Transcript - Catalyst - University of Washington

ANTH/HSERV 475
Perspectives in Medical Anthropology
Week 2: Wed, 10/6/2010
Introduction to Medical Anthropology
University of Washington
Alejandro Cerón
Office: Denny Hall 417
Office hours: Wed 11 am -13 pm
[email protected]
Outline

Today’s Goals:
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1.
2.
3.
4.
Explain what is Med Anth
Identify key terms from readings
Apply illness/disease dichotomy
Map history of theories in medical anthropology
Assignment due next week
Summary of today’s readings
Key terms
History of theories in medical anthropology
Web project assignment
 Some examples here, here, and here.
 Question:
I ask again:
 If you do not have a Google account, would you be willing to open
one?

Representations of health…
Asclepius
Sumak Kawsay / Pachamama
Today’s Readings (1)
Chapter 1
Introducing Medical
Anthropology
Chapter 2
The origins and theories of
Medical Anthropology
Book cover
Today’s Readings (2)
John M. Janzen, the author
University of Kansas
Research Experience
 Lower Congo, 1964-6, 1969, 1982
(health and patterns of health-care
seeking);
 Eastern & Southern Africa, 1982-3
(Ngoma healing and interpretations of
misfortune);
 Great Lakes region, 1994-5 (post-war
trauma relief and healing);
 West Africa & Sahel (Senegal & Sudan),
2000, 2001, 2004 (Sufi healing).
John M. Janzen at Izirangabo refugee camp
Today’s Readings (3)
Chapter 1. Introducing Medical Anthropology
 The social fabric of health
 Medical Anthropology
 3 examples (kuru, birthing, Asian medicines)
 Research basis of Medical Anthropology
Today’s Readings (4)
 “Medical anthropology is the study of health, illness, and
healing across the range of human societies and over the course
of human experience, with an emphasis on how members of the
community direct their behaviors, articulate their ideas, and
organize their resources in these realms.
 includes the study of the patterns of disease within an environment and the
ways in which diseases relate dynamically to living organisms – especially
human organisms.
 includes the ways in which the human community understands and
responds to these challenges to its existence.
 may also include the community’s access to the resources that maintain or
restore health, or the exclusion from such resources by the community’s power
structure.
 studies the meaning of the signs of illness and suffering as part of the
overall study of cultural traditions, and strives to interpret them in the light of
wider traditions of ritual and religion” (p. 2)
Another definition
 Medical Anthropology studies
 Social and cultural context where health, disease and healing
(h-d-h) happen.
 Multiple expressions of h-d-h (biological, political,
behavioral, cultural, etc).
 Ways in which people organize to take care of h-d-h,
especially in places with evident inequality.
Let’s compare both
 “Medical anthropology is the
study of health, illness, and
healing across the range of
human societies and over the
course of human experience,
with an emphasis on how
members of the community direct
their behaviors, articulate their
ideas, and organize their
resources in these realms.




patterns of disease
understands and responds
community’s access
meaning of the signs of illness and
suffering (p. 2)
 Social and cultural
context where health,
disease and healing (h-dh) happen.
 Multiple expressions of
h-d-h (biological,
political, behavioral,
cultural, etc).
 Ways in which people
organize to take care of
h-d-h, especially in places
evident
Whatwith
do you
findinequality.
useful of each?
What are their weaknesses?
Some examples
 WHO
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Changing world
Inequalities
Unhealthy trends
 CDC
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Insurance, use and access to health care services
Inequalities
 Public Health – Seattle, King County
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Chronic problems and risk factors
Injuries
Disparities (geographical, race-ethnicity, income,
Diabetes Mortality, King County
180
African
American
140
American
Indian/
Alaska
Native
120
100
Asian/
Pacific Islander
80
Latino/Hispanic
60
White
40
20
Source: Death Certificate Data: Washington State Department of Health, Center for Health Statistics.
01-03
00-02
99-01
98-00
97-99
96-98
95-97
94-96
93-95
92-94
91-93
90-92
89-91
88-90
87-89
86-88
85-87
84-86
83-85
82-84
81-83
0
80-82
Age-adjusted rate per 100,000 persons
160
The anthropological view adds…
 “Medical anthropology is the study of
health, illness, and healing across the
range of human societies and over the
course of human experience, with an
emphasis on how members of the community
direct their behaviors, articulate their
ideas, and organize their resources in these
realms.




patterns of disease
understands and responds
community’s access
meaning of the signs of illness and suffering
(p. 2)
Today’s Readings (5)
Chapter 2. The origins and theories of medical
anthropology
 Emerged as specialty in 1960s
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Understand “exotic” health care practices
Improve health care in “Third World” countries
“Crisis of medicine”
Technological developments
Today’s Readings (6)
Heterogeneity of Medical Anthropology
 Sociocultural
 Biocultural
 Applied “Development”
 “Clinical”
 Comparative study of health systems
 Culture in biocultural
 Cultural construction of medicine
 Critical
Some contemporary Medical Anthropologists
 Artur Kleinman
NY Times
Harvard
 Mark Nichter
U Arizona
Nancy ScheperHughes
CNN video
CNN video
UC Berkeley
Illness/disease dichotomy (1)
 A way to distinguish sufferer’s perception of the experience from
objectively discovered entity.
 Illness: the sufferer’s perception of the individual experience of
suffering; may occur with or without disease being identified; culturally
embedded, subjective definition given to suffering by the patient, and to
behavior in which it is expressed.
 Disease: a condition that is objectively identified with a medical label or
diagnostic name, based on externally established signs; may be identified
with or without there being a subjective perception of illness by the
individual; objective condition or pathology as determined by a medical
professional.
(all definitions from Janzen 2002)
Illness/disease dichotomy (2)
 Sickness: the individual or group subjective experience of suffering
 Suffering: the subjective, usually more chronic, condition of affliction or
painful existence; broader than sickness, the existential experience of life of
hardship and difficulty, may be permanent human condition, often
accounted for in religion and wisdom literature.
(all definitions from Janzen 2002)
Exercise
 Groups of 5
 Watch videos and think about the definitions of
illness and disease.
 What ambiguities or assumptions do the
definitions have in terms of subjective/objective
knowledge?
ADHD Diagnosis
ADD doesn’t exist
My son has ADHD
Some implications…
Illness
1
2
6
3
3
4
4
1
5
Disease
2
5
7
Sickness
6
7
Implications
Ontological
Disease
Illness
Disease
Epistemological
Normative
 Mal de ojo (evil eye) Dominican Republic (link)
Spanish
 Limpia con huevo Mexico (link) Spanish
 Iridology (link)
Next week’s readings
Briggs, Charles with Clara Mantini-Briggs (2003).
Stories in the time of cholera: racial
profiling during a medical nightmare.
Berkeley: University of California Press.
 Introduction
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Key concepts
How they did the research
Chapters
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Ethnographic description
Theoretical discussions
Main argument (s)
Key concepts
Timeline
 Individually
 Include main events, periods, theories
 Include key words that define them