Medicine Anthropology Theory
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Transabled women lost in translation? An introduction to: ‘“Extreme” transformations: (Re)Thinking solidarities among social movements through the case of voluntary disability acquisition’
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Undetectable? Looking for urban traces of HIV/AIDS in Montréal’s gay Village
No full textIn recent years, the ‘end of AIDS’ has been at the top of the international scientific and political agenda. At the same time, attention to the dark years of the epidemic is increasing, revealing a form of nostalgia for a time of collective mobilization. But what is to be said of the current state of the disease, between the nostalgia for a tragic past and the hope of a world without AIDS? This think piece was prompted by the increasing erasure of contemporary experiences of the sickness. At a time when we have the means to render HIV biologically undetectable, I propose to explore another of the virus’s materialities: its social and historic inscription in urban settings, in particularly in Montreal’s gay neighbourhood
Following ‘Fosfo’: Syntheticphosphoethanolamine and the transfiguration of immunopolitics in Brazil
Get PDFThe chemical substance synthetic phosphoethanolamine (fosfoetanolamina sintética) was developed at the University of São Paulo (USP) in Brazil at the beginning of the 1990s and, until 2014, was tested on and distributed to cancer patients by members of USP’s Chemistry Institute (IQSC) in the city of São Carlos. That year, the production and distribution of ‘Fosfo’, as it became popularly known, was forbidden by IQSC’s director with the support of USP’s rector and the Brazilian National Sanitary Surveillance Agency (ANVISA). Shortly after this first prohibition, however, Fosfo gained popularity and became a national symbol of local scientific innovation and hope for a cancer cure. Likewise, it became an object of regulatory disputes involving multiple sectors of Brazilian society. Despite several further efforts by some scientists and patients to legitimate Fosfo as a pharmaceutical, ANVISA never authorized it. Nevertheless, at the same time as parts of Brazil’s established medical communities were becoming suspicious of Fosfo, its informal production and dissemination were increasing surreptitiously, with many Fosfo users and stakeholders questioning the legitimacy of conventional cancer therapies. In this article, I aim to understand the impact of Fosfo as a biotechnological innovation in terms of the ‘transfiguration’ of the physical and juridical persons involved in this controversy. Through the lens of transfiguration, the engagement and therapeutic-regulatory experiences of Fosfo users and stakeholders appear as deviant journeys that introduce discontinuities into established biomedicine and imply radical transformations at multiple levels, ranging from individuals to larger institutional environments
Old, disabled, successful? Transfigurations of aging with disabilities in Switzerland
Get PDFAging – both the definition and the actual process of aging – has undergone fundamental local and global changes in the past decades. Various advances in technology and medicine increasingly allow senior citizens in Switzerland to ‘age successfully’ and have shifted societal expectations about what aging should include. This article looks at a group of senior citizens who encounter an increasing discrepancy between the demands fostered by the dominant discourse of ‘successful aging’ and the infrastructure made available to them. At the same time, seniors with disabilities are transfigured and come to stand for dependence, frailty, and decline because of this reconceptualization of aging. This article analyzes the cases of three senior citizens with disabilities which show the consequences of changed normative imaginaries, practices, and infrastructures on how senior citizens with disabilities experience their socialitie
Transfigurations of aging: Everyday self-care in a civil servant milieu of Dar es Salaam, Tanzania
Get PDFTo date, most social anthropological studies on aging in African contexts focus on care for poor older people provided by related others. The focus of this article is different as it focuses on older people with better financial means than the average: civil servants belonging to Dar es Salaam’s middle class. Furthermore, this contribution shifts the focus from care provided through related others to practices of everyday self-care, the care that these older people provide for themselves with the help of relatives in Tanzania and the USA. In order to stay healthy and cope with diagnosed chronic conditions, older participants in this study engage in physical exercises, eat ‘good food’, and go for regular medical check-ups. This article argues that these health-promoting self-care practices of older urban dwellers reflect changing experiences of aging, health, and care, and point to transfigurations of the social imaginary of aging in Dar es Salaam’s middle class
Bhabha in the clinic: Hybridity, difference, and decolonizing health
Get PDFBefore professional diagnosis, the determination of whether one is ‘ill’ or ‘well’ rests within the patient. These moments, when sufferers (re)cognize their own bodily and phenomenological experience as abnormal or different, are critical to the positioning of healer and patient. So too are moments when diagnosed patients, struggling with a treatment regime, compromise and adjust to embrace, if only partially, disparate ideas of health. In this article, I apply Homi Bhabha’s framework of hybridity and difference to think about the perception of illness, self-diagnosis, and power in healing relationships. I consider how sufferers enact hybrid positions between their bodily perceptions and their professional diagnoses. To illustrate the utility of Bhabha’s colonial critique for health care, I examine narratives by patients with diabetes-related vision loss about: (1) first realizations that something was wrong, what Bhabha might call the ‘intervention of difference’; (2) expressed differences between self-knowledge and biomedical knowledge, corresponding to Bhabha’s ‘partial embrace’ of the colonial ideal; and (3) the self-colonizing epistemological work that compliant patients do as they re-orient their pre-diagnostic self to a post-diagnostic habitus of self-monitoring, timed medications, and other treatments. I conclude with a discussion of how Bhabha’s colonial hybridity supports a more productively contentious medical anthropology that envisions and pursues decolonized health care
‘Unknowing’ and mental health system reform in Palestine
No full textIn this Think Piece we argue that mental health system reforms are not mainly driven by scientific evidence and international standards, but rather by concrete political constellations, national and international development agendas, local and global socioeconomic contexts, and the interactions between differently positioned actors. We further argue that these forces gain their influence not by being openly discussed, but precisely because they are rendered invisible and turned into what Geissler (2013) calls ‘unknown knowns’. To illustrate these complex processes, we present a case study that examines how mental health system reform processes in the West Bank are shaped by the Israeli occupation, particular political events, and unequal power relations between international and local institutional actors. Furthermore, we present critical reflections by mental health providers related to these processes, and their visions for a more sustainable mental health system. We end with an appeal to aid providers to stop characterising their work with abstract catchphrases such as ‘evidence-based’ or ‘best practice’, and call on them to be transparent about how political, economic, and social contexts shape their work on the ground