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Doing anD living meDical anthropology PDF

169 Pages·2010·1.75 MB·English
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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 Park-Geest-def.indd 1 28-7-2010 19:00:48 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 Park-Geest-def.indd 2 28-7-2010 19:00:48 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 Park-Geest-def.indd 3 28-7-2010 19:00:49 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 Park-Geest-def.indd 4 28-7-2010 19:00:49 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 Park-Geest-def.indd 5 28-7-2010 19:00:49 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 Park-Geest-def.indd 6 28-7-2010 19:00:49 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 Park-Geest-def.indd 7 28-7-2010 19:00:49 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. Park-Geest-def.indd 8 28-7-2010 19:00:49 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 Park-Geest-def.indd 9 28-7-2010 19:00:49

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