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Medical Anthropology

Fouzieyha Towghi
In Balochistan, Pakistan, hospitals are not the desired location for childbirth, but an affective economy of obstetric care, deceit, and clinical tactics of control has emerged, redirecting women away from midwives toward biomedical obstetrics. This economy manifests in forms such as coercing expectant mothers to deliver in the clinic rather than the home by generating fear in them and their kin through a narrative of imminent maternal and child harm. Drawing from ethnographic research, I show why Baloch midwives' ethical expertise and affective responses to iatrogenically induced emergencies haunt the postcolonial state and constrain biomedicine's haunting expectations of hospital/clinical births...
October 12, 2018: Medical Anthropology
Lynn M Morgan
The Costa Rican Constitutional Court banned in vitro fertilization in 2000, citing the inviolability of life. Conservatives hoped the ban would initiate a hemispheric movement to protect the unborn. But in 2012 the Inter-American Court of Human Rights ruled that reproductive rights are human rights and that women's rights take precedence over embryo rights. The episode precipitated a national identity crisis: how could a country that supports universal health care be labeled a human rights violator as a result of its efforts to protect nascent human life? Expanding the health and human rights framework helps us appreciate how IVF became Costa Rica's human rights crucible...
October 9, 2018: Medical Anthropology
Hayley MacGregor
At the turn of the millennium, people with mental disturbance often lived in circumstances of economic marginalization in South Africa. The historical material of one low-income urban area reveals the place of kin relations and reciprocity in enabling negotiation of a more fluid set of responses to mental illness. In this sociocultural context, "stigma" was not an inevitable reaction to mental illness, and a more complex set of social dynamics could mitigate marginalization. Research on how changing informal care practices relate to state-based community care continues to be important to inform contemporary health reforms...
October 9, 2018: Medical Anthropology
Emma Varley, Saiba Varma
In this article, we trace encounters between humans and phantasmic entities in hospitals in Indian-occupied and Pakistan-controlled Kashmir. In Pakistan, the presence of spectral beings (jinni) in hospitals is linked to state and sectarian violence, which precipitates ruptures between jinni and human worlds. Such breaches permit jinni to manifest in the medical present, where insecure actors harness them to ventriloquize unspoken anxieties. In Indian-occupied Kashmir, jinn-like, chronically mentally ill patients haunt psychiatric modernization projects...
October 8, 2018: Medical Anthropology
Shir Lerman
Puerto Rico's politically liminal status as a US territory has dire consequences for Puerto Rico's economy: the island does not receive the same funding as states for health insurance. In addition, Puerto Rico's unraveling health care system, coupled with the island's high poverty rate and the medical brain drain, interact. I weave my research on depression into this article as an example of the ways in which political and economic factors aggravate disease.
September 24, 2018: Medical Anthropology
Siri Suh
Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I demonstrate how health professionals have deployed indicators such as number of women and abortion type treated in government hospitals to demonstrate commitment to global mandates on reproductive rights. These indicators obscure discrimination against women suspected of illegal abortion as health workers negotiate obstetric treatment with the abortion law. By measuring hospitals' capacity to keep women with abortion complications alive, post-abortion care (PAC) indicators have normalized survival as a state of reproductive well-being...
August 13, 2018: Medical Anthropology
Amy Dao, Juliet McMullin
Unintentional injury prevention research focuses on parental supervision as critical to reducing toddler injury. We examine how the promotion of childproofing-as a mode of supervision-sells mothers "peace of mind" while also increasing "intensive mothering" and the "privatization of risk." Drawing on the childproofing literature and meaning centered interviews with mothers of toddlers and childproofing business owners, we argue that the connection made by these groups between childproofing and "good parenting" ultimately obscures how this form of harm reduction economically and socially individualizes responsibility for child care...
August 6, 2018: Medical Anthropology
Sabina Stan, Valentin-Veron Toma
Neoliberal reforms in health care are an accumulation by dispossession. In examining this in Romania, we show that neoliberal reforms led to an uneven landscape of public and private care. We document how patients variously situated in Romanian society respond to this situation, and demonstrate the instability of their strategies-restraining from formal care, lifting-off from public care and hooking-up to private care. Public-private biomedical pluralism proves to be detrimental to vulnerable and better-off patients alike...
August 6, 2018: Medical Anthropology
Junbin Tan
Based on research at a dementia day-care center in Singapore, I discuss how embodied care relations proceed amidst cultural expectations on aging, dementia, and care work. Engaging with approaches that conceptualize "care" as either empathy or control, I argue that care between older people with dementia, their families, and care workers can be understood as a reiterative, dialogic process whereby care participants strive to keep pace with each other, however briefly, due to cognitive decline, care workers' own limitations, and particular family difficulties...
August 1, 2018: Medical Anthropology
Cristina A Pop
Drawing from interviews and life histories, I consider the singular reproductive trajectories of women who fought infertility during the enforced pronatalist policies of the late communist era in Romania. I aim to explore the role of fine-grained ethnography in revealing both the localized mechanisms of reproductive governance and the diverse subjectivities produced by citizens' encounters with biopower. I argue that, through an analysis of these ethnographic cases, we can further conceptualize reproductive vulnerability as an intersubjective notion...
August 1, 2018: Medical Anthropology
Alice G Mitchell, Suzanne Belton, Vanessa Johnston, Wopurruwuy Gondarra, Anna P Ralph
High rates of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in Australia predominate in young Aboriginal people highlighting underlying racial and equity issues.  This article focuses on the perceptions of the disease among young Aboriginal people living in remote Australia. Participant understanding was constrained by clinicians' use of language rooted in biomedicine and delivered through English, a second language for all participants. Clinicians' communicative competency is a social determinant of Aboriginal health...
August 1, 2018: Medical Anthropology
Meike Wolf, Kevin Hall
Biopreparedness exercises are commonly depicted as indispensable means to enable people to respond to outbreaks of highly pathogenic infectious diseases. In this article, based on a 4-year multisited ethnography conducted in Frankfurt and London, we argue that exercises mobilize past and present events in a continuous rehearsal for the implementation and stabilization of emergency infrastructures. While relying on the embodied knowledge and the body techniques of its participants, these infrastructures necessitate continuous attention, investment, and training...
July 20, 2018: Medical Anthropology
Amy Nichols-Belo
At the center of conflict between the state and traditional healers (waganga wa kienyeji) over the meanings of traditional healing in contemporary Tanzania are debates about what constitutes knowledge, the production of knowledge, and the legitimacy of "traditional" ways of knowing. Drawing on media analysis and ethnographic fieldwork carried out between 2004 and 2016, I describe how healers locate their knowledge in experience, ancestors, and spirits, while the state imagines a future where traditional healers are formally educated and practice in white uniforms...
July 20, 2018: Medical Anthropology
Alex Nading, Lucy Lowe
In this article, we draw on two cases-one of the reproductive justice movements in the wake of the Latin American Zika epidemic, and one of an environmental justice movements spurred by an epidemic of chronic kidney disease among sugarcane workers-to argue for social justice as an "elastic" technology of epidemic control. In its compressed form, social justice simply refers to the fair distribution of medical goods. In its expanded form, it emphasizes the recognition and representation not just of medical problems, but of entangled histories of racial, gendered, and economic inequity...
July 13, 2018: Medical Anthropology
Bridget Bradley, Stefan Ecks
Trichotillomania (hair pulling) remains a relatively unknown form of body-focused repetitive behavior (BFRB). Sufferers tend to conceal both the action and its effects from others because of stigmatization, which is strong in both public and domestic spheres. Negative responses from close family members can add significantly to the suffering. Based on fieldwork in the United Kingdom and United States, we explore how hair pulling troubles ties even among close family members. We show why ethnographic methods reveal impacts of hair pulling that structured assessments do not yet capture and argue for a more nuanced study of BFRBs through anthropologies of relatedness...
July 12, 2018: Medical Anthropology
Joanna Mishtal
Reproductive rights struggles have continued to dominate public debates in Poland since the political resurgence of the Catholic church in 1989. In 2015, the state passed a landmark "In Vitro Policy" to regulate assisted reproductive technologies. Its religiously based compromises may jeopardize other reproductive rights. I argue that the new policy negotiations demonstrate how versions of competing human rights claims are central to reproductive governance and struggles in the new Polish "ethical order...
July 11, 2018: Medical Anthropology
Elyse Ona Singer
I analyze the alternative tactics and logics of Las Fuertes, a feminist organization that has taken an "alegal" approach to realizing the human right to abortion in the conservative Mexican state of Guanajuato. Since a series of United Nations agreements throughout the 1990s enshrined reproductive rights as universal human rights, Mexican feminists have adopted the human rights platform as a lobbying tool to pressure the government to reform restrictive abortion laws. This strategy bore fruit in Mexico City, with passage of the historic 2007 abortion legalization...
June 20, 2018: Medical Anthropology
Jaroslav Klepal, Tereza Stöckelová
Drawing on fieldwork in the postsocialist Czech Republic, we explore the transformative processes of biomedicalization, both within and in relation to complementary and alternative medicine (CAM). We argue that it would be simplistic to understand evidence of these processes in CAM as a sign that CAM has fallen prey to biomedicine. Instead, we show how particular CAM practices play a groundbreaking role in shaping developments in contemporary health care. In this respect, we question the utility of the concept of biomedicalization, arguing that it reduces the transformative processes to aspects of biomedicine...
June 20, 2018: Medical Anthropology
Hannah S Bell, Funmi Odumosu, Anna C Martinez-Hume, Heather A Howard, Linda M Hunt
Racial/ethnic identity is contingent and arbitrary, yet it is commonly used to evaluate disease risk and treatment response. Drawing on open-ended interviews with patients and clinicians in two US clinics, we explore how racialized risk is conceptualized and how it impacts patient care and experience. We found that racial/ethnic risk was a common but poorly defined construct for both patients and clinicians, who intermingled concepts of genetics, biology, behavior, and culture, while disregarding historical or structural context...
June 18, 2018: Medical Anthropology
Iben M Gjødsbøl, Mette N Svendsen
How do time and personhood become related when dementia sets in? This article brings together ethnographies from a memory clinic and a dementia nursing home in Copenhagen, Denmark, pursuing how personhood and time become intertwined across early and late-stage dementia. In the memory clinic, the dementia diagnosis is enacted and experienced simultaneously as an indispensable prophecy of discontinuity of personhood and life for the patients, and as a prognosis that renders the future indeterminate and open to intervention...
May 15, 2018: Medical Anthropology
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