Medicine Anthropology Theory
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From social distancing to social containment: Reimagining sociality for the coronavirus pandemic
Get PDFThis essay develops an anthropological critique of ‘social distancing’. While the 2020 coronavirus pandemic requires us to reconfigure established forms of sociality, distancing regimes such as ‘lockdowns’ can profoundly disrupt the provision of care and support, creating practical difficulties and existential suffering. I advocate instead for strategies of ‘social containment’, outlining several of the containment arrangements people in England have developed to reconcile relational obligations with public health imperatives during the pandemic. I end by addressing some of the steps anthropologists must take when translating such ideas into policy
Leprosy, impurity, and stigma in Vietnam
Get PDFThis Position Piece examines the nature of Vietnamese folk constructions of leprosy through Mary Douglas’s (1969) and Victor Turner’s (1967) works. Investigating Vietnamese explanations for the origins of leprosy and its channels of transmissions, symptoms, and consequences, I argue that these accounts are rooted in narratives of transition, transgression, the crossing of boundaries, and categorical confusion of various kinds. I argue that these deeply embedded perceptions of leprosy help to explain the existence of persistent stigma against leprosy in Vietnam, despite highly effective drug treatments and extensive state awareness programmes
Death as resource: A story of organ donation and communication across the ‘great mist’ in Iceland
No full textSocial scientific and humanities accounts of death have long spoken of the medicalisation of death in contemporary societies, particularly Western ones. According to these arguments, modern medicine treats death as a failure to be avoided. This special i
Blurred lines: Warfare and health care
No full textThe neutrality of medicine and health care professionals in different conflict settings in the Middle East have come under scrutiny in recent human rights reports, and should be seen as part of the broader fallout of the US-led ‘global war on terror.’ The last two decades of US military attacks on health infrastructures in Iraq and the use of polio-vaccination campaigns to track down ‘terrorists’ are acts of war that have further blurred the lines between health care and warfare. The failure of international legal processes and institutions to prevent such assaults or to prosecute those responsible raises questions about the Eurocentric system of checks and balances that shape international humanitarian law and its invocation as a ‘legal’ and ‘moral’ framework
Understanding war trauma: The ecology of loss, the prison of isolation, the role of the outsider
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Biomedical packages: Adjusting drugs, bodies, and environment in a phase III clinical trial
No full textClinical trials are a fundamental stage in a drug’s biography for they provide the standard by which a molecule’s therapeutic status is determined. Through this process of experimentation, a pharmaceutical substance acquires a new competence – that of treating or preventing disease. This article examines experimentation in drug production, and shows how this complex apparatus not only transforms the status of the molecule but also produces new understandings of and expectations for how people should act. Drawing upon observation of a trial of prophylactic prevention of mother-to-child transmission of HIV, in Ouagadougou, Burkina Faso, I show that the production of this biomedical technology – the therapeutic drug – is coupled with the production of its users. In so doing, I challenge the conception of drugs as bounded objects and instead offer the concept of ‘biomedical package’, which highlights the social relations that characterise it
Moving medicine inside the neighborhood: Health care and sociospatial transformation in Caracas, Venezuela
No full textThis article focuses on the spatial significance of health care access, analyzing how state health programs effected sociospatial transformations in poor urban neighborhoods in Caracas, Venezuela. Starting in 2003, the leftist state constructed a parallel public health system to shift biomedical care from hospital emergency rooms to small clinics in neighborhood settings, arguing that it would improve the quality and accessibility of medical care for the poor. The new national health program, Barrio Adentro (Inside the Neighborhood), explicitly reorganized public medicine according to the pragmatic and symbolic significance of place. This article, based on fifteen months of ethnographic research in central Caracas, focuses on the meanings of these new health spaces for patients. Patients viewed the placement of clinics – and doctors – in barrios and working-class neighborhoods not only as logistically necessary but also as a moral and political commitment on the part of doctors and on the part of the state that employed them. In a context of marked spatial segregation along class lines, the placement of doctors ‘inside the neighborhood’ was symbolically significant because it marked such communities as deserving of services and challenged longstanding divisions between marginalized and privileged social groups in Caracas
The moral economy of early intervention: Mothers, children, and the impact of austerity on perinatal mental health
No full textIn November 2015, protests erupted in Oxford in response to the decision of the Oxfordshire County Council to cut, among other things, forty-four Children’s Centres and seven Early Intervention Hubs. The debate about whether these centres could be considered as disposable or not did not get to an agreement. I argue that the main cause of this outcome is that the opposing arguments were based on moral positions that were not only incompatible but fundamentally incommensurable. Those in favour of reducing deficit spending argue that cuts to social services (including family and children services) are unavoidable. Parents, however, refuse to accept austerity measures that will undermine the rights of their children to access services that will improve their chances in life. Neither position is based on incontrovertible evidence. On the one hand, the decision to cut a given service always involves the arbitrary evaluation of that service against other services that will not be cut. On the other, the demand to fund those services is based on the hope that early intervention initiatives will benefit children, even if the evidence that early intervention works is unconclusive or thin. On the basis of a thematic analysis of twenty-seven stories written by Oxfordshire parents, I interpret this conflict using the notion of moral economy, and argue that such an approach allows an appreciation of the link between health economics, perinatal mental health, the morality of parenting, and the early intervention discourse
Commentary on ‘Mental Illness, Psychiatric Institutions, and the Singularity of Lives’
No full text‘Mental Illness, Psychiatric Institutions, and the Singularity of Lives’, a chapter of \u27Affliction\u27 by Veena Das (2015), illustrates the sociocultural, familial, and personal factors that determine the trajectory of mental illness from its onset to treatment. Das discusses two case histories: a young boy suffering from psychotic illness and a young girl in conflict with her father. Both of them come from families residing in the urban slums of a large Indian metropolis. Reading this chapter gave us an opportunity to ask: how are cultural issues handled in psychiatric clinical encounters in India, and how are these taught to young trainee psychiatrists? The chapter also made us curious about anthropological methods and research vis-à-vis psychiatry