Category: Medical Anthropology

Introduction

The increased participation by medical anthropologists in medical research and public health in the recent past has seen medical anthropology become an important area of study among anthropologists. It is therefore not surprising that the increasing number of medical research projects and public health interventions that involve medical anthropologists or that are closely related to social science disciplines.

This has also given rise to a powerful cooperation that now exists between anthropologists and health professionals. Despite their different ideologies, these two groups of people have been working hand in hand to lessen the effects of poverty (Pool & Geissler, 2005).

As a social science, medical anthropology addresses specific health issues and also seeks to build a broad, theoretical based understanding of what health is, how it interacts with culture, the role of social relations in shaping disease, the importance of the health environment interface, and a range of other issues (Singer & Baer, 2011).

In spite of this, true relationship between the social sciences and medicine remains a challenge for a number of reasons. First, anthropology and biomedicine are based on different assumptions about fundamental issues such as the nature of social reality and how it should be studied.

Second, medical research and public health are dominated by biomedicine and biomedical professionals often have a poor understanding of what anthropology is and what it has to offer.

Third, anthropologists have always failed to communicate effectively with medical professionals and as a result, they have been unable to make a convincing case for what anthropology has to offer. Consequently, there is often a need to mediate between these two groups of people with different disciplinary perspectives working towards the same goal.

This paper provides a discussion on the different theoretical perspectives in medical anthropology, namely, ecological, interpretive, and critical perspectives. It also looks at how biomedicine relates to culture as well as medicalization of life in Brazil and its consequences.

Theoretical Perspectives in Medical Anthropology

As is typical in science generally, medical anthropologists understand the world in certain ways. One of the influences on how a medical anthropologist approaches issues of health or illness is the particular theoretical framework or school of understanding employed. Although there are several such frameworks in medical anthropology, many individuals do not see themselves as supporters of any single perspective.

Instead, they take a more varied approach and allow the problems at hand to shape the perspectives that they use. Other medical anthropologists consider themselves advocates or even activists of particular points of view. Indisputably, however, the perspectives they bring to their research strongly influence the way a problem is approached, how questions are asked, and the kind of answers that are deemed sufficient and adequate.

Among the primary perspectives found in medical anthropology are medical ecology, interpretive or meaning-centered anthropology, and critical medical anthropology. These are explained as follows:

Medical Ecology

Entrenched in both cultural ecology and evolutionary theory, this approach began with an emphasis on adaptation, defined as behavioral or biological changes at either the individual or group level that support survival in a given environment as the core concept in the field. From this perspective, health was seen as a measure of environmental adaptation.

Initially, the central principle of medical ecology was that the type of relationships that existed within different social groups was closely associated with the health status of the members in the groups. While better health meant good relations, poor health meant the opposite. In general, beliefs and behaviors that improve health or protect societal members from disease or injury are adaptive.

From the medical ecological perspective, behavioral complexes such as medical systems, including everything from soul loss healing to biomedicine treatment of heart disease can be viewed as social-cultural adaptive strategies. As observed by Singer and Baer (2011), there is no single cause of death.

Whilst the immediate cause may be a virus, vitamin deficiency, or psychological trauma, disease ultimately is the product of a chain of interacting factors related to ecosystem imbalances, including physical and social vulnerability and resilience. Health and disease are deemed to develop within a context of interaction among physical, biological, and cultural systems.

The environment that people inhabit includes not just the physical habitat where they live but also the culturally constructed or built environment such as a city or a village, an acknowledgement that, in health, people impact their environment as much as the environment impacts them.

Interpretive or Meaning-centered Medical Anthropology

According to Baer et al. (2003), the cultural interpretive approach, resulted from the fact that the ecological perspective about health-related issues was increasingly becoming popular. By and large, the fundamental claim of cultural interpretive model is that disease is not an entity but an explanatory model.

From the interpretive perspective, illness tends to have a strong connection to the culture of medicine that is deeply rooted within societies. And culture is not only a means of representing disease but is essential to its very constitution as a human reality (Baer et al., 2003). From a cultural point of view, it is only through interpretive undertakings that both therapists, as well as their patients, get to know the diseases.

Generally, the actions or undertakings include a complex interaction of medicine and social behaviors. That different sub-specialties of biomedicine sometimes reach quite different conclusions about the same clinical episode affirms to the interpretive medical anthropologists’ fundamental role of cultural construction in the making of a disease.

Historically, the primary shortcoming of the interpretive approach from the critical perspective has been its lack of attention to the role of asymmetrical power relations in the construction of the clinical reality and the social utility of such construction for maintaining social dominance (Baer et al., 20003).

Critical Medical Anthropology

In the study by Baer et al. (2003), critical medical anthropology (CMA) seeks to understand who ultimately controls biomedicine and what the implications are of such control.

An analysis of the power relations affecting biomedicine addresses questions such as who has the power over agencies of biomedicine, how and in what forms power is to be delegated, how the power is to be expressed in the social relations of the various groups and actors comprising the health care system, and the principle contradictions of biomedicine and associated arenas of struggling and resistance that affect the character and functioning of the medical system and people’s experience of it.

Ideally, any discussion of the impact of power relations in the delivery of health services needs to recognize the existence of several levels in the health care systems of developed capitalist, underdeveloped capitalist, and socialist-oriented societies.

At the macro-social level, critical medical anthropology recognizes that the development and expansion of a global economic system represents the most significant, transcending social process in the contemporary historic period. To a large extent, capitalism has progressively shaped and reshaped social life.

As a discipline, anthropology has lagged behind in its attention to the nature and transforming influence of capitalism. As part of the larger effort of critical medical anthropology in general to correct this shortcoming, it attempts to root its study of health-related issues within the context of the class and relations inherent in the capitalist world system.

At the international level, the World Bank has become a key player in establishing health policies and making financial loans to health care undertakings. As a result of its practice of co-financing resources from international and bilateral agencies, the bank has a strong influence on health policies.

The bank also conducts country-specific health sector investigations and makes proposals for health care reforms that are compatible with market-driven economies. Despite the fact that almost all Third World nations are supposed to be politically independent, their colonial inheritance and their neocolonial situations impose health care systems modeled after those found in the advanced capitalist nations (Baer et al., 2003).

As a result of the clash and exchange between medical ecology theory, cultural perspective or meaning-centered theory, and critical medical theory, there have been developments in all three of the primary theoretical models within medical anthropology.

While medical ecologists have begun to adopt a more political-ecological orientation, interpretive medical anthropologists acknowledge and are attempting, and in some cases, succeeding in producing work that is highly sensitive to political-economic issues.

Critical medical anthropologists, on the other hand, have also developed a significant level of interest in political ecology and the role of political economy in the production of meaning.

Biomedicine and Culture

While recognizing the fundamental importance of biology in health and illness, medical anthropologists generally go beyond seeing health as primarily a biological condition by seeking to understand the social origins of disease, the cultural construction of symptoms and treatments, and the nature of interactions between biology, society, and culture.

Similarly, they tend not to accept any particular health care system, including Western biomedicine, as holding a monopoly on useful health knowledge or effective treatment. Instead, they see all health care systems from advanced nuclear medicine or laser surgery to dream based healing or acupuncture as cultural products, whatever their level of healing value and however efficiency is defined within particular healing traditions.

Medical anthropologists seek to understand and help others recognize that health is rooted in three key notions. First, there are cultural perceptions, such as culturally constituted ways of experiencing pain or exhibiting disease symptoms. Second, there are social connections, such as the type of relations that exist within the family or within society and the encompassing political and economic systems generally.

Third, there is human biology, such as the threat of microscopic pathogens to bodily systems and the body’s immune responses to such threats. In pursuing these lines of inquiry, medical anthropologists are especially concerned with linking patterns of disease, configurations of health-related beliefs and behaviors, and healing systems with cultural foundations, social hierarchies, and bio-social relationships.

Consequently, medical anthropologists have tended to look at health as bio-cultural and bio-social phenomena, based on an understanding that as both physical and socio-cultural environments interact, they determine the health of populations under investigation (Singer & Baer, 2011).

Some medical anthropologists, particularly critical medical anthropologists stress what they call a critical bio-cultural model, one that is especially concerned with investigating the role of social inequality in shaping health, health-related experience, behavior, and healing. Whatever their theoretical perspective, however, medical anthropologists tend to lean more towards a particular orientation.

They are concerned with putting their work to good use in addressing real and pressing health-related problems in diverse human communities and contexts. As noted by Singer and Baer (2011), illness is ordinarily perpetrated by the way a patient perceives his or her experienced symptoms.

Nevertheless, these interpretations are not solely personal but rather are witnessed by wider cultural understandings of illness and the comments and actions of the sufferer’s social network.

Apparently, illness behavior is impacted by various factors that include both gender and socioeconomic status. In addition, illness behavior in a society is dynamic and not static. As a society changes, illness behaviors change as well, including patterns of use of health services.

As noted by Hahn and Gaines (1984), earlier research studies demonstrated that biomedicine is a cultural system comprised of numerous variations.

The studies also stressed on the importance of observation and reporting on actual practices and beliefs, rather than employing negative or positive idealized versions of medical practice, so that it is possible to understand that the healing encounter is a social and cultural event involving communication across cultural or sub-cultural boundaries (Hahn & Gaines, 1984).

Unlike its characterization by proponents and opponents, biomedicine may be seen to be a part of the wider culture.

Theories of Supernatural Causation

The most prevalent and important theories of illness found cross-culturally in pre-modern societies involved theories of supernatural illness causation associated with personal assumption, meaning that some personal agent acted aggressively to cause the malady (Winkelman, 2008). Apparently, these notions are based on assumptions not recognized by modern medical science as being valid.

Although framed in supernatural terms regarding the powers of unusual humans or evil spirits, these theories may nonetheless represent important social and physical processes relevant to health. The most prevalent and important supernatural theories of illness are related to concepts of animism where attacks or punishment from the spirit entities are reflected in a universal theory of illness.

Animistic Causation

Animistic causes of illness involve the actions of a supernatural entity such as a spirit or ghost. These universal beliefs include the attribution that some unseen entity is the cause of our problems. According to Winkelman (2008), there are two types of animistic causation. These are spirit aggression and soul loss.

Spirit aggression is a universal belief that illness is caused by the aggressive action of the spirits, an attack that comprises the spirits putting something into a person or doing something to one’s body. On the other hand, soul loss involves a person having an aspect of his or her self, the soul or spirit, leave during a dream, or as a result of the soul being frightened or captured by a spirit or act of sorcery.

Magical Causation

Theories of magical causation involve the linking of illness to malicious actions of other people. Seemingly, the wicked human, sorcerer or witch, has negative effects on other people’s health from overt actions or inadvertent emotions, particularly envy or jealousy. A distinction between sorcery and witchcraft reflect important differences involving intentional and unintentional effects, respectively.

Sorcery includes the impairment of health caused by the intentional aggressive use of magic, affected either by an individual’s power or through assistance provided by a specialized sorcerer or spirits. According to Winkelman (2008), sorcery as a cause of illness is found in most societies of the world.

The other societies generally have beliefs in witchcraft, impairment of the health of persons, animals, or crops caused by involuntary actions by special types of persons with inherent powers to cause harm to others.

A similar belief is associated with the evil eye. In this belief, someone can inadvertently cause harm by among other things, looking at another’s property. Evil eye power is frequently thought to emanate from the eyes or mouth of persons as a result of their envy.

According to Burri and Dumit (2007), analyzing medicine as culture opens up a fresh perspective on knowledge practices and epistemic features in biomedicine, namely, the construction and fashioning of knowledge objects within science or on the arrangements and mechanisms in biomedicine that shape what is known and how it is known.

Biomedicine takes on responsibility for the release of its strange entities and facts into culturally diverse environments. Biomedical experts are, however, able to do so only in close collaboration with social science and the humanities.

Medicalization of Life

The concept of medicalization rests on the assumption that some occurrences belong in the domain of medicine while some do not. Typically, everything that we do or everything that happens to us affects or depends on the use of our bodies.

In principle, we can treat what people do or what happens to them as belonging in the domain of medicine. We can also claim that nothing that we do or nothing that happens to us belongs in the domain of medicine because everything is ordained by God and belongs in the domain of religion.

In some instances, medicalization has been used to reassure patients and relieve them of guilt, but at other times, medicalization has been held responsible of oppresses them, as when the complaints of poor and minority patients are dismissed due to bad or immoral behavior.

Equally wicked are the understated ways in which bias is built into the very diagnostic categories used by biomedical practitioners that force them to make marked distinctions between normal and abnormal and to use assigned categories of ethnicity or race to mark out those people assumed to be at differential risk for various conditions.

Generally, to understand medicalization primarily as enforced surveillance, as certain social scientists have done, is totally misleading and must be avoided. Individual citizens and even families frequently cooperate willingly with medical monitoring and management of bodily distress in the belief that they will also benefit.

In Brazil, local doctors were able to transform despair, misery, and suffering into the language of sickness. The decisions of local doctors to treat social illnesses as bodily ills and to see hunger, widely experienced by poverty-stricken shanty dwellers, as a nervous complaint rather than a symptom of politics of economic distribution were seen to represent an extreme case of what is commonly referred to as bad faith.

Through medicalization of the ailments of their patients, local Brazilian doctors consciously deflected attention from the more fundamental incubators of affliction that lie in social, political, and economic oppression.

Medicalization is regarded to be bad faith in that doctors and other health workers pretend to themselves and to others that they are not really involved in or responsible for what they are doing or the consequences of their actions.

According to Scheper-Hughes (1988), medicine can play a very critical role in reorganizing people’s needs. Although it has been argued that medicalization leads to the isolation of the experience of misery and domesticates people’s anger about the reality in which they are forced to live, it has a serious consequence of creating an over-dependence on medicines.

As an example of this negative repercussion of medicalization, consider a terrible illustration of the effect of drugs to isolated populations in Brazil. In September 1987, Goiania, a small town in central Brazil suffered a tough blow when several individuals were exposed to dangerous radioactive contamination. Due to ignorance and over-reliance on medicine, more than 200 people were seriously affected.

While some people applied the radioactive material on their bodies or faces with a hope of becoming more beautiful, others went on to swallow the poisonous substance in order to get healed from ailments (Scheper-Hughes, 1988). Clearly, this example demonstrates how these Brazilians had very high expectations of regaining their health status by depending on medicine regardless of the repercussions.

Apparently, the local physicians could not be accused of such incidences and nor could they be held liable of the free circulation of restricted drugs across the Brazil.

Nonetheless, they had to be blamed for not putting in place strict control measures to check against the importation of harmful pharmaceutical products into their country from places such as the United States, Germany, and Switzerland. Local physicians were also blamed for letting the citizens suffer due to their own selfishness and poor moral standings in the society (Scheper-Hughes, 1988).

The so-called bad faith thus operates among doctors and pharmacists, who let their knowledge and skills to be misused by the greedy in the society, and self-centered politicians who care less about the masses.

Conclusion

As has been discussed in this paper, turning to the use of medicine has completely changed the way the society views illness. In the past, people simply lived based on their cultural settings and never depended so much on advice from local medical practitioners. When people got sick, traditional approaches would be followed while explaining the cause of the illness.

Today, however, there is so much reliance on modern medicine and often times, people end up being treated by professional doctors. There is thus a medical explanation for any illness that a person may suffer from. Due to medicalization of life, most people have lost touched with their cultures and are now simply relying on doctors to guide them whenever they fall sick and are in need of treatment.

However, it is imperative for people to know that there are negative effects that are linked to the idea of medicalization. As explained earlier, heavy dependency on medicine can lead to undesirable consequences. Unfortunately, undisciplined doctors may indulge in illegal practices to satisfy their own selfish interests at the expense of the masses.

References

Baer, H. A., Singer, M., & Susser, I. (2003). Medical Anthropology and the World System. Westport, CT: Greenwood Publishing Group.

Burri, R. V., & Dumit, J. (2007). Biomedicine as Culture: Instrumental Practices, Technoscientific Knowledge, and New Modes of Life. New York, NY: Routledge.

Hahn, R. A., & Gaines, A.D. (1984). Physicians of Western Medicine: Anthropological Approaches to Theory and Practice. Hingham, MA: Springer.

Pool, R., & Geissler, W. (2005). Medical Anthropology. New York, NY: McGraw-Hill International.

Scheper-Hughes, N. (1988). The Madness of Hunger: Sickness, Delirium, and Human Needs. Culture, Medicine, and Psychiatry, 12, 429 – 458.

Singer, M., & Baer, H. (2011). Introducing Medical Anthropology: A Discipline in Action. Walnut Creek, California: Rowman Altamira.

Winkelman, M. (2008). Culture and Health: Applying Medical Anthropology. Hoboken, NJ: John Wiley & Sons.

Medical anthropology is regarded as cultural outsets of the corpse, physical condition, and disease. Medical anthropology is the science of ethnomedicine; elucidation of decease; what is the reason of decease; the appraisal of health, decease, and cure from both an ethic viewpoint; naturalistic and individual clarification, evil eye, the supernatural and sorcery; bicultural and political research of health surroundings; kinds of medical structures; enhancement of systems of medicinal skills and health care and patient-medic relations; political financial research of health philosophies and incorporating substitute remedial structures in ethnically varied surroundings.

Ethno medicine is also regarded to be the study of customary checkup practice. Theoretical classic-Medicine, Magic, and Religion classified medication as a civilizing structure. In Puerto Rico, spiritism proposes a customary option to social healthcare services. Two structures of healthcare are present in Ecuador. Healthcare in India is featured by checkup pluralism, comprising self-care, discussions with customary healers, and principal healthcare services (PHCs) These remedial structures are harmonizing, option, and alternative.

Moreover to conventional structures – Ayurvedic, Unani and Siddha there are ethnic types of medicine, spiritual treatment, and folk medication. Indian remedial procedure is not grounded on just customary medical procedures. The state healthcare plans are well-aimed but lack anthropological conference. To date, an investigation into customary medication has been covered chiefly by anthropology and it is offered that other technical regulations should be integrated to supplementary release and revalue this branch of the educational inheritance that has donated considerably to human health and the enhancement of native therapeutic skills and its reserves.

Therapeutic anthropology can be brusquely classified as that sphere of anthropological study that is connected with the components that originate, support, or donate to sickness or poor health, and the plans and observes that various human communities have enhanced to counter to sickness and decease. Medical anthropology is a sub-division of anthropology that is apprehensive with the use of anthropological and communal discipline hypotheses and methodologies to matters of health, disease, and medics.

Some remedial anthropologists are skilled mainly in anthropology as their main regulation, while others have researched anthropology after getting skills and working in the healthcare sphere or associated professions such as medicine, nursing, or psychology. Therapeutic anthropologists investigated settings as varied as countryside villages and urban hospices and hospitals. Medicine, healthcare, and disease are all partially cultural groups and various cultures have their own reasonable and optional way to deal with these. Medical anthropology looks at the ethnic beginnings of the body, physical condition, and disease. It also concentrates on health performance as a means to study the social charges and communal contacts.

In the USA, Canada, Mexico, and Brazil, cooperation among anthropology and medical sciences was originally regarded with implementing social health agendas between ethnic minorities and with the qualitative and ethnographic assessment of health structures (hospices and mental clinics) and key care services. Taking into account the social healthcare plans, the purpose was to determine the matters of instituting these services for a compound mosaic of ethnics.

The ethnographic assessment included analyzing the interclass disagreements within the structures which had an unwanted result on their secretarial reshuffle and their structural objectives, mostly those arguments among physicians, nurses, supplementary staff, and managerial employees. The ethnographic accounts show that interclass disasters straight impacted healing criteria and care of the ill. They also donated new practical criteria for estimating the new organizations resulting from the improvements as well as untried care methods such as beneficial communities.

The ethnographic confirmation maintained censures of institutional custodial and donated determinedly to strategies of deinstitutionalizing mental and social care in universal and led to, in some states such as Italy, a rethink of the teachings on tutoring and promoting healthcare.

The experimental replies to these matters led to anthropologists being comprised in lots of spheres. These involved: enhancement of worldwide health plans in developing states; estimating the impact of social and ethnic changeable in the epidemiology of particular forms of mental care pathology; research of cultural confrontation to modernization in medical care practices; and research of customary healers, folk healers, and experiential accoucheurs.

Also, since the 1960s, biomedicine in urbanized states has been challenged by a sequence of matters which require that is inspected the (unluckily-called) predisposing communal or ethnic issues, which have been decreased to mere changeable in quantitative procedures and subsidiaries to fundamental biological or genetic understandings. Among these the subsequent are of exacting note:

• The conversion among leading structures elaborated for sharp contagious pathology to a structure created for chromic degenerative pathology without any unambiguous etiological rehabilitation.
• The appearance of the necessity to enhance long-term conducts instruments and policies, as combated to perceptive healing conducts.
• The impact of ideas such as excellence of life in connection to classic biomedical healing criteria.

In addition to these are the matters connected with applying social health instruments. These matters are distinguished originally as instruments for struggling against imbalanced access to healthcare examines. Though once a complete service is obtainable to the community, new matters materialize out of racial, educational, or spiritual dissimilarities, or from dissimilarities among age collections, genders, or communal classes.

If implementing society care processes gives rise to one set of matters, then an entirely new position of matters also happens when these same devices are taken apart and the responsibilities which they once supposed are located back on the shoulders of particular members of the community.

In all these spheres, a restricted and qualitative ethnographic investigation is crucial for realizing the way patients and their social systems integrate skills on health and disease when their skills are shaded by compound cultural impacts. These impacts outline from the origin of social contacts in advanced societies and the impact of social contacting media, particularly audiovisual media and promotion.

Presently, research in healthcare anthropology is one of the key growth spheres in the area of anthropology in general. For this motive, any program is always arguable. In general, and subsequent five essential spears may be considered:

• the enhancement of structures of medical skills and medical care.
• the doctor and patient contacts.
• the addition of optional medical structures in ethnically diverse surroundings.
• the communication of social, surrounding, and biological components which influence health and illness both in the individual and the community as a whole.
• the impact of biomedicine and biomedical technologies in non-Western settings.

Significant areas have been eliminated, such as educational psychoanalysis and trans-cultural psychiatry or ethno psychiatry. These are scientific areas that have links with medical anthropology in terms of research methodology and theoretical production.

References

Chappell, Neena L., and Nina Lee Colwill. “Medical Schools as Agents of Professional Socialization.” Canadian Review of Sociology and Anthropology 18.1 (1981): 67-81.

Lambert, Helen. “Ethnocentrism: Reflections on Medical Anthropology.” Journal of the Royal Anthropological Institute 12.2 (2006): 481.

Introduction

Medical anthropology is one of the essential fields of study that primarily focuses on exploring how illness and health are understood, shaped, and experienced in relation to contemporary external factors. More and less narrow concepts and processes, including new pharmaceutical interventions or the impact of environmental disasters, are studied by medical anthropologists, and most healthcare news articles may be analyzed through the lens of this field. For instance, in her writing, Dusenbery (2018) examines the issue of health disparities and discrimination, which is today’s acute social and medical concern. The purpose of this paper is to explore the healthcare news article published by BBC and evaluate how specific anthropological concepts refer to its ideas and content.

News Article Overview: Discrimination in Healthcare

To begin with, before referring the writing’s content to the concepts studied in the medical anthropology class, it is necessary to review and summarize the news article. The main concern expressed in Dusenbery’s (2018) paper is that some people, especially women, low-income individuals, and racial minorities, cannot get access to adequate and high-quality medical services. While this century is marked by increased inclusion, tolerance, and awareness, there are still many gaps in healthcare that do not allow people to be treated and diagnosed equally, regardless of their income, gender, or race. This observation is also supported by other researchers and medical professionals. For instance, according to Anstey, Christian, and Shimbo (2019, para. 8), in 2017, more than 45% of adults in the U.S. were diagnosed with hypertension, but many of them could not receive proper medical support. Such a concern is also expressed by Carratala and Maxwell (2020), who highlight the prevalence of discrimination based on ethnicity, culture, income, and gender. Consequently, these disparities make it challenging for minorities to get diagnosed and treated adequately.

Medical discrimination is expressed not only in poor attitudes of particular healthcare employees. Unfortunately, as noticed by Dusenbery (2018, para. 6, 7), the general opinion among medical providers is that women and persons of color tend to exaggerate their symptoms, lie about the degree of pain they are experiencing, or confuse physical illness with a mental condition like ‘hysteria.’ Statistics show that minorities like people of color, low-income individuals, and women are “more likely than men to see 10 or more months pass between their first visit to a doctor and diagnosis” (Dusenbery 2018, para. 4). What is more, it was established in 2012 “that black patients were 22% less likely than whites to get any pain medication and 29% less likely to be treated with opioids” (Dusenbery 2018, para. 25). Consequently, mortality rates rise due to medical bias and errors. Indeed, this is a severe concern raised by the news article’s author, and this issue can be viewed through the lens of medical anthropology.

First Course Concept: Race

The first concept to be connected with the examined news article is race. As stated in the class presentation, race “is a form of identity used to describe physical and cultural variations within humanity.” While the concept of race is not scientifically supported, it is still medically significant due to various reasons. First, prejudices and biases are extremely common among healthcare workers (Anstey, Christian and Shimbo 2019, para. 8). Thus, it poses a great challenge to eliminate them and make healthcare providers view their patients only as patients, not as representatives of different cultures and ethnicities (Dusenbery 2018, para. 6). Second, medical professionals and researchers believe that persons of various races show different symptoms of the same conditions, and the course of some diseases is much more difficult in representatives of specific ethnic groups.

In the class materials, it is mentioned that there are two primary embodiments of race: direct and indirect. These observations are examined by Gravlee (2009) in their article. The direct embodiment of race may be seen in how discrimination based on skin color increases the risk of the individual’s condition deterioration. In other words, if a person experiences discrimination based on their ethnicity, they are likely to have or develop higher blood pressure, depression, low birth weight, preterm birth, abdominal adiposity, coronary artery calcification, risk of breast cancer, and other complications (Gravlee 2009, p. 48). As for the indirect embodiment of race, it is discussed precisely in Dusenbery’s (2018) news article. This concept refers to healthcare disparities, unequal access to high-quality and adequate medical services, and poor attitudes of professionals towards individuals of different skin color (Gravlee 2009, p. 47). One may agree that no inequality should be present in healthcare. Medical providers should treat their patients properly, regardless of their ethnicity, and cultural characteristics need to be taken into consideration only to improve health outcomes, not otherwise.

It is noticeable that both direct and indirect embodiments of race are covered in the selected news article. Dusenbery (2018, para. 25) talks about racial minorities, especially African Americans, receiving inadequate diagnosis and treatment primarily because of their skin color. The author also notices that women and low-income individuals tend to face similar experiences (Dusenbery 2018, para. 4). As for the direct embodiment, some diseases may be indeed more complex in Asians, African Americans, Mexicans, and people of other races. The question is whether this is due to differences at the genetic level, or it is the long-lasting severe discrimination that has deteriorated the health of ethnic minorities so much that their immunity finds it difficult to cope with many diseases.

Second Course Concept: Pain

The second concept to be explored in relation to the selected news article and medical anthropology course materials is pain. It is noticeable that this concept also refers to the one discussed above. Overall, as stated in the lecture, physicians, clinical social workers, and psychiatrists have always been interested in examining the nature and characteristics of pain, as well as determining whether people of various races could experience pain differently. Furthermore, according to Scheper-Hugh and Lock (1978, p. 10), who managed to investigate the aforementioned concepts, pain “was either physical or mental, biological or psycho-social-never both nor something not-quite-either.” At the same time, researchers tried to understand whether ethnicity could, to any extent, impact the individuals’ experiences of pain, and it is possible to say that many professionals were wrong in their conclusions (Clarke et al. 2022, para. 6). When some medics found out that the representatives of some ethnic groups experienced lower pain levels than other races, this conclusion resulted in numerous biases and medical errors (Hoffman et al. 2016, p. 4296). Therefore, it is essential to dispel this myth, which still affects society and healthcare providers who do not want to treat their diverse patients equally.

This severe concern is also mentioned in the selected article. As stated above, Dusenbery (2018, para. 4, 8, 9, 25) provides statistics that highlight that African Americans and other racial minorities face obstacles when receiving pain management and opioids. Healthcare workers tend to doubt the sincerity of such patients’ complaints of pain, so they do not want to take it seriously to reduce and manage it (Dusenbery 2018, para. 5). In the article by Hoffman et al. (2016, p. 4267), it is explained that there is a common misbelief among healthcare staff that there are “biological differences between blacks and whites,” like black people’s skin being thicker. Precisely this misbelief results in healthcare disparities and the fact that African Americans and other ethnic minority groups are undertreated for pain and underdiagnosed in general. Unfortunately, these people, as well as women who are believed to exaggerate the level of their pain (Dusenbery 2018, para. 5), face numerous severe challenges when merely trying to feel better and feel adequate medical support. These negative experiences and wrongful statements have to be eliminated, and people’s access to high-quality healthcare services free of discrimination should be promoted and increased.

Conclusion

To draw a conclusion, one may say that it is indeed valuable and informative to view some healthcare concepts and articles through the lens of medical anthropology. This scientific field deals with an extended number of valuable and necessary topics and processes that make it possible to better understand healthcare, from the concept of pain to how medicine and diagnoses can travel. The news article selected for this paper, as well as other additional research, demonstrates how a patient’s race can have a significant impact on the attitudes of medical workers and the way they perceive and treat this individual. What is more, precisely race, according to some biased healthcare providers, can influence the degree and nature of the pain experienced by the patient, which further adds to the process of medical disparities.

References

Anstey, D. Edmund, Jessica Christian, and Daichi Shimbo. 2019. “Income Inequality and Hypertension Control.” Journal of the American Heart Association 8 (15).

Carratala, Sofia, and Connor Maxwell. 2020. “Health Disparities by Race and Ethnicity.” American Progress. Web.

Clarke, Gemma, Emma Chapman, Jodie Crooks, Jonathan Koffman, Shenaz Ahmed, and Michael I. Bennett. 2022. “Does Ethnicity Affect Pain Management for People with Advanced Disease? A Mixed Methods Cross-National Systematic Review of ‘Very High’ Human Development Index English-Speaking Countries.” BMC Palliative Care 21 (46).

Dusenbery, Maya. 2018. “’Everybody Was Telling Me There Was Nothing Wrong’.”Web.

Gravlee, Clarence C. 2009. “How Race Becomes Biology: Embodiment of Social Inequality.” American Journal of Physical Anthropology 139 (1): 47-57.

Hoffman, Kelly M., Sophie Trawalter, Jordan R. Axt, and M. Norman Oliver. 2016. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs About Biological Differences Between Blacks and Whites.” Psychological and Cognitive Sciences 113 (16): 4296-4301.

Scheper-Hugh, Nancy, and Margaret M. Lock. 1978. “The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology.” Medical Anthropology Quarterly, 6-41.

What is female genital mutilation (FGM), why does it occur, what is it prevalence and how does it affect the women and girls in the society? How do we curb it and protect the women from it?

Female Genital Mutilation is the female circumcision or female genital cutting. It comprises all surgical procedures involving partial or total removal of the external genitalia or other injuries to the female genital organs for cultural or other non-therapeutic reasons. The health consequences of the practice vary according to the procedure used. Never the less it is universally unacceptable because it is an infringement on the physical and psychosexual integrity of women and girls and is a form of violence against them. They are different traditional practices that involve the partial or total removal of the external female genitalia and/or injury to the female genital organs.

FGC is seen as an understatement by many due to male circumcision. Without making judgments on the consequences of male circumcision, female circumcision represents a serious violation of a girl’s health and human rights; the most minimal form can affect her wellbeing in a negative way. The use of the word “mutilation” reinforces the idea that this practice is a violation of girls’ and women’s human rights, and thereby helps promote national and international advocacy towards its abandonment. At the community level, however, the term can be problematic. Local languages generally use the less judgmental “cutting” to describe the practice (Amnesty, 1998).

There many classifications of Female Genital Mutilation. Excision of the prepuce, with or without excision of part or the entire clitoris, this is known as Type I or Type A. Excision of the clitoris with partial or total excision of the labia minora is classified as Type II or B. Excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening or in other words infibulations, this is the Type III or C. The unclassified form includes piercing or incising of the clitoris and/or labia, cauterization, scraping, or cutting of vaginal tissue etc. These operations are all irreversible. Acute complications include death, hemorrhage, shock, infection and severe pain. In addition, women can suffer severe long-term damage to their reproductive and sexual health, risk HIV infection, and are often left with psychological scars (Amnesty, 1998).

Female genital mutilation is an age old practice that its roots are not found. The origins of this practice are unknown. It existed before the beginning of Christianity and Islam. It is not required by the Quran or the Bible. It crosses religious lines. It also crosses ethnic and cultural lines and is performed in many countries around the world, but is most prevalent in Africa. FGM is prevalent in 28 African countries, in a few Arab and Asian countries, and among certain African immigrants in the West (Yoder et al, 2004).

An estimated 130 million girls and women worldwide have undergone the practice, with another three million girls being affected each year. Types I and II account for 80 to 85% of all cases, although the proportion may vary greatly from country to country. For instance in Djibouti, Somalia and Sudan most women undergo Type III. Infibulations is practiced on a smaller scale in parts of Egypt, Eritrea, Ethiopia, Gambia, Kenya, Mali, Malaysia, Oman, Saudi Arabia, Israel and Pakistan. Some immigrants practice various forms of FGM in other parts of the world, including countries in Europe, the United States, Canada, New Zealand and Australia. Many of these countries have enacted laws banning the practice. In countries where it is practiced, FGM affects a segment of the population that is critical for development, economic growth and prosperity. These development and health implications and concern over the violation of basic human rights make FGM a matter of pressing concern. FGM is also an important reproductive health issue, but it must be approached with clear understanding of the cultural context in which it is practiced (Yoder et al, 2004).

FGM tends to be justified among others because of many reasons. The apparent need to control women’s sexuality was seen as men empowerment over women. It was also viewed as an alleged medical advantage of genital cutting. Religious obligation and the belief that female circumcision was the only cleansing customary tradition made it rampant in prevalence. Implicitly underlying these is the social construction of female sexuality and identity. In the psychosexual beliefs it attenuated sexual desire in the female hence maintaining chastity and virginity before marriage and fidelity during marriage and it was also believed to increase male sexual pleasure. It was believed in the sociological class as identification with the cultural heritage, initiation of girls into womanhood, social integration and maintenance of social cohesion. Among some societies, the external female genitalia are considered unclean and unsightly, and so are removed to promote hygiene and provide aesthetic. It is practiced in a number of communities, under the mistaken belief that it is demanded by certain religions. Others have the belief that it enhances fertility and promote child survival (Gruenbaum, 2001).

FGM can have devastating and harmful consequences for a woman throughout her life. The health problems a girl can experience depend a great deal on the severity of the procedure, the sanitary conditions in which it was performed, the competence of the person who performed it and the strength of the girl’s resistance. Old women and barbers who perform FGM are medically unqualified and can do extreme damage to a woman or a girl, sometimes resulting in death. In cases where the procedure is carried out in unsanitary conditions and unsterile equipment is used, the dangers of infection are great. When it is performed in the sanitary conditions of a hospital by qualified personnel risk of infection may be reduced, but the long-term consequences remain (Amnesty, 1998).

Short-term consequences include bleeding (often hemorrhaging from rupture of the blood vessels of the clitoris) severe bleeding sometimes leads to death. Post-operative shock may occur. There will also be damage to other organs resulting from lack of surgical expertise of the person performing the procedure and the violence of the resistance of the patient when anesthesia is not used. Infections, including tetanus and septicemia, can occur because of the use of unsterilized or poorly disinfected equipment. Urine retention caused by swelling and inflammation causes’ great pain to the females (Amnesty, 1998).

Long-term consequences vary from procedure to the next. Chronic infections of the bladder and vagina can easily occur in all types. In Type III, the urine and menstrual blood can only leave the body drop by drop; the build up inside the abdomen and fluid retention often cause infections and inflammation that can lead to infertility, dysmenorrheal, or extremely painful menstruation. There is excessive scaring of tissues at the site of the operation. Cysts form on the stitch lines. There is a possibility of child birth obstruction, which can result in the development of fistulas. The vaginal and/or bladder wall might tear up due to pressure build up and chronic incontinence. There is a growing speculation of a potential risk of HIV/AIDS associated with the procedure, especially when the same unsterile instruments are used on multiple girls.

Reinfibulation must be performed each time a child is born. When infibulation (Type III) is performed, the small opening left in the genital area is too small for the head of a baby to pass through. Failure to reopen this area can lead to death or brain damage of the baby and death of the mother. The excisors must reopen the mother and re-stitch her again after the birth. In most ethnic groups the woman is re-stitched as before with the same tiny opening. In other ethnic groups the opening is left only slightly larger to reduce painful intercourse. (In most cases, not only must the woman be reopened for each childbirth, but also on her wedding night when the excisors may have to be called in to open her so she can consummate the marriage.)Scientific studies are needed on the precise psychological effects of FGM on a girl or woman. However, changes have been observed in some girls who have been subjected to the procedure. Nightmares, depression, shock, passivity, feelings of betrayal are not uncommon among these girls (Amnesty, 1998).

In order to contain the vice various things must be placed in consideration. Building a protective environment for children is a major point to ponder as there the most vulnerable in the group. The attitudes, traditions, customs and beliefs need to change. Governments need to show commitment to ending female genital mutilation by supporting those fighting the vice. Children and adolescents need to be informed and enabled to reject female genital mutilation. Understanding the prevalence and nature of female genital mutilation is an essential first step to addressing it. Medical services have to be able to respond to the consequences of female genital mutilation promptly to avoid deaths or long term effects, and the education system should be able to contribute to preventing of the vice. There should be a non-coercive and non-judgmental approach whose primary focus is the fulfillment of human rights and the empowerment of girls and women. Awareness should be brought in on the part of a community of the harm caused by the practice. They should decide to abandon the practice as a collective choice of a group that intermarries or is closely connected in other ways.FGM. A process should be organized to diffuse and ensure that the decision to abandon FGM spreads rapidly from one community to another and is sustained (Yoder et al, 2004).

Other methods according to Amnesty (1998) are the empowerment of women by supporting micro credit schemes for women, job training of former excisors in other occupations, provision of information on the human rights of women, efforts to increase women’s participation in and access to decision-making in institutions of power and governance at local, national and international levels. Enforcement of FGM laws by supporting host countries’ efforts to draft, implement and enforce legislation pertaining to FGM. Support dissemination of information about the law throughout the country in all local languages. These can also be done by supporting provision of graphic information about the law in those areas of the country with a high degree of illiteracy and training for law enforcement officials, judges and lawyers about the law. Include in any information campaign about the law, information on the harmful effects of FGM on a woman’s health.

Bibliography

Amnesty International (1998), “Section 1: What is Female Genital Mutilation”, Female Genital Mutilation – A Human Rights Information Pack. Web.

Gruenbaum, Ellen (2001), the Female Circumcision Controversy, University of Pennsylvania Press, Philadelphia.

Yoder, P. Stanley, Noureddine Abderrahim and Arlinda Zhuzhuni, female genital Cutting in the Demographic and Health Surveys: A Critical and Comparative Analysis, DHS Comparative Reports No. 7, 2004, ORC Macro.