Doing anD living meDical anthropology

169 Pages·2010·1.75 MB·English

health, cultuRe and Society health, cultuRe and Society
StudieS in medical anthRoPoloGy and SocioloGy StudieS in medical anthRoPoloGy and SocioloGy
The essays in this volume consider what medical anthropology
means in the academy and outside of it. Written by a diverse Doing anD living
group of anthropologists, some of whom also work as doctors,
public health workers, and NGO staff members, the essays share
personal insights on how they used anthropology to solve health meDical anthropology
problems and improve interventions.
personal reflections
Several of the contributors draw on their own illness
experiences to reconsider the health challenges they have
previously sought to understand, analyse, and document.
Other essays come from authors who have struggled to
incorporate anthropological methodologies and perspectives in
multi-disciplinary research and medical relief work. Also included
are essays from professional anthropologists who refect on the
value of their discipline’s mission and methodology.
This collection demonstrates how anthropology is used in policy
and health interventions and attempts to bridge the gaps be-
tween policymakers, clinicians, NGO workers, doctors, and aca-
demic researchers.
Rebekah Park is a PhD candidate at the University of California,
Los Angeles in the Department of Anthropology. She is currently writing her
dissertation based on her work with the Association of Former Political
Prisoners of Córdoba, Argentina.
Sjaak van der Geest is emeritus professor of Medical Anthropology at
the University of Amsterdam. He carried out feldwork in Ghana and
Cameroon on a variety of topics in medical anthropology, including social
meanings of medicines, growing old, and culture & hygiene.
AMB Publishers
ISBN 97890 79700 25 7
Rebekah PaRk &
Sjaak van deR GeeSt (editoRS)
9 7 8 9 0 7 9 7 0 0 2 2 6
Doing and living medical anthropology BRUIN.indd 1 29-7-2010 14:39:45
Rebekah PaRk &
health, culture & society Doing anD living meDical anthropology
Sjaak van deR GeeSt
Doing anD living meDical anthropology
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Editors: Sjaak van der Geest & Paul ten Have
Published in this series:
Anja Krumeich
Te blessings of motherhood. Health, pregnancy and child care in Dominica
Sjaak van der Geest, Paul ten Have, Gerhard Nijhof, Piet Verbeek-Heida (red.)
De macht der dingen. Medische technologie in cultureel perspectief
Cor Hofer
Islamitische genezers en hun patiënten. Gezondheidszorg, religie en zingeving
Peter Ventevogel
Whiteman’s things. Training and detraining healers in Ghana
Ria Reis
Sporen van ziekte. Medische pluraliteit en epilepsie in Swaziland
Anne Reeler
Money and friendship. Modes of empowerment in Tai Health Care
Joke Haafkens
Rituals of silence. Long-term tranquilizer use by women in the Netherlands
Michael Tan
Good medicine:
Parmaceuticals and the construction of power and knowledge in the Philippines
Sylvie Fainzang
Of malady and misery. An African perspective on European illness
Marian Potting
Van je familie... Zorg, familie en sekse in de mantelzorg
Jessica Mesman
Ervaren pioniers. Omgaan met twijfel in de intensive care voor pasgeborenen
Robert Pool
Dialogue and the interpretation of illness. Conversations in a Cameroon village
Sjaak van der Geest & Ria Reis (eds.)
Ethnocentrism. Refections on medical anthropology
Winny Koster
Secret strategies. Women and abortion in Yoruba society, Nigeria
Shahaduz Zaman
Broken limbs, broken lives. Ethnography of a hospital ward in Bangladesh
Francine van den Borne
Trying to survive in times of poverty and aids. Women and multiple partner sex in Malawi
Helle Max Martin
Nursing contradictions. Ideals and improvisation in Uganda
Miranda van Reeuwijk
Because of temptations: Children, sex and hiv/aids in Tanzania
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health, CultuRe and SoCiety
StudieS in MediCal anthRoPoloGy and SoCioloGy
Doing anD living meDical anthropology
personal reflections
Rebekah PaRk & Sjaak van deR GeeSt
(editoRS)
AMB
Diemen
2010
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Tis book is dedicated to our teacher,
colleague and friend Els van Dongen († 2009).

isbn 97890 79700 25 7
© 2010, Rebekah Park & Sjaak van der Geest
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopy, recording or any information storage and
retrieval system, without a written permission of the copyright owner.
Cover: Van Marum Graphics
Illustration cover: Sjaak van der Geest conversing with Nana Kwaku Nyame, a Ghanaian elder,
on the joys and pains of ageing. Te cassette recorder is directed toward
Nyame, and Van der Geest is pointing at himself: “doing and living medical
anthropology”. Te photograph was taken by Patrick Atuobi, Van der Geest’s
co-researcher.
Lay-out: Hanneke Kossen, Amsterdam
amb Publishers, p.o. Box 7, 1110 aa diemen, Te Netherlands – www.amb-press.nl
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Table of contents

Preface vii
sjaak van der geest & rebekah park
Chapter 1 Doing and living medical anthropology:
An introduction 1
rebekah park & sjaak van der geest
Chapter 2 Staking a middle ground between public health and medical
anthropology to reduce health disparities in the usa 11
emily bhargava
Chapter 3 A medical anthropology contribution:
Participatory research with young people in Uganda 25
paul bukuluki
Chapter 4 From revelation to reality:
Te struggle of a doctor trained in medical anthropology 35
laura ciaffi
Chapter 5 Medical anthropology and hiv prevention:
Analyzing the use of condoms among gay men in Chile 43
carla donoso orellana
Chapter 6 A bump in the neck:
From doctor to patient to doctor 57
michael golinko
Chapter 7 From participant observation to refection:
Notes on returning from the feld 69
rebekah park
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Chapter 8 Tick and thinned description:
How useful can medical anthropology be? 91
sjaak van der geest
Chapter 9 Saving my soul 107
els van dongen
Chapter 10 We came, we saw, we misdiagnosed:
How medical anthropology can enhance
emergency medical relief programmes 117
vanessa van schoor
Chapter 11 Why medical anthropology matters:
Looking back on a career 131
corlien varkevisser
Chapter 12 Journeying with medical anthropology 145
shahaduz zaman
Index 153
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Preface

In May 2007 the Amsterdam Master’s of Medical Anthropology (amma) of the
University of Amsterdam celebrated its tenth anniversary with a conference
about “Teaching and Applying Medical Anthropology.” Tis volume contains
nine selected essays from this conference and two additional ones since the
conference. amma graduates wrote seven of the chapters and faculty mem-
bers penned the remaining four. Te contributions feature autobiographical
accounts on applying medical anthropology in diverse professional positions
and in personal lives, contextualised within the broader history and theoreti-
cal development of the discipline. Te authors engage in refexive anthropol-
ogy, delving into the role medical anthropology plays both in and outside of
academia. Several essays recommend medical anthropological pedagogies and
applications in settings of both theory and work.
Te amma programme opened its doors in 1997 with eleven students. By
2010, 159 students had graduated from amma. From the start, the student
body has always been, and remains, global. Each year, the classes are flled
with extremely diverse individuals, of varying ages, professions, and cultural
backgrounds. Te vast majority of the students already possess an advanced
graduate degree and work in various health-related felds. Students are often
doctors, public health ofcials, social science researchers, and ngo workers
who are looking to improve their existing professions with a medical anthro-
pology perspective. Tey have encountered obstacles in their work, such as fail-
ing interventions due to lack of cultural knowledge, and desire knowledge on
qualitative methodologies. Tey also look for a richer theoretical understand-
ing of culture, particularly in terms of health, illness and medicine.
In many ways, the personal identities of the students create an ideal envi-
ronment to learn anthropology because each class discussion is a practice for
cultural brokering. Speaking about ‘genital mutilation’ with students who have
undergone circumcision rituals, or classic early anthropological works con-
ducted in ‘primitive cultures’ where many of the students are from, creates
an entirely diferent experience than if taught to a homogenous student body.
In amma, students are engaging with others who can draw from their per-
sonal and professional experiences, particularly since amma students are what
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viii Doing and living medical anthropology
the tradition has often defned as the ‘other.’ Tus, this programme not only
trains a diverse generation of anthropologists, but it also teaches anthropology
through its peers.
Te student profle is also refected in the main purpose of amma, which
is to enable its graduates to help solve health problems with anthropological
theories, concepts and methodologies. Faculty members take pride in showing
how anthropology can be used to improve existing health eforts. While the
length of time limits the breadth of knowledge that can be conveyed within a
year, the programme still endows its students with core concepts that enable
them to better champion an anthropological perspective in multi-disciplinary
teams. In other cases, amma strives to equip the individual with the tools to
consider cultural, political, and economic factors in the process of creating and
implementing health interventions.
On the occasion of its jubilee conference, the amma department invited all
its alumni to submit a paper on their lives after amma. Te invitation posed the
following questions as possible themes for their contribution:
– What kind of work did you engage in after graduating from amma?
– How did you use the skills and knowledge gained from amma in your cur-
rent work?
– Can you present and discuss concrete cases and/or projects in which medi-
cal anthropology made a diference?
– Can you present and discuss concrete cases and/or projects where the oppo-
site happened?
– Are there case studies in which the integration of medical anthropology
improved past failures in health-related initiatives?
– Could you, on the basis of your (and others’) experiences draw wider theo-
retical, methodological, ethical or policy-related conclusions (or raise ques-
tions of more general importance)?
In total 33 abstracts were submitted for the conference, and 19 of those abstracts
were chosen to be presented and discussed at the conference. As mentioned
before, nine of the conference papers were eventually selected for this book,
which were peer-reviewed and went through substantial revisions.
We encouraged the writers to personally refect on the intertwinement of
medical anthropology in work and life. Both the personal refection and the
emphasis on research outside academia follow the ‘culture’ of amma’s teaching
and organization. Applied medical anthropology is for many of the students a
crucial objective, especially those who have previous training in medical and
related professions to which they return to upon graduation.
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Preface ix
We hope that this collection of essays will not only serve as a – perhaps nos-
talgic – memory of a successful conference and ten years of amma life, but will
also inspire present-day colleagues and future generations of the professional
and existential potentials of medical anthropology.
And fnally, we want to thank all who contributed to the success of the con-
ference in 2007 and the production of this book, in particular Trudy Kanis,
Peter Mesker, Janus Oomen and Chris Aldenhuijsen, the authors and their dis-
cussants during the conference, Susan R. Whyte, Michael L. Tan, Sera Young
and Ria Reis who advised us in the selection of the conference papers, the
anonymous peer reviewers, Anthony Holslag, and the other amma colleagues.
We dedicate this book to Els van Dongen, an original anthropologist and
gifted teacher who taught eight generations of amma students. She passed away
in 2009, at the age of 62. We are grateful that we have been able to include her
last publication, a refection on her fnal year, as patient and medical anthro-
pologist.
Sjaak van der Geest
Rebekah Park
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