L48 Anthro 3283 Study Guide - Midterm Guide: Dracunculus Medinensis, Global Health, Western Pattern Diet
Global Health Test #2
• A Salvage Ethnography of the Guinea Worm" by Amy Moran Thompsan o Jimmy
Carter: president, then worked on global health
• Guinea worm eradication campaign in Ghana in the late 1980s
• Eradicated in 2011
• BUT problematic aspects of "magic bullet" approach
• Instead of robust public health approach to improve water quality thru purification,
Jimmy Carter's program distributed filtered drinking straws and containers which are less
effective and acceptable
• Low levels of uptake (why it took 20 years to eradicate the disease): local populations
weren't readily using these straws
• Cultural interpretation of worms as implanted in blood at birth via ancestors or witches:
doesn't matter if you use the straws, because the worms are already in your body (or not)
from birth
• Didn't purify the water source (worms still in the water)
• Ghanaians question why international powers are focusing on non-fatal diseases rather
than HIV/AIDS...worms don't really affect their lives
• Asthma Epidemic in the Barbados o Medical Schismogenics by Ian Whitmarsh
• Caused by pollution caused by deforestation, industrialization, etc
• Barbados culture uptook pharmaceuticals
• Non-compliance
• "Culture" associated with irrational fears, lack of education, refusal to adhere to
biomedical knowledge and expertise...especially blaming mothers
• If the kids weren't taking their medications, the mothers were blamed (became in charge
of making sure they took it)
• Patients critiqued the focus on drugs as part of the "Americanization" of society,
including cars, industrial farming, and a Western diet
• Medical Schismogenics o Ian Whitmarsh
• Competing claims about responsibility and irresponsibility among patients and clinicians
• Patients think doctors are irresponsible because they aren't paying attention to
deforestation and its role in causing disease and our daily lives and how that gets in the
way of taking medications
• Doctors don't listen, belittle the patients, send them to jail if they don't follow orders,
ignore patient requests, use poor patients as bodies for practice (while they have private
practices where they make more money)
• Doctors think patients are irresponsible because they are not doing what they can to get
better
• Role of healthcare workers and healers: asking questions, prying, taking blood samples,
issues about medicines and therapies
• "Doctors Don't Know Anything" by Seth Holmes o Did work with indigenous Mexican
farm works in California and Oregon with a focus on migrant health
• This chapter is about the common notion among migrant fruit pickers from Mexico that
doctors "don't know anything"
find more resources at oneclass.com
find more resources at oneclass.com
• Not a literal claim; they mean that the doctors just don't "get it" (missing important
aspects of these Mexican's reality)
• Migrant farmworkers miss appointments, have no medical records, poor communication
skills: misses the picture of their working life and circumstances
• Not unexpected among people who might be undocumented, have to work very hard,
don't have a lot of money, don't necessarily speak English as a first language, limited
means of transportation → but doctors don't UNDERSTAND this which is frustrating to
these workers
• Need to work creates disincentive to seek medical help (creates reputation of one who
needs help, have to repay for work missed)
• "The Spirit Catches You and You Fall Down" by Anne Radioman o Hmong migrants:
ethnic minority in China that was refugees in Laos after social upheavals in the 20th
century → in the 1970s, became refugees in the US (California) after communist
insurgency/cold war politics/counterinsurgency in Southeast Asia
• Differences in legal system and question of who has power over children
• Confusion about meaning of "freedom" and "authority" in the U.S.: Lia Lee's parents left
communist China to come to the "land of the free" but they come here and their lives are
uprooted
• BUT doctors and healthcare workers don't understand or know about traditional healing
practices (like lesions from coin rubbings and vacuum cups, feel that the Hmong are too
loud)
• Hmong have monosyllabic "yes" to indicate listening, but not comprehension (doctors
continue to talk, thinking they understand, but they really don't...questions of informed
consent)
• Consent for obstetric care in women had to be cleared by elders, clan leaders, or
husbands
• Attachment to place and landscape of the Hmong
• Powerful sense of cultural identity
• They came from an egalitarian farming society
• Lack of assimilation in China, Laos...and the US
• Lia Lee o Had "quag dab peg" (the spirit catches you and you fall down): epilepsy
• Social workers suggest that Lia be removed from the custody of her parents by CPS: took
Lia for medical tests and discovered that she was not receiving the full dose of treatments
so they put her in foster care with her aunt for months
• Lia's parents inside that she needs spiritual treatment (this is a blessing, not a disease) and
that meds diminish the effects of spiritualism
• Parents thought medicine was sapping her energy and making her more sick
• Doctors told parents that Lia would die if she wasn't given a feeding tube (deeply
offended parents/violated a cultural taboo → this was taken as a threat)
• For 2 years she was kept alive by modern medicine in a vegetative state
• After leaving hospital in near-fatal state, she recovered → doctors attributed it to natural
processes having to do with reduced swelling, parents to herbal remedies
• Parents remained "non-compliant" and did not give her meds, choosing traditional
therapies and rituals
• Practical Problems in Treating Lia Lee o Non-compliance
find more resources at oneclass.com
find more resources at oneclass.com
• Drug side-effects
• Language barriers (parents have no idea what's going on)
• Mistrust of doctors/healthcare system
• Strained relationships
• Worsening symptoms and episodes
• Cultural Competency o Means of creating new and improved forms of healthcare
delivery...BUT must include an evaluation of the "culture" of biomedicine and health
professionals
• Cultural competency training can't be this stereotype that it's just the patient with
cultural...so does biomedicine!
• Cultural competency now TAUGHT in medical schools
• Involves a lot of elements: actions, customs, language, personal identification, thoughts,
communication, beliefs, values, institutions that are specific to ethnic, racial, religious,
geographic, or social group
• "Anthropology in the Clinic" by Arthur Kleinman o Trait list approach: lots rules the
doctors have to memorize
• Think about folk illnesses: call depression "neurasthenia" to Chinese immigrants, etc.
• Structural Violence o Different than "direct violence" (like hitting someone, where the
violence is very clear)
• Often invisible and difficult to pin down a locus of agency
• Normalized, routinized, taken for granted
• Policies and structures that cause "bio-inequalities": different people more prone to
getting shot, life expectancy, incarceration rates, etc
• Not random and not fully biological (ex: African Americans don't biologically/naturally
live shorter lives, but rather that is structured into how policies are made, cities are built,
etc...in a way that put people in harm's way)
• Although whites and blacks use marijuana at roughly the same rates, black people are
much more likely to get arrested/go to prison because of it
• Organ Donation o Nancy Scheper-Hughes: anthropologist at Berkeley and founding
director of Organs Watch
• Argues that the organ trade is a form of structural violence
• Social construction of the organ as a "gift" or "sacrifice" masks the dangers of donation
(can lead to your own death/bioinequality/harm) → not portrayed as violent to the person
who is donating
• Gender bias in families: in places like India, organs are typically donated by the weakest,
poorest, most vulnerable person in the family, usually a woman, in order to support a
wealthier member of the family
• Scars across the stomach symbolize masculinity and honor in the Philippines: people who
have given organs for money are respected for this sign of sacrifice (selling organs to
people in wealthy families in other countries)
• Thorny ethical, medical, and social problems of children donating kidneys to
grandparents: what if these kids grow up and need kidneys?
• These minors give organs to their grandparents (who have more social power) just so that
they will live ~10 years longer
find more resources at oneclass.com
find more resources at oneclass.com
