Medicine Anthropology Theory
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‘Money spoils the medicine’: Gift exchange and traditional healing in Northern Ghana
Get PDFIn this article, I use classical anthropological and sociological theory on exchange to explain the robustness of the cultural economy of healing in Northern Ghana. While many scholars have argued that health care in Africa should be understood through the lens of neoliberal marketization, ethnographic research among Mamprusi healers shows that practices of traditional healing are firmly embedded in a cultural system of exchange. Although confronted with an expanding monetary economy, the healers adhere to the local credo that ‘money spoils the medicine’. This alludes to an approach to healing characterized by a kind of reciprocity that reflects (post-)Maussian principles of gift exchange. Drawing on these principles, I propose to complement our understanding of exchange with the concept of ‘moral monies’. As peculiar monetary (counter)gifts, these serve as instruments to reconcile contemporary monetary needs with the sociocultural, moral, and historical institutions in which traditional health care is rooted
Treating ‘collective biologies’ through men’s HPV research in Mexico
Get PDFMedical testing assesses individual bodies, yet its effects reach beyond their boundaries. Building on insights from medical anthropology and STS regarding the co-construction of medical technologies and bodies, I investigate how heterosexual Mexican couples used men’s HPV testing to understand and assert membership in collective ‘couple’s biologies’. I analyze interviews undertaken during men’s participation in a longitudinal, observational HPV study. Men underwent annual DNA-based HPV testing, often receiving unexpected diagnoses that led couples to deal with the possibility of HPV transmission and its possible harms. I argue that these couples drew on context-specific ideologies of gender and race in their understandings of and responses to men’s test results. I show how they understood HPV positivity as a condition of the couple’s biology, mediated by what participants viewed as potentially racially innate if problematically backward gender attributes. Couples then used the experience of medical testing to live out self-consciously modern forms of gender, marriage, and self-care, which they hoped would counteract the harms of HPV. I conclude by discussing the importance of considering context-specific collective biologies, rather than just individual bodies, in the use and social scientific study of medical technology
Advocating for evidence in birth: Proving cause, effecting outcomes, and making the case for ‘curers’
Get PDFThe notion of ‘evidence’ circulates in two realms of current maternity care: biomedical ‘evidence-based’ obstetrics and efforts to reform conventional obstetric practices. I observed that in California’s childbearing culture, ‘evidence’ is a boundary object that allows diverse actors to engage in related conversations despite fundamentally different assumptions about what evidence is or does. Sometimes these actors form productive hybrids and other times they talk past one another. This article uses recent work from the history and philosophy of science to distinguish the biomedical use of evidence, which is based on controlled experiments to prove cause and effect, from reformists’ use of evidence, which foregrounds patient outcomes. Using Stengers’s classification of doctors, charlatans, and curers, I discuss the role of rationality and experience in producing authoritative knowledge. Reformists’ use of evidence, in effect, challenges medical power dynamics on what they perceive to be the terms of medical authority itself; in doing so, it has the potential to fundamentally alter who is the primary beneficiary of medical protocols. The challenge is continuing to use evidence in a way that doesn’t simply ossify a new set of norms, but becomes increasingly capacious, flexible, specific, and patient centered
A composite case: Thinking with ‘BME’ categories in UK mental health care
Get PDFIn this think piece, I discuss a composite category – Black and Minority Ethnic (BME) – that has emerged and expanded to incorporate race, ethnicity, and now also immigration status, in a somewhat clumsy meeting of political narratives and sanitised public health-speak. I look at how this category has been interrogated and put to work in a particular UK mental health setting, one that is committed to improving access and inclusion for ethnic and cultural minorities. Using the analytical tool of ‘thinking with’, I explore how the category was used in relation to an absent majority or mainstream, and consider what such a category might show ‘us’ in all its glaring imperfection. I ask: Is it possible to push forward anthropological thinking by paying attention to these composite, unwieldy categories? Might this be one way to embrace the clumsy conspicuousness of our proverbial elephant in the room
Engaging Afghan men at a societal level to increase women’s access to contraception
Get PDFMother and child mortality rates in Afghan internally displaced person (IDP) camps are high. Most women have unplanned pregnancies; many are child brides. Contraception can lower maternal mortality/morbidity from unintended pregnancy and short birth intervals, but in Afghan culture men make health decisions. Using knowledge of Afghan society gleaned from Afghan health workers, we trained respected elders and imams to start men’s groups to share practical, financial, and religious facts about contraception and promote discussion. The aim was to inform and allay misconceptions and fears so informed spousal conversation could occur; the overall objective was to allow women wanting spaced pregnancies or smaller families to gain spousal understanding and approval for use of contraception. Societal responses were monitored for one year among nine hundred families in three IDP camps where weekly men’s groups were conducted. Taking photographs captured unique ethnographic aspects of the intervention especially for those involved in this research who were not in Afghanistan and hence missed being directly engaged with the community. The maternal and infant health challenges and cultural issues addressed are global in nature; this model is globally applicable to other camps and Islamic societies
From field sites to field events: Creating the field with information and communication technologies (ICTs)
Get PDFThe incorporation of various information and communication technologies (ICTs) in ethnographic methods mandates a reconsideration of the understanding and practice of fieldwork. In this article, we explore how the ‘field site’ may be reimagined in today’s highly mobile, ICT-facilitated world. Based on our research among Indian transnational families and young migrant workers from Malaysia, we argue that the field may be conceived as a collection of ‘field events’ that are co-created by ethnographers, their study participants, and ICTs. As ICTs are increasingly intertwined with people’s lives and thereby feature importantly in ethnographic fieldwork, we encourage ethnographers to carefully consider how these devices and platforms actively shape their ethnographic data as well as their relations with study participants
From the human to the planetary: Speculative futures of care
Get PDFThis is largely a theoretical, speculative essay that takes on the question of what ‘care’ looks like at a moment when climate change is increasingly taking center stage in public and political discussions. Starting with two new practices, namely, humanitarian care for nonhumans and One Health collaborations, I seek to determine what forms of political care can incorporate the well-being of future generations and future iterations of the earth. After an exploration of One Health as an approach to planetary care, I ask what its parts enable us to think, despite its limitations; I focus on the new human-nonhuman assemblages connected through different biosocial models, such as neuroscience or immunology, to see how these scientific theories might enable new possibilities. I argue that a focus on biological ecologies at different scales – as opposed to ethicomoral categories like humanity – can open the way to a larger imaginary of human and nonhuman flourishing and a space for nonmoralistic politics
‘MSM’ as a ‘doing thing’: An ethnographic genealogy of sexual alterity and the emergence of global health in Postcolonial Namibia
Get PDFDrawing upon long-term ethnographic research in Namibia, I examine the label ‘MSM’ through a materialist interpretation of affect, viewing ‘MSM’ as a ‘doing thing’ that unsettles the boundaries between subjects and objects. From this analytic perspective, I reconsider the ‘MSM’ label as an inadequate signifier that overlooks, conceals, or erases social complexity. Instead, this perspective reveals what happens when the MSM label travels, thereby better accounting for the socialities it is instrumental in making up. Its very design and appearance – which portray bodies and behaviours in universalistic ways – allow this ‘doing thing’ to gain entry to diverse spaces where it comes to exist alongside some contentious postcolonial political formations, such as those surrounding LGBT rights. I argue that although the label is designed to be insulated from politics, as a ‘neutral’ behavioural category, when ‘MSM’ travels it is still highly relational, continually entangling itself in contexts, stirring up postcolonial anxieties, and reinforcing global inequalities, while also setting the stage for global health worlds coming into being
