Medicine Anthropology Theory
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Pathways, intersections, and hotspots: Multisited fieldwork and the South African HIV/AIDS policy process
No full textSince the late apartheid era, the South African HIV/AIDS movement has mobilized infected and affected communities and cultivated alliances to establish and expand a national HIV/AIDS response that is based on human rights. In doing so, HIV/AIDS activists have actively engaged with political dynamics across the institutional domains of the state. Participant observation research with South African HIV/AIDS activists and analyses of the South African HIV/AIDS policy process therefore necessitate following the movement of research participants across many sites. Bringing together existing approaches to multisited research, the concepts of pathways, intersections, and hot spots are utilized to represent the social and spatial experiences of HIV/AIDS activists, state health administrators, and other policy actors within a unified conceptual framework
Boom and bust: Thinking through health care resource allocation in an oil economy
Get PDFIn this think piece I argue that there is an interactive relationship between physical and symbolic landscapes, and that the interplay of the two forms a ‘therapeutic landscape’. This reformulation of Gesler’s (1992) concept of the therapeutic landscape helps to make visible the relationship between utilitarian systems of natural resource extraction and notions of deservingness for care. I show how in Alberta, Canada, there was a shift in the therapeutic landscape following the late 2014 crash in the global price of oil. Alberta is an ‘oil economy’ with an economic system that is strongly dependent on its oil and gas extractive industry; its public health care system is supported in part by royalties paid by private oil companies. When the global price of oil dropped, both health policy researchers and parents of children with rare and severe genetic diseases worried that costly treatments might be valued differently in this new terrain and that patients might be deemed undeserving of such expense. The therapeutic landscape concept applied in this way becomes a tool for understanding the linkages between economies of care and the political economy of place
Lost in translation? On collaboration between anthropology and epidemiology
Get PDFThis rather unorthodox essay is a dialogue between an anthropologist and an epidemiologist, both of whom were involved with a large-scale collaborative ethnographic project exploring medical field studies, or ‘trial communities’, in western Kenya. Reflecting on their involvement with this project, the authors consider the pragmatics of what ‘collaboration’ represents in different disciplines and how it is enacted. The dialogue, which included a follow-up interview after the research was completed, highlights the expectations and tensions in such collaborative projects and offers the epidemiologist an opportunity to highlight the ideas, methods, and possibilities that he perceived as being ‘lost in translation’ between sociocultural anthropology and experimental medicine. We raise critical issues regarding the disjuncture between epidemiological and anthropological practices in research design, methods, epistemology, and collaboration, with the hopes of provoking more discussions regarding best practices in collaborative research projects. 
The language of suffering: A commentary on Veena Das\u27s \u27How the Body Speaks\u27
Get PDFThe recently published book \u27Affliction\u27 by Veena Das explores the meaning of normalcy, illness, suffering, and loss in the lives of the marginalized urban poor living in and around India’s capital city of Delhi. The language that evolves in such communities to describe the afflictions of the body forms from an amalgamation of terms derived from medical, spiritual, and faith-based systems, resulting in a unique vocabulary that needs to be understood by the clinical service provider. This think piece is a psychiatrist’s interpretation of an anthropological exploration of the understanding of various illness experiences. The commentary focuses primarily on the introductory chapter of the book, entitled ‘How the Body Speaks’, and discusses the various themes and theorizations offered by Das regarding communication about illness. The book and the chapter complement and broaden the biomedical understanding of what constitutes sickness and cure for the vulnerable and the disadvantaged
Introducing Veena Das and her interlocutors on \u27Affliction: Health, Disease, Poverty\u27
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The program is perfect: Narcotics Anonymous and the managing of the American addict
Get PDFThis article examines Narcotics Anonymous (NA) membership in two ways: how blame for failure is displaced from the ‘perfect’ organizational program and onto the individual addict working to remain sober and how this displacement is accompanied by notions of individual responsibility and work. These discourses illustrate the influence of a neoliberal outlook on the life course among ‘clean’ NA members, particularly as the social safety net in the United States has been systematically reduced and replaced by a system that focuses attention on personal responsibility. I show how NA’s ideological approach blinds group members and the larger public to the complexity of addiction, turning addicts who struggle with recovery into failures, through internalized ideological trajectories that root responsibility in the self while discounting context
