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Medical anthropology

Broadly defined as the study of health, illness and healing through time and across cultural settings


What do medical anthropologists focus on?

- Illness as a social phenomenon, just as much as personal, individual
- How patients and healers are connected to social systems, which may inform diagnoses, treatment decisions, experiences of patients
- The meaning of people’s experiences of illness and what illness signifies and represents in a given context
- Examining both medicine and medical systems as cultural practices


What do medical anthropologists study?

- The body and embodiment
- Different healing systems and healers (e.g. Western medicine and traditional healers such as shamans)
- Biosciences and biotechnologies (e.g. IVF, organ transplantations, ultrasounds)
- Patterning and spread of disease (e.g. epidemiology)
Political economic impacts on health



Applications of natural sciences such as biology to clinical practices



A study or comparison of the traditional medicine practiced by various ethnic groups, and especially by indigenous peoples



A biomedical condition characterized by a harmful biological irregularity in an organism



A culturally defined state (or role) of general physical and/or mental discomfort and poor health



The process by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment.


Medical pluralism

Defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM) for health and illness.


Medical hegemony

Belief that there's only one way of seeing health + disease


Importance of context

- Illness is necessarily cultural – how we define and respond to illness
Kleinman and the two interpretations of symptoms (1988):
The meaning of the symptom itself
The cultural significance of the symptom
E.g. Cancer in North America, Neurasthenia in China
- All health practices must be understood within the local context in which they occur (whether ‘traditional’ or ‘biomedical’)


Individuals' explanatory model

Individuals’ own cognitive models related to their own illness
E.g. “water on the lungs”


Doctor model

1. Etiology: Study of the causes of a disease/illness
2. Onset of symptoms
3. Pathophysiology: the disordered physiological processes associated with disease or injury.
4. Course of illness (type of sick role – acute, chronic, impaired) and severity of disorders
5. Treatment


Three main theoretical approaches in medical anthropology

- Biocultural
- Cultural constructivist or interpretive
- Critical medical anthropology (CMA)
*In practice, many approaches bridge 1 or 2 or 3 theoretical perspectives. E.g. Holmes (2015)
*Research is often theoretical or applied or some combination of both



Relationship between biology, health, and environment


Cultural constructivist or interpretive

Cultural interpretations or meanings of illness


Critical medical anthropology

Political economic impacts on health, arguing that social inequality and power differentials are primary determinants of health and health care


Biocultural example

- Barrett’s (2005) research on the stigma of leprosy or Hansen’s disease in Banaras, India
- Stigma of disease is so powerful that it remains with a person even after cure
- Stigma combines with biology of disease to make disease worse


Interpretive example

Adelson’s (2000) work on miyupimaatissiun or “being alive well” amongst the James Bay Cree of Northern Quebec, Canada
For the Cree, health is inseparable from being Cree and being Cree is inseparable from the land, from eating Cree food, from being protected from the cold


CMA example

- Farmer’s work (2004) on primary care, poverty, and human rights in Haiti
- Structural violence
- “Violence that results from the way that political and economic forces structure risk for various forms of suffering within a population” (Schultz, Lavenda, and Dods 2015, 120)
- Predisposes certain people to suffer (story of Acephie, pg. 121-122)
- Perpetuates inequalities and prevents certain people from accessing health


Healing systems

- All healing systems deal with questions of:
1) bafflement (why me?)
2) action (what can be done?)
- Sectors of health care:


Taxonomy of healing systems

- theory of etiology (disease causation or explanatory models)
- system of diagnosis
- techniques of appropriate therapy


Theories of disease causation

- Naturalistic (e.g. TCM, Ayurvedic)
- Personalistic (e.g. Tumbuku healing)



- Single level of causality
- Natural environment
- Cures focus on individual body



- Disease due to an agent (human or nonhuman)
- Sick person intended victim
- Cure deals with underlying causes and social rifts (social body)


Tumbuku healing (Malawi)

- Illness caused by Gods, spirits and witches. In this sense, illness caused by witchcraft is always intimate – by someone related to you or someone you know. Not impersonal or ‘objective’
- Mizimu (ancestors) can send illness by withdrawing their protection
- Nyanga (bad medicines, considered living things) are responsible not only for diseases but also financial disasters, love problems, poor harvests, things biomedicine would not count as its areas of specialty
- Yet, even now, we acknowledge that social problems (poverty, stress, heartbreak) do cause us to feel ill. We look for the physical manifestation in the body, whereas Tumbuku do not need to see it to know something is wrong


Tumbuku healing (nchimi)

- Witches living in parallel world to nchimi but world of evil
- Body is seen as permeable (if sweat comes out, then things go in), connected to environment and social relations
- Both patient and healer will dance until very hot, trying to release excess heat caused by bad spirits entering your body



Repetitive social practice set off from everyday routine and composed of a sequence of symbolic activities that adhere to a culturally defined ritual schema and are closely connected to a specific set of ideas significant to the culture


Rite of passage

A special type of ritual that serves to transition a person from one type of social identity to another
E.g. graduation, marriage, baptism, funerals


3 stages of rite of passage

- Separation: leaving behind symbols and practices of previous position (e.g. hair, activities)
- Transition or Limen (threshold): the in between phase where you're really nothing
- Re-aggregation: reintroduced into society in new position