States of Being in Wellness and Illness

Question 1

Medical Anthropology

Answer 1

Study of health, healing, disease, illness and sickness in cultural context (across people and places)

Question 2

Biological Approach to Medical Anthro:

Answer 2

Physical/Biological anthropologists who seek to explain through evolutionary policies, evolution of disease to understand current diseases. (Bio-medical: foundation for what we understand & our main basis of comparison, privileges the body as an end point of health, based in Western medicine.)

Question 3

Ecological Approach to Medical Anthro

Answer 3

Relationships between organisms and their total environment, based of 3 different premises: 1.) The interdependent interactions of plants, animals and natural resources form an ecosystem with characteristics that transcend the basic parts (whole is bigger than the sum of its parts)

2. ) Common goal in the ecosystem: Homeostasis (balance between environmental degradation and the survival of living populations).
3. ) The modern human adaptations now include cultural and technological innovations that can dramatically alter homeostasis for ex: air pollution, created by humans & can create lung disease

Question 4

Ethnomedical approach to Medical Anthro:

Answer 4

(Folk Medicine) How people make sense of how members of different cultures think about and treat diseases, comparisons of different healing systems (shamans etc…)

Question 5

Experiential approach to Medical Anthro:

Answer 5

Focuses on how people experience their illness through a narrative - how they express it, talk about it, experience it, perceive it, feel and live with their illness. The stories people tell around illness and treatment that is important, these stories can provide great insight to what is happening and how they cope - meanings and whats happening (value for chronic pain and mental illness)

Question 6

Critical approach to Medical Anthro:

Answer 6

Centres around critical analysis and post modernism: Marxism, deconstructionism: allows people to critically examine their own ideas of how the world works, deals with political and ecological relationships that affect our notions of health and healing.

Macro level: Large scale factors quite opposite to experiential.
Power Relationships: Who has the power? Does the medical community have more power?

Question 7

Applied approach to Medical Anthro:

Answer 7

Trying to solve problems in communities, approaches to using certain systems, particular social and health problem, could be in a clinical setting but it is dealing with direct application trying to solve a problem.

Question 8

BioCultural

Answer 8

Body as a starting point, family context, SES, environmental quality. No hierarchy, there is no one cure for everyone, everyone is different and may not be affected by medicine the same way.

Question 9

Wellness/Health

Answer 9

A state of complete and psychological well being. Includes social opponent with physical health, universal right to equality of life sufficient to ensure health and well being: who determines quality of life, how is it measured? Many dimensions, can be the absence of disease.

Question 10

Healing

Answer 10

Trying to restore to wellness, balance/homeostasis

Question 11

Disease

Answer 11

Abnormalities in the structure or function of organs/organ systems. Pathological states whether or not they are culturally recognized, claimed by biomedical model, alters biological function. Common states: injury, infection, malnutrition, genetic, chronic, physiological or behavioural… Not the same as illness.

Question 12

Illness

Answer 12

Can have disease without illness and vice versa, Disease is always factual while illness is not always real. Culturally identified state of general physical and or mental discomfort. A personal experience of suffering that prompts the afflicted to seek intervention and that underlies all culturally defined interventions to alleviate suffering.

Question 13

Arthur Kleinman on Disease

Answer 13

People recast illness as disease in order to define it. Illness is subjective while disease is objective, both are important.

Question 14

Sickness

Answer 14

Blanket term to label events involving disease and or illness, sickness is related to and may cause suffering. Stigma around behaviour and what it might represent (“sick role”).

Question 15

Paul (1955) Quote

Answer 15

“If you wish to help a community improve its health, you must learn to think like people of that community”

Question 16

Doctor

Answer 16

M.D vs. PHS: MD in a new kind of healing traditions, a scholar who is more focused on treating and dealing with illnesses. Doctor originally meant teacher. Could be a shaman/witch in other cultures.

Question 17

Healer

Answer 17

Cultural definition where he is an expert of treatment and medicine as well as spiritual issues. A with doctor typically deals with psychological aspects of an illness often using what we would call placebos to try and heal, quite often practice ancestral worship that brings in an element of the past (prevalent in South African countries).

Question 18

Levi Strauss & 3 parts of myth

Answer 18

1. ) Practitioners belief in the effectiveness of what he is doing.
2. ) Patients belief in practitioners ability to carry it out.
3. ) Faith and expectations of the group to socially sanction it

Question 19

Comparison of a Shaman to a Farmer

Answer 19

Farmer’s as a form of doctor - They provide health through food, see themselves as healers of soil: (taking care of the soil no antibiotics or steroids), growing healthy grass and grains to feed animals that feed us. Not widely constituted as a form of healer, not sanctioned, no community support

Question 20

Palaeolithic evidence for healing practices

Answer 20

Shanidar Caves in Iraq: Shanidar I Skeleton - fractures that had healed instead of worsening, injuries had occurred long before individuals death: implies that Neanderthals had concern for their group. (60-80 thousand BP)

Question 21

Healing systems and traditions arise out of?

Answer 21

• Attempts to survive disease and injury
• A desire to surmount death and suffering, trying to prolong life
• Social and cultural responses to sickness

Question 22

Healing systems are comprised of different components…

Answer 22

Causation (Etiology): Personalistic of Naturalistic

Question 23

Personalistic

Answer 23

Illness caused by supernatural forces, spirits

Question 24

Naturalistic

Answer 24

Illness cause by the physical world: weather, imbalance in the body

Question 25

Social Systems of ‘healers’

Answer 25

What are the social systems for passing down knowledge of healing - ‘internship’ with a healer or 10 years of university, depends on culture

Question 26

Symbols of healers

Answer 26

Medicine wheel, prayer, lab coat, stethoscope (symbolizes well trained doctors in Western society)

Question 27

Popular Health Care Sector

Answer 27

Where healing acts depend on a general body of knowledge that almost anybody would have access to (immediate family - healing is not the privileged ability of doctors).

Question 28

Professional Health Care Sector

Answer 28

Healing carried out by individuals with specialized training and knowledge, credentials and licenses and structured relationships and various specializations, those who oversee all of this and makes sure it is consistent.

Question 29

Folk sector

Answer 29

Medicine of the people, intermediary between popular and professional, usually done by non-professionals with specializations and non-formal education like apprenticeships with other healers

Question 30

Origins of “Modern” Healing Traditions: Hippocrates

Answer 30

• The Hippocratic School: intellectual ancestor of “modern” medicine
• Hippocrates (460-377 BC): Greek Physician interested in origins and causes of illnesses
  >Promoted health as balance: Hot and Cold (Humeral Etiology)
  >Hippocratic Oath to practice ethically and honestly

Question 31

Origins of “Modern” Healing Traditions: Galen

Answer 31

• Galen (129-200 AD), Born in Pergamon Turkey and worked in Rome on Gladiators
• Cautioned against eating fruits: They caused headaches or early death, used for digestive aids or laxatives, only as a dietary supplement to restore health
• Physician, Surgeon and Philosopher
• Interested in human anatomy - the pieces of the body
• Wrote 400 books

Question 32

Early Medical Anthropology

Answer 32

• Colonial Enterprise: Disease spread through new contact, Indigenous populations decimated by European diseases
• Health programs and civilizing missions: Folk medicines vs. European medicines
• WWI & WWII
• Foreign Aid Policies
• Alternative and complimentary approaches - what is the role of tradition vs. modernity and science

Question 33

The Pioneer: WHR Rivers

Answer 33

(1864-1922)

• Foreshadowed medical anthropology
• Torres Strait Expedition (1898)
• Diseases caused by Agency
• The practice of medicine is a social process subject to the same laws as other social processes

Medicine = Social Behaviour

Question 34

Erwin Ackernecht

Answer 34

(1895-1988)

• Physician turned Anthropologist
• Influenced by functional theory and the holistic approach
• A short history of medicine (1955)

“What is a disease… not a biological fact but a decision of society”

Question 35

Why Not call modern medicine “Alternative?”

Answer 35

• Don Bates (2000)
• Modern –> Scientific –> Biomedicine
• The “Classic” vs. “20th Century” Paradigms
• Germ theory of disease
• The institution of the medical profession
• The hegemony of scientific medicine and lack of diversity

Question 36

Theoretical Approaches to Medical Anthropology

Answer 36

Biological, Ecological, Ethnomedical, Experiential, Critical, Applied, BioCultural

Question 37

Medical Anthropology is open to _ knowledge

Answer 37

Traditional (knowledge that is culturally held by people and passed on from generation to generation)

Question 38

Integrative Approach

Answer 38

Comparative, uses comparison as a basis to get away from a hierarchical structure which implies one is superior to another. Deals with power.

Question 39

Is the Biocultural approach hierarchical?

Answer 39

No - there is no one cure for every individual it is different for everyone. Medicine may not affect everyone the same way all the time.