child and maternal mortality have been reduced to the standards of some of the healthiest countries in the world. The young of the formerly illiterate population are being rapidly educated in new schools scattered throughout the nation. New roads are penetrating the jungle and a thriving lumber industry has been established. Motor boats for the rivers, T.V. and even a national airline have been added. Despite these incursions a vigorous proseletizing by the Moslem and to a lesser extent by the Christian church, the villagers have held tenaciously to their ancient animistic beliefs. Living in long houses, they have also been able to maintain a tightly cohesive patriarchal family structure. Against this background there is as yet little or no evidence of the major diseases of Western society—coronary artery disease and hypertension, although most forms of cancer are commonly encountered. Brunei offers a splendid opportunity to test the putative relationship of chronic vascular disease to social structure and a way of life. Future studies may be made prospectively as the almost inevitable breakdown of old customs and patterns of living occurs in the face of rapid modernization. 相似文献
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