EASA, 2010: EASA2010: Crisis and imagination

Maynooth, 24/08/2010 – 27/08/2010

(W026)

Applied anthropology, crisis and innovation in health and medicine

Location Callan CS2
Date and Start Time 25 Aug, 2010 at 11:30

Convenors

Rachael Gooberman-Hill (University of Bristol) email
Josiane Tantchou (CNRS) email
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Long Abstract

In recent years, anthropologists have become increasingly involved in applied health research, whether as academics, government employed researchers or those in the private sector. Anthropologists working in health have been involved in a vast range of enterprises, including responses to humanitarian crises, debates about novel healthcare technologies or interventions and exploration of 'public' involvement in research and healthcare which might reflect broader crises about power relations in health and illness. This workshop will explore how applied anthropology responds to crisis and innovation in health and medicine, and how anthropologists have reformulated or re-imagined themselves and their work in response to increasing demand for applied research. There is now a solid history of discussion about the application of anthropology to health, and this workshop will aim to update such discussion in light of current work. Questions might also arise about the degree to which applied anthropology is creating and recreating its own crisis by focusing attention on concerns about applied research. Papers in this panel might address the use and defence of ethnographic methods in applied research, and the growing role of interview and multi-method approaches. Papers might also explore the roles of reflexivity and creativity in applied research and the issue of anthropology's identity as one of many disciplines working applied fields. In addition, papers might address ethical concerns that might arise during involvement in applied health or medical research projects. The panel welcomes submissions from those working in any sector that relates to applied health research.

This workshop is closed to new paper proposals.

Papers

A crisis in fieldwork: personal, ethical & methodological reflections

Author: Julie Hastings (Brunel University)  email
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Long Abstract

In 2008, whilst monitoring a schistosomiasis (Bilharzia) control programme in Tanzania as part of my doctoral research I was accused of poisoning children by village residents forcing me to leave my study site in somewhat alarming circumstances. This led to a tangible crisis in my fieldwork. Despite relocating to a new research site I doubted it was possible to be viewed as an impartial observer. I was concerned about those who had assisted me previously and still resided in the village. I questioned my methodology and, in so doing, the validity of my data. The programme was postponed; my research funding was gone.

This paper reflects on methodological and ethical issues arising from my own fieldwork experiences and asks whether impartiality can really be attained, especially for those of us engaged in applied research.

Anthropology and setting up research on the education of families with risk of thromboembolism in a university hospital

Author: Claudie Haxaire (Medical School)  email
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Long Abstract

Medical anthropologists are asked to elaborate research projects that follow up on clinical research when the results point to the need for preventive measures and therapeutic education of patients.

I will present the example of a request submitted to me by the internal medicine and pneumology departments, in liaison with an "asthma school" in Brest. I was first asked to set up a programme of therapeutic education for patients, and then to construct a research project on the prevention of thromboembolic disease in the first-degree relatives of patients with a history of an idiopathic episode, and therefore a genetic risk. This project is conducted with hospital physicians. It faces various challenges. It has to show how anthropology can bring a specific viewpoint to the issue at hand. It faces a methodological challenge, because our project use illnesses narratives and systemic carts. And lastly has a practical challenge, because the legitimacy of the anthropologist's approach is validated only by the results obtained in terms of effectiveness.

Are anthropological data always useful for public health programs? The experience of case review audits for obstetrical care in Burkina Faso

Authors: Marc-Eric Gruénais (Université Bordeaux Segalen)  email
Fatoumata Ouattara (Institut de Recherche pour le Développement)  email
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Long Abstract

In the field of applied medical anthropology, researchers deal more and more with populations viewed as health facilities' clients. This is the background of our involvement in a public health program to improve the quality of medical care (QoC) in case of emergency obstetrical need in Burkina Faso. This program used case review audits as a tool for QoC. Case review audits are an auto-evaluation approach of clinical practices by health personnel. During the audit sessions physicians and nurses analyse a critical case (i.e., still birth, hemorrhage during delivery, etc.) and try to find solutions for preventing these situations. The original feature here was to add to the medical and clinical approach a reporting of the women's personal experiences of their delivery based on interviews at home made by anthropologists. Generally speaking, audits sessions, even if they are strictly confidential and on a voluntary basis, seem to be like a trial for health personnel, always underlining a failing, a mistake or an error. The reporting by anthropologists of women's experiences makes personnel's bad practices more acute., and they were seen to be exclusively on the women's side. They are suspected not taking account of bad work conditions, especially when care seems to be convenient and health personnel not involved in the critical event reviewed. Therefore, anthropologist intervention can be counter-productive and at the opposite of audit sessions objectives which are supposed to achieve collective solutions and to reinforce teams.

Anthropology and the problem of comparison: shaping public health policy in four Mediterranean countries

Author: Peter Phillimore (Newcastle University)  email
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Long Abstract

This paper focuses on an analytical challenge which often faces medical anthropologists working on large multidisciplinary projects: cross-country comparison. While both a necessity and a potential strength in this kind of policy-oriented research, comparison has been largely out of vogue in anthropology for many years, despite recent efforts to rethink its potential and reemphasise its centrality to the discipline (e.g. Fox & Gingrich 2002). This paper explores both the potentialities and pitfalls of cross-country comparison in the context of an EU funded project which aims to identify policy to reduce the ever-growing burden of diabetes and cardiovascular disease in four Mediterranean countries: Turkey, Syria, Palestine and Tunisia. Anthropology, epidemiology and health economics are each crucial to this collaboration: but what becomes of comparison in pursuit of this cross-disciplinary dialogue, and what gets lost in translation?

This workshop is closed to new paper proposals.