Over the past few decades, maternal childbirth injuries have become a potent symbol of Western biomedical intervention in Africa, affecting over one million women across the global south. Western-funded hospitals have sprung up, offering surgical sutures that ostensibly allow women who suffer from obstetric fistula to return to their communities in full health. Journalists, NGO staff, celebrities, and some physicians have crafted a stock narrative around this injury, depicting afflicted women as victims of a backward culture who have their fortunes dramatically reversed by Western aid. With Beyond Surgery, medical anthropologist Anita Hannig unsettles this picture for the first time and reveals the complicated truth behind the idea of biomedical intervention as quick-fix salvation.
Through her in-depth ethnography of two repair and rehabilitation centers operating in Ethiopia, Hannig takes the reader deep into a world inside hospital walls, where women recount stories of loss and belonging, shame and delight. As she chronicles the lived experiences of fistula patients in clinical treatment, Hannig explores the danger of labeling “culture” the culprit, showing how this common argument ignores the larger problem of insufficient medical access in rural Africa. Beyond Surgery portrays the complex social outcomes of surgery in an effort to deepen our understanding of medical missions in Africa, expose cultural biases, and clear the path toward more effective ways of delivering care to those who need it most.
Over the past several decades, scholars in both the social sciences and humanities have moved beyond the idea that there is a “body proper”: a singular, discrete biological organism with an individual psyche. They have begun to perceive embodiment as dynamic rather than static, as experiences that vary over time and across the world as they are shaped by discourses, institutions, practices, technologies, and ideologies. What has emerged is a multiplicity of bodies, inviting a great many disciplinary points of view and modes of interpretation. The forty-seven readings presented in this volume range from classic works of social theory, history, and ethnography to more recent investigations into historical and contemporary modes of embodiment.
Beyond the Body Proper includes nine sections conceptually organized around themes such as everyday life, sex and gender, and science. Each section is preceded by interpretive commentary by the volume’s editors. Within the collection are articles and book excerpts focused on bodies using tools and participating in rituals, on bodies walking and eating, and on the female circumcision controversy, as well as pieces on medical classifications, spirit possession, the commodification of body parts, in vitro fertilization, and an artist/anatomist’s “plastination” of cadavers for display. Materialist, phenomenological, and feminist perspectives on embodiment appear along with writings on interpretations of pain and the changing meanings of sexual intercourse. Essays on these topics and many others challenge Eurocentric assumptions about the body as they speak to each other and to the most influential contemporary trends in the human sciences.
With selections by: Henry Abelove, Walter Benjamin, Janice Boddy, John Boswell, Judith Butler, Caroline Walker Bynum, Stuart Cosgrove, Michel de Certeau, Gilles Deleuze, Alice Domurat Dreger, Barbara Duden, Friedrich Engels, E. E. Evans-Pritchard, Judith Farquhar, Marcel Granet, Felix Guattari, Ian Hacking, Robert Hertz, Patricia Leyland Kaufert, Arthur Kleinman, Shigehisa Kuriyama, Jean Langford, Bruno Latour, Margaret Lock, Emily Martin, Karl Marx, Marcel Mauss, Maurice Merleau-Ponty, Nancy K. Miller, Lisa Jean Moore, John D. O’Neil, Aihwa Ong, Mariella Pandolfi, Susan Pedersen, Gregory M. Pflugfelder, Rayna Rapp, Nancy Scheper-Hughes, Kristofer Schipper, Matthew Schmidt, Peter Stallybrass, Michael Taussig, Charis Thompson, E.P. Thompson, Anna Lowenhaupt Tsing, Victor Turner, Terence Turner, Jose van Dijck, Keith Wailoo, Brad Weiss, Allon White
In Bioinsecurities Neel Ahuja argues that U.S. imperial expansion has been shaped by the attempts of health and military officials to control the interactions of humans, animals, viruses, and bacteria at the borders of U.S. influence, a phenomenon called the government of species. The book explores efforts to control the spread of Hansen's disease, venereal disease, polio, smallpox, and HIV through interventions linking the continental United States to Hawai'i, Panamá, Puerto Rico, Cuba, Congo, Iraq, and India in the twentieth and twenty-first centuries. Ahuja argues that racial fears of contagion helped to produce public optimism concerning state uses of pharmaceuticals, medical experimentation, military intervention, and incarceration to regulate the immune capacities of the body. In the process, the security state made the biological structures of human and animal populations into sites of struggle in the politics of empire, unleashing new patient activisms and forms of resistance to medical and military authority across the increasingly global sphere of U.S. influence.
Examining medical pluralism in the United States from the Revolutionary War period through the end of the twentieth century, Hans Baer brings together in one convenient reference a vast array of information on healing systems as diverse as Christian Science, osteopathy, acupuncture, Santeria, southern Appalachian herbalism, evangelical faith healing, and Navajo healing.
In a country where the dominant paradigm of biomedicine (medical schools, research hospitals, clinics staffed by M.D.s and R.N.s) has been long established and supported by laws and regulations, the continuing appeal of other medical systems and subsystems bears careful consideration. Distinctions of class, Baer emphasizes, as well as differences in race, ethnicity, and gender, are fundamental to the diversity of beliefs, techniques, and social organizations represented in the phenomenon of medical pluralism.
Baer traces the simultaneous emergence in the nineteenth century of formalized biomedicine and of homeopathy, botanic medicine, hydropathy, Christian Science, osteopathy, and chiropractic. He examines present-day osteopathic medicine as a system parallel to biomedicine with an emphasis on primary care; chiropractic, naturopathy, and acupuncture as professionalized heterodox medical systems; homeopathy, herbalism, bodywork, and lay midwifery in the context of the holistic health movement; Anglo-American religious healing; and folk medical systems, particularly among racial and ethnic minorities. In closing he focuses on the persistence of folk medical systems among working-class Americans and considers the growing interest of biomedical physicians, pharmaceutical and healthcare corporations, and government in the holistic health movement
The Body Multiple is an extraordinary ethnography of an ordinary disease. Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations.
The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice.
Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine.
Anthropology, with its dual emphasis on biology and culture, is--or should be--the discipline most suited to the study of the complex interactions between these aspects of our lives. Unfortunately, since the early decades of this century, biological and cultural anthropology have grown distinct, and a holistic vision of anthropology has suffered.
This book brings culture and biology back together in new and refreshing ways. Directly addressing earlier criticisms of biological anthropology, Building a New Biocultural Synthesis concerns how culture and political economy affect human biology--e.g., people's nutritional status, the spread of disease, exposure to pollution--and how biological consequences might then have further effects on cultural, social, and economic systems.
Contributors to the volume offer case studies on health, nutrition, and violence among prehistoric and historical peoples in the Americas; theoretical chapters on nonracial approaches to human variation and the development of critical, humanistic and political ecological approaches in biocultural anthropology; and explorations of biological conditions in contemporary societies in relationship to global changes.
Building a New Biocultural Synthesis will sharpen and enrich the relevance of anthropology for understanding a wide variety of struggles to cope with and combat persistent human suffering. It should appeal to all anthropologists and be of interest to sister disciplines such as nutrition and sociology.
Alan H. Goodman is Professor of Anthropology, Hampshire College. Thomas L. Leatherman is Associate Professor of Anthropology, University of South Carolina.
Chronic Conditions, Fluid States explores the uneven impact of chronic illness and disability on individuals, families, and communities in diverse local and global settings. To date, much of the social as well as biomedical research has treated the experience of illness and the challenges of disease control and management as segmented and episodic. Breaking new ground in medical anthropology by challenging the chronic/acute divide in illness and disease, the editors, along with a group of rising scholars and some of the most influential minds in the field, address the concept of chronicity, an idea used to explain individual and local life-worlds, question public health discourse, and consider the relationship between health and the globalizing forces that shape it.
In Cooking Data Crystal Biruk offers an ethnographic account of research into the demographics of HIV and AIDS in Malawi to rethink the production of quantitative health data. While research practices are often understood within a clean/dirty binary, Biruk shows that data are never clean; rather, they are always “cooked” during their production and inevitably entangled with the lives of those who produce them. Examining how the relationships among fieldworkers, supervisors, respondents, and foreign demographers shape data, Biruk examines the ways in which units of information—such as survey questions and numbers written onto questionnaires by fieldworkers—acquire value as statistics that go on to shape national AIDS policy. Her approach illustrates how on-the-ground dynamics and research cultures mediate the production of global health statistics in ways that impact local economies and formulations of power and expertise.
In health care delivery and health care research, basic concepts of cultural behavior are ignored—at a high personal and financial cost—because both fields are dominated by technical solutions and quantitative analysis. They have little use for what is often regarded as irrelevant information.
In this wide-ranging book, written for students and non-specialists, Gesler applies cultural geography to health care and shows that throughout the world, in western and developing countries alike, the social sciences can inform the medical sciences nd make them more effective and less expensive.
In 2001, Thailand introduced universal health care reforms that have become some of the most celebrated in the world, providing almost its entire population with health protection coverage. However, this remarkable implementation of health policy is not without its weaknesses. Drawing on two years of fieldwork at a district hospital in northern Thailand, Bo Kyeong Seo examines how people in marginal and dependent social positions negotiate the process of obtaining care.
Using the broader concept of elicitation, Seo analyzes the social encounters and forces that shape caregivers. These dynamics challenge dichotomies of subjugation and resistance, consent and coercion, and dependence and autonomy. The intimate and moving stories at the core of Eliciting Care from patients and providers draw attention to a broader, critically important phenomenon at the hospital level. Seo's poignant ethnography engages with feminist theory on the ethics of care, and in so doing, makes a significant contribution to emerging work in the field of health policy and politics.
Embodying Culture is an ethnographically grounded exploration of pregnancy in two different cultures—Japan and Israel—both of which medicalize pregnancy. Tsipy Ivry focuses on "low-risk" or "normal" pregnancies, using cultural comparison to explore the complex relations among ethnic ideas about procreation, local reproductive politics, medical models of pregnancy care, and local modes of maternal agency.
The ethnography pieces together the voices of pregnant Japanese and Israeli women, their doctors, their partners, the literature they read, and depicts various clinical encounters such as ultrasound scans, explanatory classes for amniocentesis, birthing classes, and special pregnancy events.
The emergent pictures suggest that athough experiences of pregnancy in Japan and Israel differ, pregnancy in both cultures is an energy-consuming project of meaning-making— suggesting that the sense of biomedical technologies are not only in the technologies themselves but are assigned by those who practice and experience them.
Scholars in folklore and anthropology are more directly involved in various aspects of medicine—such as medical education, clinical pastoral care, and negotiation of transcultural issues—than ever before. Old models of investigation that artificially isolated "folk medicine," "complementary and alternative medicine," and "biomedicine" as mutually exclusive have proven too limited in exploring the real-life complexities of health belief systems as they observably exist and are applied by contemporary Americans. Recent research strongly suggests that individuals construct their health belief systmes from diverse sources of authority, including community and ethnic tradition, education, spiritual beliefs, personal experience, the influence of popular media, and perception of the goals and means of formal medicine. Healing Logics explores the diversity of these belief systems and how they interact—in competing, conflicting, and sometimes remarkably congruent ways. This book contains essays by leading scholars in the field and a comprehensive bibliography of folklore and medicine.
Based on extensive field research in the Manianga region of the Lower Congo, Health in a Fragile State is an anthropological account of public health and health care after the collapse of the Congolese state in the 1980s and 1990s. This work brings into focus John M. Janzen's earlier books on African health and healing, revealing the collaborative effort by local, national, and international agencies to create viable alternative institutions to those that represented the centralized state. This book documents and analyzes the realignment of existing institutions and the creation of new ones that shape health and healing.
Janzen explores the manner in which power and information, including science, are legitimized in the preservation and improvement of health. Institutional validity and knowledge empower citizens and health practitioners to gain the upper hand over the region's principal diseases, including malaria, tuberculosis, typhoid, and HIV/AIDS.
After the atomic bombing at the end of World War II, anxieties about survival in the nuclear age led scientists to begin stockpiling and freezing hundreds of thousands of blood samples from indigenous communities around the world. These samples were believed to embody potentially invaluable biological information about genetic ancestry, evolution, microbes, and much more. Today, they persist in freezers as part of a global tissue-based infrastructure. In Life on Ice, Joanna Radin examines how and why these frozen blood samples shaped the practice known as biobanking.
The Cold War projects Radin tracks were meant to form an enduring total archive of indigenous blood before it was altered by the polluting forces of modernity. Freezing allowed that blood to act as a time-traveling resource. Radin explores the unique cultural and technical circumstances that created and gave momentum to the phenomenon of life on ice and shows how these preserved blood samples served as the building blocks for biomedicine at the dawn of the genomic age. In an era of vigorous ethical, legal, and cultural debates about genetic privacy and identity, Life on Ice reveals the larger picture—how we got here and the promises and problems involved with finding new uses for cold human blood samples.
In this important collection, prominent scholars who helped to establish medical anthropology as an area of study reflect on the field's past, present, and future. In doing so, they demonstrate that medical anthropology has developed dynamically, through its intersections with activism, with other subfields in anthropology, and with disciplines as varied as public health, the biosciences, and studies of race and ethnicity. Each of the contributors addresses one or more of these intersections. Some trace the evolution of medical anthropology in relation to fields including feminist technoscience, medical history, and international and area studies. Other contributors question the assumptions underlying mental health, global public health, and genetics and genomics, areas of inquiry now central to contemporary medical anthropology. Essays on the field's engagements with disability studies, public policy, and gender and sexuality studies illuminate the commitments of many medical anthropologists to public-health and human-rights activism. Essential reading for all those interested in medical anthropology, this collection offers productive insight into the field and its future, as viewed by some of the world's leading medical anthropologists. Contributors. Lawrence Cohen, Didier Fassin, Faye Ginsburg, Marcia C. Inhorn, Arthur Kleinman, Margaret Lock, Emily Martin, Lynn M. Morgan, Richard Parker, Rayna Rapp, Merrill Singer, Emily A. Wentzell
In a world now filled with more people who are overweight than underweight, public health and medical perspectives paint obesity as a catastrophic epidemic that threatens to overwhelm health systems and undermine life expectancies globally. In many societies, being obese also creates profound personal suffering because it is so culturally stigmatized. Yet despite loud messages about the health and social costs of being obese, weight gain is a seemingly universal aspect of the modern human condition.
Grounded in a holistic anthropological approach and using a range of ethnographic and ecological case studies, Obesity shows that the human tendency to become and stay fat makes perfect sense in terms of evolved human inclinations and the physical and social realities of modern life. Drawing on her own fieldwork in the rural United States, Mexico, and the Pacific Islands over the last two decades, Alexandra A. Brewis addresses such critical questions as why obesity is defined as a problem and why some groups are so much more at risk than others. She suggests innovative ways that anthropology and other social sciences can use community-based research to address the serious public health and social justice concerns provoked by the global spread of obesity.
The Origin of the World is a revealing, intimate, and ultimately liberating study of female sexuality at its heart: the vagina. Working from the assumption that sex is pleasurable and fulfilling insofar as its participants fully understand how it works, sexologist Jelto Drenth gives readers a guided tour of the complex, challenging, and often misunderstood "origin of the world."
Drenth describes the workings of the vagina in simple language, enriching his description throughout the book with the imagery, mythology, lore, and history that has surrounded the vagina since the Middle Ages. The Origin of the World moves from basic physiognomic facts to the realms of anthropology, art history, science fiction, and feminist literature-all in the service of mapping the dark continent. Drenth's journey takes him from Renaissance woodcuts to vibrators, clitoridectomies to "virginity checks," fears of the vagina (the vagina dentata) to its celebration. Part medical exposition covering the function of female genitalia from orgasm to pregnancy and part cultural history discussing contemporary and historical views of such aspects of the feminine as pubic hair, Freud's theories of coitus, and slang terms for the vagina, The Origin of the World is encyclopedic in its breadth, fascinating in its content, and familiar in its subject.
This lightly written exploration can be seen as both an owner's manual and a guide for the perplexed. Women and men alike will benefit from its entertaining erudition and from its fundamental mission of demystifying sex and sexuality in the service of greater understanding and, from that understanding, greater pleasure.
“Drenth’s tale is mostly more cheerful than cautionary, with fascinating accounts of the physiology of vaginal response, thoughtful readings of literature, films, and works of art, and a surprising range of trivia. The erudite book displays a brisk and slightly demented sense of humor.”—Village Voice
From physical location to payment processes to expectations of both patients and caregivers, nearly everything surrounding the contemporary medical clinic's central activity has changed since Michel Foucualt's Birth of the Clinic. Indebted to that work, but recognizing the gap between what the modern clinic hoped to be and what it has become, Rebirth of the Clinic explores medical practices that shed light on the fraught relationship between medical systems, practitioners, and patients.
Combining theory, history, and ethnography, the contributors to this volume ground today's clinic in a larger scheme of power relations, identifying the cultural, political, and economic pressures that frame clinical relationships, including the instrumentalist definition of health, actuarial-based medical practices, and patient self-help movements, which simultaneously hem in and create the conditions under which agents creatively change ideas of illness and treatment.
From threatened community health centers in poor African American locales to innovative nursing practices among the marginally housed citizens of Canada's poorest urban neighborhood, this volume addresses not just the who, what, where, and how of place-specific clinical practices, but also sets these local experiences against a theoretical backdrop that links them to the power of modern medicine in shaping fundamental life experiences.
Contributors: Christine Ceci, U of Alberta; Lisa Diedrich, Stony Brook U; Suzanne Fraser, Monash U; John Liesch, Simon Fraser U; Jenna Loyd, CUNY; Annemarie Mol, U of Amsterdam; Mary Ellen Purkis, U of Victoria.
The Republic of Therapy tells the story of the global response to the HIV epidemic from the perspective of community organizers, activists, and people living with HIV in West Africa. Drawing on his experiences as a physician and anthropologist in Burkina Faso and Côte d’Ivoire, Vinh-Kim Nguyen focuses on the period between 1994, when effective antiretroviral treatments for HIV were discovered, and 2000, when the global health community acknowledged a right to treatment, making the drugs more available. During the intervening years, when antiretrovirals were scarce in Africa, triage decisions were made determining who would receive lifesaving treatment. Nguyen explains how those decisions altered social relations in West Africa. In 1994, anxious to “break the silence” and “put a face to the epidemic,” international agencies unwittingly created a market in which stories about being HIV positive could be bartered for access to limited medical resources. Being able to talk about oneself became a matter of life or death. Tracing the cultural and political logic of triage back to colonial classification systems, Nguyen shows how it persists in contemporary attempts to design, fund, and implement mass treatment programs in the developing world. He argues that as an enactment of decisions about who may live, triage constitutes a partial, mobile form of sovereignty: what might be called therapeutic sovereignty.
An important contribution to medical anthropology, this work defines the principal causes if illness that are reported throughout the world, distinguishing those involving natural causation from the more widely prevalent hypotheses advancing supernatural explanations.
Bringing together essays by nineteen respected scholars, this volume approaches dementia from a variety of angles, exploring its historical, psychological, and philosophical implications. The authors employ a cross-cultural perspective that is based on ethnographic fieldwork and focuses on questions of age, mind, voice, self, loss, temporality, memory, and affect.
Taken together, the essays make four important and interrelated contributions to our understanding of the mental status of the elderly. First, cross-cultural data show that the aging process, while biologically influenced, is also culturally constructed. Second, ethnographic reports raise questions about the diagnostic criteria used for defining the elderly as demented. Third, case studies show how a diagnosis affects a patient's treatment in both clinical and familial settings. Finally, the collection highlights the gap that separates current biological understandings of aging from its cultural meanings.
As Alzheimer's disease and other forms of dementia continue to command an ever-increasing amount of attention in medicine and psychology, this book will be essential reading for anthropologists, social scientists, and health care professionals.
In many cultures, leprosy elicits fear, stigma, and misunderstanding. Historically, people affected by leprosy were banished or isolated from the rest of society. Although the worldwide incidence of leprosy has declined markedly over the past quarter century with the advent of new multidrug therapies, developing nations are still encountering a high number of cases.
In An Uncertain Cure, Cassandra White goes deep into the shantytowns of Rio de Janeiro to give a riveting account of the contemporary leprosy experience among poor and working class Brazilians. In this ethnographic treatment of leprosy sufferers, White exposes the web of historical, socioeconomic, religious, and political forces that complicate the path to wellness and perpetuate high rates of infection. Drawing on nearly ten years of research, White shows how anthropological research can contribute to more effective treatment of chronic infectious diseases around the world.
Far from celebrity media spotlight, ordinary individuals, many older and less advantaged, suffer the disabling pain of Parkinson's disease (PD), an illness whose progressive symptoms often mimic old age and cause mobility impairment, communication barriers, and social isolation.
At the heart of With Shaking Hands is the account of elder Americans in rural Iowa who have been diagnosed with PD. With a focus on the impact of chronic illness on an aging population, Samantha Solimeo combines clear and accessible prose with qualitative and quantitative research to demonstrate how PD accelerates, mediates, and obscures patterns of aging. She explores how ideas of what to expect in older age influence and direct interpretations of one's body.
This sensitive and groundbreaking work unites theories of disease with modern conceptions of the body in biological and social terms. PD, like other chronic disorders, presents a special case of embodiment which challenge our thinking about how such diseases should be researched and how they are experienced.
In Women as Healers, thirteen contributors explore the intersection of feminist anthropology and medical anthropology in eleven case studies of women in traditional and emergent healing roles in diverse parts of the world. In a spectrum of healing roles ranging from family healers to shamans, diviner-mediums, and midwives, women throughout the world pursue strategic ends through healing, manipulate cultural images to effect cures and explain misfortune, and shape and are shaped by the social and political contexts in which they work. In an introductory chapter, Carol Shepherd McClain traces the evolution of ideas in medical anthropology and in the anthropology of women that have both constrained and expanded our understanding of the significance of gender to healing-one of the most fundamental and universal of human activities.
The contributors include Carol Shepherd McClain, Ruthbeth Finerman, Carolyn Nordstrom, Carole H. Browner, William Wedenoja, Marjery Foz, Barbara Kerewsky-Halpern, Laurel Kendall, Merrill Signer, Roberto Garcia, Edward C. Green, Carolyn Sargent, and Margaret Reid.
In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal. Your Pocket Is What Cures You examines qualitative shifts in health and healing spurred by these reforms, and analyzes the dilemmas they create for health professionals and patients alike. It also explores how cultural frameworks, particularly those stemming from Islam and Wolof ethnomedicine, are central to understanding how people manage vulnerability to ill health.
While offering a critique of neoliberal health policies, Your Pocket Is What Cures You remains grounded in ethnography to highlight the struggles of men and women who are precariously balanced on twin precipices of crumbling health systems and economic decline. Their stories demonstrate what happens when market-based health reforms collide with material, political, and social realities in African societies.