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- Convenors:
-
Natashe Lemos Dekker
(Leiden University)
Hansjörg Dilger (Freie Universität Berlin)
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- Formats:
- Panels Network affiliated
- Sessions:
- Wednesday 22 July, -, -
Time zone: Europe/Lisbon
Short Abstract:
This panel asks how anthropologists have analyzed the profound transformations that health, medicine, and healing have been undergoing since the 1990s; how this has prepared them for understanding emerging medical realities; and what directions future research in medical anthropology might take.
Long Abstract:
Since the early 1990s, the domains of health, medicine, and healing - on all societal levels - have undergone significant shifts in all parts of the world. Not only have these various domains been affected by the increased mobility of people, pathogens, and health-related, practices, and technologies, which have conditioned new socialities and entanglements across national and regional borders. There have also been significant structural reconfigurations in health systems worldwide, which have been induced by new diagnostic, therapeutic, and prognostic developments, and the often massive impact of neoliberal reform processes and globalizing funding arrangements. However, while health care systems - and the patients, providers, and resources within them - have been exposed to these transformations across the globe in often strikingly similar ways, there have been continued - and often widening - gaps concerning access and quality of health care between and within healthcare systems in the Global North and Global South.
This panel asks how anthropologists have approached transformations in health(care) and medicine with regard to the theoretical, methodological, and epistemological ramifications of their research topics, and how this has prepared them for understanding emerging medical realities and healthcare arrangements with regard to the years to come. It also aims to highlight how medical anthropologists have responded to the complex ethical and political challenges that these "shifting grounds" have implied, and how this has led to new types of collaborative research and public engagement. Finally, it explores the affordances of the current moment for future research in medical anthropology.
Accepted papers:
Session 1 Wednesday 22 July, 2020, -Roberta Raffaetà (Ca' Foscari Venice University)
Paper short abstract:
To understand and anticipate biomedical futures, I will illustrate how researchers create knowledge about the microbiome, aspiring to blend the 'molecular vision' of traditional molecular biology with an ecosystemic view and how and why anthropologists can intervene in this process
Paper long abstract:
When I first started to study medical anthropology in the late '90s, biomedicine and its professionals were the main actors shaping and reproducing processes of medicalization and biopower. Through the years, those same professionals shifted from being actors of those processes to recipients together with their patients, especially with regard to technology and policy innovations. That's why I decided to shift the focus of my ethnographic gaze from the biomedical encounter to the places where those innovations originate. In particular, I analysed how researchers give shape to new frontiers in biomedicine and how this matters to people's lives. I will present the results of my long-term ethnography (2014-2020) across Italy and California on how researchers create knowledge about the microbiome, in a field of study known as 'metagenomics'. I will illustrate why metagenomics is best positioned within postgenomic to blend the 'molecular vision' of traditional molecular biology with an ecosystemic view. I will describe the ontoepistemic but also biographical tensions, challenges and aspirations, which ground researchers' attempts at remaking health by joining the micro with the macro scale. My argument is that metagenomics is a particularly propitious field where anthropologists and researchers can collaborate in order to configure together a new concept of health, possibly without being caught in new alluring traps, rather advancing a more promising biopolitics for both humans and non-humans
Violeta Schubert (University of Melbourne) Daniel Perkins
Paper short abstract:
Drawing on ongoing cross-disciplinary research of ayahuasca and medicinal psychedelics, the paper explores the shifting rhetorics and discourses of psychedelics. We highlight the tensions and challenges associated with western medicinal orthodoxy and what constitutes 'public good' in healing.
Paper long abstract:
Anthropology's engagement with indigenous practices and use of psychedelics, especially ayahuasca, is extensive. In contrast, scientific research into the psychedelics has for a long time been in a hiatus and at the height of the Cold War research into the therapeutic potential of psychedelics was banned. In a significant moment in 2014, the American Scientific published an editorial calling for an end to the scientific research ban. The growing acknowledgement of the therapeutic potential of psychedelic substances for treating mental health disorders and addiction is undoubtedly entering the scientific mainstream and a number of clinical trials are in progress at various universities. Though there is increasing research attention, however, medicinal psychedelics present many challenges to how healing and wellbeing is approached and conceptualised within western medicinal orthodoxy. Drawing on ongoing research into the use of psychedelic therapies and the Global Ayahuasca Project, we highlight the challenges of conceptualising and engaging with alternative therapeutic models and the complex and negotiated space-making that emerges with cross disciplinary collaboration and engagement with government and civil society actors. Beyond highlighting the epistemological and methodological synergies and disjunctures that collaboration between anthropology, psychiatry and sociology solicit, the paper explores the shifting rhetorics and discourses of psychedelics and the call for reframing what constitutes 'public good' in the domains of health, medicine and healing.
Sadaf Islam (Durham University)
Paper short abstract:
I will discuss the challenges I faced initially using a theory rooted in the North American context to understand the empirical findings in a country situated in the Global South.
Paper long abstract:
My doctoral research finds death and dying have changed over the last few decades in hospitals in Bangladesh, after the introduction of life support technologies in the 1980s. In the age of the neoliberal economy, many modern biomedical technologies and resources are available in Bangladesh, and they are utilised by both the private and public health care sectors. Yet, the sociocultural and economic context of the technology-receiving country (Bangladesh) is different in nature to that of the technology-producing countries in Europe and North America. The experiences of uneven access to resources, which end up in withdrawal of life support, can be considered as a contextual Bangladeshi feature of the biomedicalisation of death. Here, I argue that the practice of life support technologies is characterised by constant ambivalence and negotiation; negotiation between relatives and life support technology, also a negotiation between ethics, legality and institutions. To analyse these dilemma and contradiction brought, biomedicalisation theory and other relevant theories originating in the Global North do not provide me with the appropriate basis on which to describe the changes brought about by the recent advancements of life support technologies in Bangladesh. Thereby, I will discuss the challenges I faced initially using a theory rooted in the North American context to understand the empirical findings in a country situated in the Global South. Put another way, how can we conceptualize biomedicalisation and the use of life support technologies in non-Western Bangladesh and how colonial legacy is entangled within this biomedical practice in Global South?
Stephan Kloos (Austrian Academy of Sciences)
Paper short abstract:
The ongoing emergence of Asian medicines as modern industries of global influence and relevance indicates a major shift in medical realities globally. This paper proposes "Asian medical industries" as an innovative conceptual framework to grasp and adequately understand this new phenomenon.
Paper long abstract:
Over the past decades, we can observe a diminishing interest in so-called "traditional" medicines in medical anthropology, as the empirical and theoretical focus of the discipline has shifted to mostly biomedical topics. Paradoxically, this shift coincides with an unprecedented expansion of non-biomedical healthcare during the same period, with especially Asian medicines undergoing an industrial revolution. While the healthcare industry, governments, and global organizations take this development seriously (e.g. WHO 2019), much of medical anthropology continues to frame "traditional medicine" as cultural or epistemic systems of little relevance to healthcare or anthropological theory.
In this paper, I argue that the impact of Asian medicines on healthcare, health policies, and health economies around the world will grow into a phenomenon of major proportions and global relevance in the foreseeable future. This phenomenon, however, cannot be adequately understood within the common conceptual framework of "traditional medical systems". Anticipating a revival of medical anthropological interest in Asian medicines, I therefore propose a fundamental reorientation of focus to Asian/non-biomedical health industries, as both a novel conceptual framework and a vast subject of research.
In order to outline this new approach, I define five characteristics of Asian health industries, based on my own research on contemporary Tibetan/Mongolian medicine and an overview of recent cutting-edge work on other Asian medicines. All have in common that they exceed the notions of "traditional", "Asian", and even "medicine", and instead show new ways of engaging with emerging medical realities not just in Asia, but around the world.
Camilla Laursen (Aarhus University)
Paper short abstract:
Based on ethnographic fieldwork in Denmark, this paper explores how social and biological circumstances interact in relation to irritable bowel syndrome, discussing how medical anthropologists can contribute to a conceptualization of such interactions in challenging medically unexplained disorders.
Paper long abstract:
In a time when many disorders can be diagnosed and treated, and biomedical progress is followed by expectations that biomedicine can cure most ailments, some disorders remain difficult to diagnose and treat, causing frustration for patients and health professionals. This paper raises the question of how to understand and care for medically unexplained gut trouble or what is often termed irritable bowel syndrome (IBS), a highly prevalent disorder which evades common biomedical ways of knowing and caring? Neither etiology nor cure(s) are known yet, but IBS is presumed to be associated with people's ways of living. Based on 12 months of ethnographic fieldwork in two Danish outpatient gastroenterology clinics and among 18 gut troubled Danes, this paper explores how these people theorize IBS as a problem of interacting social and biological circumstances. It describes how life conditions and events may settle in the gut, making the gut a central organ for the expression of social problems or disparities. The paper discusses how medical anthropologists, through taking seriously the theories of interlocutors, may contribute to an understanding of the multicausality of emergent medically unexplained disorders and the relation between the gut and social life through concepts such as situated biologies (Lock and Nguyen 2018) and political etiologies (Hamdy 2008). The paper stresses the importance of going beyond distinctions between mind and body, biological and social, and what is inside and outside bodies, while taking seriously the role of biology and emerging biomedical research on gut microbiota and gut-brain interactions.
Magdalena Góralska (University of Warsaw)
Paper short abstract:
Inquiring into practices and relations that constitute community-based health advice, that grows in popularity across the Polish speaking Internet, the paper proposes a term digital distrust to talk about the future of public healthcare system and the expert authority crisis of the Internet era.
Paper long abstract:
"There are in it for money, profiting if we get sick, not if we stay healthy. So I take matter into my own hands, and do my own research". Bozena is one of many Polish-speaking Internet users, who do not trust medical authorities. Instead, they look across the Web for solutions, and often reach out to 'networked publics' (boyd, 2011) - social networking sites, such as dozens of easily accessible Facebook groups, with thousands of members of various ages and backgrounds, interested in medical issues, from homemade cures, Ayurveda, TCM, alternative cancer treatments, to nutritional advice and meditation. It's simple how it works - you post a question, with pictures or not, and soon enough you get numerous comments from people sharing their own experiences and knowledges. Those loose networks of community-care, based on an individual experience of self-care, form a collaborative health advice "system" - a new, peculiar kind of "public" healthcare in social media. It emerges online amongst strangers united by a common cause of gaining or maintaining health, trust towards each other, and a distrust towards the conventional medical authorities. Building on a long-term ethnographic fieldwork (2016-2020), the paper argues that the digital communication have unexpectedly contributed to the medical expert authority crisis, introducing a concept of digital distrust. The paper asks, what the future holds for such highly popular, but grass-root and spontaneous community health initiatives? Can we imagine the future of healthcare in Europe, that somehow acknowledges the community-care, and initiatives beyond the conventional medicine?
Valentina Kharitonova (Institute of Ethnology and Anthropology, RAS)
Paper short abstract:
The paper examines the transformations of healthcare and health promotion in Russia over the past 30 years, areas of studying the medical realities of this period with a focus on the idea of integrating medical systems, practices and methods, and suggests areas for further research.
Paper long abstract:
Medical anthropology as a scientific branch in Russia was formed in the 2000s, even though research in the framework of medical ethnography and anthropology has been conducted before. Since the early 1990s scholars studied the processes occurring in healthcare (the destruction of the Soviet system). But the most important and interesting for researchers was the analysis of what happened in connection with the national revival - the activation of traditional medicine and magical-mystical practices (including shamanistic healing). In the early 1990s "folk healing" was formed as a special version of modernized folk medicine (approved by the Law on the Protection of Citizens' Health in 1993). Then the active process of building "integration medicine" and attempts to "integrate" biomedicine, folk healing began. A little later, traditional medicine of the East appeared in the Russian Federation (Chinese traditional medicine, Indian Ayurveda, etc.). Since the 2000s the activity of their interaction significantly increased. To date, we have a complex field of interaction between various folk medicines, traditional medicines, mainly in the form of traditional medical systems, and modern scientific medicine, presented differently in the field of healthcare and health promotion.
An interdisciplinary group of researchers (employees of various institutions, members of the Russian Association of Medical Anthropologists) has now finished a three-year research project entitled "Problems of Integration of Medical Systems, Practices and Methods in the Context of Medical Anthropology". The paper will report on the author's personal research and on the main findings within the framework of a collective project.