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Feb. 6:8- How does the Western science model of health and illness differ from medical models found in other cultures? (Pt. I- ethnomedicine) .pdf

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ANTH 1120
David Murray

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6 February - 12 February Feb. 6/8: How does the Western science model of health and illness differ from medical models found in other cultures? (Pt. I- ethnomedicine) Readings: 1) CA pp.63-68 (Illness and Inequality and the Meaning of Illness) • P.63 - Question 2.4: how does the eastern science model of health an illness differ from medical models found in other countries? • Illness and inequality • Science consist of a knowledge system and a way of knowing that is privileged and set above and detached from everyday life • Western science is contrasted with superstition and even with the sciences of other cultures • Science that western biomedicine claims its position of privilege • Triumph of modern society is the treatment and cure of disease • P.64 • The single most important detainment of a countrys ability to protect its citizens from disease is the degree of economic equality • Your chances of coming into contact with a deadly pollutant is determined by our income and where you live • We can better judge the extent to which we have progressed in the degree to which we are protected from the infectious disease by examining what it takes fro us to die of an infectious disease • Four things have to happen: 1)come into contact with pathogen or vector (such as a mosquito / flea/ tick that carries it), 2) the pathogen must be virulent, that is it must be able to kill us, 3) if we come into contact with a deadly pathogen it must evade our bodys immune system, 4)the pathogen must be able to circumvent whatever measures our society has developed to prevent it from doing harm • Our chances of dying are affected at every step by social and cultural patterns, particularly by the degree of economic and social inequality • Cultural complexity has served to increase our exposure to infectious agents • Permanent settlements cause rodents and human waste to build up Schistosomiasis is a disease caused by worms or snails that thrive in the irrigation ditiches • constructed to support agriculture • Domestication of animals and their microorganisms that come in contact with people • The requirement of large populations for the storage and processing of food also increases the likelihood of the survival and spread of disease causing agents • In the modern world, the poorer you are, the more likely you are to be exposes to infectious pathogens • P.65 • Generally it is not to the advantage of the pathogen n to kill their hosts; it is better for the pathogens to allow its host to live and supply its nutrient • You are far more likely to contract a more deadly disease if you do not have access to clean and treated water • The ability of your immune system to function is clearly a product of your diet and diet is largely determine by income level • If our immune system fails to repel an infectious pathogen, societies do develop methods to cure whatever illness afflicted them • Unfortunately, citizens access to these cures is determined largely by the degree of economic inequality in their country, and not by the countries absolute wealth Bigger the gap = shorter life expectancy • • The relationship between wealth and access to cures is most evident with HIV/AIDS • Medicines exist to prevent HIV from developing into full blown aids, but there are prohibitively expensive and completely out of reach of victims living in poor countries whose health care systems have been decimated by world bank • In sum, while the biomedical model has indeed made dramatic progress in understanding and curing infectious disease, medical systems based on this model have made no progress and have regressed and continue to regress in their ability to provide access to these cures • Global exposure to environmental pollutants and infectious pathogens have increased • The meaning of illness • P.66 • The meanings members of different societies give to illness vary as much as the meanings they give to other aspects of their lives • Illness may be attributed to witchcraft, soul loss or spirit possession • Those of us who believe in the western medical model sometimes have difficulty appreciating the meanings others place on events, and the meaning of illness is no exception • The belief in illness or death by witchcraft, sorcery, etc, involves an additional belief that illness has social as well as supernatural causes • Members of societies that believe in spiritual or magical causes for illness do not believe that the witch strikes at random • They may also believe that there are social reasons for the witch to act • The chewa of Malawi in southeast asia claim that illness and death are cause by sorcery and occurs when there is a conflict over judicial rights and claims or when someone fails to observe some social norm • Whereas north americans who accept the biomedical model react to illness or death by seeking the disease or accident responsible, chewa ask what wrong has the victim committed, with whom has the victim quarrelled , or who is jealous of the victim • Chewa recognize he connection between sorcery and social tension; they say that people who have quarrelled are likely to practise sorcery against each other • P.67 • Chewa who becomes ill consults a diviner the cause of the illness • The diviner needs to know about the patients relationships with kin and if ancestral spirits may be responsible, the genealogy of the patient • Thus, chewa medical theory, wile couched in the idiom of sorcery, isa social theory of illness, not simply a supernatural one --Someone gets ill because of a breach in social relations, not solely because of some magical act • Disease syndrome in latin america called susto is based on the belief that the soul has detached itself from the body--bc sudden encounter or accident and the cure beings with a diagnostic session between the patient and healer, the massaged and relaxed body • Susto occurs only when the patient perceives some situation as stressful, and the stress results form difficulties in social relations with specific persons • Gusto is a statement about social tension, not simply a description of a magical event • All social theories of illness are expressions of an interpersonal theory of disease • Interpersonal theory of disease is assumed that illness is caused not by microorganisisms by tensions or conflicts of social relation • Biomedical explanations for illness fail to take into account that witches are mediating concepts; they are theoretical entities that, like germs, provide a link between a social cause (tension / conflict) and a physical result (illness / death) • If giving meaning to an illness involves the attribution of illness to social causes, then it follow that the cure must also be, at least in part, social Ndembu believe that a persistent or scree illness is caused either by the punitive action of • some ancestral ghost or the secret malevolence of a sorcer or witch • Ghosts punish people when they forget to make a ritual offering to their ancestors, or bc kin are to living well together • Illness results either from personal failure to fulfil social obligations or from social conflict • P.68 • To effect a cure, ndembu patient consults a native doctor who inquires about the patients social relations • They recognize social strain and stress may produce physical illness and one way to treat illness is to treat the sources of social strain • Western medical practice has been slow to recognize the impact of stress on physical healthier, but there is significant evidence that certain life events can increase the likelihood of becoming ill (death, loss of jobs,holidays) • Rather than viewing the local ethnomedical ealing practices of small scale societies as somehow inferior, it makes far more sense to recognize that they focus on real causes of illness-social stress- that their ruing techniques are well equipped to address • Ethnomedical cures not only can be beneficial, they are also affordable • One of the consequences of biomedical advances is the increasing dependence on expensive technology • While significant advances have been made in medicine, the cost to the patient of many advances has made them unavailable to all but a small percentage of the world population • In societies where healing is the responsibility of everyone instead of a commodity to be purchased, it follows the moral values of a social obligation rather than those of business 2) Singer, Merrill & Hans Baer. 2012. “Ethnomedicine: The Worlds of Treatment and Healing.” In Introducing Medical Anthropology: A Discipline in Action, Second edition. Lanham, MD: AltaMira Press: 117-129. • P.117 • All medicine systems, be they national guise of biomedicine or indigenous medical systems or folk medical systems in complex societies, either preindustrial or postindustrial, are part and parcel of culture and society Various anthropologists have attempted to categorize medical systems • • Various types of societies ranging from nomadic foraging to postmodern societies seek to explain the causes of illness as well as the categories healers in order to identify and treat sickness • Approaching ethnomedicine • Historically, medical anthropologists looked at indigenous or tribal societies, in peasant communities, and among subgroups of urbanities in developing nations • P.118 Ethnographers first began recording data about health beliefs and practices, including • healing techniques in indigenous societies • Medical systems in indigenous society and peasant communities and among other ordinary peoples have often been defined within anthropology as ethnomedicienes • Charles hughes- ethnomedicine as those beliefs and practices relating to diseases which are the products of indigenous cultural development and are not explicit derived from the conceptual system of modern science • Biomedicines also constitutes an ethnomedical system, one that has diffused from western societies to many other societies around the world • Shaman - part time religious healer who makes contact with the supernatural realm, often by going into a trance n order to alleviate the distresses and diseases of his or her patients • Modern biomedical physician, a healer with unparalleled technological resources for measuring, visualizing and treating diseases who still must deal face to face with a nervous patient in need as much ace as cure • All medical systems consist ethnomedicines in that they developed form and are embedded in particular sociocultural systems, regardless of whether they are small scale or state societies • All healer, shamans to cardiovascular surgeons, are ethnohealers • Biomedicine is shaped by its specific cultural or national setting • American biomedicine relies much more on invasive forms of therapy, including cesarean sections, hysterectomies, breast cancer screening, and high dosages of psychotropic drugs, than does biomedicine in the other three countries • P.119 • German biomedicine emphasizes the self recuperative aspects of the body and has long been open tot natural healing techniques • German biomedicine consists of two varies (a) schulmedizin, or school medicine, which is taught in major medical institutions and (b) naturheilkunde (natural cure) which biomedical physicians may acquire training in through special workshops and apprenticeships • French biomedical practitioners generally take rectal rather than oral temperatures bc of the greater accuracy of the former • French women prefer breast reductions • P.120 • Nichter--ethnomedical research entails the study of how well being and suffering are experienced bodily as well as socially; the multivocality of somatic communication; and processes of healing as they are contextualized and directed toward the person, household, community and state, land and cosmos • Indigenous and folk medicine systems • P.121 • Ways of healing • Many indigenous and folk medical systems or traditional enthomedical systems do have in common is that they tend to place a strong emphasis on magic-religious rituals as well as to seek to reestablish harmony between humans and/or between humans the supernatural and natural realms • Often incorporate members of the community who function as therapeutic management group • Navajo - singer constructs an elaborate sand painting depicting the holy people and chants over the patient in order to re-establish harmony, the loss of which is believed to cause illness Singer destroys sections of the sand painting, believe that various aspects of the patients • sickness are eradicated • Traditional medicine, like navarjo healing of ten stresses emotional catharsis for the patient and draws the supportive attention of fellow members of the community to the patients illness • Navarjos healing has a naturalistic orientation as well, as it is evidenced by its broad pharmacopoeia consisting of herbs, powders, teas and animal substances • An estimated 25-50% of the substances in the traditional nonbiomedical pharmacopoeia of indigenous healers have been shown empirically to be effective as measured by conventional sciatic and biomedical standards • People sometimes view healers form other cultures or societies as more powerful and effaces than their own healers • Cross cultural healing may sever as a means of fostering social connections that prevent or reduce interethnic conflict and avoiding local healer who may be viewed as capable of malevolent or exploitative acts • P.122 • Ironically, in developed societies, including the US and Australia, large numbers of people have come to embrace nonwestern medical systems, such as traditional Chinese medicine, tibetan, etc • Typologies of healing systems • Efforts to summarize the broad diversity and range of health beliefs and practices found in a wide diversity of sociocultural systems around the world, medical anthologists have created various typologies of conceptions of disease aetiology within medical systems George m foster--every medical system embraces both a disease theory system and a • health care system and, further that medical system include both an ideological component and a social structural component • The disease theory system includes ideas about het nature of health and ideas about the causes of disease or illness • The former view disease as resulting from the action of a sensate who may be a supernatural being, a non human bring, or a human being • Naturalistic systems, by contrast, view disease as emanating from the imbalance of certain in animate elements in the body, such as the male and female principles of yin and yang • The health care system, according to foster, refers to the social relationships and interactions between the healers and their patients • The healer may be assisted by various assistants and in the case of complex societies may work in an elaborate bureaucratic structure, such as a clinic, health maintenance organization or hospital • Sobo categorize shamans, mediums, sorcerers and priests as examples of personalistic practitioners, while they group herbalistis, chemists and bodyworkers in the category of naturalistic practioners • P.123 • Herbalists are found in the greater majority of societies and prescribe or treat patients using medicinal plants but also minerals • Bodywork's are musculoskeletal specialists who massage or manipulate the body in order to alleviate muscular tensions or skeletal misalignments • In reality, specific healers may be a blend of the various types delineated by loustanunau and sobo , such as when humoral doctors act as both chemists and herbalists or healers mix naturalistic and personalistic te
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