1. ANTH/HSERV 475 Perspectives in Medical Anthropology University of WashingtonAlejandro Cerón Office: Denny Hall 417 Office hours: Wed 11 am -13 pm maceron@uw.edu Week 2: Wed, 10/6/2010 Introduction to Medical Anthropology

2. Outline Today’s Goals:  Explain what is Med Anth  Identify key terms from readings  Apply illness/disease dichotomy  Map history of theories in medical anthropology 1. Assignment due next week 2. Summary of today’s readings 3. Key terms 4. History of theories in medical anthropology

3. Web project assignment Some examples here, here, and here.here Question:  I ask again:  If you do not have a Google account, would you be willing to open one?

4. Representations of health… AsclepiusSumak Kawsay / Pachamama

5. Today’s Readings (1) Chapter 1 Introducing Medical Anthropology Chapter 2 The origins and theories of Medical Anthropology Book cover

6. Today’s Readings (2) John M. Janzen, the author University of Kansas Research Experience Lower Congo, 1964-6, 1969, 1982 (health and patterns of health-care seeking); Eastern & Southern Africa, 1982-3 (Ngoma healing and interpretations of misfortune); Great Lakes region, 1994-5 (post-war trauma relief and healing); West Africa & Sahel (Senegal & Sudan), 2000, 2001, 2004 (Sufi healing). John M. Janzen at Izirangabo refugee camp

7. Today’s Readings (3) Chapter 1. Introducing Medical Anthropology The social fabric of health Medical Anthropology 3 examples (kuru, birthing, Asian medicines) Research basis of Medical Anthropology

8. Today’s Readings (4) “Medical anthropology is the study of health, illness, and healing across the range of human societies and over the course of human experience, with an emphasis on how members of the community direct their behaviors, articulate their ideas, and organize their resources in these realms. includes the study of the patterns of disease within an environment and the ways in which diseases relate dynamically to living organisms – especially human organisms. includes the ways in which the human community understands and responds to these challenges to its existence. may also include the community’s access to the resources that maintain or restore health, or the exclusion from such resources by the community’s power structure. studies the meaning of the signs of illness and suffering as part of the overall study of cultural traditions, and strives to interpret them in the light of wider traditions of ritual and religion” (p. 2)

9. Another definition Medical Anthropology studies  Social and cultural context where health, disease and healing (h-d-h) happen.  Multiple expressions of h-d-h (biological, political, behavioral, cultural, etc).  Ways in which people organize to take care of h-d-h, especially in places with evident inequality.

10. Let’s compare both What do you find useful of each? What are their weaknesses? Social and cultural context where health, disease and healing (h-d- h) happen. Multiple expressions of h-d-h (biological, political, behavioral, cultural, etc). Ways in which people organize to take care of h-d-h, especially in places with evident inequality. “Medical anthropology is the study of health, illness, and healing across the range of human societies and over the course of human experience, with an emphasis on how members of the community direct their behaviors, articulate their ideas, and organize their resources in these realms. patterns of disease understands and responds community’s access meaning of the signs of illness and suffering (p. 2)

11. Some examples WHO  Changing world  Inequalities  Unhealthy trends CDC  Insurance, use and access to health care services  Inequalities Public Health – Seattle, King County  Chronic problems and risk factors  Injuries  Disparities (geographical, race-ethnicity, income,

14. Diabetes Mortality, King County Source: Death Certificate Data: Washington State Department of Health, Center for Health Statistics.

16. The anthropological view adds… “Medical anthropology is the study of health, illness, and healing across the range of human societies and over the course of human experience, with an emphasis on how members of the community direct their behaviors, articulate their ideas, and organize their resources in these realms. patterns of disease understands and responds community’s access meaning of the signs of illness and suffering (p. 2)

17. Today’s Readings (5) Chapter 2. The origins and theories of medical anthropology Emerged as specialty in 1960s  Understand “exotic” health care practices  Improve health care in “Third World” countries  “Crisis of medicine”  Technological developments

18. Today’s Readings (6) Heterogeneity of Medical Anthropology Sociocultural Biocultural Applied “Development” “Clinical” Comparative study of health systems Culture in biocultural Cultural construction of medicine Critical

19. Some contemporary Medical Anthropologists Artur Kleinman NY Times Harvard Mark Nichter U Arizona Nancy Scheper- Hughes CNN video CNN video CNN video CNN video UC Berkeley UC Berkeley

20. Illness/disease dichotomy (1) A way to distinguish sufferer’s perception of the experience from objectively discovered entity. Illness: the sufferer’s perception of the individual experience of suffering; may occur with or without disease being identified; culturally embedded, subjective definition given to suffering by the patient, and to behavior in which it is expressed. Disease: a condition that is objectively identified with a medical label or diagnostic name, based on externally established signs; may be identified with or without there being a subjective perception of illness by the individual; objective condition or pathology as determined by a medical professional. (all definitions from Janzen 2002)

21. Illness/disease dichotomy (2) Sickness: the individual or group subjective experience of suffering Suffering: the subjective, usually more chronic, condition of affliction or painful existence; broader than sickness, the existential experience of life of hardship and difficulty, may be permanent human condition, often accounted for in religion and wisdom literature. (all definitions from Janzen 2002)

22. Exercise Groups of 5 Watch videos and think about the definitions of illness and disease. What ambiguities or assumptions do the definitions have in terms of subjective/objective knowledge? ADHD Diagnosis ADD doesn’t exist My son has ADHD

23. Some implications… Illness Disease 1 3 4 5 6 2 Sickness 7 1 2 3 4 5 6 7

24. Implications OntologicalEpistemologicalNormative Disease Illness Disease

25. Mal de ojo (evil eye) Dominican Republic (link) Spanishlink Limpia con huevo Mexico (link) Spanishlink Iridology (link)link

26. Briggs, Charles with Clara Mantini-Briggs (2003). Stories in the time of cholera: racial profiling during a medical nightmare. Berkeley: University of California Press.  Introduction  Key concepts  How they did the research  Chapters  Ethnographic description  Theoretical discussions  Main argument (s)  Key concepts Next week’s readings

27. Timeline Individually Include main events, periods, theories Include key words that define them