I. Cultural biases of medical practice

A. Race, gender and diagnosis

1. Schizophrenia among African-American men
2. Anorexia as disease of white middle and upper-middle class women

B. Somatization: mental distress gets expressed as a physical symptom

1. Biomedicine has trouble connecting social, emotional, and physical aspects of illness
2. Schizophrenia may reflect experience of racial prejudice rather than a medical condition, which, because of that prejudice, gets interpreted by physicians as pathological

C. Rational knowledge vs. irrational belief

 

II. Dr. Arthur Kleinman and Illness Narratives

A. illness: lived experience of suffering, connected to kin and social networks
B. disease: explanation produced by a medical practitioner, specialized diagnostic system
C. sickness: macrosocial or institutional forces, economics or politics

 

III. Origins of medical anthropology

A. Post-World War II aid projects
B. Health and healing as social and cultural, involve assumptions about body and world

 

IV. The Three Types of Body

A. Nancy Scheper-Hughes and 3 types of body

1. Individual body

a. the mindful body
b. bodily boundaries
c. social construction of individual bodies, consciousness

2. Social body

a. cultural meanings of bodily forms, movements
b. bodily metaphors for society

3. Political body

a. body politic
b. soldiers
c. women: reproduction and sexuality

B. Disease and the political body: Anita and AIDS in Do Kay

 

V. Personal and Naturalistic Systems of Disease

A. Naturalistic: Disease comes from natural forces

1. Western biomedicine
2. Chinese medicine

B. Personalistic: disease due to an agent -- human, witch, deity, ancestor

1. Azande
2. Eduardo the Healer
3. AIDS as a sent illness

C. Healing in personalistic systems: Haitian houngan, voodoo priest

 

VI. Interpreting AIDS in Haiti: Hermeneutic of Generosity

A. Biomedicine rejects other explanations as outmoded, superstitious
B. Hermeneutic of generosity
C. Haitian non-biomedical explanations of AIDS

1. Conspiracy theories

a. Whites blame Haitians as source of disease
b. Americans want to buy Haitian blood
c. Americans purposely gave Haiti AIDS and then blamed Haitians

2. Poverty because of dependence on the US: Haiti, not Cuba

a. Dam project
b. Poverty ==> migration to city, exposure
c. Swine fever

3. Social repercussions, jealousy and sent illness: "brothers shooting brothers"

D. "Regardless of their ultimate origins, Haitian readings of AIDS and social responses to it are redolent of their readings of the world in general -- a world where power and wealth and health are so unevenly distributed" (243).
E. Biomedicine focuses on one culturally-specific notion of individual body, ignores social and political body
F. What assumptions about human condition does biomedicine make? +/-? What understandings get left out?

 

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