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Lecture 4

ANT100Y1 Lecture Notes - Lecture 4: Maternal Death, Autoethnography, Human Capital Flight


Department
Anthropology
Course Code
ANT100Y1
Professor
Tania Li
Lecture
4

Page:
of 6
February 3, 2014.
Lecture 4 Global Health, Biomedicine and Medicalization
Medical Anthropology
Study of disease, health problems, health care systems, and theories about illness in
different cultures and ethnic groups
oDisease: a scientifically identified health threat
oIllness: a condition of poor health perceived or felt by an individual or
community
oHealth-care systems: beliefs, customs, specialists, techniques
Theories about causes of illness:
oPersonalistic disease theories: illness caused by agents such as sorcerers, witches,
ghosts, or ancestral spirits
oEmotionalistic disease theories: illness caused by extreme emotional experiences
oNaturalistic disease theories: impersonal explanations of illness
1. Biomedical Model
oScientific epistemology
Natural basis of illness; natural science
oThe human body and its functions
Claude Bernard (1813 – 1878)
An Introduction to the Study of Experimental Medicine (1865)
Homeostasis = health
Equilibrium, body in balance, constant
“Constancy of the internal environment is blah blah blah”
Concept applied to social theory; model for society as well;
influenced Durkheim (father of sociology)
oEpidemiology
Illness in populations/demography
Distribution of diseases
2. Cultural – Interpretive Model
oTranscending the limits of the biomedical model
oExamining the “cultural” basis of illness and health
oPhenomenology
Why do things happen to particular people at particular times
Form of philosophy that analyses subjectivity and personal experience
oGender aspect; important to healing in some cultures
What if women and men aren’t supposed to touch each other (publicly, if
strangers) and all doctors are men, etc.
3. Critical Medical Anthropology Model
oDoes not reject biomedicine; recognizes its advances
oLooks at how health can be related to larger factors
oHealth and social inequality
Different levels of access to different resources and treatments
oHealth and capitalism
oMedicalization
Medicalizing various issues and illnesses (like mental issues such as sex
addiction or hoarding)
Shamanism
Universal mode of healing
Doctor, priest, social worker, mystic
Contact with spirit world
oHeal “soul loss”; go into spirit world for cures
Same curing odds as MDs
Shared meaning between patient and healer is essential
oClaude-Levi Strauss emphasised this
Anthropologists credited viability of shamanistic power as early as 19th century while
scientific community was still rejecting their relevance as late as the 80s
Paul Farmer: An Anthropology of Structural Violence
What is/was:
oStructural violence
oLiberation theology
60s and 70s radical political attention on Latin America because of fascist
dictatorships predominant in the area at the time; Catholic Church had
been greatest defender of people in the area
Mixing of Marxist principles with Catholic Church doctrine; liberating the
poor
oImpact of “resistance”
oEffects of specialization in social sciences
oThe role of France in Haitian history
Huge amount of French wealth came from exploiting Haiti and African
slaves
oThe history of US involvement
Diplomatic and economic embargo on Haiti; became an assembly line of
manufactured US goods
oDuvalier
Family that ran Haiti from 1957 to
Wealthy as fuck
Dictatorship; brutal regime; ruled by force; reputed to have killed 50 to
100 000 people during their regime
Also used voodoo as an instrument of state oppression; secret police
thought to be powerful voodoo priests; Ton Ton?
oAristide
First democratically elected president 1991
Catholic priest: liberation theologian
Assassination attempts
oAIDS theory
AIDS came from Haiti
In actuality it was introduced their through sex tourism industry FROM
US
oTB and Haitian folk belief
Thought it was caused by evil spirits; program implemented where
population received medicine and they adopted a more naturalistic
approach to explain sickness
oCritique of structural violence?
Wacquant: structural violence fails to distinguish between different types
of violence; how exactly are people living within the Western world
complicit to structural violence
Paul Farmer: Intelligent Design
Partners in Health (PiH)
oJim Yong Kim?
The first principle of the emerging global health movement
oDon’t copy mainstream programs; what everybody else is doing; the United
Nations; proceed from different principles
Accompagnateurs
oConcept developed in Haiti
oCommunity health workers; part of the poor
oConcerned with how to GET medication to people; particularly people in hard to
reach areas; simple logistical issues
The problem with NGOs
o60 000 AIDS NGOs at the time of writing this
oBureaucracy and high paying jobs; resources are directed to this as opposed to
people who REALLY need them
Capping
oLinked with neoliberal policy
oCap on health expenditure or it will be too costly
oFarmer argues the best investment you can make is on healthcare expenditure;
how you put people on the road to independence and autonomy
Stove-piping
oGarret says that all the money that became available for funding AIDS research
and treatment was at a detriment to the rest of healthcare; AIDS became the
celebrity disease that funneled funding away from other programs and diseases
oFarmer says there ISN’T other programs; AIDS funding is important because you
need to get the funding where you can get it and then morph what it is directed
towards
The basis of health care program design
oConceptual shift into discourse of human rights
Paul Farmer: Challenging Orthodoxies: The Road Ahead for Health and Human Rights