Anthro in the news 4/20/15

• On human understanding

Tanya Luhrmann published an op-ed in The New York Times exploring how people around the world can use multiple angles that might include both Western scientific ways of thinking and “belief”-based thinking. She cites the work of psychologist Cristine H. Legare and colleagues “…who recently demonstrated that people use both natural and supernatural explanations in this interdependent way across many cultures. They tell a story, as recounted by Tracy Kidder’s book on the anthropologist and physician Paul Farmer, about a woman who had taken her tuberculosis medication and been cured — and who then told Dr. Farmer that she was going to get back at the person who had used sorcery to make her ill. ‘But if you believe that,’ he cried, ‘why did you take your medicines?’ In response to the great doctor she replied, in essence, ‘Honey, are you incapable of complexity?’”

• Not a “medical moon shot”

An article in The New York Times reviewed Partners in Health’s aspirations and challenges in addressing Ebola in West Africa:

“Partners in Health, a Boston-based charity dedicated to improving health care for people in poor countries, signed on to the Ebola fight last fall with high ambitions. Unlike Doctors Without Borders and other relief agencies that specialize in acute response to crises, Partners in Health pledged to support the deeply inadequate health systems in Sierra Leone and Liberia for the long haul. Its leaders also publicly criticized the low level of care provided to Ebola patients and promised that its treatment units would do better. “’Let’s have a medical moon shot,’ the group’s co-founder, Dr. Paul Farmer, said last October.  But the medical group, which had never responded to an Ebola outbreak before and had rarely worked in emergencies, encountered serious challenges.” [Blogger’s note: Nonetheless, without a doubt, PIH did save lives. Whether or not they will be able to effect long-term preventive changes awaits to be seen.]

• Take that anthro degree and…

…become a community life director and chef. Liana Hernandez is the community life director and executive chef at the YWCA in Tucson, Arizona. Having studied anthropology at the University of Arizona, she gained from it an understanding of the imbalance that exists between marginalized communities of color and the dominant ones in the U.S. This insight, coupled with a strong sense of social service, drives her work at the YWCA where she says she is “setting the table for change,” an image that she takes seriously.

Anthro in the news 10/20/14

• Anthro advice: Don’t panic over Ebola

An article in the Springfield News/Sun (Ohio) on the Ebola epidemic advised against panic in the U.S.  It quoted Simanti Dasgupta, an anthropology professor at the University of Dayton in Ohio. According to Dasgupta, this disease can further the “othering” of Africa as a “wholly dark” place rather than a continent that encompasses deserts, jungles as well as ports and big cities.

Anthro in the news 4/14/14

• Health equity, smart aid, and “stupid deaths”

KPBS radio (San Diego) interviewed medical anthropologist and health activist Paul Farmer about how to improve health care around the world.

Farmer talked about how to ensure equal access to health care through smart aid and the need to avoid what he calls “stupid deaths.” He comments on the “equity approach” in responding to a question about the aftermath of the Rwanda genocide.

He also addresses tough questions about HIV/AIDs and how to help the poorest people.

• Jim Kim: On leadership and cholera

The Washington Post carried a brief interview (embedded below) with Jim Yong Kim, president of the World Bank and a medical anthropologist and physician.

Kim discusses leadership and the need to develop a thick skin, in some areas, and openness in others.

During the April 12 meetings of the World Bank, Kim called for a renewed sense of urgency and more coordination from the international community to help Haiti eliminate cholera, which has killed thousands of Haitians since its outbreak in October 2010.

http://www.washingtonpost.com/posttv/c/embed/b4e9c246-c0ee-11e3-9ee7-02c1e10a03f0

Assisted reproductive technologies: reviewing recent perspectives and addressing research gaps in medical anthropology

Guest post by Jessica Grebeldinger

ICSI is a common form of IVF in which sperm is injected directly into the egg. Photo courtesy of Wikimedia.

In 1978, Brigitte Jordan published her foundational cross-cultural ethnography Birth in Four Cultures, declaring that childbirth “is everywhere socially marked and shaped” (Jordan 1993[1978]:3). This publication signaled the birth of reproduction as a focused field of anthropological inquiry. That same year, the world’s first “test tube baby” conceived through in vitro fertilization (IVF) was born, ushering in the age of assisted reproductive technologies (ARTs). Over thirty years later, both biomedical reproductive technologies and anthropological attention to technological approaches to reproduction have increased substantially. Anthropologists are engaged in studying the intersections of technologies and reproduction because they are deeply connected, indeed, central, to many other aspects of human life, including gender, kinship and notions of the family, individual identity, religion, social inequality, globalization, and health care policy. Concerning ARTs, Rapp has stated that “there can be no more hallowed or classic ground on which anthropological interpretation reverentially and critically occurs” (2006:421).

Birth in Four Cultures by Brigitte Jordan

ARTs developed and spread rapidly, if not evenly, throughout the globe after the birth of the first baby conceived through IVF. An estimated 5 million babies have been born using ARTs since 1978, with an average 27% of treatment cycles resulting in the birth of a baby, the majority of these resulting from traditional IVF or intracytoplasmic sperm injection (ICSI), in which fertilization is achieved by injecting a single sperm into the egg (ESHRE 2012). Assisted reproductive technologies created new opportunities to study biomedicine’s involvement in conception, and, indeed, medical anthropologists have answered Ginsburg and Rapp’s (1995) call to situate reproduction at the center of social analysis. The importance of ARTs to this effort is evidenced by the number of edited volumes produced in the last 15 years that are devoted either completely or in part to the study of these technologies (Birenbaum-Carmeli and Inhorn 2009; Browner and Sargent 2011; Culley et al. 2009; Dumit and Davis-Floyd 1998; Davis-Floyd and Sargent 1997; Franklin and Ragoné 1998; Inhorn 2007a; Inhorn and van Balen 2002; Inhorn et al. 2009; Morgan and Michaels 1999).

The review that follows presents a survey of some of the most recent anthropological literature on reproductive technologies, focusing on those published in the last 5 years (2007 and forward). The review demonstrates the breadth of this field of research, which has produced important insights on such topics as infertility experiences, the commodification of reproductive bodies, the phenomenon of international reproductive travel, new kinship configurations, among others. However, the review reveals that this research area has also suffered from a narrowed field of focus resulting from certain gaps in the literature along racial, socioeconomic, geographic, and gender lines. These imbalances problematize our ability to document the varied uses and impacts of reproductive technologies at global and local levels. I discuss this problem after the review section and underscore some recent studies that point the way toward a more inclusive and complete field of reproduction-focused medical anthropology.

Society for Medical Anthropology launches newsletter

Welcome to the new quarterly electronic newsletter from the Society for Medical Anthropology: Second Opinion: News and Ideas. The first issue features details on a joint international conference with a thematic focus on “encounters and engagements”  in Tarragona, Spain, recent awards and achievements of SMA members, and a new anthropology and medical health interest group.

Critical medical anthropology gone mild?

by Barbara Miller

Merrill Singer’s 1989 article “The Coming of Age of Critical Medical Anthropology” is a landmark contribution in shaping the direction of critical medical anthropology. In its conclusion, he lists seven tasks that I paraphrase as:

1. Contributing to the political economy of health.
2. Analyzing micro-macro relations.
3. Studying power relations at global and local levels.
4. Clarifying the meaning of “critical medical anthropology.”
5. Studying biomedicine and how it links the capitalist and working classes.
6. Examining the specific relationships between biomedicine and capitalism.
7. Conducting fieldwork on socialist health systems.
8. Contributing to the creation of a new medical system that is counter-hegemonic.

Every year, I assign this article, along with other early writings in critical medical anthropology, for the first week of my graduate medical anthropology seminar. It never fails to generate good class discussion.

In recent years, Singer has become a veritable publishing machine, turning out articles, chapters, and co-authored or co-edited books at an amazing rate. He is now an Associate Editor of the journal Medical Anthropology. As testimony to his many professional and academic achievements, Singer has received major awards including the Rudolph Virchow Prize, the George Foster Memorial Award for Practicing Anthropology, the AIDS and Anthropology Paper Prize, and the Prize for Distinguished Achievement in the Critical Study of North America. After working for many years with the Hispanic Health Council in Hartford, he is now professor of anthropology at the University of Connecticut and affiliated with Yale University’s Center for Interdisciplinary Research on AIDS.

Without doubt, Merrill Singer is a pillar of medical anthropology.

So I was delighted to see an essay by him in Medical Anthropology entitled “Pathogens Gone Wild? Medical Anthropology and the ‘Swine Flu’ Pandemic.” (By the way, Singer invented and mainstreamed the term “pandemic”). In the early part of the article, true to form, Singer talks about the “macropolitics” and “micropolitics” of epidemics and anxiety-producing “emerging diseases.” He points to the causal role of anthropogenic global environmental changes in emerging diseases and how such changes differentially affect the poor. He makes a pitch for medical anthropology as being of particular value in understanding modern epidemics because of its attention to biosocial and biopolitical processes and its grounded study of the social factors of disease. All vintage Singer.

Turning to H1N1 specifically, he provides a list of tasks for medical anthropology:

1. Field monitoring of the pandemic as a biosocial phenomenon.
2. Assessment of the biosocial origins and ongoing social influences of the pandemic.
3. Involvement that is research-based and culturally-informed in public health efforts.

Under point #1, he includes important topics such as mapping the “geography of blame” and critical analysis of social stigma and of media overreaction. Under point #2, he urges anthropologists to probe possible connections between the H1N1 outbreak and industrial farm animal production (IFAP) including improper disposal of animal waste. Here he makes a pitch for syndemics in examining human-animal linkages as routes of transmission. His discussion of point #3 receives only one paragraph in which he says that anthropologists can contribute to health care programs in several ways including:  formative research for program design and involvement in program implementation, management, and evaluation, and in public education programs. This paragraph reads as if it came from an applied anthropology cookbook–nothing Singerish here.

The three points, however, stand as valid even if the last is weakly developed. But the article is not up to the standard set in his 1989 article. First, at the global level, the role of the pharmaceutical industry and the likely huge profits being reaped from the sale of the vaccine must be brought in to the picture of H1N1 to make it more complete. Second, the vaccine links to another missing topic: medical anthropologists should do local-level research to about people’s refusal to get the vaccine, including health care providers. This topic will provide insights into people’s fear of the unknown side-effects of the vaccine and their resistance to the bioestablishment which promotes the vaccine as a moral imperative.

Compared to the Merrill Singer who wrote the 1989 article, the Merrill Singer of 2009 has gone mild. In his recent essay, he is right to finger capitalist agriculture but errant in ignoring pharmaceutical capitalism. Furthermore, the new Merrill Singer seems to have abandoned his 1989 vision of anthropology contributing to a “counter-hegemonic” health system.

My heartfelt congratulations to Merrill Singer for all his accomplishments. At the same time, I miss the Merrill of twenty years ago.

Photo, “Influenza Virus H1N1 HA Protein”, on Flickr via Creative Commons.