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Bianca Dahl

ANTA02- November 19 , 2012 Structural Violence Medical Anthropology Stuff that constrains our agency: STRUCTURE  Agency – space for freedom  Structure – constrains you Why are poor people poor in the first place… and why are they more likely to experience serious illness?  Think of those two questions!  Structure is relevant for all of anthro, but today we will focus on medical anthro.  Why are poor people poor? How do anthro understand social inequality “Culture” of poverty?  This is wrong, but need to know it. Common explanation that people give  The claim: sure, the poor have fewer resources, but they also have their own value system that keeps them poor  Oscar Lewis, 1959: 5 families: Mexican case studies in the culture of poverty have sympathy for poor people  Poverty imposes burdens..  ..which lead to formation of special subcultures, and socialize people into behaviours and attitudes that perpetuate the cycle --> suggests that poor people are poor b/c they are lazy why is this argument missing the point? What might be the problems with this?  it’s overgeneralizing, there may be poor people that are lazy, but not all  Avoiding economic problems: no opportunities for self improvement, education (structural arguement) Herman Cain (US politician) on the “occupy” movement  “if you aren’t rich, blame yourself”  everybody has equal opportunity, and if you want to do better for self, you need to work harder  main idea behind culture of poverty  Inequality: the product of choices, policies, and social structures (ex. Different gender roles, different opportunities for employment, forms of racism) that constrain individual people and social groups unevenly  Anthropologists DON’T see inequality as being primarily the result of people’s cultural practices or qualities like “laziness” doesn’t mean those things aren’t relevant, do play a part  but don’t focus on cultural poverty anymore  Of course those things may factor in, but where you have systemic poverty or inequality, we must also look at social structure to understand what else constrains people different locations where poor people congregate types of business’, housing, education etc available are lower in poor areas – thus more difficult to better self social structural factors that leads to a perpetuation cycle of poverty hard to get out of poverty if living in bad environment What’s structural violence then?  “Suffering is structure by historically given (and often economically driven) processes and forces that conspire- whether through routine, ritual, or, as is more commonly the case, the hard surfaces of life – to constraining agency”  Structures include: “ racism, sexism, political violence and grinding poverty” hard surfaces of life there are constraints that limits a person agency  the “social machinery of oppression” structural factors that constraints a person’s ability to lift themselves out of the boot strap (better self)  The anthropological study of illness should be more than a sear for “cultural meaning,” that perennial object of cognitive and symbolic inquiry  Cautionary tale for Anthropologists:  “common indeed are the ethnographies in which poverty and inequality, the end result of a long process of impoverishment, are reduced to a form of cultural difference. We were sent to the field to look for different cultures. We saw oppression; it looked, well, different from our comfortable lives, in the university; and so we called it ‘culture’. We came, we saw, we misdiagnosed (culture).” (farmer, infections & inequalities, p.7.)  if we focus too much on cultural diff and diff manifestation of illness we will miss the fact that peoples way of understanding ill health is a response to structural response to what made them ill in the first play can’t just restrict to culture, ex. Brazalian and breast feeding, b/c there is more to it then just that. social factors that constrain us (machinery of oppression)  Beware of the conflation of “structural violence” and “cultural difference” don’t be like herman cain don’t blame culture only, there is also individual differences  When culture is blamed, it preserves inequality:  by blaming the victim; when a poor women in brazil is faced with extreme poverty, by saying it is her culture/lack of education that leads her to practices that increase child death. That is ignoring that fact that she is exposed to extreme scarcity  by preserving the taken-for-grantedness of ‘our’ (westerners) privilege anyone in better circumstances blaming others for their poverty, makes it seem like it’s a natural thing inequality isn’t natural, product of social, political things etc Lessons:  Unnatural history of disease/sickness  Social stratification: patterns of inequality in a society in which some groups have more:  Resources  Power (ability to control people and situations) if you are poor/uneducated, you have less power/ability to better situation in life  Prestige (how one is socially evaluated) racism and sexism  All these elements in death w/o weeping resulted in case that babies dying at massive rates  Anthropologists say: more inequality than is strictly functional = unequal burdens of disease  in many parts of the world, inequality is so pronounce it leads to unequal burdens of disease (share/likelihood of contracting a particular illness) ex. In U.S. black people have disproportionate burden of HIV, more likely to contract it – for social reasons, social structural (fewer access to resources etc.) More key concepts in medical anthropology:  Medicalization: the process by which human conditions and problems come to be defined and treated as medical issues, or viewed through a medical lens  wherever there are things that aren’t strictly biomedical orgin, they get interpreted into medical problems ex. Stress, not enough money, not enough food, etc – which leads to aches/pains etc. thus gives dr’s a way to medicalize it with pharmaceuticals ex. Felt sick, went to dr. and they said it was inflammation, but was just hungry (the reading)  Somatization: “the communication of personal and interpersonal problems in physical idiom of distress and a pattern of behavior that emphasizes the seeking the medical help”  when you experience in your body things that are social in nature/environmental/mental well being stress is a main one – can’t sleep, body aches, head aches etc hunger/malnutrion get somatized and believe that there is something wrong with them in the body, when really there is nothing  E.g. Kleinman found that many Chinese people experience the cluster of symptoms associated with depression as physical aches and pains in the body  E.g. Hunger itself can be somatizeds by Brazilian women Death without weeping  Published in 1992, winner of Margaret mead award for public anthropology  Nancy scheper-hughes had been a peace corps volunteer in brazil in 60’s, returned in 80s as an Anthropologist  Books explores grinding poverty, people’s sometimes confusing responses to it Vicious cycle  A combination of political factors in brazil have led to a “medicalization of hunger” talk about historical/demographic/contemporary/epidemiological problems  Neoliberalization, capitalism  cycle of poverty  perpetual hunger neoliberalism (allow market process of s and d to dictate economy) as brazlilian market opened up, capitalism became name of game (couldn’t pla
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