Medicine Anthropology Theory
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Longing for evidence-based traditions: Addiction treatment in Canada\u27s Northwest Territories
No full textIn Native North America, clinical/healing spaces are caught up in political struggles for autonomy. In Canada’s Northwest Territories, where rates of alcohol consumption are substantially higher than national averages, there are ongoing attempts to align therapeutic practice with traditional Aboriginal modes of healing and well-being. This Think Piece traces the ‘therapeutic trajectory’ of alcohol treatment in and out of this subarctic region. I show how the language of ‘evidence-based practice’ affords both gains and losses with regard to the assertion of collective identity and values vis-à-vis the state. Against the backdrop of the closure of the region’s sole residential treatment program, I contrast a conversation with a clinician responsible for implementing culture-based programs with the experiences of Destiny, a young Dene woman who, in the absence of local treatment options, spends time in clinics some one thousand kilometers away from her home community. In her movements away from the place to which she is indigenous, Destiny activates different forms of Aboriginal care than those intended by state and community actors. These divergent perspectives speak to the enmeshment of addiction with the perils and politics of liberal forms of recognition
After illness, under diagnosis: Negotiating uncertainty and enacting care
Get PDFA vast portion of the world’s population live with ill health following acute infection or disease and its emergency management. This reflects the increased capacity of technological innovations and pharmaceuticals to interrupt decline or complications, even when cure is unlikely. The authors in this Special Section illustrate how, in different localities, people live with risk for themselves or their offspring; with non-communicable, degenerative, autoimmune, and congenital conditions; with the after-effects of diagnostic procedures and surgical interventions; and with continued treatment and surveillance. We attend to the value of conceptualising this as ‘living under’ diagnosis or description. We illustrate how diagnostic labels overdetermine subsequent embodied states of being, structuring interactions and social relations with family, friends, and health professionals. Living under diagnosis, we argue, impacts on self-care, care for and by others, everyday lives, and anticipations of the future
Naming and framing ecological distress
Get PDF]We are living in a time of massive anthropogenic ecological and climatic shifts. Awareness of these changes and their effects on human lives is increasing, with recognised impacts on mental health. At present, a variety of different terms exist to describe ecological change-related distress. They range from the philosophical to the clinical, and are already beginning to form part of professional practice, as well as popular discourse, with prescriptive implications. In this piece, I explore some of the different names and frames for ecological distress by drawing on a sample of 30 online articles, blogs, and videos, and bringing these into dialogue with scholarly literature. My purpose is to open up a conversation about how medical anthropologists might attend to the meaning-making processes that surround ecological distress and (individual, institutional, and political) responses to it.  
Revelation or confirmation? The ‘fake probe’ in global health
Get PDFFakes have become a matter of concern across global health. Commissioning inquiry into presumed fake practices in global health requires both a pre-existing sense of what would constitute real provision and a suspicion that it is not being offered. In this Position Piece, we analyse the research methods being used to identify and reveal other—presumed—fakes in global health provision. We put forward the concept of the ‘second-order fake’—the fake that is used to reveal a fake—to draw attention to the methodological politics at stake in the use of the fake. By reviewing historical cases of the creation of methods of deception, we analyse the assumptions they bring into global health from other disciplines. We foreground the promises of revelation that are embedded in probes that rely on fakes to uncover fakes. We suggest that despite the growing prevalence of methods which themselves deploy fakes to find fakes, these techniques bring us no closer to understanding the lived ambiguities of everyday practices of fakery
Relational anatomy: Dissecting and memorialising the dead in medical education
No full textRelational dimensions of contemporary anatomy, as a body of knowledge and a field of material practices, are examined in this article, focusing on the treatment and uses of bodies after death in anatomical education. Attending to the intersection of the
Topography and scale in a community-driven maternal and child health program in Eastern Indonesia
No full textIn 2007, the Indonesian government introduced Generasi, a community-driven development program to address village priorities such as reducing poverty, maternal mortality, and child mortality. When describing Generasi’s biggest challenges, program facilitators on the eastern Indonesian island of Flores used a geographic vocabulary of fields (medan, lapangan) and topography (topografi) that evokes the demands of supervising Generasi’s implementation across dozens of mountain villages with poor infrastructure. But their geographic language also extends metaphorically to the enduring problems of scale and governance. I analyze these discourses of topography and field in relation to the changing therapeutic landscape of maternal and child health services in the Manggarai highlands of western Flores, then follow Generasi’s scalar scaffolding from the meetings and clinics in villages, to the technocratic policy work in Jakarta, and to the academic spaces of Auckland and Cambridge
From an ethnography of the everyday to writing echoes of suffering
No full textVeena Das has introduced a major shift in our contemporary conception of ethnography. While she brings forward a new way of looking at everyday life, which is already a major achievement, she also offers a conceptual resolution to a classical unresolved opposition between the individual and the collective, and between idiosyncratic psychology (subjectivity) and collective modes of thinking, through a challenging debate on what makes one a member of a group and yet radically distinct from all others. The ethnography in her book Affliction stands on three major pillars: The first is the ethnographer’s subjective position in the field regarding the issues of lives, testimony, and research. The second is the neighborhood as the site of fieldwork, with all of its heterogeneity, rather than the group, such as an ethnic or racial group or one cohering around another criterion of belonging. The third and final pillar is the focus on the ordinary through ethnography of the everyday. I then illustrate Veena Das’s perspective on subjectivity with my own fieldwork with survivors of the Cambodian genocide
Rethinking repetition in dementia through a cartographic ethnography of subjectivity
Get PDFThis article critically engages with the predominant understandings of repetitive bodily practices within a dementia context. Rather than interpreting such practices as pathological and abnormal, I instead approach them through an ethnographic mapping, paying particular attention to the affective dynamics of repetition. Critically developing Fernand Deligny’s insights and methods of tracing and mapping bodily movements in dialogue with Tim Ingold’s notion of dwelling, I demonstrate affect-underpinned encounters and interactions of repetitive phenomena. I then argue for the extension of recent anthropological discussions about affect, repetition, and subjectivity by suggesting a more productive dialogue among theories of affect, body, atmosphere, cognition, memory, language, and life history
Rethinking sociality and health through transfiguration
Get PDFIn this introductory article to the Special Section, we intend to literally bring sociality to (bodily) life and ask what medical anthropology might gain by using the lens of sociality for a better understanding of the phenomena it is concerned with. Conversely, we probe how the field of health and illness – including themes concerning embodiment, vulnerability, suffering, and death – might help to further spell out the notion of sociality both conceptually and methodologically. Drawing on the contributors’ ethnographic enquiries into contemporary health phenomena in East Africa, South America, and Western Europe, we do so by bringing sociality into conversation with transfiguration. By this we refer to: (1) the constantly unfolding processes of particular extended figurations encountering, affecting, and becoming enmeshed in each other; as well as (2) the (temporarily) stabilized figurational arrangements emerging from these enmeshments. It is our hope that this notion of transfiguration will help render visible the modalities through which human engagements with each other and the world form diverse arrangements. Moreover, we aim to better understand the processes by which these arrangements – which we term ‘extended figurations’ – interact with each other, change over time, and possibly vanish and make way for others. A detailed appreciation of the workings of these extended figurations, we believe, can significantly enhance our comprehension of the particular processes of change that stand at the center of our ethnographic interest. In this sense, the concept of transfiguration constitutes one possible way of structuring the messiness and complexity of sociality for analytical purposes