醫(yī)學人類學 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.
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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
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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)
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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
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- 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.
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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.
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Cultural Competency
- Training for medical practitioners;
- Teaches techniques and skills for managing cross-cultural clinical encounters.
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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.
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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).
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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.
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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...)
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Acts of resistance and refusal
- Area whites complaining about discriminatory practices at the bank;
- Rumors about Pepsi;
- Strike.
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Infrastructure
- Built networks that facilitate the flow of goods, people, or ideas, and allow for their exchange over space (Larkin 2013).
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Health Infrastructure
- Built networks that support health and the administration of medicine.
- eg hospitals, equipment, supplies, etc.
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“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.
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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...)
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Health Infrastructure - one of the Naturalization of inequality.