Indigenous peoples are inheritors and practitioners of unique cultures and ways of relating to people and the environment. They have retained social, cultural, economic and political characteristics that are distinct from those of the dominant societies in which they live.
In India, the most diverse country on earth, the indigenous people are respectfully called ADIVASI. The indigenous people of the Andaman and Nicobar Islands Once Jarawa Sentinelese and Andamans are closely related racially to the first migration out of Africa : Orang Asli of Malaysia and also the Indigenous people of Philippines (NEGRITO).
ANTHROPOLOGY ESPECIALLY CULTURAL/SOCIAL ANTHROPOLOGY IS ABOUT THE WAY HOW PEOPLE THINK
Anthropological thinking cannot be gained by reading books alone, but has to be PARTICIPANT OBSERVATION. This is very important in Medical Anthropology as it involves the natural cycle of life. Birth Life Health and Death.
Participant Observation
The Observer is influenced by their culture , also lack of knowledge of the other culture
The observed has taboos and also has a desire to please so may not reveal all the information. Menstruation carries almost an International Taboo.
Observation is one of the most important methods used during qualitative data collection. Thus a fieldworker must be open in order to discover phenomena. Observations are used to learn about the following aspects:
- what people do (practices)
- (non-verbal) communication
- social interactions
- events and settings
CONTEXT
Maurice Merleau-Ponty, French Philosopher. I highly recommend reading him and understand Phenomenology of Perception as against the Cogito ergo Sum of Descartes
For Merleau Potty , things have no meaning without CONTEXT (embodied nature of human existence, according to his thoughts)
I will give a simple example
If I say, Indians have a high rate of Type 2 Diabetes, without context the understanding is not complete
Who do you call Indians?
Sindhis of Gujarat or a Naga or an Onge from the Andmans?
Indians of North and South America?
In the USA, people of Indian, Pakistani, Sri Lankan, Bangladeshi and Nepalese origin are put together as South Asian which has very little meaning.
Indians of Suriname are so different from Indians of Mauritius even though they both originated in the same geographical areas of India.
The highest rate of Cardiovascular disease in North America is among the migrant population from Subcontinental India ..Should you not think of the stress of migration? The thought that you are not living in your own country? And the thought that you might be a second class citizen?
MEDICAL ANTHROPOLOGY
The best definition was from Paul Farmer, a Physician Anthropologist .
Medical Anthropology teaches you to divert your gaze from the sterility of the Epidemiologists and Clinicians (pardon the pun) and go beyond facts and figures and transcend to the level of the suffering and focus on the society in which the patient lives.
https://medicoanthropologist.blogspot.com/2020/12/a-day-of-recognition-for-dr-paul-farmer.html
CULTURE IN A DOCTOR-PATIENT ENCOUNTER
CASE OF HAITI
A doctor who didn’t understand local culture would probably mistake many patients’ complaints for bizarre superstitions, or at best be utterly baffled – by the female complaint called move san, lèt gate, for instance. The condition was said to be brought on by seziman, that is, by a surprise or by someone’s frightening action. Move san, “bad blood,” could follow, and produce in turn lèt gate, a condition in which a nursing mother’s milk was spoiled or stopped flowing. None of this would be mysterious to a young ethnographer-doctor who, like Farmer, was willing to puzzle out the social meanings of the syndrome. (Mountains Beyond Mountains, 83).
My own medical anthropological observations are the participant ones among the Indigenous people of North and South America. In North America they are called INDIANS and have been able to learn about their WORLD VIEW and use it to offer help in healing of their Illnesses
WORLD VIEW
HEALING AND CURING
DISEASE and ILLNESS and SUFFERING
WORLDVIEW
A worldview is a collection of attitudes, values, stories and expectations about the world around us, which inform our every thought and action. Worldview is expressed in ethics, religion, philosophy, scientific beliefs and so on (Sire, 2004). A worldview is how a culture works out in individual practice.
THIS MAY EXPLAIN WHY A SURINAMESE WHOSE ANCESTORS MIGRATED 150 YEARS AGO FROM BIHAR THINK DIFFERENTLY FROM THE MIGRANTS FROM THE SAME REGION TO MAURITIUS 150 YEARS AGO. ( Amitav Ghosh’s TRILOGY of books on this migration is an excellent Literary and cultural and anthropological read. Ghosh holds a PhD in Anthropology from Oxford)
I work with a small group of native people who have lived in Florida USA for thousands of years. Miami the principal city of Florida is full of immigrants from various Latin American countries and the predominant language is Spanish. Do you expect the world view of the Native to be the same as the recent immigrant to his land ?
Is there a difference between DISEASE and ILLNESS ? WHAT IS SUFFERING?
Arthur Kleinman shaped the concepts of illness and disease. While disease is regarded as a natural phenomenon (etic view), illness is conceptualised as a cultural construction (emic view) (Kleinman 1981).
EMIC
ETIC
ILLNESS is the patient’s perspective of his ill health, withers social and cultural implications and the meaning it has for him or her.
DISEASE is the objectification of the symptoms of the illness by the doctor who may o may not have any cultural understanding of the patient.
SICKNESS is what the society and others attribute to the person with ILLNESS (the sick role). In Japan, as you know, what is good for the group is more important than what is good for the individual . During Tsunami the elderly wanted the younger people rescued rather then them
As an anthropologist I would like to add SUFFERING. Of the individual , the family and friends. The suffering we feel with disasters and wars far away from us which has an effect on our health.
EMIC
an emic perspective (the ability to empathize and understand other participants' perspectives and actions)
EVEN IN BUSINESS MANAGEMENT, EMIC, Subjective/idiographic/qualitative/insider set of methodologies rather than the objective/nomothetic/quantitative/outsider seT..IS BECOMING POPULAR .
The etic (scientist-oriented) approach shifts the focus from local observations, categories, explanations, and interpretations to those of the anthropologist. The etic approach realizes that members of a culture often are too involved in what they are doing... to interpret their cultures impartially.
ONE HAS TO UNDERSTAND THE QUALITATIVE AND QUANTITATIVE ASPECTS
ILLNESS IS QUALITATIVE WHEREAS DISEASE AND ITS TREATMENTS ARE QUANTITATIVE IN BIOMEDICINE
NATIVE PEOPLE OF MY ACQUAINTANCE THINK QUALITATIVELY WHEREAS MANY AMERICANS THINK QUANTITATIVELY
THIS HAS AN IMPACT ON THEIR HEALTH CARE SEEKING AND ALSO SATISFACTION
An anthropologist feels and understands the person and his reaction
A doctor assesses the situation , offers a solution . There is no need for feelings
Anthropologists do not tend to objectify whereas Doctors do, in fact that is what they call Diagnosis.
Objectiificaton is reducing something complicated to something simple. Or something abstract to something that is understandable or visible
It is perhaps the reasons why there is dissatisfaction with CURING
No patient comes to the doctor saying My proton pump is overactive in the stomach when they have gastritis or my cerebral circulation has increased when they have Migraine.
EXPLANATORY MODEL
Many patients feel that the doctors and nurses talk down to them as if they havee no knowledge of their bodies or their health. Most people who are ill, have also an explanation of why they are sick . Just now I saw a man who was complaining of Irritable Bowel and he told me he has these symptoms because he drank coconut water from the shop which comes in a Ctetrapak, packed perhaps one year ago. He is convinced and for good relationship, do not argue with him. Tell him your side of the story when confronted with a situation like these
These models are called Explanatory Models and I think it was Dr Arthur Kleinman who coined the term. It is the explanation the patient has which makes sense to his world view .
DECONSTRUCTION is a philosophical concept, conceived by the French Jewish philosopher Jacques Derrida. In Medical Anthropology, it is a form of opening our eyes to things that do not mean the way they are supposed to.
The best example is our concepts of the BODY . Here is a good de construction of the BODY by Dr Scheper Hughes and Dr Lock
Conceptions of the body are central not only to substantive work in medical anthropology, but also to the philosophical underpinnings of the entire discipline of anthropology, where Western assumptions about the mind and body, the individual and society, affect both theoretical viewpoints and research paradigms. These same conceptions also influence ways in which health care is planned and delivered in Western societies. In this article we advocate the deconstruction of received concepts about the body and begin this process by examining three perspectives from which the body may be viewed: (1) as a phenomenally experienced individual body-self; (2) as a social body, a natural symbol for thinking about relationships among nature, society, and culture; and (3) as a body politic, an artifact of social and political control. After discussing ways in which anthropologists, other social scientists, and people from various cultures have conceptualized the body, we propose the study of emotions as an area of inquiry that holds promise for providing a new approach to the subject.
