Exploring Medical Anthropology

170 Pages·2017·1.9 MB·English

by  Donald Joralemon

Exploring Medical Anthropology
Now in its fourth edition, Exploring Medical Anthropology provides a concise and engaging
introduction to medical anthropology. It presents competing theoretical perspectives in a
balanced fashion, highlighting points of conflict and convergence. Concrete examples and
the author’s personal research experiences are utilized to explain some of the discipline’s
most important insights, such as that biology and culture matter equally in the human ex-
perience of disease and that medical anthropology can help to alleviate human suffering.
The text has been thoroughly updated for the fourth edition, including fresh case studies
and a new chapter on drugs. It contains a range of pedagogical features to support teaching
and learning, including images, text boxes, a glossary, and suggested further reading.
Donald Joralemon is Professor of Anthropology at Smith College.
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Exploring Medical Anthropology
Fourth Edition
Donald Joralemon
Fourth edition published 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2017 Donald Joralemon
The right of Donald Joralemon to be identified as author of this work
has been asserted by him in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or retrieval
system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
First edition published by Pearson Education, Inc. 2006
Third edition published by Pearson Education, Inc. 2009; Routledge 2016
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book has been requested
ISBN: 978-1-138-20187-3 (hbk)
ISBN: 978-1-138-20186-6 (pbk)
ISBN: 978-1-315-47061-0 (ebk)
Typeset in Goudy
by codeMantra
I dedicate this book to my wife, Phoebe Ann Porter,
for her patience and support.
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Contents
Preface xi
Acknowledgments xiii
1 What’s So Cultural about Disease? 1
Culture in Medicine 2
Disease in Other Cultures and Times 2
The Impact of Culture on Contemporary Biomedicine 4
Development of Medical Anthropology 6
Health as a Measure of Social Standing 6
Medicine as a Social Process with Functional Purpose 7
The Applied Roots of Medical Anthropology 8
Medical Anthropology Today 9
Summary: Placing Medical Anthropology among the
Social Sciences of Medicine 10
Suggested Readings 11
Notes 12
2 Anthropological Questions and Methods in the Study of Sickness
and Healing 13
Studying Shamans in Peru 13
Research Questions 13
Research Methods 15
From Fieldwork to Analysis and Interpretation 16
Studying Medicine in the United States 17
Organ Transplantation as an Anthropological Subject 17
Research Questions 18
Research Methods 21
Summary: The Anthropological Vision 24
Suggested Readings 24
Notes 25
viii Contents
3 Recognizing Biological, Social, and Cultural Interconnections: Evolutionary
and Ecological Perspectives on a Cholera Epidemic 26
Thinking about Epidemics 27
History and Biology of Cholera 27
Epidemiological Accounts of Peru’s Cholera Epidemic 29
Evolution and the Ecological Framework 30
Cholera and the Evolutionary Framework 32
Medical Anthropology Embraces the Ecological/Evolutionary Model 34
Suggested Readings 36
Notes 36
4 Expanding the Vision of Medical Anthropology: Critical and
Interpretive Views of the Cholera Epidemic 38
Political Economy of Cholera 39
Political-Economic versus Ecological/Evolutionary Perspectives 42
Interpretive View of Cholera 43
Taking a Broader, Inclusive Perspective 47
Suggested Readings 50
Notes 50
5 The Global Petri Dish 51
Transitions 53
SARS: The First Global Epidemic of the Twenty-First Century 54
Ebola: Out of the Forest 54
One Health Ecology 55
Challenges to the Ecological/Evolutionary Perspective 55
Fluid Constructions: The Interpretive Perspective in a World Context 56
The Critical Perspective: A Political-Economy of SARS and Ebola? 58
Global Germ Governance 59
Conclusion 60
Suggested Readings 60
Notes 60
6 Healers and the Healing Professions 62
Healing Roles: Organizing the Diversity 62
Health Care Sectors 62
Healers’ Relationships between and within Health Care Sectors 63
Authority of Healers 64
Social and Cultural Dimensions: General Concepts 64
Therapy Outcome and Healer Authority 65
Authority in the Folk Health Sector: Position of Peruvian Curanderos 66
Social Authority of Peruvian Curanderos 66
Outcome of Curandero Therapy 66
Cultural Authority of Curanderos 67
Contents ix
Authority in the Professional Health Care Sector: Case of Biomedicine 67
What Sets Biomedicine Apart? 67
Social Authority of Biomedical Healers 68
Outcome of Biomedical Healing 68
Cultural Authority of Biomedicine 69
Challenges to Biomedical Authority 69
Economic Critique and Biomedicine’s Social Authority 70
Clinical Critique and Biomedicine’s Cultural Authority 70
Outcome Critique 71
Impact of the Critiques 71
Authority of Biomedicine in Non-Western Countries 72
Good News, Bad News 72
Importance of Primary Health Care 73
Alma Ata and PHC in Question: Biomedicine Reasserts Its Authority 74
Conclusion 76
Suggested Readings 76
Notes 77
7 Drugs: A Fieldwork Encounter with Drugs 79
When a Pharmacologist Turns Whistleblower 79
HIV, the Global Drug Economy and Public Health Priorities 81
Bringing It Home: Drugs in America 82
The Future of Drug Research in Medical Anthropology 84
Suggesting Readings 86
Notes 87
8 Applying Medical Anthropology 88
Medical Anthropology in International Development: A Brief History 90
Anthropological Troubleshooters, 1945–1973 91
Disenchantment and Disengagement 92
Social Soundness Guidelines and the Return of Applied
Anthropology, 1973–1980 93
The Reagan/Bush Years (1981–1993) and Beyond 94
Work of Applied Medical Anthropologists in International Contexts 94
Medical Anthropology and HIV/AIDS Prevention: Sex Workers in 
Congo (Formerly Zaire) 95
Community Participatory Involvement (CPI) in Ecuador 96
Applying Medical Anthropology in the United States 97
Cultural Competency: Whose Culture, Whose Responsibility? 97
Between a Rock and a Hard Place: Applied Medical Anthropology under Attack 99
Critical Medical Anthropology Assault on Applied Medical Anthropology 99
Response from Applied Medical Anthropologists 100
Personal Reflections 101
Conclusion 102
Suggested Readings 103
Notes 103