On the Relevance of Medical Anthropology - Coursework Example

On the relevance of medical anthropology Medical anthropology pertains to the biological and non-biological factors that lead to diseases, ailments and various conditions of the body and how societies respond to these (Baer et al., 2003). Medical anthropology holds that the body’ is shaped not only by physiological forces but also by culture and by man’s several states (Baer et al., 2003). In medical anthropology, health and wellness are cultural constructions whose meanings can vary across societies and historical epochs (Baer et al., 2003). From a medical anthropological perspective, a disease is not simply a result of a pathogen but the result of “social problems such as malnutrition, economic insecurity, occupational risks, industrial and motor-vehicle pollution, bad housing, and political powerlessness” (Baer et al., 2003, p. 6). The conditions mentioned produce vulnerability to the disease or exacerbate an ailment (Baer et al., 2003, p. 6). It is also possible to show that certain diseases are associated with the social structure and the social terrain. For example, obesity is a medical condition that is expected to be associated with advanced societies rather than with underdeveloped ones. On the other hand, malnutrition can be associated with low income societies or communities as well as with the quality and availability of schools and educational institutions. A branch in anthropology, also known as critical medical anthropology, “attempts to place health and illness within the large context of political economy, history and society” (ANTC61 2012, p. 1). According to ANTC61 (2012, p. 1), a human “illness is not just a biological condition but needs to be understood on the level of the social body and body politic as well as the individual body.” An illness or a medical condition has a social dimension and some illnesses or medical conditions can have strong social dimensions. For example, it may mean that society is not organizationally strong to manage the disease or ailment or that certain values, lifestyles, habits, and similar factors produce the vulnerability or can exacerbate the seriousness of the disease or ailment. Another perspective, known as activist medical anthropology, goes out further and argues that “addressing global inequities” has become a domain of medical anthropology (Butt, 2002, p. 1). In particular, activist medical anthropology covers “the effect of global economic trends and neo-liberal policies on the destitute and the disadvantage, particularly with regard to people’s health and health care programs (Butt, 2002, p. 1). Of course, one militant anthropological perspective is that by Scheper-Hughes (1995) who tended to emphasized on the ethical aspects. The application of the Butt (2002) perspective on medical anthropology can involve emphasizing on the ethical aspects of medical anthropology. To a certain extent, the matter is also covered in Butt (2002). However, Butt (2002) focused on the international morality aspects of inequities in health and health services. Another medical anthropological perspective is that by Csordias and Kleinman (1996). From the perspective of Csordias and Kleinman, a medical condition may have a cross-cultural dimension. For example, a condition may be considered as an illness in one culture but may be “taken for granted” in another (Csordias and Kleinman, 1996, p. 13). Let us elaborate on the perspectives discussed in medical anthropology. 1. Medical anthropology pertains to how populations respond to an illness, disease, or physiological condition Different populations respond differently to an illness, disease, or physiological conditions. The form of response may be a function of culture, history, political economy, values, and traditions of society. Some psychological conditions, for example, can be taken for granted by one society but it is called as neurosis by other societies. In addition, some societies may have developed a particular approach to an ailment and may have elevated that approach to an ailment to the status of “science”. Some Chinese, for example, refer to acupuncture as Chinese traditional medicine and some even call it as eastern medicine or eastern medical science, calling conventional medical science as western medicine or western medical science. The same is also true for the Chinese Qigong. Qigong became popular during the time of Communist Leader Deng Xiaoping during the 1980s and was even jokingly referred to as the “fifth modernisation” (Hsu, 1999, p. 21). Hsu described the medical practice as “Daoism.” Later, it became known as meditative practice with “life maintaining and therapeutic effects” (Hsu, 1999, p. 21). “Telepathy, clairvoyance, psychokinesis and other phenomena” are believed to result from the practice of Qigong (Hsu, 1999, p. 21). There are Buddhist, wushu and unarmed combat art elements in the Qigong (Hsu, 1992, p. 21). Yet, despite the presence of elements which may be considered to be bereft of science, the practice of Qigong has been very long. The earliest records on Qigong has been as far back as 475 -221 B. C. (Hsu, 1992, p. 22). To become a Qigong healer, one must “cultivate one’s Inner qi and practice soft qigong (Hsu, 1999, p. 33). There are two qigongs: the soft and the hard qigongs (Hsu, 1999, p. 33). It is possible that there are certain elements in Qigong that are therapeutic and this can be studied by conventional medical science. Perhaps it is possible to identify elements in Qigong that are sound and which can really assist the patient. Conventional medical science need not dismiss all of the practice of Qigong as superstition. The soft qigong rely on meditation while the hard qigong relies on strong movements like “hitting sacks filled with gravel, tree trunks, and stone walls with one’s bear hands, and beating oneself with a sack of gravel” (Hsu, 1999, p. 33). Accounts on Qigong are surprising to many. Lights or glow are supposedly manipulated throughout the body through meditation. A warm sensation is supposedly felt as the glow circulates through the body and those meditating under Qigong can be rewarded with a feeling of relaxation. It is easy, of course, to dismiss the sensation as a product of self-hypnosis. However, the fact that it has provided relaxation to many and offer relief from stress to many suggest that if a patient is able to derive relief from stress from the Qigong experience, then it may be possible to tap the practice of Qigong into western medicine. If patients are able to derive relaxation from Qigong then why not use it for depression and certain types of psychological or psychiatric conditions? Of course, Moerman (2000) tells us that there can be placebo effects and the placebo effect can vary in various cultures. At the same time, not all medical anthropology is immediately useful for medical science. Some illnesses or conditions experienced by a population are not immediately explainable by “scientific” medical science and local explanations for the disease can involve the supernatural or superstitions and this presents a challenge. The superstitions can even be perceived by a population as “real.” In the first place, as Waldram (2008) has shown, the notion of an ailment or healing can vary from culture to culture. In the case of aboriginals in Canada, for example, healing is viewed as ultimately about “reparation of damaged and disordered relationships” (Waldram, 2008, p. 6). 2. A medical condition has a social dimension and some medical situations have stronger social rather than biological roots while other illnesses or medical conditions have stronger biological rather than social roots Illnesses or medical conditions have social dimensions. What is normal versus what is an ailment or a medical condition is always viewed from a social lens. Some societies have supernatural explanations for an ailment. The supernatural explanations are taken by the society as real while other societies can view the explanation for the ailment as “superstition.” One example of an illness or a medical situation which was earlier thought to be the result of a supernatural or demonic possession is the Sudden Unexpected Nocturnal Death Syndrome or SUNDS. Adler (1994, p. 23) reported that “scores of seemingly healthy Hmong immigrants have died mysteriously and without warning” from the ailment. Earlier, it was believed that “medical research has provided no adequate explanation” for the sudden death (Addler, 1994, p. 23). In July 1997, for example, more than 100 deaths were attributed to SUNDS and scientists and western biomedicine were not able to explain the SUNDS. Laotians in the United States who reported the SUNDS associate the ailment to an evil spirit taking possession of the human body. The impression of a possession is “confirmed by a visual perception of a being, which places itself on the sleeper’s chest and exerts a pressure great enough to interfere with respiration” (Adler, 1994, p. 24). The experience is blamed on a spirit or demonic figure “to which nocturnal assaults are attributed” and the experience of the possession takes place under the “impression of wakefulness, immobility, realistic perception of the environment and intense fear” (Adler, 1994, p. 24). Those who managed to be resuscitated from the SUNDS or who managed to survive the experience narrate an experience of paralysis: they wanted to talk but cannot and they had wanted to call out but also cannot and experienced a sensation of dying. Adler (1994, p. 34) explained that the victims of the SUNDS probably died in REM sleep in which the body is asleep but the mind is not and there is a feeling of wakefulness accompanied by hallucination. In other words, the “sleep paralysis is accompanied by hypnagogic hallucinations, which consist of complex visual, auditory, and somatosensory perceptions occurring in the period of falling asleep and resembling dreams” (Adler, 1994, p. 34). Adler (1994) showed that the SUNDS were actually correlated with refugee arrivals in the United States (p. 51). Adler (1994) suggested that cases of the SUNDS were actually have been related to stress and, thus, the SUNDS does have a sociological or anthropological cause although biological factors like heredity may be at work. Another medical anthropological perspective that highlights a social or anthropological dimension of an illness is that by Good (1990, p. 5) who has viewed illnesses as a “syndrome of experience.” According to Good (1990, p. 5), “illness realities are constructed, authorized, and contested in personal lives and social institutions.” How ailments are addressed flow from the beliefs on the causation of an illness (Good, 1990). Thus, while western medicine may focus on the physiological causes of the ailment, some societies may focus on the supernatural. Others like traditional Chinese medicine may see the ailment in terms of an imbalance between the yin and the yang and attempt to cure the illness or ailment in terms of balancing the yin and the yang. Another culture may rely on sorcery or on “the efficacy of certain magical practices” for an illness (Strauss, 1977, p. 446). 3. Medical anthropology lead society and the medical profession to address inequity with regard to health and health services Health and equity issues interface. One example of a medical anthropological perspective that relates inequity and health is that by Foley (2010). For example, in Senegal, economic reforms are affected by social structures and in turn influence health decisions (Foley, 2008). Gender factors and choice can affect how illness is experienced (Foley, 2008). Foley (2008) asserted that men and women are coping with illnesses within a spectrum of power profile determined by social stratification and social relationships. In reference to the African continent, Foley (2008, p. 257) said, “Neoliberal economic policies, along with accompanying social sector reforms, have dramatically affected susceptibility to disease and health-seeking strategies throughout the continent.” According to Foley (2008, p. 257), although the neoliberal policies were designed to reform economies, they often lead to economic collapse and spark migration thereby creating urban pressures, unemployment and poverty. Thus, for Foley (2008) vulnerability to illnesses cannot be separated from sociological or anthropological factors and diseases can be biologically linked as well as linked with people’s interaction with people. Thus, illnesses have anthropological dimensions. This is reflected, for example, in the case reported by Moniruzzaman (2012) in Bangladesh. According to Moniruzzaman (2012), the phenomenon of human organs sale in Bangladesh can lead to people in the relatively rich upper classes to become healthier but it can result to deteriorating health among the poor. The creation of the technology for organ transplant may not lead to better health for humanity but it can lead to better health for only a section of humanity at the price of deteriorating health for another section as more of their organs are harvested and sold. 4. Medical anthropology alerts us to investigate the sociological or anthropological contexts of a medical case It is important to look into the sociological or anthropological background of a disease or ailment. For example, Koch (2006) reported that tuberculosis in the Georgian prisons is widespread because tuberculosis patients enjoy privileges that are not available to many prisoners thereby promoting the transfer of sputum from person to person so the recipient is able to fail the tuberculosis test, become part of the tuberculosis program, and enjoy the privileges available to patients such as sunshine. This indicates that how society structures its benefits or resources can influence the spread of a disease. The sociological or anthropological context of a medical case is also reflected in the report of Lock (1995). The report of Lock (1995) refer to the case of the advancement of health technologies in Japan that made it possible to prolong the life of a patient who are “brain dead.” Thus, while it is possible to prolong life through modern medical technologies, society may disagree on whether the life that is “brain dead” should continue to receive medical support or whether it has to be allowed to die via “natural means.” In summary, medical anthropology is relevant for several reasons. First, it allows us to see how society responds to the disease or how the disease is a response to a social condition. This way we are able to address a disease or ailment better. Second, it allows us to see the anthropological dimensions or a disease for better health response. Third, it allows us to see which population is most vulnerable based on equity issues involved. And finally or fourth, it allows us to see the social context which makes the disease widespread. References Adler, S. (1994). Ethnomedical pathogenesis and Hmong immigrants’ sudden nocturnal deaths. Culture, Medicine and Psychiatry, 18, 23-59. ANTC61. (2012). Medical anthropology – Essay topic suggestion. University of Toronto at Scarborough. Baer, H., Singer, M. and Susser, I. (2003). Medical anthropology and the world system. 2nd ed. Connecticut: Praeger Publishers. Butt, L. (2002). The suffering stranger: Medical anthropology and international morality. Medical Anthropology, 21 (1), 1-24. Csordas, T. and Kleinman, A. (1996). Theoretical perspectives. In: Johnson, T. and Sargent, C. (Eds.), Medical anthropology: Contemporary theory and method. New York: Praeger. Foley, E. (2010). Neoliberal reform and health dilemmas: Social hierarchy and therapeutic decision making in Senegal. Medical Anthropology Quarterly, 22 (3), 257-273. Good, B. (1990). Medicine, rationality and experience: An anthropological perspective. Lewis Henry Morgan Lectures 1990. New York: Cambridge University Press. Hsu, E. (1999). The transmission of Chinese medicine. New York: Cambridge University Press. Hughes, N. (1995). The primacy of the ethical: Propositions for militant anthropology. Current Anthropology, 36 (3), 409-440. Lock, M. (1995). Contesting the natural in Japan: Moral dilemmas and technologies of dying. Culture, Medicine and Psychiatry, 19, 1-38. Moerman, D. (2000). Cultural variation in placebo effect: Ulcers, anxiety, and blood pressure. Medical Anthropology Quarterly, 4 (1), 51-72. Moniruzzaman, M. (2012). “Living Cadavers” in Bangladesh. Medical Anthropology Quarterly, 26 (1), 69-91. Strauss, C. (1977). The sorcerer and his magic. In D. Landy (Ed.), Culture, disease and healing. New York: Macmillan Publishing Co., Inc. Waldram, J. (2008). Aboriginal healing in Canada: Studies in Therapeutic Meaning and Practice. Ottawa: Dollco Printing. Read More