EASA, 2010: EASA2010: Crisis and imagination

Maynooth, 24/08/2010 – 27/08/2010

(W121)

Uncertainties, risk and socio-political change: medical pluralism and diverse agencies

Location Callan SLT
Date and Start Time 26 Aug, 2010 at 11:30

Convenors

Britta Rutert (Free University of Berlin) email
Alessia Villanucci (Comitato Collaborazione Medica) email
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Long Abstract

Power shifts at the political and economic level create uncertainties but also new opportunities that affect therapeutic practices, health-seeking behaviour and governance practices related to the health of populations. In situations of political or economic change, pharmaceutical properties, therapeutic traditions and new medical technologies can gain new significance; they can articulate cultural heritage, neo-liberal market reforms and progress and modernity.

Users of health care resources react to situations of crisis and uncertainty with pragmatic decision-making and eclectic therapy choices in order to cope with the ensuing instability. Choice of therapies and notions of sickness can provide meaningful idioms through which people's new social positions are expressed?

The papers focus on pharmaceutical properties as cultural resources; strategies of integrating traditional medicines into the public health care system; the disclosure and secrecy of knowledge; the emergence of new medical markets; how therapies mediate social and political change; how notions of sickness express risk and fear; and how medical technologies produce new uncertainties. An additional focus is on how states and various stakeholders instrumentalise pharmaceutical properties and therapeutic traditions; how practitioners navigate new competition and opportunities in expanding medical markets; how patients use medical traditions with pragmatic eclecticism; and how new technologies create novel uncertainties. The panel aims to give a broad and at the same time in-depth picture of diverse agencies in pluralistic medicinal settings in times of ongoing political change and inherent crisis.

This workshop is closed to new paper proposals.

Papers

Mekelle as a 'market of therapies': healers dealing with social and political transformations

Author: Alessia Villanucci (Comitato Collaborazione Medica)  email
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Long Abstract

Starting from the anthropological debate on the professionalization of traditional medicine in developing countries, the paper will sketch the plural medical system of Mekelle (Tigray, Ethiopia) as a "market of therapies", characterized by relations of cooperation and competition shaping the therapeutic offer.

Mekelle is an expanding town, involved in a deep economic and social transformation: from a socialist model, Ethiopia is going towards the liberalization of the health system and the opening to the private enterprise.

Questioning the dichotomy between tradition and modernity, the A. proposes to classify local therapeutic resources within three sectors: a governmental (biomedical), a no-profit (biomedical) and a private one (biomedical and traditional). The paper will focus on the strategies by which some traditional healers "move" into the medical system, facing the social and political changes and negotiating the prospect of their integration into the official health care system as part of the emerging private sector.

Bioprospecting in South Africa: new hopes, old troubles

Author: Britta Rutert (Free University of Berlin)  email
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Long Abstract

This paper is based on research done in South Africa from January 2009 to February 2010. Essential question of this research was to analyse how traditional knowledge around medicinal plants is protected by various stakeholders. Medicinal plants were followed from a particular govermental laboratory (Indigenous Knowledge Health Lead Programm) to local communities and individual knowledge holders to gather ways of knowledge protection. In the emerging field of bioprospecting the discrepancies between searching for new chemical compounds for future medicinal properties and the protection of knowledge becomes salient. Within this tension secrecy is a major aspect of knowledge protection on individual, community and institutional level. On the other hand, new hopes for "big bugs" and the new opportunity to claim medicinal plants are created through the advent of traditional knowledge promotion by the state. South Africa`s political past and its economic present does play a vital role in this ambivalent realm.

Social bonds and structural boundaries: pluralism, experience and risk in the birthing process in an eastern Moroccan oasis

Author: Irene Capelli (University of Torino)  email
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Long Abstract

This paper looks at childbirth within the medical pluralistic context of a Moroccan oasis, where the local knowledge of birth is a contested domain. Central in the social reproduction of the community, it is perceived as endangered by the lack of its transmission and by the attempts of eradicating the role of 'traditional birth attendants' ('TBAs'). National policies actually strive for the medicalisation of birth and forbid their training. Some local birth attendants incorporate instead local and biomedical knowledge of birth eclectically. Flexibility, pluralism and pragmatism come significantly into play also in mothers' approaches to childbirth, especially in facing complications during labour and in balancing between the risks of home birth and those of long-distance transfer to hospital. This paper argues, therefore, that birth practices, understandings of risk, the access to prenatal care and maternal mortality are as much socio-cultural as historical products, to be contextualized in the broader political economy of health.

Non-institutional healing practice as a response to ethical crisis in Slovenia

Author: Katerina Ferkov (University of Nova Gorica/Slovenian Academy of Arts and Sciences)  email
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Long Abstract

This research seeks to present how and why certain women in Slovenia use non-institutional complementary healing techniques in order to solve their mental and emotional issues. I was interested in how 'new age spirituality' is used in personal ethical reconstruction of purpose amidst the profound social changes in times of Slovenian transition, that resulted in economic, health care and social crisis, since entering EU (2004). I argue that diversification of healing approaches in the era of neoliberal capitalism, is a creative non-institutional act, that aims to recreate social networks that existed in socialism, with adding the spiritual dimension that was absent before. The main critique of 'new age spirituality' is, that it actually propels neoliberal economy and 'self-management'. I will claim that in post-socialist circumstances 'new age spirituality' can act as a diversification for the postmodern fascism of profit at any stake.

An evaluation of healthcare services' provision in relation to children's perspectives: a reflection of dilemmas in applied medical anthropology

Author: Grace Akello (Gulu University)  email
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Long Abstract

During my ethnographic fieldwork, in wartime northern Uganda, a context where there were various interventions intended to ensure children's wellbeing, I presented to healthcare institutions what the children themselves identified as priorities and needs. In this paper, I will discuss my experience with disseminating children's own needs and priorities. I will examine my experiences with bridging the gap between children's healthcare needs and existing interventions under themes (1) the state-led healthcare services, and (2) the humanitarian agencies' healthcare interventions. The data presented was collected over a one-year period in 2004 to 2005 with children aged 9 to 16 years. Key informants included two psychiatrists, five nurses, two paediatricians, seven NGO coordinators, fifteen counsellors, twenty-eight primary school teachers, five primary school head teachers, four camp leaders, and thirteen drug shop and clinic owners. Parents and legal guardians were interviewed to assess their perspectives about children's healthcare priorities.

Crisis inside medical vision of pregnancy and labour health care attention? Results from an ethnography in Madrid

Author: Maribel Blazquez-Rodriguez (Complutense University of Madrid)  email
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Long Abstract

Until now, health care attention to pregnancy and labor in Madrid has been organised through biomedicine. Biomedical model is based mainly on a risk approach, sanitary protocols and technical procedures. Nowadays, medicalisation is being questioned because of it's effects, we could say that it is in crisis. Health care attention of labor is proposed an physiological vision. Woman´s movement and health associations promote this model like the alternative for an attention that takes in account social and cultural aspects of birth and that includes the participation of women in the process. Spanish Health and consumption Department approved, during my fieldwork, a National Strategy for normal labor attention that tried todemedicalise the process. Nevertheless, we can find some contradictions implied in the continuity of risk approach and biomedical control as it emphasise biological naturalization, standardization of care and supported the hegemonic management of health and illness process.

This workshop is closed to new paper proposals.