医学人类学 18 - Book Study 2

Book to read: Fresh Fruit, Broken Bodies (just read the notes can be fine).

Embodiment of Inequality (Chapter 4 & 5 Book)

Revisit Embodiment

- The manifestation of social experience in the body;

- Shapes our habits and the ways we perceive the world;

- Manifests social inequality in the body.

Book example: sleep in the private room, etc.

Disease: can be understood as Embodiment of social Inequality

Eg, HIV, black people history & living condition

Fresh Fruit, Broken Bodies Ch. 4 Examples:

- Abelino’s knee

- Suffering caused by labor (picking food)

- Forced into this position (larger social context) - Structural Position

- Crescencio’s headache

- Symbolic violence

- Reinforce the stereotype (abuse)

- Bernardo’s stomach pain

- by police

- direct political violence

Epidemics and the Embodiment of Inequality

- Zika risk mirrors racial, class, and geographic-based inequalities in Brazil;

- Compounds existing gender inequality;

- Inequalities in exposure to COVID-19 (eg remote workers)

Ch.5: Why do migrant workers say that “doctors don’t know anything?”

Values Associated with Biomedicine

- Reductionist Rationality

- Authority over the body

- Individualism

- Technological Orientation

- Abelino’s knee

- X-ray over his self-narratives;

- Able to “fix” the body, but not the social position;

- Crescencio’s headache

- Promote his own acceptance of his place in the labor hierarchy;

- Bernardo’s stomach pain

- Language issue;

- No seeing social contexts.

Medicalization Revisited

- “The medical gaze:” Doctors learn to objectify patients and their diseases and to discount social aspects of their case;

- Medicalization: defining a condition as a disease or as in need of medical surveillance.

Cultural Competency

- Training for medical practitioners;

- Teaches techniques and skills for managing cross-cultural clinical encounters.

Critiques of Cultural Competency Training

- Produces stereotypes of cultural difference;

- Places blame on patient’s “culture;”

- Obscures structural imbalances;

- Fails to recognize biomedicine as a culture itself.

Structural Competency

- Recognize the structures that shape clinical interactions; (eg, doctor diagnose for what? What will you give the patient for such diagnosis?);

- Teach social inequality in addition to cultural difference;

- Observe structural interventions;

- Develop structural humility (assumed not understanding the patient’s background).

Naturalization & Health Infrastructure (Chapter 6 Book)

Naturalization: The process of making something appear natural;

Denaturalization: Taking something that appears natural, and showing that it has social, cultural, political, economic, and /or historical dimension.

Denaturalization is the goal of many anthropological writings.

 - Holmes wants to make inequality “strange” to us.

Justifications of social inequality:

- Through language used to describe migrant workers;

- Blaming them for their suffering;

- Making suffering appear normal (normalization);

- Claiming that Oaxacans are ideal for working in fields because of their height;

- Metaphors around body “position.” (eg upstanding citizens...)

Acts of resistance and refusal

- Area whites complaining about discriminatory practices at the bank;

- Rumors about Pepsi;

- Strike.

Infrastructure

- Built networks that facilitate the flow of goods, people, or ideas, and allow for their exchange over space (Larkin 2013).

Health Infrastructure

- Built networks that support health and the administration of medicine.

- eg hospitals, equipment, supplies, etc.

“Improvising Medicine”

- Biomedical standards and best practices have been developed with the assumption of infrastructure;

- Practice of medicine may be under lower-level-quality infrastructure;

- Physicians have to “improvise” in different situations.

Infrastructure with relationship with health

- Water, Power, and Sewage Infrastructure

- Access to water requires both material (pump) & social (legal request) processes

- Without Water Infrastructure: Providing Water source off the Grid

- Infrastructure & Human Rights (eg water is right not commodity...)

Health Infrastructure - one of the Naturalization of inequality.