AHS 547B (UNIT 3)

CULTURAL DISEASE AND ILLNESS

TOPIC: MEDICAL
ANTHROPOLOGY IN
INTERNATIONAL
DEVELOPMENT

SUBMIT TO:
Ms. RITA KUMARI

SUMBITTED BY:
SAKSHI GARG
M.sc 4thSemester (Group B)
Department of Anthropology
Panjab University
MEDICAL ANTHROPLOGY
Medical anthropology is the application of anthropological theories and methods
to questions of health, illness, medicine, and healing.

The Society for Medical Anthropology uses a more lengthy definition:

Medical Anthropology is a subfield of anthropology that draws upon social,

cultural, biological, and linguistic anthropology to better understand those
factors which influence health and well-being (broadly defined), the
experience and distribution of illness, the prevention and treatment of
sickness, healing processes, the social relations of therapy management,
and the cultural importance and utilization of pluralistic medical systems.
The discipline of medical anthropology draws upon many different
theoretical approaches. It is as attentive to popular health culture as bio
scientific epidemiology, and the social construction of knowledge and
politics of science as scientific discovery and hypothesis testing. Medical
anthropologists examine how the health of individuals, larger social
formations, and the environment are affected by interrelationships
between humans and other species; cultural norms and social institutions;
micro and macro politics; and forces of globalization as each of these
affects local worlds. (Society for Medical Anthropology 2015)

This definition can be daunting to someone coming to anthropology for the first
time, but its essential point is as stated: Medical anthropology is the
anthropological study of health and healing. Medical anthropology takes the tools
of anthropology and applies them to human illness, suffering, disease, and well-
being.

Medical anthropology studies human health problems and healing systems in

their broad social and cultural contexts. Medical anthropologists engage in both
basic research on issues of health and healing systems and applied research
aimed at improving therapeutic care in clinical settings or improving public health
programs in community settings. Drawing from biological, social, and clinical
services, medical anthropologists engage in academic and applied research,
contributing to the understanding and improvement of human health and health
services worldwide. The field also has other areas of research, such as the cultural
analysis of biomedicine and the understanding of the globalization of biomedical
technologies.

History of the Field

Medical anthropology emerged as a formal area of study in the mid-20th century.
Its roots are in cultural anthropology, and it extends that subfield’s focus on social
and cultural worlds to topics relating specifically to health, illness, and wellness.
Like cultural anthropologists, medical anthropologists typically use ethnography –
or ethnographic methods – to conduct research and gather data. Ethnography is a
qualitative research method that involves full immersion in the community being
studied. The ethnographer (i.e., the anthropologist) lives, works, and observes
daily life in this distinctive cultural space, which is called the field site.

Medical anthropology grew increasingly important after World War II, when
anthropologists began to formalize the process of applying ethnographic methods
and theories to questions of health around the world. This was a time of
widespread international development and humanitarian efforts aimed at
bringing modern technologies and resources to countries in the global South.
Anthropologists proved particularly useful for health-based initiatives, using their
unique skills of cultural analysis to help develop programs tailored to local
practices and belief systems. Specific campaigns focused on sanitation, infectious
disease control, and nutrition.

INTERNATIONAL DEVELOPMENT OF THE FIELD

Contemporary approaches in medical anthropology study relationships between

cultural and social structures, people's beliefs about cause, course, cure and
prevention, and their health behavior. `Culture' extends to issues of power,
control, resistance and defiance as well, and anthropology seeks to understand
the links between social stratification (gender, ethnicity, and social class), access
to material and immaterial goods (food, water, health services, and education),
illness representations, cultural constructions of femininity and masculinity,
attitudes to health promotion, and health behavior. These elements form a
specific cultural system in which tasks, responsibilities and proper conduct have
become self-evident (Lock and Scheper-Hughes, 1990; Morsy, 1990; Singer, 1990).
Describing the relations between these elements is called a `thick description'
(Geertz, 1973). Thick descriptions are based on meticulous fieldwork which may
include participant observation, open-ended, unstructured or semi-structured
interviews and many other techniques.

In the United States, Canada, Mexico and Brazil, collaboration between

anthropology and medicine was initially concerned with implementing
community health programs among ethnic and cultural minorities and with the
qualitative and ethnographic evaluation of health institutions (hospitals and
mental hospitals) and primary care services. Regarding the community health
programs, the intention was to resolve the problems of establishing these
services for a complex mosaic of ethnic groups. The ethnographic evaluation
involved analyzing the interclass conflicts within the institutions which had an
undesirable effect on their administrative reorganization and their institutional
objectives, particularly those conflicts among the doctors, nurses, auxiliary staff
and administrative staff. The ethnographic reports show that interclass crises
directly affected therapeutic criteria and care of the ill. They also contributed new
methodological criteria for evaluating the new institutions resulting from the
reforms as well as experimental care techniques such as therapeutic
communities.
The ethnographic evidence supported the criticisms of the institutional
custodialism and contributed decisively to policies of deinstitutionalizing
psychiatric and social care in general and led to in some countries such as Italy, a
rethink of the guidelines on education and promoting health.
The empirical answers to these questions led to the anthropologists being
involved in many areas. These include: developing international and community
health programs in developing countries; evaluating the influence of social and
cultural variables in the epidemiology of certain forms of
psychiatric pathology (transcultural psychiatry); studying cultural resistance to
innovation in therapeutic and care practices; analyzing healing practices toward
immigrants; and studying traditional healers, folk healers and empirical midwives
who may be reinvented as health workers (the so-called barefoot doctors).
Also, since the 1960s, biomedicine in developed countries has been faced by a
series of problems which stipulate inspection of predisposing social or cultural
factors, which have been reduced to variables in quantitative protocols and
subordinated to causal biological or genetic interpretations. Among these the
following are of particular note:
a) The transition between a dominant systems designed for acute infectious
pathology to a system designed for chronic degenerative pathology without any
specific etiological therapy.
b) The emergence of the need to develop long term treatment mechanisms and
strategies, as opposed to incisive therapeutic treatments.
c) The influence of concepts such as quality of life in relation to classic biomedical
therapeutic criteria.
Added to these are the problems associated with implementing community
health mechanisms. These problems are perceived initially as tools for fighting
against unequal access to health services. However, once a comprehensive
service is available to the public, new problems emerge from ethnic, cultural or
religious differences, or from differences between age groups, genders or social
classes.
If implementing community care mechanisms gives rise to one set of problems,
then a whole new set of problems also arises when these same mechanisms are
dismantled and the responsibilities which they once assumed are placed back on
the shoulders of individual members of society.
In all these fields, local and qualitative ethnographic research is indispensable for
understanding the way patients and their social networks incorporate knowledge
on health and illness when their experience is nuanced by complex cultural
influences. These influences result from the nature of social relations in advanced
societies and from the influence of social communication media, especially
audiovisual media and advertising.

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