Differences between Critical and Conventional Medical Anthropology - Assignment Example

Anthropology :Illness and healing How critical medical anthropology is different from conventional medical anthropology What differentiates criticalmedical anthropology from conventional medical anthropology? What does critical medical anthropology teach us about the political economy of health and/or the three bodies? Medical anthropology is the study of human health and disease, health care systems, and biocultural adaptation (McElroy, 2002, p 1). The health of regional populations of diverse ethnicity and cultures and of different periods are analysed and compared in medical anthropology. Health is the result of environmental adaptation and inequilibrium in adaptation produces illness. Critical medical anthropology is also known as the political economical medical anthropology (Baer, Singer and Susser, 2002). The conventional medical anthropology explained health-related beliefs and behaviours in terms of factors of ecological conditions or cultural configurations or psychology (Singer, 2004, p 24). From the critical medical anthropological (CMA) point of view, these traditional explanations were insufficient. The ‘vertical links’ (of Mullings, 1987) that connected the social group being studied to the larger regional, national and global human society and to social relationships determining behaviours, beliefs, attitudes and emotions needed to be addressed (Singer, 2004, p 24). Conventionally, health is understood as absence from disease. Health in CMA is defined as the ‘access to and control over the basic material and nonmaterial resources that sustain and promote life at a high level of satisfaction’ (Singer, 2004, p 26). CMA sees health as the possession of complete physical, mental and social well being by the standards of WHO (1978). Barriers like social inequality, class, gender, race, discrimination, structural violence, social trauma, relative depravation and working in a toxic environment have been understood to set them up (Singer, 2004, p 26). Disease in conventional medical anthropology is considered to be the sufferer’s experience of the clinical manifestations of illness. CMA believes that disease is beyond the scope of the anthropologist. It is a social issue as much as it is biological. Organic, climatic and geographic conditions as well as productive activities, resources and reproduction change the features of the illness in significant ways from one nation to another (Singer, 2004, p 26). CMA believes that illness is not just due to a pathogen. The tendency to downplay factors of nutrition, environment, occupation, residence and experiential conditions must be eliminated. Malnutrition, economic insufficiency, risks of jobs, pollution, poor housing and absence of political leanings or clout make one susceptible to illness (Baer, Singer and Johnsen, 1986). CMA in short considers microparasitism (the pathogens, malfunctions and behaviours) as important as macroparasitism (social exploitations). Conventional medical anthropology sees an illness superficially while CMA notices the social and other aspects of why an illness occurred and even how it could have been prevented. The concept of syndemics was introduced by CMA in the 1990s. It is the ‘big picture’ approach to illness which include factors like biology, epidemiology, understanding the illness in the sufferer’s eyes and the community view, and the social, political and economic conditions contributing to it (Singer, 1996). The conventional medical anthropology tends to isolate, study and treat illnesses. The CMA on the other hand tries to understand the social and biological aspects as they stand within the inequalities of society. Syndemic is a term now used by the Center for Disease Control and Prevention and implies two or more epidemics which interact within the human bodies and contribute excessively to disease or the consequences of health from two coinciding illnesses (Singer, 2004, p 27). HIV can co-exist with Mycobacterium tuberculosis worsening the pathology and accelerating the progression of illness. Living in shelters, prisons, domestic violence, political violence, racial discrimination and living in poverty are some of the social conditions emphasized as pathology (Farmer, 1999). The immune system of these patients would be in a compromised state. Some researchers have assessed the social factors being of greater importance than the pathogens themselves. The challenge is greater but tackling the disease with this broad perspective could produce better results. Sufferer experience is also different in CMA. This is how an ill person has his illness or distress manifested. The concept of ‘mindful body’ was coined by Nancy Scheper-Hughes and Lock to describe sufferer experience (1987). 3 bodies are described; the individual body, the social body and the body politic. The individual’s body could be in a state of health or disease as understood by the cultural system. The body also serves as a social person with natural, supernatural, socio-cultural and spatial relationships. Both these are part of a power relationship in a society or the world. Sufferer experience is thereby a social product. The body politic refers to the influence of social and political control over healthcare. Scheper-Hughes has recounted the moving experience of mothers and children in Bom Jesus in Brazil when the local sugar plantations failed and multinational companies moved in presumably to help. Medicalisation is a problem seen as a constant attempt to extend new pathological terminology to cover new conditions. No experience is made easy for patients. Simple matters like that of childbirth are being magnified and turned into pathological events. This has prompted many women to seek home deliveries. It is the profit that would ensue on discovering new illnesses that is driving medicalisation. Individual level problems are increased depending on medical control (Waitzkin, 1983). Another problem in CMA faced by people is hegemony which is the process by which capitalist ideas and values have usurped medical diagnosis and treatment. Politicians and the ruling class are directly dominating civil society in areas of medical treatment apart from education, religion and mass media (Singer, 2004, p 29). This problem is also evident in the doctor patient interactions. Globalisation is believed to be behind hegemony. Health care and practices around the world have now assumed a Western influence. Medical pluralism is the co existence of several methods of medicine. In the long run one system attains dominance over all the others (Baer, 1989). All class divided societies have this problem which actually reflects the unequal social relationships. The emphasis of critical medical anthropology on research has been on the political economic factors in health and this has influenced the work of many medical anthropologists believing in the critical view (Singer, 2004, p 30.) References: Baer, H. A.; (1989), “The American dominative medical system as a reflection of social relations in the larger society. Social Science and Medicine, 28, 1103–1112. Baer, H. A.; Singer, M. & Johnsen, J. (eds.); (1986), “Towards a critical medical anthropology [Special issue]. Social Science and Medicine, 23(2). Baer, H., Singer, M., & Susser, I.; (2002), “Medical anthropology and the world system: A critical approach” (2nd ed.). Westport, CT: Bergin & Garvey. Farmer, P.; (1999), “Infections and inequalities: The modern plagues” Berkeley: University of California Press. McElroy, A; (2002), “Medical Anthropology”, in The Encyclopaedia of Cultural Anthropology by D.Levinson and M.Ember, Henry Holt, New York, 1996 Mullings, L.; (1987),”Cities of the United States in urban anthropology.” New York: Columbia University Press. Scheper-Hughes, N., & Lock, M.; (1987), “The mindful body: A prolegomenon to future work in medical anthropology”. Medical Anthropology Quarterly (n.s.), 1, 6–41. Singer, Merrill; (2004), “Critical Medical Anthropology” in the Encyclopaedia of Medical Anthropology by Carol Ember and Melvin Ember, Springer Reference,US Singer, M. ;(1996), “Farewell to adaptationism: Unnatural selection and the politics of biology. Medical Anthropology Quarterly (n.s.),10(4), 496–575. Waitzkin, H.; (1983), “The second sickness: Contradictions of capitalist health care”,. New York: Free Press. World Health Organization (1978). Primary health care. Geneva, Switzerland: World Health Organization. Medical Pluralism Medical Pluralism Critically analyse the notion of ‘medical pluralism’ (see also, Ferzacca 2002, Finkler 1994, Price 2003, in your reader). Drawing on ethnographic examples, outline the potential problems of linking ethnomedical practices with biomedical practices. Do you consider biomedicine an ethnomedical practice? Medical pluralism refers to the all the medical subsystems that co-exist in a cooperative or competitive relationship with one another (Baer, 2004, p 109). The healers and patients form the essential components of a medical system. The healers could vary from the medicine man in indigenous systems, family physicians and specialists in modern medicine, bone-setter, herbalist, and midwife to mediums. At some point in history, there were two group of physicians; one for the royal family and elite and another for the general population (Baer, 2004, p 109). With the historical changes and European colonialism, the evolution of the prestigious biomedicine was seen even influencing traditional forms of medicine. The Third World had their traditional medicines which were influenced by the religious thoughts of Hinduism, Islam, Confucianism, Buddhism and Taoism. The traditional medicines formed the backup of the general population when the biomedicine exhibited shortfalls (Baer, 2004, p 110). It was realised that pluralism was invariably associated with class divides (Frankenberg, 1980, p 198). Race, ethnicity and gender differences in a capitalist society have different medical systems very much in line with their views of reality (Baer, 2004, p 110). Though many people believe that medical pluralism is the trend, other social scientists allow one dominant capital-intensive system and ignore alternative medicine systems. Critical medical anthropology attempts to overcome these discrepancies. One system may dominate but people have a tendency to avail of two systems (Romanucci-Ross, 1977). In the modern world, biomedicine has a first place. It has legal backing which provides a monopoly. This automatically reduces or prohibits other practices. However other forms of medicine have gained importance through legal backing by soliciting the good wishes of their well placed clients (Baer, 2004, p 111). Britain has thus recognized the homeopathic physicians, the United States the osteopathic physicians, India the Ayurvedic and Unani physicians all with full practice rights. Other who have been given partial practice rights are the chiropractors in North America. Women have challenged the hegemony of the politically backed corporate class through resorting to alternative medicine. Leslie’s ethnographic studies on the medical pluralism in India identified 5 groups of healers (1977). They were the biomedical doctors, the group of traditional medicine physicians of the Ayurvedic, Unani and Siddha medicines, homeopathic physicians, religious scholars and priests with healing abilities and local folk healers and midwifes. He found that cosmopolitan medicine dominated the scene but the Ayurveda physicians are also increasingly been sought after. Janzen’s study concentrated in Zaire (1978). He identified a therapy management group consisting of all those close to the patient including the relatives, friends and peers who direct the patient to the different physicians. 4 groups of healers were identified: the biomedical physicians, banganga or indigenous healers, kinship therapy and bangunza or diviners and prophets. The clan meetings were the focus of kinship therapy. Diagnostic sessions would be followed by therapies. The African Christian missionaries were the bangunza. Even though the people recognize the advantages of biomedicine, they still resort to traditional medicine. An ethnographic study set in the Philippines had investigated the plausibility of having an integrated system of medicine whereby the traditional and modern biomedical systems existed together in one system (Islam, 2005 p 1). 6 systems of healing existed here. It was found that biomedical and alternative systems could exist side by side but could never be integrated. The biomedical and traditional healers could never work together. They wished to remain separate. There was however no strain between the two groups as they are socio-economically disparate groups. Three sectors for health were evident here; the popular sector, the folk sector and the professional sector. Economic affordability and the level of education decided the healer (Islam, 2005, p 4). When the traditional medicines failed to heal, the option was to turn to biomedicine. Things could happen vice versa too. Medical professionals believed that traditional healers should not be paid. There was also the complaint of using inappropriate medicines in traditional medicine (Islam, 2005, p 6). It is possible to allow the continued existence of the biomedicine and traditional forms of medicine as separate without ever integrating the two. Traditions may continue to influence maintenance of health but scientific explanations have begun to influence traditional medicine. The latter still determines certain practices of promoting health, securing good harvests, making good marriages and ensuring that the dead make a good trip to the afterlife. These may be permitted without interference as they do not affect the worsening of health. Financial reasons may account for selecting the traditional system of healing. It has been noticed that the traditional healers accept the biomedicine but the biomedicine physicians cannot accept traditional medicine which they claim is unscientific. Even though people have a habit of opting for traditional medicine, their attitude towards biomedicine is favourable. Biomedicine physicians and specialists have the advantage of years of formal training which make them well equipped for treating and doing surgeries. Traditional healers do not have this kind of preparation. Biomedicine is not an ethnomedical practice. Ethnomedicine uses indigenous methods of healing. References: Baer, hans A.; (2004), “Medical Pluralism”, Encyclopaedia of Anthropology, by Carol Ember and Melvin Ember, Springer Reference, US Frankenberg, R. (1980). Medical anthropology and development: A theoretical perspective. Social Science and Medicine, 14B, 197–207. Islam, Md.Nazrul; (2005), “Pluralism, parallel medical practices and the question of tension: the Philippines experience”, Anthropology matters”, Vol 7 (2), 2005 Janzen, J. (1978). The quest for therapy in lower Zaire. Berkeley: University of California Press. Leslie, C. (1977). Medical pluralism and legitimation in the Indian and Chinese medical systems. In D. Landy (Ed.), Culture, disease, and healing: Studies in medical anthropology (pp. 511–517). New York: Macmillan. Romanucci-Ross, L. (1977). The hierarchy of resort in curative practice: The Admirality Islands, Melanesia. In D. Landy (Ed.), Culture, disease, and healing: Studies in medical anthropology (pp. 481–487). New York: Macmillan. Read More