Alan Harwood - Böcker

A guiding principle of international primary health care since the 1970s is contained in the slogan, 'community participation in health'. In practice, however, national and local political considerations are often decisive in the implementation of health policies. Dr Morgan shows how 'community participation' was sacrificed to competing political priorities even in Costa Rica, a country known for its dedication to health care. Focusing on a banana-growing community, she documents and analyses the process by which local health policy is politicized. Her sophisticated case study sets a detailed rural ethnography in both a national and international context. This book will be of great interest to medical anthropologists, planners, and anyone concerned with international health and development policy.

A guiding principle of international primary health care since the 1970s is contained in the slogan, 'community participation in health'. In practice, however, national and local political considerations are often decisive in the implementation of health policies. Dr Morgan shows how 'community participation' was sacrificed to competing political priorities even in Costa Rica, a country known for its dedication to health care. Focusing on a banana-growing community, she documents and analyses the process by which local health policy is politicized. Her sophisticated case study sets a detailed rural ethnography in both a national and international context. This book will be of great interest to medical anthropologists, planners, and anyone concerned with international health and development policy.

Morality and medicine are inextricably intertwined in rural Haiti, and both are shaped by the different local religious traditions, Christian and Vodoun, as well as by biomedical and folk medical practices. When people fall ill, they seek treatment not only from Western doctors but also from herbalists, religious healers and midwives. Dr Brodwin examines the situational logic, the pragmatic decisions, that guide people in making choices when they are faced with illness. He also explains the moral issues that arise in a society where suffering is associated with guilt, but where different, sometimes conflicting, ethical systems coexist. Moreover, he shows how in the crisis of illness people rework religious identities and are forced to address fundamental social and political problems.

This book examines the role of the Nepali physicians in the revolutionary changes in 1990. These doctors are trained in the Western tradition, and participate in international scientific debates, yet they have always been concerned to develop a form of medical practice that was relevant to Nepali conditions, and which could speak to local conceptions about health, and so their medical practice was always politicized. Vincanne Adams argues that the commitment of these professionals to the values of science, and to public health, was crucial in their political activity, and that ideas and practices associated with the notions of 'democracy' and of 'science' supported each other. Describing her book as 'a story that explores how very fine the line is between politics and scientific medical truth claims', it therefore encompasses both the modern political history of Nepal and the role of medicine in a poor, largely rural, Hindu kingdom.

Some of the most interesting ethnographies of experience are concerned to highlight the indeterminate nature of life. Questioning Misfortune is very much within this tradition. Based on a long-term study of adversity and its social causes in Bunyole, eastern Uganda, it considers the way in which people deal with uncertainties of life, such as sickness, suffering, marital problems, failure, and death. Divination may identify causes of misfortune, ranging from ancestors and spirits to sorcerers. Sufferers and their families will then try out a variety of remedial measures, including pharmaceuticals, sorcery antidotes, and sacrifices. But remedies often fail, and doubt and uncertainty persist. Even the commercialisation of biomedicine, and the peril of AIDS can be understood in terms of a pragmatics of uncertainty.

Some of the most interesting ethnographies of experience are concerned to highlight the indeterminate nature of life. Questioning Misfortune is very much within this tradition. Based on a long-term study of adversity and its social causes in Bunyole, eastern Uganda, it considers the way in which people deal with uncertainties of life, such as sickness, suffering, marital problems, failure, and death. Divination may identify causes of misfortune, ranging from ancestors and spirits to sorcerers. Sufferers and their families will then try out a variety of remedial measures, including pharmaceuticals, sorcery antidotes, and sacrifices. But remedies often fail, and doubt and uncertainty persist. Even the commercialisation of biomedicine, and the peril of AIDS can be understood in terms of a pragmatics of uncertainty.

This book shows how practitioners in the emerging field of 'cultural epidemiology' describe human health, communicate with diverse audiences, and intervene to improve health and prevent disease. It uses textual and statistical portraits of disease to describe past and present collaborations between anthropology and epidemiology. Interpreting epidemiology as a cultural practice helps to reveal the ways in which measurement, causal thinking, and intervention design are all influenced by belief, habit, and theories of power. By unpacking many common disease risks and epidemiologic categories, this book reveals unexamined assumptions and shows how sociocultural context influences measurement of disease. Examples include studies of epilepsy, cholera, mortality on the Titanic, breastfeeding, and adolescent smoking. The book describes methods as varied as observing individuals, measuring social networks, and compiling data from death certificates. It argues that effective public health interventions must work more often and better at the level of entire communities.

Daniel Moerman presents an innovative and enlightening discussion of human reaction to the meaning of medical treatment. Traditionally, the effectiveness of medical treatments is attributed to specific elements, such as drugs or surgical procedures, but many things happen in medicine which simply cannot be accounted for in this way. The same drug can work differently when presented in different colours; drugs with widely advertised names can work better than the same drug without the name; inert drugs (placebos, dummies) often have dramatic effects on people (the 'placebo effect'); and effects can vary hugely among different European countries where the 'same' medical condition is understood differently, or has different meanings. This is true for surgery as well as for internal medicine. This lively 2002 book reviews and analyses these matters in lucid, straightforward prose, guiding the reader through a very complex body of literature, leaving nothing unexplained but avoiding any over-simplification.

Originally published in 1970, this book explores the role of concepts of disease in the social life of the Safwa of Tanzania, particularly through beliefs concerning witchcraft and sorcery. Examining Safwa ideas about the cuasation of disease and death and the use of aetiological terms in actual cases, it demonstrates a parallel between these ideas and terms, on the one hand and the Safwa system of social categories on the other. A descrption of the Safwa environment, way of life and social system is followed by an account of the concepts of death and disease and of their causes as revealed in ancestor rites, divination and autopsy. An analysis of case histories demonstrates that the cause assigned to a particular instance of illness or death depends upon the status relationship between discputing parties who are associated with the patient. The way in which the parallel between aetiological and social categoeis helps to control the outcome of disputes is also examined.