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ANT348 Lec 3 Quest for Therapy Health care systems Medical Pluralism & Critiques.pdf

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University of Toronto St. George
Sharon Kelly

Lec 3 Quest for Therapy: Health care systems "Medical Pluralism" & Critiques September-26-13 12:02 PM Reading Response - get to the point of the author Include Group # at the title Annotated Bibliography assignment - get started / decide on topic at least… - Browse recent medical anthropology Recap from last lecture: - Subjectivity: understanding of a person of their place in their world; internal - Subject position : the historical and cultural things that affect one's self perception; how one's place in the world is affected externally - Das & Das discusses the relationship between kinship and health Overview of Lecture 1. Health Care Systems 2. Medical Pluralism 3. Critique of Medical Pluralism 4. Themes in contemporary literature: biomedical dominance / hegemony; immigrant health-seeking 5. Cultivating respectful curiosity toward unfamiliar medical systems Health Care System: Kleinman's definition: - "Socially organized responses to disease that constitute a special cultural system […] of symbolic meanings, anchored in particular arrangements of social institutions and patterns of interpersonal interactions" (Kleinman 1980:24) - Patients and Healers in the Context of Culture - Traditional and indigenous means of healing is changing - Biomedicine = glossed as 'modern' ○ Cultural and traditional - Thus health care is a false dichotomy(?), increasing globalization of biomedicine, - Contemporary biomedicine will not entirely replace traditional and indigenous ways of healing and health practices even though it may be more predominant Crandon-Mallamud's Critique of medical pluralism - Worked in Bolivia in 80s, ethnography - Argues that medical pluralisms represent "bounded traditions" = which is misleading 1. Representation of "bounded traditions" is misleading 2. Instead attend to historical dynamism and political-economy of medical systems 3. Neglects "nonmedical significance of medical traditions" (1997:51) - focus on efficacy, and safety 4. It is not sufficient to analyse medical pluralism as simply a "hierarchy of resort" (=meaning no set hierarchy / ranking of preference in relation to criterion such as efficacy [effectiveness]) 5. Medical treatment-seeking "restructures social relations outside the medical context (1991:11) Global biomedical dominance (global hegemony) - Biomedicine displaces and alters indigenous medical systems, but not always in predictable or stable ways - Relationship is modulated by many local and translocal actors, including state health care systems and multilateral agencies Helen Lamber (1997) Plural Traditions? Folk therapeutics and 'English' medicine in Rajasthan - Wide range of indigenous therapies still practiced - Biomedicine incorporated into indigenous frameworks, one option amongst many - Practices of some specific indigenous therapeutic forms have been significantly reduced ○ In the terrain of biomedicine Cameron, Mary. Feminization and Marginalization? Women Ayurvedic Doctors and Modernizing Health Care in Nepal - Against romanticization of indigenous medicine: historicizing practice, attending to globalization effects - Nepali state's modernization and marginalization of Ayurvedic medicine - Medical anthropology's neglect of women professional healers - Gendered analysis Anahi Viladrich (2006) Beyond the Supernatural: Latino Healers Treating Latino Immigrants in NYC - Migrants' and refugees' challenges in accessing health care in North America - Latino immigrants in NYC: street-level Botanicas provide accessible and affordable services - Health-seeking shaped by economic and political forces as well as a common system of meaning in relation to illness and affliction Discussion Questions 1. What social conflicts or disharmonies underlie the illnesses and quests for therapy in each of Janzen's case studies? - Consensus - 1st case:
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