107 research outputs found
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Cross-Cultural “Allies” in Immigrant Community Practice: Roles of foreign-trained former Montagnard health professionals
Full text linkThis pilot case study describes foreign-trained former Montagnard refugee physicians’ practice experiences in Vietnam and their current community health worker and “ally” roles within the Montagnard refugee community. It highlights key features that facilitate cross-culturally responsive health care. We interviewed five Vietnam-trained former Montagnard refugee physicians using an open-ended interview format during March, 2012. We used content analysis procedures to identify key themes characterizing Montagnard physicians’ former and current practice experiences and emphasizing the roles they currently play in their new homeland. Montagnard physicians were fighting infectious diseases in homeland Vietnamese communities. Since coming to the U.S., Montagnard physicians have reoriented their competencies to fit within a community health workers model, and have shifted practice to fighting chronic disease in this refugee community. Tasks now include describing and contextualizing unique characteristics of the Montagnard languages and cultures to outside constituents. They become cross-cultural allies to the U.S. health care and facilitate individuals’ medical adherence with mainstream physicians’ orders. They ensure accuracy of interpretation of Montagnard patients’ medical complaints during a medical visit. Our findings reveal the potential roles that can be ascribed to a cross-cultural ally and can be built into practice to fulfill the Montagnard community’s unmet health needs: oral historian, mediator, facilitator/negotiator, quality assurer, psychosocial confidant, and health advocate
The Place of Healers-Diviners (Ombiasa) in Betsileo Medical Pluralism
Full text linkThis article is concerned with the training and curing practices of Betsileo ombiasa (‘healers-diviners’), and their relationships with biomedical practitioners and Christian healers, in particular Fifohazana exorcists. We first give an account of what we think is characteristic in the process of becoming an ombiasa, highlighting in particular the role of ancestors and other spiritual entities. We then give a brief description of the ombiasa’s healing practices and the kind of remuneration they usually ask for. In the last part of the article we discuss their collaboration and conflicts with other health practitioners, showing how ombiasa are constantly adapting their practice to avoid open confrontations with their competitors, accommodate their patients’ expectations and continue to carve out a niche for themselves within Betsileo medical pluralism
Happiness: Notes on History, Culture and Governance
Full text linkIn this paper, I explore the emergence of happiness and well-being as keystones of contemporary EuroAmerican culture. Drawing on the relationship between disciplinary enterprises and forms of governance, as well as on cross-cultural comparison with fa’asamoa (the Samoan Way), I work to situate the current EuroAmerican obsession with happiness and well-being as a cultural formation – that is, as an artifact of a historically and culturally unique set of patterns and forces – thus problematizing its taken-for-granted status, in academic and policy-making circles, as a self-evident and universal goal with universal characteristics. I pay particular attention to the forms of governance that the contemporary orientation to happiness inaugurates and instantiates
Local Aetiology and Pathways to Care in Malaria among the Ibibio of South-coastal Nigeria
Full text linkThere is a parallel between local and bio-medical perceptions of malaria among the Ibibio people of South-coastal Nigeria, as in many other societies of sub-Saharan Africa where malaria is endemic. Despite the fact that this accounts for resilience of the disease, earlier studies on malaria in Africa focused on causes, prevalence and socio-environmental factors. Local meanings of malaria and their influence on therapeutic choices have been largely ignored. This study examines local perceptions of malaria among the Ibibio and explains how attitudes are generated from indigenous meanings. It also examines how such attitudes inform a local aetiology of malaria. Similarly, our study examines how local meanings of, and attitudes towards malaria, set the pathway of care in malaria management among the Ibibio. Through qualitative and descriptive ethnography, Key Informant Interview (KII), Focus Group Discussion (FGD) and the textual analysis of documents, our study seeks to establish that malaria is caused by parasites–protozoa. 83% of the respondents held that malaria is due to witchcraft, exposure to sunlight and eating of yellowish food items such as yellow maize, paw-paw, orange and red oil. These local perceptions are drawn from local conceptions which in turn encourage malaria patients to seek assistance outside modern health care facilities. This also discourages local communities from attending health education workshops that link malaria with germ theory and care. Treatment of malaria is thus mostly home-based where a wide variety of traditional remedies is practiced. Our study concludes that the lack of convergence between local knowledge-contents and bio-medical explanations account for a high prevalence rate and the lack of effective management. For proper management of malaria, there is a need to understand local knowledge and indigenous concepts in order to establish a convergence between bio-medical explanations and indigenous perceptions. Only then can a community acceptable means of changing bio-medical perceptions of the disease be facilitated
Who Defines Culturally Acceptable Health Access? Universal rights, healthcare politics and the problems of two Mbya-Guarani communities in the Misiones Province, Argentina
Full text linkThis paper seeks to analyze the problems and barriers encountered when public policy health programs are implemented within indigenous communities. The initial stumbling block for such programs is precisely the idea of health as a universal right, around which emerges a characterization and stereotype of the indigenous population who are consequently addressed as a homogenized unit subsisting below the poverty line, and marginalized. A result of this is that the particular ethno-cultural register of such populations fails to be acknowledged and form part of a systematic public health policy. Consequently, health policies become generalized in character, unable to variate and differentiate according to the culturally specific contexts within which health outreach and access is needed. In this sense, based on the results of an ethnographic study carried out in two Mbya-Guaraní indigenous communities of Argentina, our study highlights as to how public policies of indigenous health are perceived, their impact value measured, and the meanings which emerge locally about the policy practices implemented.Lastly, our study identifies problems that can be avoided in fulfilling the goals of universal policies and certain questions to consider at the time of policy design and implementation.This paper seeks to analyze the problems and barriers encountered when public policy health programs are implemented within indigenous communities. The initial stumbling block for such programs is precisely the idea of health as a universal right, around which emerges a characterization and stereotype of the indigenous population who are consequently addressed as a homogenized unit subsisting below the poverty line, and marginalized. A result of this is that the particular ethno-cultural register of such populations fails to be acknowledged and form part of a systematic public health policy. Consequently, health policies become generalized in character, unable to variate and differentiate according to the culturally specific contexts within which health outreach and access is needed. In this sense, based on the results of an ethnographic study carried out in two Mbya-Guaraní indigenous communities of Argentina, our study highlights as to how public policies of indigenous health are perceived, their impact value measured, and the meanings which emerge locally about the policy practices implemented. Lastly, our study identifies problems that can be avoided in fulfilling the goals of universal policies and certain questions to consider at the time of policy design and implementation.
The Neoliberal Circulation of Affects: Happiness, accessibility and the capacitation of disability as wheelchair
Full text linkThe International Symbol of Access (ISA) produces, capacitates, and debilitates disability in particular ways and is grounded by a happy affective economy that is embedded within neoliberal capitalism. This production of disability runs counter to the dismantling of ableism and compulsory able-bodiedness. In charting the development of the modern wheelchair, the rise of disability rights in North America, and the emergence of the ISA as a universally acceptable representation of access for disabled people, I argue that this production of disability serves a capacitating function for particular forms of impairment. These capacitated forms are celebrated through a neoliberal economy of inclusion. I conclude by critically approaching the happy affects of the ISA, including the way in which the symbol creates a sense of cruel optimism for disabled people
Against Flourishing: Wellbeing as biopolitics, and the psychoanalytic alternative
Full text linkThis article critically analyzes what is at stake in the recenttranslation of the term ‘happiness’ into the inter-related terms ‘well-being’and ‘flourishing’ within Happiness Studies. Focussing on the work of MartinSeligman, the article argues that the category of ‘flourishing’ in particularhighlights Happiness Studies and positive psychology as a new, neoliberalinterpretation of utilitarianism. This is supported with reference to MichelFoucault’s late lectures at the Collège de France on the connections betweenneoliberalism and the direct political administration of life that he termed‘biopolitics’, a concept which explains the interweaving of health andhappiness in today’s dominant therapeutic cultures. Finally, the articleattempts to outline a radical alternative to the biopolitical notion of‘flourishing’ by appealing to psychoanalysis, specifically Lacanianpsychoanalysis - its critique of consumer happiness, but also its clinicalcommitment to working transformatively with unhappiness
Staying Positive: Women\u27s illness narratives and the stigmatized vernacular
Full text linkThis article uses the stigmatized vernacular (Goldstein & Shuman, 2012) as a conceptual framework for examining the public construction and reception of women’s illness narratives. I begin by making the case that personal illness narratives – a genre that works to translate the subjective illness experience to a public audience – are rich sites for exploring how discourses of veneration and repudiation can become inextricably intertwined. Discussing illustrative examples of the construction and reception of women’s illness narratives shared in contexts of breast cancer and fibromyalgia, I show how popular understandings of emotions, particularly positive emotions like happiness, play a major role in the regimes of value shaping how women’s illness experiences become tellable or untellable, and thereby valued or devalued. Integrating scholarship on illness narratives, stigma, and happiness, I aim to contribute to a richer and more multifaceted view of the illness narrative genre and the discursive contagion of stigma
Research/Advocacy/Community: Reflections on Asian American trauma, heteropatriarchal betrayal, and trans/gender-variant health disparities research
Full text linkThis article first examines the author’s positionality with reference to the historical and inter-generational transmission of Asian trauma, the contemporary plight of North Koreans, and the betrayal of anatomically-female individuals (including those who are sexual minority/gender-variant) within Asian heteropatriarchal systems. An analysis of the relevance of empirical research on low-income trans/gender-variant people of color is then discussed, along with an examination of HIV and health disparities in relation to the socio-economic positioning of low-income trans/gender-variant people of color and sexual minority women, and how social contexts often gives rise to gender identity, including transmasculine identities. What next follows is an appeal to feminist and queer/trans studies to truly integrate those located on the lowest socio-economic echelons. The final section interrogates concepts of health, well-being, and happiness and how an incorporation of the most highly disenfranchised/marginalized communities and populations challenges us to consider more expansive visions of social transformation
As If You Have a Choice: Autism mothers and the remaking of the human
Full text linkThis paper utilizes feminist phenomenology to explore how contemporary representations of autism, and autism mothers, are integrally caught up in western (and now globalizing) understandings of health, happiness and the “normative” human. I examine the historical emergence of “autism mothers” as a new category of identity, and track this alongside a global autism mother recruitment campaign to get at what’s “behind” this phenomenon. I argue that emerging autism mother figures like the feminine warrior are new and contradictory neoliberal subjectivities that contain a most “hateful” unethical and increasingly global duty: the reinscription and intensification of the “normal” human as bourgeois, nondisabled, white and western, and the “new” femininity as “naturally” nurturing and necessarily instrumental. Even more, these new subjectivities are governmental, operating as western colonialist translations of happiness, compelling compulsory participation in increasingly limited, violent, and globalizing frames of normative humanity for us all