1,721,228 research outputs found
Fighting Violence Against Women
No full textLenore Manderson looks at the extensive impact of violence on all areas of women's lives. She argues that the main challenge is to change the culture of masculinity that underpins male-female relationships in such a way as to facilitate or excuse gender-based violence. Development (2001) 44, 6–8. doi:10.1057/palgrave.development.1110253
Disability, Global Legislation and Human Rights
No full textLenore Manderson looks at the rights and conditions that determine the well-being of the estimated 600 million people with disabilities worldwide. She examines the need for a convention to protect their rights, not only in the North but especially in the South where people with disabilities are particularly disadvantaged in terms of access to health, education and employment and have little or no protection of their rights. Development (2004) 47, 29–35. doi:10.1057/palgrave.development.1100027
Appendix 1 and 2 -Supplemental material for Cultural expressions of depression and the development of the Indonesian Depression Checklist
No full textSupplemental material, Appendix 1 and 2 for Cultural expressions of depression and the development of the Indonesian Depression Checklist by Herlina Siwi Widiana, Katrina Simpson and Lenore Manderson in Transcultural Psychiatry</p
How COVID-19 Reveals Structures of Vulnerability
No full textAs coronavirus infection spread across Europe and north America to much poorer parts of the world, calls for personal protection – hand washing, physical distancing, and masks – highlighted the structural challenges of implementation. Australians took to panic buying, physically fighting over toilet rolls in supermarkets, precipitating a national shortage. As Susan Levine noted dryly, elsewhere many people don’t have toilets. At the same time as the toilet paper rush, the South African Institute of Plumbers ran a 90-minute webinar for hundreds of plumbers and laborers on infrastructure and infectious disease control, with Lenore Manderson taking questions on the risks of what was now essential front-line work in maintaining taps, pipes and toilets. This was virtual applied anthropology.
These personal measures were complemented by public health directives, worldwide, for populations to stay home, or in the US, to “shelter in place.” In these noisy early days, little attention was paid to what this might mean for those who had nowhere to shelter, who were living in temporary, rudimentary or inadequate housing, or were already at risk at home. At any time, overcrowding, poor maintenance, intermittent power, lack of fuel and water, an insanitary environment, and lack of municipal services, compromise health, exacerbating mental health problems and nurturing the transmission of parasitic, viral and bacterial diseases. COVID-19 fed on this. It thrived on the structural vulnerabilities that worldwide shape access to, quality and security of housing.
Structural vulnerability, as defined by Quesada, Hart and Bourgois (2011), derives from economic exploitation and discrimination; we use this term routinely to explain how the disparities of class, culture, gender, sex and race impact on individuals, families and communities. Here, however, we also acknowledge its use in relation to geography and engineering, and so the physical structures that provide shelter. To these structural vulnerabilities, the volatility of governments and the private sector make access to and the security of shelter precarious everywhere
Why the world needs (medical) anthropologists: Lessons from a (more than just a) handbook on medical anthropology
Get PDFReview: The Routledge Handbook of Medical Anthropology. 2016. Edited by Lenore Manderson, Elizabeth Cartwright and Anita Hardon. New York: Routledge. XXIX + 393p. ISBN 9781138015630
Woman teaching women's health: Issues in the establishment of a clinical teaching associate program for the well woman check
No full textThe impact of screening programs for cervical cancer would be increased with the greater participation of currently under-screened women. Training for medical students and doctors in the fine technical and communication skills required in breast and gynaecological examinations would improve participation by increasing the confidence and skill of doctors in raising the issue of screening, thereby making the examination a more positive experience for women. Gynaecology Teaching Associate (GTA) programs, using specially trained standardized patients, have been used in over 90% of American and Canadian medical schools for more than ten years to provide such training. Australia has been slow to adopt this teaching method. A Clinical Teaching Associates in Gynaecology program (CTA) was first established in 1996 by the Department of Obstetrics and Gynaecology at the University of Queensland, building on the Pap test program from Adelaide. Other medical schools subsequently introduced such programs and in 2000, the Department of General Practice, University of Melbourne, established a CTA program based on the Queensland program, with a grant from PapScreen Victoria. This paper describes the methods of recruitment and training of CTAs, use of CTAs in the medical course, preliminary evaluation, and ethical and other issues in the Melbourne and Queensland University programs
“I can’t believe that I have robeng” understanding health-seeking behaviour related to tuberculosis in Cambodia
No full textTuberculosis (TB) is a leading cause of morbidity and mortality worldwide, killing nearly two million adults annually, the majority of whom live in developing countries. Research has shown that multiple factors— individuals, misunderstandings of TB, economic hardship of patients, the fragmentation of health services, gender, and stigma all influence transmission, detection and treatment of TB. After a decade of implementation of the international TB control strategy centred on the Directly Observed Treatment Short-course (DOTS), TB incidence and prevalence in Cambodia remains among the highest in the world, with a considerable number of cases remaining undetected. However, little is known about the factors hindering the success of the TB control programs efforts. This thesis is based on ethnographic research conducted in Kampong Speu province, Cambodia, aiming to describe TB patients’ pathways to the DOTS programs, and factors determining the pathways and treatment adherence. Methods used included in-depth interviews with TB patients, family members, health providers, community health volunteers and Kru Khmer (traditional healers); focus group discussions with community members; a community survey; participation in meetings and workshops aimed at health workers; and observation of daily activities at participating health facilities. The two most important challenges for TB control in rural Cambodia were delayed presentation for TB diagnosis and non-adherence to TB treatment programs. Both contributed to persistent TB infection within the community, and were influenced by the interaction and combination of individual, institutional (related to the health system), and socio-economic factors. TB patients and community members had limited understanding of TB symptoms, causation, and treatment; therefore they did not respond appropriately, and present with early symptoms for timely diagnosis and treatment. Lay explanations of these early symptoms were mostly influenced by folk information shared within community networks. Despite this, community members chose providers of western medicine as their first choice, and only used Kru Khmer when western medicine did not resolve their symptoms. Access to public health service presented significant barriers for obtaining early TB diagnosis, and was critically undermined by the interaction between the five dimensions: accommodation, availability, accessibility, affordability and acceptability. Low government salaries and shortages of health staff, limited supplies, and dual job practices of health staff all significantly impacted on public service delivery. This under-performance increased people’s reliance on the private health sector which, due to the lack of collaboration between the two health sectors, contributed to delayed TB diagnosis and increased health care costs. Ineffective monitoring of the private health providers further exacerbated diagnostic delays. TB patients experienced prolonged pathways, consulted multiple providers, and spent substantial time and money before reaching DOTS. Large differences in delay were influenced by patients’ ability to afford private treatment, TB diagnostics errors, and denial of the possibility of TB. Presentation to DOTS was resultant from social disruption, intervention by significant others and/or self-suspicion about TB. Patients usually enrolled in a directly observed treatment (DOT) promptly after TB diagnosis, however, although this required TB treatment to be taken under DOT by health worker or a community member, all patients self-administered TB medicines without observation. Thus treatment non-adherence was commonly reported, and discontinuation of treatment occurred mainly among vulnerable groups (elderly and poor) for two reasons: feeling better and side-effects. This study raised concerns related to the treatment of re-infection TB cases, as many such people return to treatment but are not correctly registered and treated. Socio-economic factors played an important role in TB treatment-seeking and shaped available family support, ability to pay and stigma associated with TB. Stigma played a considerable role in delaying TB diagnosis, and affected the psychological well-being of patients. It was derived from fears of contagion and the dangers presented by TB, the perceived association between HIV and TB, misunderstanding about TB causation, and attitudes of health staff. Rejection of TB patients was associated with perceptions that TB patients lacked a sense of moral responsibility to protect others from contracting TB; their extremely low social status was also significant. Although TB diagnosis and treatment was within reach of most of the population, obtaining timely diagnosis and compliance with TB treatment remained difficult, particularly for those who were most in need. Although challenges were caused by individual and socio-cultural factors, institutional factors related to the public health facilities created significant barriers for people in accessing the services. Improving TB patient outcomes requires effort and commitment to not only address individual and socio-cultural factors, but to redress shortcomings in health supply and staffing through effective public health system strengthening
Custodians of purity : an ethnography of the Brahma Kumaris
No full textThis thesis is an ethnographic study of the Brahma Kumaris World Spiritual University (Brahma Kumaris). The Brahma Kumaris is a millenarian new religious movement (NRM) established in Northwest India in the 1930s in 2009 and is located in more than 120 countries. I define members (BKs) of the Brahma Kumaris as social ascetics. BKs live a life of rigorous purity, based around their central practice of meditation. The disciplines of these social ascetics are designed to free the mind, through mastery over the body, culminating in self-sovereignty. While some BKs live in ashrams in moderately cloistered communities, most live at home with their families and conduct normal lives according to their environment, culture and circumstances. For this reason, BKs endure and moderate unique tensions as they arbitrate leading a life that is spiritually meaningful while maintaining authentic relationships and fulfilling their worldly responsibilities. Over a period of fifteen months, I conducted fieldwork in New York, USA and Orissa, India in an attempt to understand how BKs actualize their beliefs in traumatic circumstances through a variety of disasters including a flood, cyclone and act of terrorism, as well as personal battles and a case of spirit possession. BK theology rests on the belief that each person is an immutable, conscious and inherently valuable eternal and immortal soul, an infinitesimal point of light that dwells in the forehead of the physical costume of the body. Originally pure and embodying peaceful and joyous states of awareness, all souls have gradually lost their original purity and associated happiness and peace through taking rebirth in the physical world. BKs believe the world we live in today is the result of that spiritual demise. The present time in which humanity is living is the time when the lowest and highest points of human and environmental history converge, and is known as the age of confluence or Sangamyuga. It culminates in liberation, peace and happiness for all souls, and restoration for the world. The research shows that within Brahma Kumaris philosophy, acts of war and environmental demise, political unrest and financial collapse are expected and understood to be the natural order of things, as the impurity of the world comes to its zenith. BKs normalize what the world considers to be ‘disasters’ through their theology. This thesis explores the ways in which BKs respond to environmental disasters and acts of war, as well as threats to physical and spiritual purity. BKs say that it is purity that will restore balance, value and peace. I analyze how BKs’ focus on purity influences the ways in which they manage traumatic circumstances, and the ways that they discuss those circumstances and engage in acts of care. For BKs purity is the seed of peace, happiness and world restoration. Impurity is the cause of the world’s decline and the associated horrors and sorrow. Therefore, for BKs, a threat to or violation of purity is the most significant disaster. Ultimately the thesis argues that BKs live with daily tensions that may make them a potentially valuable and calming, non-proselytizing resource for the broader community during disasters. This can have further implications for the ways in which faith-based communities are utilized and may enable disaster managers to more courageously integrate the spiritual skills of faith-based non-governmental organizations (NGOs) and their members. It also exposes difficulties that spiritual practitioners must manage, in a world in which people may be oblivious to unusual forms of tension
Dancing with power: Aboriginal health, cultural safety and medical education
No full textThis thesis is a study of the relationships between Aboriginal and Torres Strait Islander health scholars and the medical schools within which they work. It is an empirical study, and a story, not only of the inclusion of Indigenous health into medical curricula in Australia, but an analysis of the relationships that underpin the way Aboriginal health in Australia is conceptualised, defined and translated into policy and practice. Theory, literature, field notes, case studies and Indigenous autoethnography are synthesised into a rich analysis of the pedagogy of place, power and power relations, structural violence and whiteness. The notion of ‘inclusion’ is revealed as problematic in Australian health, higher education, state and social institutions, in that these institutions tend to include Aboriginal peoples on terms which appear altruistic, but which actually reify white power and racism. In this way, medicine and medical education is practiced upon and for Aboriginal peoples, rather than with, using paradigms that render Aboriginal individuals as the problem. Medical schools and state institutions have difficulty in understanding Aboriginal paradigms of health care, and in particular, difficulty in implementing and applying these paradigms in action. Medical schools, while sustaining Indigenous health programs, can exhibit differing and covert values and motivations, a reticence to share economic control and governance, and poor adherence to, or understanding of, accountability and quality as it relates to Aboriginal health. The thesis proposes clearer definitions of what constitutes ‘Aboriginal health’ and ‘cultural safety’, a clearer model of applied cultural safety, and an implementation framework for making institutions culturally safe as a pretext for the practice of Aboriginal health using Aboriginal health paradigms
- …
