Care itineraries of cancer patients in the centre of France (Auvergne)
Clémentine Raineau (Maison des Sciences de l'Homme)
Paper short abstract:
We will present care itineraries of cancer patients and the panel of recourses, and local networks, discovering different speeches and ways to integrate them, both in medical institutions and personal care itineraries. To conclude, we will interrogate about actual and specific situation in France.
Paper long abstract:
This paper will propose an analysis of health care behaviours of cancer's patients living in Clermont-Ferrand (350.000 inhabitants), capital of Auvergne, a rural and central region of France. In this city, a national centre of cancer treatment, namely "Centre de Lutte Contre le Cancer" (CLCC), like the other centre in France provides very new biomedical care and treatment and makes research in new protocols. But the cancer patients of this region also use a diverse set of other different cares and treatments accessible around. We propose here an analysis of the health care behaviours from conventional treatments to Asiatic supportive cares. We have done a participative ethnographic survey in the city of Clermont-Ferrand and its surroundings -note1- . Since November 2005, we have been following health care itineraries of cancer's patients consulting clinics (generalists or healers ones): in medical services, in NGOs and in the city. With the help of direct observations and several formal and informal interviews, ill persons' following-up have been done, and meetings and training courses have been observed. Different places have been investigated : hospital services and surgeries, NGOs' offices, information cells on cancer and CAMs (institutional or not), well-being shops and natural stores, bookshops, etc. In those care itineraries, we find a plurality of recourses, at different levels : nutrition and diets, fitness and body technics (relaxation, "eutonie", Qi cong), psychology and spirituality (oncopsychology, hypnosis, cult of saint) and training courses in "natural therapies". Those levels are involved in various degrees : first of all, as prophylaxis in order to escape to the disease, in a second time to support biomedical treatment or as an alternative for a part of biomedical treatment. Those recourses mix local and extra-local technics : asking for a "charmeur de secret" to cure radiotherapy burnings with going to the acupuncturist "to regulate energies". The paper will focus on the specific use of asiatic/oriental references, cares or treatments existing in this city and on their uses by the cancer's patients. How these people are integrating tools, remedies, objects and/or ideas, philosophies and way of life, from Orient or other cultural origin ? And trough the exploration of the networks of these CAM's we will consider how information and knowledge are circulating. These questions will feed the current preoccupations of the very new French National Institute of Cancer (INCA) on the use of CAM's in France -note 2- , on which we will conclude. -note 1 - We actually live in Auvergne, after spending more than 3 years in mountainside making our field for our doctorate thesis of ethnology ("Sickness and unfortunate events in Auvergne : healers, doctors and patients, from mountainside town to hospital", Marc Augé director, EHESS, Paris, 2001). -note2- This research will be integrated to the very new European collective research project supported by INCA on a french regional and international comparison of the use of CAMs by cancer's patients (Normandy, Auvergne and PACA for France, and Belgium and Switzerland) and in association with three french research laboratories (GRIS, University of Rouen, CReSSS, University Paul Cézanne of Aix-Marseille3 and GETI, University of Paris 8), one from Belgium (Facultés universitaires Saint-Louis de Bruxelles) and with the Institut of anthropology and Sociology (IAS), University of Lausanne, Switzerland.
Ethnographies of medical encounters between Europe and Asia