Medical Anthro Final Review

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medical anthro definition

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- subfield of anthro: social, cultural, biological and linguistic anthro to better understand factors which influence health and well being
- includes experience and distribution of illness, prevention and treatment of sickness, healing processes, social relations of therapy management

-different theoretical approaches, examine how health of individuals, larger social formations and the environment are affected by interrelationships bw humans and other species; cultural norms and social institutions, micro and macro politics, forces of globalization as each of these affects local worlds

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Peter Brown's 5 subdisciplines of medical anthro and what does he leave out
1. biological
2. ecological.
3. ethnomedical

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1. is evolutionary med, working through colonial history, 'why do ppl have diabetes', were all biological creatures, colonial histories + archeological evidence to understand degree of genetic adaptation
local biologies= in contrast to biological anthro
2. relationships bw organisms and their environment (malaria, schistosomiasis)
ex ppl living on stilts to not get malaria, ppl have own way of relating to environment and avoiding illness (culturally learned- prevention)
3. study of how members of different cultures think about disease and organize themselves toward treatment and social organization of treatment (challenges taussigs medicine as ideology), all societies provide aetiology methods of diagnosis and practise for care
4. critical theory; critically examine our own intellectual assumptions political economy, ex. structural violence, repressive anture of pwoer
5. working on clinical setting to solve problems, closer to public health, ex smoking in old age homes

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4. critical medical anthro (CMA)
5. applied anthro

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4. critical theory; critically examine our own intellectual assumptions political economy approach: how large scale political, econ and cognitive structures constrain individuals decisions, behaviour and their risk for disease
ex. poverty socially constructed, structural violence, repressive anture of power
** HIV/AIDS in haitai as a consequence of US political neglect for centuries?
5. working in health organizations, med schools and businesses, working in clinical setting to solve problems, closer to public health, ex smoking in old age homes
ex. age old diseases as Kuru; transmitted through practices of women and children who prepared dead bodies and consumed the dead

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cultural difference; culture can be defined as 3 basic components??

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1st attributed to either climate or race

1. economic & material culture
2. social organization and power relations
3. belief systems

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epistemology and ontology

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idea of how people know things (how ppl produce knowledge) vs things that we know (you've already figured it out)

-epist= assumptions about knowledge and truth making (azande)
- ontol = assumptions about reality and being

ontology= there are no witches, vs the systems of knowledge and thought of the Azande (epistemology)

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E.E Pritchard's paradox and rationality debate; Azande

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paradox= rationale, progressive ppl that believe in witchcraft though no one is a self conscious witch
1. self confirming
2. self vindicating
3. self validating

=anthro question of that time was how tun understand rationality when something doesn't make sense to our rational scientific minds
- the Azande were rational and progressive and had their own system of knowledge --> witchcraft= natural philosophy

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3 different oracles and their rationale

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- hierarchy of oracles which were devices for revelation that the Azande consulted for a wide range of things --> knowledge, guidance, memory, truth derived from the oracle

termite oracle= 2 branches from different trees inserted into termite mound and left overnight
rubbing board= a device made of 2 small pieces of wood, easy carried and to be consulted anywhere
poison oracle= poison administered to small chicken, most costly and difficult to administer

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emic vs etic point of view

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inside view; how local people think their perceptions, categories; outside view (scientist orientated), interpretation of the anthropologist

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sickness thought:
2 ways disease vs illness

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2 parts of sickness= disease & illness
disease= pathologies and clinical bio manifestations
illness= human perceptions and experience of health

** sometimes people are ill without any presence of disease (psychosomatic ex. sick building syndrome
** sometimes ppl have diseases but are not ill
ex. HIV but fully well and functioning body*

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explanatory models (Kleinman); 3 characteristics; young's critique of it

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1. analytic (way of analyzing ones sickness predicament)
2. pedagogic (ways to training medical students to understand the patients POV)
3. clinical (ways to understand the patients disease)
ex. explanatory outside of western biomedicine like illnesses that are geographic specific (nervios in mexico, soul loss among hmong); boomed ideas for treatment for worms s more traditional ideas about treatment of worms

Geissler= Luo have biomed and indigenous traditional EMs for explaining worms in the body --> they don't clash, Luo are able to explain both rationales

critique= indivudalistc, ignores power relations, sickness not a blanket term

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semantic illness networks (Good); limits to it

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ex. heart distress --> contraceptive pill --> menstrual blood --> pollution
= pathways linking symbolic with physiological, role of language in linking social experices to disease, strategic use of illness language, how change in med language can lead to broader social change
- EM are the organizing framework for SIN
** gives meaning to one's illness, gets at the core, organized through core symbolic elements, language, meanings

limits= tended to focus on individual symptoms rather than larger health issues (ex feminist interpretation focus on women's oppression in being confined to small living quarters living and take care of multi gen)

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medicine as ideology (Taussig)

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- western med is just as much a part of the ideological apparatus of our social order; desocialized facts of nature and reified
- medical values part of an ideology
- biomed desocializes the science of med (becomes facts of nature) without considering how it reinforces a greater political ideology (vs CMA looking at critical violence)
- standard alc consumption changes in different cultures

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sociocultural orientation; empiricist vs non-empiricist

anthropology of illness

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- medical soci: get facts right hen figure out puzzle; facts and anthros ideas themselves also subject to particular historical and social determinants

=understand illness in order to improve disease outcomes, learn ppls explanatory models in order to cure them,

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anthro of sickness

sickness= process for socializing disease and illness

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= social forces and social relations permeate medical antrho's field; key concepts in anthro of illness, healing, illness efficacy, ex can't be understood without understanding larger whole systems

1. plural med systems (who gets what illness depends on diagnostician)
2. physicians have right to diagnose, to translate sigs and symptoms into illness

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Young: sickness as a process for socializing disease and illness

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- sickness not a blanket term but incorporates illness as a social process
- EM and SIN are too individualistic and ignore power relations, sickness shouldnt be used as a blanket term but be incorporate illness as a social process

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Deborah Gordon's assumptions of biomed

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autonomy of nature (7 assumptions)
1. naturalism (autonomy of nature over the supernatural and separation of reality and knowledge)
2. nature is autonomous from human consciousness (reality exists and is observable and distinct from observer; distinguish bw signs; objective dincitors of patients disease vs symptoms: bodily complaints, feelings, illness
3. atomism (part is independent of whole, diseases separate entities from their host), treat lungs, heart, throat separately
4. nature is separate from culture (nature characterized by a unitary ontology,not separate from culture but prior to it)
5. nature is separate from morality (is indifferent to good/evil,
6. nature is autonomous from society (natural is beyond sphere of social influence; gender differences not learned but natural, disease outcomes 4 diff social classes= individual problems)
7. nature and truth are universal, separate from time and space (doctor tells truth bout disease as if theres only 1 truth)

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assumptions of biomed contd

3 assumptions possessive individualism

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autonomy of individual (3 assumptions )
1. autonomy of rationality
- separation bw reality an culture, separate from morality, knowing means separating self from reality (maintain differences bw subjective and objective)
2. autonomy of human beings
- sovereign individual, human begin as single unit (NA tend to define fetus as separate from womb carrying it, individual is prior to society and culture)
3. autonomy of morality
- defend sovereignty of individual body ex bioethics, naturalism as bedrock of morality

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deborah gordon argues??

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be careful not to blame biomed for its ills to just reproduce its ideology bc it is autonomous from society and individuals in society= mutually reinforcing
** if its dehumanizing, need to consider what we mean by begin human in western society

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Gavsie lecture on CAM- what is it and what are its assumptions; integrative medicine; who uses it; 3 legged stool of health

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-focus onto the disease from the whole person
- anything that is not conventional medicine is alternative med/complementay such as TDM, osteopathy, homeopathy
= whole med systems= naturopathy, homeopathy, TCM
mind body med= meditation, breathing, yoga,
biologically based practices= nutrition, herbal and plant med
manipulative & body based practices= manipulation, massage, chiropractic
energy med= biofield therapies, bioelectromagentic based therapies

= healing oriented med that takes account of the whole person (body, mind, spirit), including all aspects of lifestyle emphasizes therapeutic relationship and makes use of all appropriate therapies

- those with higher levels of education, more exposure to health paradigms, chronic health problems,
= stress reduction, nutrition and diet, exercise

assumptions- complementary alternative medicine used in conjunction with conventional biomedicine

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biomedicine studies as a cultural object; rhodes

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mary jo good= historically, chronologically, global, local or national comparisons, clinical narratives
ex. dementia in North America and Japan

Rhodes= biomed is one kind of ethnomed; anthro use to distinguish bw biomed systems of healing as science and ethnomed as folk explanations; ethnomed based on the idea that all societies can explain: disease aetiology, methods for diagnosis, prescriptions and practices for curative, palliative or preventative care

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shamanism; soul loss; cultural relativism***; cultural brokers

cultural relativism understood in 3 ways

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= role of shamanism and healing for the Hmong
= Hmong diagnosis of Lia's condition vs biomed diagnosis of epilepsy
= have to maintain careful balance bw oblivious relativism with institutional intolerance; the idea that all ethical truths are relative bw different cultures, certain kinds of behaviours are right or wrong relative to a specific society/community/culture
=all ethical truth is relive, not say a certain behaviour is right or wrong; only that a certain kind of behaviour is right or wrong relative to a specific society/community
1. moral relativism (ethics depend on a social construct ex lia lee) 2. situational relativism (right or wrong is based on the particular situation) 3. cognitive relativism (truth itself has no objective standard) god vs evolution both right and both wrong

brokers=important in bridging and mediating bw groups of different cultural backgrounds; lia's fam lacked these resources, could have positively impacted Lia's experience n rel w doctors

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tropical disease model vs epidemiological model

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that a place needs to be cleansed vs that ppl need to be cleansed of disease

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Hmong story of Lia Lee; ethnomedicine and biomedicine, what happens when they clash what happens when different explanatory models are used

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- biomedical systems= scientifically based & ethnomedicine (folk explanations)
- parents, doctors, social workers and other health personnel, historical different perspectives on soul loss and how bio med erased these folk interpretations, where Hmong

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illness narratives; fadiman book about illness narrative from what 3 perspectives

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- hmong have ambivalent relationship to epilepsy, developing countries have higher incidence rate

- epilepsy= socially devalued condition, labelling theory, ideas about contagion and disgrace of losing bodily control

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historical different perspectives on soul loss and how biomed erased these folk interpretations, where Hmong ideas still incorporate in ethnomed

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1. ancient greek philosophy
2. early christianity: care of the soul, caring for others souls
3. descartes realm of reality vs realm of divine: constitution (physical aspects vs non-physical), parameters (closed contain dysstem vs unbounded), functionality (lacks volition/self motion vs controls physical realm but doesn't participate in it), epistemology (analyzed rationally vs known thguoh divine revelation, religious teachings)
4. ancient jewish theories= death & resurrection,
5. hinduism= reincarnation= an alternate pathway
6. buddhism= body and soul ethics, renouncing attachment

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animism
spirit possession, soul loss, witchcraft

western med= psychiatry, mind, soul

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dreaming and breathing, disembodied spirits, ancestors and the dead, having 2 parts: belefi in the human soul that survives bodily death and belief in other spirits, including deities

= itnernalzinig and externalizing systems, exorcisms, seances,

=

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internalziing vs externalizing med systems

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2 anthro ways of classifying medical systems approaches to illness and disease
internal= autonomous to a high degree, physical health is not overtly linked to social or moral health (biomed)

external= focus on social and cosmological relations, interlinked with other cultural domains like religion, have little conceptual autonomy (Azande and witchcraft; hmong and spirits and soul loss)

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split horn about the shaman; his story and what it tells us about explanatory models, SIN, & ideology

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-

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chinese traditional medicine vs biomedicine; similarities

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= over 3000 yrs of history,
shang dynasty=oracle bones ex of healing practices
- science and tech key to modernizing china, Mao claimed TCM as chinas unique heritage, acceptable way of thinking
- helps restore body to balance and works on an energetic level, energy follows thru channels thru body
- links bw yin and yang and 5 elements, pathogenic factors of external environment as a cause of disease

=disease processes in body, neither focuses on public health or preventative med, focus on remedies and to relieve suffering have to induce disorder to restore health
similarites= disease processes in body, neither focus on public health or preventative, focus on remedies
differnces= TCM own forms of diagnosis, treatment, therapies, philosophy, epistemology, helping to restore balance in the body --> meridians and Qi

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5 elements theory for TCM

yin-yang theory

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1. wood for construction
2. fire for warmth
3. earth produces crops for survival
4. metal for tools
5. water all life depends on it

- day is to night as heat is to cold, sumer is to winter

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everett zhangs concept of moral symptomology

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maoist= shame of impotence felt as a moral shortcoming thus treatment for yijing
post maoist= frame impotence as an eidetic that need med attention as a med condition thus treatment for impotence

= history and politics influence medicine, judgment knowledge and practice , societies can produce difference diseases by giving them attneiton in rank order of their moral importance and creates different kinds of medical patients

- case of impotence and nanke in post maoist china; social course of an illness: societies produce different diseases by ranking conditions based on moral values, producing different medical subjects
Mao era: sex --> reproduction--> part of collective --> population growth.... impotence shameful bc can't reproduce but desire more shameful bc it goes against the collective

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evidence based medicine; strengths and shortcomings

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- its not new, particular kinds of evidence are considered acceptable, conscientious explicit and judicious use of current best evidence in making decisions about the care of individual patients , is he current best evidence in making deiciosns about care of patients BUUUTTT now reduced to RCT evidence

=RCT has limits like noone over 64 yrs, women of childbearing age excluded etc, illness narratives can't be part of RCT; in order to validate a treatment, certain ppl are excluded from trials, want to assess evidence and there no place for illness narratives
ex. evidence based popular in china**

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controversy over current organs donation strategies

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- body parts sold as commodities, cadaver and living donors
- idea of gift, trade and exchange in organ donation, body parts should eb donated as gifts (gift economy- margaret lock)
- shortage of particular organ donors bc of: fewer car accidents, trauma units better, aging population, public health effective, increased numbr of waiting lists, confusion and misunderstandings

commodity fetish= organs as a commodity fetish,

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Jason Berhman's work on gay organs, why leave out LGBT donors and what it does for organs procurement

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stigma against LGBT community: oppression and power are based on heteronormative and hetero-superior assumptions of sex, gender, sexual orientation vs minority status
- core issues in health: over medicalziation and pathologizaiton in the LGBTIQ community: underlying social-cultural-medical values that define disorder vs normal diversity --> health policies perpetuate this stigmatization and othering
- men who have had sex with man from lifetime ban to 5 yr ban to donate blood

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stigma against LGBT community

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gfbcv

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M. Lock's solution to moving from opt out to opt in system

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- opt in system in canada might be reason for donor shortage

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fictive kinship (lesley sharp lecture)

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- most common is godparents, donors mothers and fathers (reconfigurations of kinship)

- donor mothers and fathers reconfigure these ideas of kinship --> contrast to schneiders biogenetics

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commodity fetish (MArx) but applied to organs, what does it mean

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- fetisihism brigns out the magic of a commodity; objects can have a use value (a kind of magical power invested in things and objects) --> then once it enters the economic market, the object takes on an exchange value --> commoditfication of an object

- human labour also becomes obscured: real producers are hidden, the relationship exists bw object and market (think of anonymity of organ donation); organs become a commodity fetish

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social life of things (Appadurai)

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social life of organs= follow gender differences in USA, men can sell sperm, women must donate eggs

- things/objects can take on a life of their own and you can follow their trajectories as they are circulated socially --> think of these things as taking on social lives of their own

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biogenetics (schneider)

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- american bilateral kinship relations, self defined through blood ties to both parents, biogenetic quality understood as natural, biological determinism

- american kinship organized in terms of blood (nature) and marriage (law)
- self defined through blood ties to both biological parents
- biogenetic quality understood as natural
- biological determinism
- contrast to Sharps idea of fictive kinship

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cultural amnesia (Lesley sharp)

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- refusal to recognize the hybrid nature of dead bodies as potential donors, both dead and alive at same time

- cultural refusal to recognize the hybrid nature of dead bodies as potential organ donors: donors and organs are simultaneously dead and alive

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biotechnical embrace (MJ Good)

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- medical imaginary= affective, imaginative dimensions in science
- biomed takes place in a political economy of hope for the technological advances of medicine and science- driven also by the local culture (patients)
- leads to an embracing of medical technologies, pharmaceutical drugs

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biological citzenship (Petryna)

disease mongering (Moynihan)

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idea that your biological markers are what helps you obtain access to health care, ex. post-chernobyl ukraine --> leads to a new economy of illness and health care
- linked to the idea of ethical variability: international ethical standards become more lax in these settings of poverty --> the critique is that pharmaceutical industry taking advantage of these global inequalities/ disparities in health

- the corporate construction of disease vs the social construction of illness, critique of pharmaceutical companies, a specific kind of corporate driven medicalization

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randomzied clinical trials- stregnths and limits of them

guinea piging (Carll Elliot)

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3 stages= aim to test all procedures, drugs, techniques for...1. efficacy (test intervention more good than harm under ideal conditions) 2. effectiveness (intervention more good than harm in real world) 3. safety

- oversimplifies clinical care, treats patients as one cohort, social, economic and gender of patients makes a difference in not just care but cuases of illness
ex. tuskegee syphilis experiments , nazi medical experiments

= ex chicago shift work study

- idea of health ppl as professional guinea pigs --> a business transaction bw testers and test subjects: health ppl can't expect therapeutic benefit to taking the drugs (unlike sick ppl in later stage clinical trials who need to gain access to a new drug), halt subjects are compensated

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HeLA cells

te racialziaiton and seuxalizaiton of henrietta Lacks

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-immortal cell line extracts from the cancerous cervical cells of henrietta lacks
- radicalization and sexualization of henrietta lacks as an african america woman: metaphors used to described the moral qualities of her cells
- used in the context of our class as an ex of biological citizenship

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anne causto-sterling and cultural and biological constructions of sex and gender

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- anthro interested in question 'how many genders' are there in different societies --> different societies can have vastly different notions of gender --> challenging the binary dualism of male and female and biological essentialism (history of science)
** gendered behaviour and identity neither universal nor constant throughout the life cycle

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sex vs gender

gender as performance

interest conditions
interest society of north america

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biological basis for classifying persons as females or males, social process that assigns sex at the first ultrasound scan and reinforced at birth by examining external genitalia
vs
- gender norms must be continually reaffirmed and expressed through social practice, everyone possesses a sex but its what members of the 2 sexes perceive as behaviour that constitutes gender

=soemthign that must be performed every single day, how are we reinforced by our gender? it is an everyday eprfroamnce, how we reproduce carry present gender roles in social relations --> dress, speech, physical appearance, activities

Hyde's research**** on endocrinology and interest infants in Boston and San Francisco; medically accepted (genitals)
- paediatricians encourage parents to assign gender to child immediately, although parents may wish for child to decide their gender on their own
- divergent views of paediatric endocrinologists: operate immediately with parental consent vs wait for childs cons

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cheryl chase and ISNA- challenges to biomedical treatment options in the 2000s

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thfbgvc

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what the alphabet soup of sexual identity is LGBT

gendered behaviour and identity not universal??

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dfbvc

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epidemiolgoicla transitions

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1. nomadic to settled groups: (> 1000 yrs ago) rise in infectious diseases that accompanied neolithic revolution
2. industrial revolution (medical revolution) (>200 yrs ago): shift from infectious to chronic disease mortality associated with industrialization
3. infectious disease coming back and new ones emerging (antibiotic resistance) (>30 yrs ago): resurgence of ID mortality - re-emerging, emerging, and antibiotic resistant pathogens in the context of accelerated globalization of human disease ecologies
4.
** public health calling for input from social and behavioural sciences to address the complexity of the diverse sociocultural processes involved in the re/emergence of infectious disease- anthro position

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neoliberalism
neoliberal subjectivities

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free trade and open market, enhanced role of private sector, economic liberalization, privatization, deregulation by gov - wendy brown argues that this is a political rationality that produces a certain kind of ideal individual citizen/subject, someone who capitalizes on productivity - a good consumer, particular lifestyle - choices and desires for consumption
- consumption as eating and consumption as spending intertwined in the rise of market forces in china, human and non humans as consumables

-as consumers and consumables; post SARS and the feeding frenzy in china; racialzied bodies connected to unframeable/wild animals in terms of consumption- strategies of othering for both consumption and infectious disease correlation - aligning the chinese body with david beckham instead of the civet cat; related also to aspirations of middle class -- understanding neoliberal hybrids thru patterns of consumption: civet cat and grasshoppers to beckham

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Mei Zhan

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through bodily encounters of various humans and nonhumans during and after SARS, the uneasy conflation bw these 2 types of consumption have refigured orientalist tropes, while at the same time positioning them vis-a-vis neoliberal discourses of lifestyle and consumer choice

- consumption is heterogeneous and unruly , foregrounding and challenging the pervasiveness and seamlessness of neoliberal discourses and subject formation
Hybrid= boundaries of nature/culture, human/nonhuman, tradition/modernity, local/global - boundaries contested
**china doesn't fit model of neoliberal transition thru which consumption and market economy would be neatly linked up with private ownership, consumer choice and liberal democracy
- the key is to point out new ways of thinking about chinese socialist government, the SARS epidemic, consumption, pure neoliberal lineage, discourses about race and ethnicity

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biopower

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rise of the clinic and the nation state; power is diffuse and relates to the production of populations (closely aligned with disciplinary power but different bc about managing births, death, reproduction, illnesses of population - fostering life of a population, shift in 18th century- public hygiene methods**

**how chinese state that was very concerned about population dynamics, began to see HIV as a problem of risky bodies in a risky landscape- not just about epidemiological thinking but about geographic thinking as well - that the history of Sipsongpanna plays into colonial expansion of china for land, resources, and people (the colourful ehtnics who are often portrayed as the heart of china)

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habitus

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daily practices and habits reveal the macro frameworks people live within
- how ppl embody perceptions, thoughts, movements and actions, linked to structural position in society
- shows the internalization of power structures (in china, specifically the social structures)
**habitus of sex workers in book

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socialist governmentality

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triangle of govern mentality within the socialist circle
governmentality= art of government or the how to govern- the way that governments try to produce citizens best suited to fulfill their policies, ideologies; the organized practices (mentalities, raiotnalities, techniques) thru which subjects are governed
*** take from foucault- the diffusion of power so that govern mentality is everywhere, not just a matter of state power; aligned with the rise of economy/market forces and may lead to neoliberalism
** where the state retreats and market forces take over, except in chain end up with both, a hybrid govern mentality with HIGH socialist project like mapping disease among ethnic minorities and identifying them as risk groups and setting up 100 of centres for disease control and police stations every few blocks and relying more and more on foreign NGOs to manage prevention and spread of HIV/AIDS epidemic
CHINA= NEOLIBERAL HYBRID; are modes of surveillance still by high socialist

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transactional sex and HIV/AIDS

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sex as a transaction involves power dynamics but also complex multiple identities uses terms prostitute, sex worker or female entertainment worker
- mracialziation (tai lie as more promiscuous and sexier than Han; mimesis of tai-lue- performance of ethnicity, linking HIV as a prostitute as vector and client as the victim**
- women get it from clients to, considered higher risk at borders of China, thailand and othering of the disease both through gender and ethnicity
** surveillance by police and anti-epidemic stations (regimes of power, capitalization of fines and prevention of commercial sex

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hydes argument

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dai-lue women targeted as risk group bc of han prejudice against ethnic minorities, a tourist industry that incorporated a sex tourist industry and a burgeoning AIDS epidemic that had almost no (geographic) centre, meaning no way to understand how it got into china
** targeted as risk group without higher rates of hiv bc of these ways of imaging sexuality of dai-lue women (gendered and ethnic othering here)

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structural violence

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suffering is structured by historically given processes and forces that conspire... life choices are structured by racism, sexism, political violence and grinding poverty
** in haiti, aids, political violence, poverty are causes of death and suffering
- careful not to conflate structural violence within cultural difference --> leads to an othering and presumes that the anthropologist and his subject occupy different worlds; be way of using cultural relativism as a form of essentialism used to explain away assaults on dignity and suffering

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Bourdieu habitus and espanola heroin addicts

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- how they embody the social strutters, colonial history, poverty how these are engined with drug use

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human capital
social capital
cultural capital
economic capital
symbolic capital

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=knowledge, habits, social and peronsality attributes, creativity, cog abilities, ability to perform labor for economic value; education
= expected collective or economic benefits derived from preferential treatment and cooperation bw individual and social networks
= non financial social assets that promote social mobility beyond economic means- education, intellect, style of speech, dress, physical appearance
** sex worker sin chain don't have cultural capital bc they're a part of a shadow/underground economy, they don't have the education or cultural knowledge that confers power and status (doesn't mean they don't have economic capital)
= command over economic resources (cash, assets)
= resrouces available to an individual on basis of honour, prestige, teocngiton --> cultural value (ex. veterans, war hero)

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foucault and power

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not only negative (disciplinary) but also productive (biopower)
- new med technologies cease new ways of being human, treatment programs to assist with chronic drug addiction, the managing of population health
negative power= social inequality produces disease and different kinds of illness; linked back to structural violence

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social suffering

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results from what political economic and isnititional power does to ppl and reciprocally from how these forms of power themselves influence reps ones to social problems ** idea that suffering occurs bc of social forces and also as social collective experience

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frantz fanon

welfare colonialism

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systematic negation of the other person and a furious determination to deny the other persons all attributes of humanity, colonialism forces the ppl it dominates to ask themselves this
** colonialism infiltrates and damages the psychic, subjective life of the dinvidual ** canadian arctic

= think of this vc conventional ideas of colonaism as extracting and exploiting resources

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angela garcia pastoral clinic

critical medical anthro

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= ethnography takes place in a detox centre in espanola valley: mot patients are court appointed/ sentenced to detoxification, the first official step in a longer process of drug recovery and punitive rulings

= rates of poverty, prison system in the US, drug culture

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geographies of addiction

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connection bw geography and illness - heroin tells the colonial history of the relationship of mexico to the US the tale of stolen lands --> udenrstanding waves of colonialism
- geography of addiction encloses multiple forms of spatial and existential ruin, sedimented and entangled throguhh time --> about dispossession and loss of land --> intersecting of addiction, institutions (legal an health) and history --> entangling of local moral world
**material and symbolic nature of finding syringes= heroin had brome enmeshed in every aspect of physical space and everyday life. everywhere on landscape
** public health and legal apparatus as part of this geography of addiction: managing in a sense the experience of drug addicts and how they udenrstand themselves (self-discharge, good citizen vs relapse / treatment failure )