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Lecture 3

Lecture 3 Global Health.docx

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Victor Barac

ANT369H1 2014‐02‐03 Global Health / Bio‐medicalization Medical anthropology • Study of disease, health problems, health care systems, and theories about illness in different cultures and ethnic groups – Disease – a scientifically identified health threat (something that can be measured or quantified. Eg, antigens) – Illness – a condition of poor health perceived or felt by an individual or community (being sick, there is always a cost to being sick) has one symptom with more than one cause – Health‐care systems – beliefs, customs, specialists, techniques, every society has to deal w/ the sick and ill, how do you care for them? Have ethnographic examples of these. Medical anthropology – 2 -emphasis on the natives pt of view. What are their theories about the cause of disease? Theories about the causes of illness: – Personalistic disease theories – illness caused by agents such as sorcerers, witches, ghosts, or ancestral spirits (good part of the world believes in this eg evil eye.. someone looks at you can causes you to be sick) – Emotionalistic disease theories – illness caused by extreme emotional experiences (eg trauma, witnessing misfortune of someone else, loss of social position or loss of a loved one) . Western perspective would be from a psychological view; depression, imbalance of the mind. Chemical imbalance in the universe causing the person to be sick and use of a shaman to help balance this. Shamans were precursor to religion and medicine etc. – Naturalistic disease theories – impersonal explanations of illness – No concept of supernatural, illness due to scientifically identifiable natural cause, or could be an accident, poison 1. Biomedical Model : Presents 3 models • Scientific epistemology – Natural basis of illness; natural science – Valued knowledge derived from scientific experimentation ANT369H1 2014‐02‐03 – Eg someone tells you that they are hot, state a specific temp • The human body & its functions – Claude Bernard (1813‐1878) (founders of modern medicine) turned medicine into a scientific study. – An Introduction to the Study of Experimental Medicine (1865)-radical idea , talked about homeostasis (maintaining balance), internal body harming, body temp works in various ways to maintain equilibrium – “constancy of the internal environment… “ influence on Durkheim – things are totally connected, whole idea of functionalism came along – Homeostasis = health – • Epidemiology: studying the distribution of diseases , part of the biomedical model – Illness in populations / demography (hunter/ gather societies eg) -Has limitations this where the cultural interpretive model comes in 2. Cultural – Interpretive Model • Transcending the limits of the biomedical model , provides partial understanding of the cause of illness (eg Kuru) –Anthropologists want to know the everyday context, lived experience of the person you are studying -eg a tenant , coughing so much was visiting Doctors, checked his apartment and saw there was mold , cleaned it up and he was fine • Examining the “cultural” basis of illness and health : look at traditions and daily life etc Eg Witch craft accusations had to health problems, causes of disease, gender is important as well (some men are not allowed to touch women, what if you live in a society where men are only doctors…) • Phenomenology : form of philosophy examines aspects of experience and ANT369H1 2014‐02‐03 subjectivity, behaviors are observable, 3. Critical Medical Anthropology Model (evaluating it) -does not reject the influences of biomedicine -how capitalism resulted in the development of new tech. such as modern surgery, antibiotics, development of health institutions, and public sanitation (diminish mortality) • Health and social inequality look at health as a function of this -redefined as medical problems, eg homosexuality was medicalized, sex addiction, or homelessness, attention deficit disorder etc -Medical hegemony, developing ideologies of medicalization, theories of health and disease that shape the world, have to have cost effective medical plans • Health and capitalism • Medicalization Shamanism -dominant form of medical practice, were like docs priests and leaders were all encompassing worlds, women were original shamans, they heal soul loss, contact the supernatural • Universal mode of healing seen in most ethnographics • Doctor, priest, social worker, mystic • Contact with spirit world • Same curing odds as MDs , almost 90% of diseases were self limiting • Shared meaning between patient and healer is essential –patient has to believe ANT369H1 2014‐02‐03 that the healer is doing something good for them. Paul Farmer 2004 An Anthropology of Structural Violence – 2 -structural violence -liberation theology : body of literature, and also political activity guided by a certain orientation -impact of ‘resistance”: resistance is overblown in social science literature, nobody has the big picture. Basically comparing the social sciences unfavorably. -effects of specialization in social sciences -role of France in Haitian history: most of the wealth in France came from Haiti, conquered it from the Spanish -the history of US involvement : didn’t support Haiti, bullied them over smallest trade issues and invaded them , turned Haiti into an assembler or US manufactured goods ( cheap labor) -Duvalier: Dictatorship that the US supported, the father was Papa Doc and Baby Doc, they were very wealthy, AC palaces where women could wear fur coats, brutal regimes (killed many ppl) used voodoo as instrument of state oppression, had chief of police who were said to be voodoo priests and the ppl believed in this -Aristide: 1 democratically elected President , tried to kill him, Catholic Priest, liberation theologian Paul Farmer 2004-An Anthropology of Structural Violence-2 • AIDS theory: came from Haiti, well actually it was intro from SA through the sex trade • TB and Haitian folk belief: thought it was caused from spirits. Pop’n adopted a naturalistic theory after immunization • Critique of structural violence? -structural violence was a new term (neologism) ANT369H1 2014‐02‐03 -it fails to distinguish b/w qualitatively defined types of violence -cant just use a generic concept of structural violence Paul Farmer 2007 Intelligent Design -gives tips on what to do eg how to alleviate suffering • What is/are: – Partners in Health (PIH) : -started an NGO in Boston with Jim Yong Kim (Korean American) became the President of the World Bank (2013) • – The first principle of the emerging global health movement : don’t copy the mainstream programs (what everyone else is doing) • – Accompagnateurs : concept developed in Haiti, community health workers that are part of the urban or poor and were proven to be the best dispensers of medication , how to get th
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