Medicine Anthropology Theory
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An emergent affliction in today’s Egypt: Islamic healing, the psy sciences, and what lies in-between
Get PDFThis article examines the emergence and constitution of a new affliction category in contemporary Egypt: wahm, meaning (self-)illusion, locally defined as the condition of being falsely convinced one is possessed by spirits called ‘jinn’, all the while exhibiting real possession symptoms. As I show, wahm transcends the domain of revivalist Islamic healing from where it originates by mobilizing and entangling Islamic and psy concepts and practices. It both exploits the local dichotomy of jinn afflictions/mental disorders and grows from the cracking of this binary. In this manner, wahm provides a new idiom for critiquing current therapeutic practices, for understanding suffering, and for analyzing modern life in today’s Egypt. Through the analysis of wahm, this article contributes to scholarly investigations of ontology and the emergence of diseases by moving the lens from biomedical categories to the terrain where biomedicine meets religious healing, highlighting not only intersections but also the new formations they engender
Global health enabling systems: Accounting and critique in the era of ‘America First’
No full textThis think piece argues for the importance of administrative and bureaucratic labor –‘mundane’ things – in maintaining US-African global health research partnerships and the power relations within them. The daily work of accounting, compliance, and risk management undertaken by global health ‘enabling systems’ created by US universities contrasts with global health’s heroic self-image and conjures up negative imaginaries of intransigent African bureaucracies, crumbling communication infrastructure, and corruption. These negative imaginaries help to authorize forms of US fiscal and administrative control that may contradict global health’s ethic of partnership and its related goal of ‘building capacity’ in low-income partner nations, as well as feed ‘creative accounting’ practices by both partner entities. Critiquing these inequalities may seem risky in an era of ‘America First’ and threatened cuts to global health funding. In fact, advocating for equity in global health partnerships and prioritizing the building of African institutional capacity are only made more urgent by the current political climate
After the livestock revolution: Free-grazing ducks and influenza uncertainties in South China
Get PDFSince the 1970s, virologists have pointed to South China as a hypothetical ‘epicenter’ of influenza pandemics. In particular, several key studies highlighted the farming practice of ‘free-grazing’ ducks (fangyang) as the crucial ecological factor driving the emergence of new flu viruses. Following the emergence of highly pathogenic avian influenza viruses in 1997 and 2004, free-grazing ducks became a primary target of biosecurity interventions from global health agencies and China’s national government. This article compares the global health ‘problematization’ of free-grazing ducks as a pandemic threat with the manner in which duck farmers around Poyang Lake, China, engage with the dangers of disease in their flocks. Showing how both global health experts and duck farmers configure the uncertainty of disease against ideal modes of ordering the relations among species, I conclude by examining how these two problematizations interact in ways that mutually intensify – rather than moderate – uncertainty
But are they actually healthier? Challenging the health/wellness divide through the ethnography of embodied ecological heritage
Get PDFA holistic definition of ‘health’ remains difficult to operationalize, despite decades of attempts by medical anthropologists and the World Health Organization to do so. Anthropologists routinely reject dichotomous notions – belief vs. knowledge, wellness vs. health, mental vs. physical, environment vs. self – yet demands for physiological evidence of ‘health’ persist. In this article, I ask what evidence would sufficiently demonstrate health, and explore the possibility of measures that move beyond the physiological. Using ethnographic data collected in indigenous Maya communities in Belize and in immigrant communities in New York City, I argue that ecological heritage practices can provide a lens through which to locate and collect evidence of health, holistically defined. Developing a framework of ‘embodied ecological heritage’ (EEH), I discuss how communities and individuals communicate and measure health as part of everyday ecological activities, which they describe as ‘traditional’ or ‘heritage’ practices. Theorizing unexpected links and feedback loops, which cross temporal, spatial, and social boundaries, I assert that health is connected to practice through tangible, embodied experience and that ethnography thus provides powerful evidence to understand and define it
Epidemiology, social history, and the beginnings of medical anthropology in the highlands of New Guinea
Get PDFShirley Lindenbaum’s study in the early 1960s of the origins and transmission of kuru among the Fore people of the eastern highlands of New Guinea is one of the earliest examples of an explicitly medical anthropology. Lindenbaum later described her investigations as assembling ‘an epidemiology of social relations’. How might the emergence of medical anthropology, then, be related to the concurrent development of the social history of medicine and global epidemic intelligence? Are these alternative genealogies for medical anthropology
Donor data vacuuming: Audit culture and the use of data in global health partnerships
Get PDFIn this essay, we seek to understand how the stunning rise of data vacuuming, necessitated by the pretense of ‘partnership’ within global health, has fundamentally altered how routine health data in poor countries is collected, analyzed, prioritized, and used to inform management and policy. Writing as a team of authors with experiences on multiple sides of global health partnerships in the United States, Mozambique, Nepal, Lesotho, Kenya, and Cote d’Ivoire, we argue that solidarity-based partnership between donor and recipient countries is impossible when evidence production and management is effectively outsourced to external organizations to meet the criteria of donor partners. Specifically, to meet the 2030 Sustainable Development Goals, equity-oriented strategies are critically needed to create data collection, analysis, and use activities that are mutually beneficial and sustainable
Citizens, dependents, sons of the soil: Defining political subjectivities through encounters with biomedicine during the Ebola epidemic in Sierra Leone
Get PDFThe impact of biomedicine and biomedical technologies on identity and sociality has long been the focus of medical anthropology. In this article we revisit these debates in a discussion of how unprecedented encounters with biomedicine during the West African Ebola outbreak have featured in Sierra Leoneans’ understandings of citizenship and belonging, using the case study of an Ebola vaccine trial taking place in Kambia District (EBOVAC Salone). Analysing our ethnographic material in conversation with a historical analysis of notions of belonging and citizenship, we show how participation in a vaccine trial in a moment of crisis allowed people to tell stories about themselves as political subjects and to situate themselves in a conversation about the nature of citizenship that both pre-dates and post-dates the epidemic