Hutabolon Village Community Behavior in Overcoming Health Problems

The behavior of the Hutabolon Village community in overcoming the problem of diseases that occur or that they experience is still relatively moderate. The community is already aware of the importance of health, but because there are insufficient facilities or health facilities, it makes the community still have a little difficulty in getting treatment. The research method used is qualitative with a descriptive approach, through this research method researchers get information about the types of diseases that often occur, modern and traditional medicine carried out by the people in Hutabolon Village as a behavior in overcoming health problems. The results of the study concluded that the types of diseases that often occur in Hutabolon Village are eight such as flu or respiratory infections, fever, rheumatism, diarrhea, wounds or vulnus, cavities or toothache, acute respiratory infections, and stomach acid. Behavior of the people of Hutabolon Village To overcome the problem of the disease is to use modern medicine or medical services coupled with traditional medicine.


I. Introduction
Health is a very important element of the quality of life in national development. The national health system has established that the goal of health development is to increase awareness, willingness, and ability to live healthy for everyone so that a high degree of public health can be realized -high human resources, as an investment for socially and economically productive development (Health Law No. 36 of 2009). (Hasibuan et al, 2020) Health is one of the most important aspects in human life so that healthy and sick events will affect human life. Health is such a valuable thing that humans try to solve a health problem that attacks their lives. Some health problems which are a threat to human life are simple and some are complex (Foster / Anderson, 2013). The imbalance of elements in the human body that causes illness is a simple cause of health problems, whereas those that are complex cannot be determined by just one cause, because humans have a culture so that they can interpret these health problems from various sides of life (Foster / Anderson, 2013). Skinner (in Sudarma, 2009) states that health behavior is a person's (individual) response to stimuli or objects related to illness and disease, the health service system, food and beverages, and the environment. From this definition, it is then formulated that health behavior is related to (1) preventive behavior, cure disease, and recovery from disease, (2) health improvement behavior, (3) nutritional behavior (food and drink). The health behavior that has been formulated is a form of culture that is action and based on ideas.
The concept of a medical system known in health anthropology is theoretically divided into two, namely the modern medical system and the traditional medical system as described by Sikkink (2009). Modern medical medicine uses treatment methods which are based on scientific research in the process and based on knowledge from various aspects. Usually medical treatment uses several applications of scientific disciplines in treating a disease, the way of examination and diagnosis of the disease is more accurate than traditional medicine. Foster / Anderson (2013) have assumed that scientific medicine is significantly superior to non-Western (traditional) medicine in the clinical dimensions of modern medicine and is superior to non-Western medicine. Traditional medicine is a treatment that comes from a local area which is passed down from generation to generation, usually from their ancestors. However, this traditional medicine can also diffuse from one area to another.
Traditional medicine often plays an important role in the development of national nationality, because it can symbolize the past of the country concerned and its cultural level in the past (Foster / Anderson, 2013). The two types of medical systems described in Foster / Anderson (2013), each stand alone with the knowledge system or theoretical concept that underlies it.
Several studies on traditional medicines have also been carried out, Nasution, (2009), on Oukup, a traditional karo ethnic ingredient for postpartum health which was analyzed by using Bioprospection of Indonesian Tropical Plants. Nasution, et al (2016). Ethnobotany Study of Medicinal Plants by Ethnic Communities in Aras Napal Kiri Hamlet and Aras Napal Kanan Hamlet, Bukit Mas Village, Besitang District, Langkat Regency. . Ethnobotany Study of Zingiberaceae as a Traditional Medicine for the Toba Batak Ethnic in North Sumatra. . Ethnobotany Study of Karo Oil. Lubis, et al. (2017).Ethnobotany Study of Mangrove Plants by the Community of Nipah Village, Iii Village, Sei Nagalawan Village, Perbaungan District, Serdang Bedagai Regency, North Sumatra. This research is proof, that our traditional society, is so rich for the diversity of medicines and tardisonal ingredients which are very high in the system of knowledge in it.
As we all know that culture is dynamic, society is also dynamic, always evolving according to the dimensions of space and time. Societies that are different from one another also develop different knowledge systems. Culture at the level of these ideas always appears as a result of the dynamism of society (Imzastini, 2016).
Culture at the level of ideas always emerges as a result of the dynamism of society. One form of these ideas that exist in Hutabolon Village is the formation of human knowledge about the health medical system as a solution to improving health and solving health problems in the community. Ethnicity as one that sustains a sense of primordialism is often interpreted as a social group in a social or cultural system that has a certain meaning or position because of heredity, customs, religion, language, and so on. Members of an ethnic group have a common history (ancestry), language, value system, customs, and traditions. Overall, the ethnic group takes an important position in the social interaction of the intermingling process in all ethnic groups of indigenous peoples in the social community. (Angkat et al, 2019) Hutabolon Village is one of the villages in Pangururan Subdistrict which was founded in 1986. Hutabolon Village has two village health facilities, namely the auxiliary puskesmas in hamlet II and each is served by one midwife and one paramedic. In terms of population, in fact the existence of these two health facilities is not sufficient for Hutabolon Village, this is due to the still difficulty in accessing health facilities in this village area because the distance from one hamlet to another is still a distance of approximately 2.5 km.
Hutabolon Village community developeda health system that supports a reciprocal relationship that does not diminish in the prevailing view of life. What is meant here is that the medical system is not only a matter of treating diseases but includes everything related to health knowledge systems, beliefs, health care as well as matters relating to health care to hygiene, environmental sanitation, provision of clean water, variety of fresh food. , dietary nutrition to the problem of sports for a healthy life as described by Foster / Anderson (2013).
Although access to health is still inadequate, the people in Hutabolon Village are already aware of the importance of maintaining health, this can be seen from the attitude or behavior of the community when they are sick, the people in Hutabolon Village will seek treatment at the pustu in the village. In addition to medical treatment, the community also often participates in meetings in the health sector such as integrated fostered posts, integrated service posts, immunizations, and others.
Based on the background and phenomena above, the researcher is very interested in researching "Hutabolon Village Community Behavior in Overcoming Health Problems ". Research conducted by Rahayu (2012) in a journal article entitled factors related to the choice of traditional medicine in the working area of the Muara Siberut Community Health Center, Suberut Selatan District, Mentawai Islands Regency in 2012. The approach used in this study is a qualitative approach. The study contains the selection of traditional medicine by the Muara Siberut community and the results of the research show that the variables of knowledge, attitude, education and culture have a significant relationship with the choice of treatment.
Research conducted by Rahayu is a point of view in the selection of a medical system by the community based on attitudes, education and culture. While the research conducted by researchers focused on the behavior of the Hutabolon Village community towards modern and traditional medicine in overcoming health problems.

II. Research Methods
This type of research used in this research is qualitative research with a descriptive approach. The descriptive approach is a way to solve the problem that is the goal in this study by describing and describing the condition of the subject or research object based on the facts found at the research location (Creswell, 2014).
Through this descriptive qualitative research, the authors obtained information about the acculturation of modern and traditional medicine by the community in Hutabolon Village as a behavior in overcoming health problems. In this Hutabolon Village, the community is already open to the health system, when a community is sick they will always go to the puskesmas in the Hutabolon Village area, apart from modern medicine, the people in Hutabolon Village also often use traditional medicine to help their healing. One type of treatment that is often used by the people of Hutabolon Village is massage oil.
The location of this research is in Hutabolon Village. Hutabolon Village is one of the villages in Pangururan District which was founded in 1986, with the following boundaries: a. North side: Situngkir Village, Pangururan District, b. Next to the East: Parbaba Dolok Village, Pangururan District, c. South side: Siopat-sosor Village, Pangururan District, and d. West side: the boundary of Lake Toba. The area of Hutabolon Village is around 3,900,003 Km2 or 3900,0.03 Ha, of which 60% is land with hilly topography, and 40% of the land is used as agricultural land which is used for irrigated rice fields, rain-fed rice fields and smallholder plantation areas.
In this study, there were four informants that the researchers interviewed. Research informants are people who are used to provide information about the situation and background conditions of the research (Moleong 2000). One of the four informants was made by the researcher as the key informant because he was considered to know and understand the problems that the researcher was researching. Three of the other four informants were used by researchers as supporting informants because these informants were residents who lived in Hutabolon Village, which is the place where this research was carried out, which aims to find out how the community's behavior in overcoming health problems.
To obtain data that is in accordance with the research problem, the data collection techniques used are observation, interviews, and documentation study in the research process. Bungin (2007) suggests several forms of observation, namely: participant observation, unstructured observation, and group observation. The observations made by researchers in this study were group observations. By making direct observations by a group of researchers whose research theme has been determined, namely regarding health problems at the research site, namely Hutabolon Village.
In this study, to get results that are in accordance with the research objectives, the researchers used in-depth interviews. Because through interviews, data regarding the problems in this study can be obtained. Researchers can obtain the results of interviews regarding the acculturation of modern and traditional medicine in the community in Hutabolon Village in overcoming health problems.
Documentation study is a method of collecting data that is not shown directly to the research subject. Documentation study is a type of data collection that examines various kinds of documents that are useful for material analysis (Sugiyono, 2009).In this study, researchers collected data using a cellphone camera to take pictures (photos) related to the implementation of the research. Researchers also recorded a video of the state of the research location to describe the state of the location.

Types of Diseases that Often Occur in Hutabolon Village
According to the large Indonesian dictionary (KBBI), disease comes from the word "sick" which means health disturbance caused by bacteria, viruses, or system or tissue abnormalities in body organs (in living things). Apart from viruses and bacteria, illness can also usually be caused by the environment, weather, and food (http://kbbi.web.id> sick).
According to the community and health workers in Hutabolon Village, there are eight types of diseases that often occur in Hutabolon Village, namely flu or respiratory tract infections, fever, rheumatism, diarrhea, wounds / vulnus, cariesdentis or toothache, respiratory tract infections or asthma, dyspepsia or acid stomach. The following is a description of the types of diseases that often occur in Hutabolon Village:

a. Flu or Respiratory Infection
Flu or respiratory infectionusually appears about one to three days after exposure to the virus, peaks around day four, and subsides around day seven. The life cycle of this disease is usually between 7 to 10 days. Depending on immunity or other health problems experienced by the sufferer. As has been explained by our informant, Mrs. Pusli Simarmata (55 years) that: "Flu or often called bahal-bahal in Hutabolon Village usually occurs because of the influenza virus and due to the influence of changing weather. The informant also explained the symptoms that often occur when a person has the flu, such as chills, tightness in the chest, sore muscles, and sometimes accompanied byfeverhigh, coughand nasal congestion".
The informant also explained the behavior often carried out by the people of Hutabolon Village when they had the flu, usually the people would seek treatment through medical treatment, such as visiting the auxiliary puskesmas in Hutabolon Village.

b. Fever
Fever is usually marked by an increase in body temperature than usual. According to our informant, Mrs. Agustina Turnip (45 years) said that: "Fever or what the people of Hutabolon Village often call fever usually occurs as a response to an infection or inflammation. However, fever can also be caused by prolonged exposure to hot temperatures. Someone is said to have fever when the body temperature is more than or equal to 38˚C".
The informant also explained the behavior often carried out by the people of Hutabolon Village when suffering from fever, usually if the fever temperature is not too high the community will usually treat with karo param. However, if the fever is too high and for more than two days, the community will usually seek treatment through medical treatment such as visiting the auxiliary puskesmas in Hutabolon Village.

b. Rheumatism
Rheumatism is a disease that causes inflammation and then results in pain, stiffness, and swelling in the joints. According to our informant, Mrs. Agustina Turnip (45 years) said that: "Rheumatism is usually caused by gout, obesity or obesity and also because of bathing at night. Rheumatism in general in Hutabolon Village is caused by the community who bathe too often at night, usually the people of Hutabolon Village come home too late from the fields so they have to bathe at night. Usually people affected by this rheumatic disease range in the age 30-40 years" According to the informant, the behavior that is often carried out by the people of Hutabolon Village when suffering from rheumatism is to seek treatment at a helper puskesmas and some even go to the city to be examined at the hospital and usually this medical treatment is accompanied by traditional treatments, namely massage oil and sibutar-butar massage oil.

c. Diarrhea or stomach pain
Diarrhea or stomach pain isa disease that causes sufferers to have frequent bowel movements, with watery stools. According to our informant, Mrs. Pusli Simarmata (55 years) said that:"Diarrhea or stomach ache which is commonly called diarrhea by the people of Hutabolon Village in general, occurs due to food and drink exposure to viruses, bacteria, or parasites.Usually this diarrhea only lasts a few days. The people of Hutabolon Village usually go to the auxiliary puskesmas immediately if they suffer from diarrhea".

d. Wound or Vulnus
According to our informant, Mrs. Agustina Turnip (45 years), said that: "The wound / vulnus or what the people of Hutabolon Village call it is a type of disease that is often treated by our informants. These sores / vulnus often occur in the Hutabolon Village area because in that area there is one tourist attraction, namely a white sand beach. So that sometimes many visitors get injured or injured due to falling from a bananaboat or speatboat and not only visitors, but even the surrounding community often experience it.
To overcome this, usually visitors or people who are injured or injured are immediately rushed to the auxiliary puskesmas in Hutabolon Village to get first aid.

e. Tooth Cavities or Toothache
Cavityis a condition in which the hard coating of the teeth is experienceddamagepermanent, causing the formation of fissures orholeon the teeth. According to our informant, Mrs. Agustina Turnip(45 years old), said that: "Tooth decay or uriman is usually called by the people in Hutabolon Village is usually caused by several factors such asbacteriain themouth, snacking habits, frequent consumption of sweet foods or drinks and not cleaning your teeth properly".
To treat this toothache problem, usually people in Hutabolon Village take medication at the health center and also use traditional medicine, namely whiting which is applied to cavities to reduce pain.

f. Acute Respiratory Infections
Acute respiratory infections are infections in the respiratory tract, which cause symptoms of cough, runny nose, accompanied by fever. According to our informant named Mrs. Pusli Simarmata (55 years) said that: "Acute respiratory infections or commonly called asthma by people in Hutabolon Villagewill cause inflammation of the respiratory tract, from the nose to the lungs. Most of these diseases are caused by viruses".

g. Gastric Acid
According to our informant named Mrs. Agustina Turnip (45 years) said that:"Acid reflux or often called ulcers is usually characterized by discomfort in the upper abdomen. Gastric acid is a sign or symptom of another digestive disease that a person experiences. Stomach acid can be caused by many things. Often this is associated with lifestyle and can be influenced by consumption of food and drink or the side effect of drugs". People in Hutabolon Village usually go to the auxiliary puskesmas in the village immediately if the community experiences stomach acid pain.

Traditional Medicine Still Performed by Hutabolon Village Communities
Traditional medicine in Hutabolon Village is still used, in addition to medical treatment. Public trust in traditional medicine is fairly good. According to our informants named Mr. Danil Pasaribu (48 years) and Mr. Sihola (53 years) said that: "When sick, not a few people choose to use medical drugs and also accompanied by traditional medicines. The informant said that the people who live in Hutabolon Village have used medical treatment to treat their illnesses. But the use of traditional medicines is still used by the people of Hutabolon Village, for example, such as massage oil and param Karo. They buy this massage and param oil from a trader of traditional Karo medicines who come to Hutabolon Village.
The Puskesmas in Hutabolon Village also routinely holds outreach on the importance of health and medical treatment, but traditional medicines such as oil and param Karo are also recommended by the puskesmas to be used because the effects of oil and param are indeed able to cure diseases such as aches, colds, heal wounds, treat back pain, and other external diseases.

Hutabolon Village Community Behavior in Overcoming Diseases That Occur
The behavior of the people in Hutabolon Village in dealing with the disease that occurs is still classified as moderate, this is due to inadequate health facilities or facilities in Hutabolon Village. However, despite incomplete health facilities or facilities, the people who live in Hutabolon Village really care about health. According to our informant named Ibu Pusli Simarmata (55 years) said that: "The behavior of the people who are aware of the importance of health in the hutabolon village is inseparable from the role of medics such as midwives and mantri in improving public health through health education facilities to the community. Through research conducted by researchers, meetings or community meetings conducted by medical personnel in Hutabolon Village are usually held once a month.
In general, people always go to the puskesmas or the pustu in the hutabolon village area. If they are sick, people are no longer reluctant to go to the medical or to the puskesmas because people are aware of the importance of healthy living.

IV. Conclusion
There are eight types of diseases that often occur in Hutabolon Village. Diseases such as flu or respiratory tract infections, fever, rheumatism, diarrhea, sores or vulnus, cavities or toothaches, acute respiratory infections, and stomach acid. The causes of these diseases include viruses or bacteria, an unclean environment, weather, and food.
People in Hutabolon Village still use traditional medicine coupled with modern or medical medicine. Traditional medicine that is still used by the people of Hutabolon Village is massage oil and param karo. The people get this massage and param oil from the Karo traditional medicine traders who come to Hutabolon Village.