Medicine Anthropology Theory
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Heaviness, intensity, and intimacy: Dutch elder care in the context of retrenchment of the welfare state
Full text linkIn the Netherlands the recent shift to a ‘participation society’ has led to a reconfiguration of health care arrangements for long-term care. The new long-term care act, scheduled to commence January 2015, forms the political realization of the participation society: people are expected to decrease their dependency on state provisions and instead become self-sufficient or dependent on family and community solidarity. In this Think Piece we argue that the implicit references of policy makers to pre-welfare state community solidarity and self-sufficiency do not adequately consider the historical and social embeddedness of care. Referring to Rose’s concept of ‘politics of conduct’ we argue that in framing care as a moral obligation, the current politics of conduct may obscure the physical and psychological heaviness of intimate care between family members, the diversity of care relations, and their sociohistorical embeddedness
‘Making known’ or ‘counting our children’? Constructing and caring for children in epidemic South Africa
Full text linkThe article explores how regimes of documentation, quantification, evidence, and accountability have come to shape encounters between program implementers, researchers, young people, and caregivers in one locality in northeastern KwaZulu-Natal, South Africa. Rather than simply critiquing the overemphasis on counting and accounting in global health, I examine the effects of these processes on the provision of services to young people and families. For those whose lives had been systematically excluded from view, processes of form filling could in fact be construed as services in themselves. Further, encounters structured around form filling could work to facilitate other modes of engagement, centered on the construction of forms of recognition, reciprocity, and obligation, and mediated by complex networks of patronage and dependence. Drawing on these findings, the article describes how local histories and contemporary life experiences can shape the ways in which technologies of global health are taken up, and their effects on everyday life
Critical medical anthropology as a roadmap: Understanding access to abortion in the Catalan health system
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Medical stratification in Vietnam
Full text linkMarket transition in Vietnam is known to have fueled health disparities, but racialized and nationality-linked aspects of the country’s medical stratification have received less attention, despite the growing presence of foreigners using the health system. Field experiences reveal the country’s increasing health and medical inequity – legible in the social, linguistic, economic, and physical distinctions between public health stations staffed by government employees and the private clinics serving mostly expatriates. Ethnographic interviews and experiences of receiving care in both public and private facilities inform my argument that the privatization of Vietnam’s health sector produces racialized, classed, and citizenship-linked forms of medical profit, privilege, segregation, and risk – trends visible both in recent debates over US health policy and recent episodes of pandemic disease outbreak
An embodied belonging: Amenorrhea and anorexic subjectivities
Full text linkUntil the publication of the DSM-V in 2013, amenorrhea was one of the four criteria that comprised anorexia nervosa. Diagnostically, amenorrhea played a definitional role, dividing the ‘strictly’ anorexic from their ‘subthreshold’, menstruating peers; however, the implications that menstrual cessation, and menstruation itself, held for the lived realities and identities of women with anorexia remain under-explored. In this article, I examine the positioning of menstruation and amenorrhea in the narratives of Israeli women diagnosed with eating disorders during the eras of the DSM-IV and DSM-IV-TR. I find that the participants’ narrative uses of amenorrhea mirrored, and at times explicitly engaged with, the official diagnosis of anorexia nervosa. Notably, although the participants invoked amenorrhea as a defining sign of illness, they did not cast menstruation as a sign of health rather, they spoke of their menstrual periods as contradicting their anorexic-identified selves. Amenorrhea, then, emerged as central in the embodied making of anorexic subjectivities
Changing cartographies of health in a globalizing world
Full text linkAnthropologists have described, often in eloquent detail, local destruction of opportunities to lead a healthy life (the social determinants of health) attendant on the macroscale economic processes conveniently described as ‘globalization’. Recent reorganizations of production and finance redraw maps both literal and metaphorical of the inequalities that affect health. I argue that it is essential to focus attention on the common origins of such local destructions in new modalities and power structures of global capitalism, and in doing so to focus on what William Robinson has described as a shift from ‘territorial’ to ‘social cartographies’. These include a number of cross-border ‘emerging markets’ or bidding wars that are relevant to health and its social determinants. The article sets out three propositions about how the social science of health disparities should respond to globalization, emphasizing possibilities for research on globalization and health that draw on the complementary perspectives of anthropology and political economy
