About Shavon Alexander

My name is Shavon Alexander. I am a Human Development and Family Studies major. I will be a junior in the fall. I am looking forward to learning new things about illness and culture in this class. I plan on going to medical school so I am really excited about this course!

Sexual Health in India

There has been many issues regarding sex in India. One problem in particular is HIV. The rates of HIV are extremely high in India. Not only is this a concern, it is a major concern for the age group in which HIV is spreading. HIV is rapidly spreading in young people between the tender ages of 15-24. There are several reasons why HIV is spreading among Indians and research scientists continue to search for answers.

One major problem among the Indian population is condom usage. A lot of Indians do not use condoms. Condom size is a major problem for Indian males. It is found that the size of Indian males’ penises are 2 inches too short in size for the condoms that are in local stores. For a further 30 percent, the difference was at least 2 inches. A poor fit meant the prophylactics often didn’t do the job they were bought for, and led to some tearing or slipping off during use (msnbc.msn.com).

From reading the article, they did not mention a solution or even a possible solution to this problem. Personally, I think a perfect solution to this problem would be to make condoms specifically for Indian men. This way, the rate of the spread of HIV will slow down and people will not have to worry about the condom slipping off all the time.

It is also said that many Indian men are embarrassed to ask for condoms because of their penis size. By making customized condoms specifically for Indian men, I think that they will be less embarrassed to ask for them or less embarrassed to go purchase them. I have not witnessed any article or anthropologist in an article to try to solve this problem.

The problem is talked about a lot but not the solutions. In the Indian culture, a lot of them are also against teaching sexual education because they do not consider it education. I think that the Indian culture should be more open to this because if more people were educated, there would be less HIV going around.

Sources

http://www.popcouncil.org/pdfs/wp/seasia/seawp19.pdf. August 10, 2012.

http://www.msnbc.msn.com/id/16157113/ns/health-sexual_health/t/condoms-big-problem-men-india/#.UCWTh51lTlY. August 10, 2012.

 

Clinical Medical Anthropology

I chose clinical anthropology because I feel that it is very important as far as management and improving the healthcare system. It is something that is very near and dear to my heart. For example, some people have medicaid or medicare, which is the “government” type of insurance. Therefore, there are a lot of doctors that do not take that type of insurance. It makes it a bit harder on the patient to have to search for doctors that take that particular type of insurance.

Sometimes it is also difficult for a patient to even go see a doctor because of clinical hours interfering with their job schedules. These are all problems that medical anthropologists take into consideration when practicing clinical medical anthropology. Their job is to try to make solutions to the problems or even make the problem better in certain aspects of it.

If I was a working provider, such as a doctor, it would be good to have these certain anthropological perspective on some of these situations. For example, if a doctor prescribes medicine to a patient for Diabetes, the patient may or may not take the medicine that the doctor has prescribed.

A good anthropological approach to see why the patient is doing this would be considering their insurance situation. Does the patient’s insurance cover this? Does the patient have transportation to get to the pharmacy to get the medicine that they need? The situation could also be psychological. What if the patient does not like poking themselves with needles?

There was an example in lecture that was also used. In Africa, there is a net that they use to protect them from mosquitos and Africans will have less of a chance to get malaria. However, many of them do not use the net because it is uncomfortable to sleep in. Some of them even use it for other things such as coverings for the windows. This is also a big issue and it could be adding to the problem more than being a solution. Clinical anthropology is very interesting to me because they are the ones that get to look at all of these factors and weight out the situation to make it better. Clinical Anthropologists change lives and the paradigms of medicine.

Sources

Lecture 6.1

http://www.medanthro.net/definition.html. August 10, 2012.

Obesity

Obesity has become majorly medicalized in society. Obesity is now said to have outnumbered the amount of malnourished people (C.Crandell, T.Crandell, J.Zanden). The condition itself is not considered an illness. But Obesity is very influential of other illnesses. A lot of people who are obese have illnesses such as high blood pressure, diabetes, and polycystic ovarian syndrome (livestrong.com). The overall western culture primarily makes obesity, itself into an illness. For example, there are a number of commercials that advertise to people ways to become thin and go on crash diets sometimes.

Economically, this makes people a lot of money. People that advertise, insurance companies, and many other people because obesity is an extreme problem in Western Culture. Western culture emphasizes how important it is to be thin. In my opinion, it is better to be overall healthy than thin. If you go to a doctor’s appointment and your vitals are exceptional and your weight does not effect your daily activities, then you should be accepted by society.

However, you’re not accepted by society unless you are thin. Here is a video of an advertisement that uses the taste of chocolate and some other techniques to engage people into being thin and buying the product simultaneously.

As you can see, during the commercial, it starts off showing tons of chocolate and how good it tastes. They know that people tend to love chocolate and they use this to catch the audiences’ attention. They also try to say that this isn’t regular “dieting” its basically the primary way you should be eating. They use the social role of society hating to diet as the girl in the video says “I hate dieting but I love my slimmies.” This is what Western culture is. They think that being thin is healthy. They also present medical information where they briefly show a chart that measures the slimmies product compared to placebo effect. Therefore, people will think that this product actually works. I honestly think that this is very unsafe. People who use this product the wrong way can put themselves in an even worse situation.

I think that society needs to change the image of losing weight and being thin to focusing on the overall health of a person. Why doesn’t anybody think of doing advertisements where people check their sugar and high blood pressure and then have them say its because hard work, dedication to eating healthy, and exercise is the reason for weight loss instead of focusing so much on actual size? I think that this would encourage more people to become healthy the correct way.

Sourceshttp://www.livestrong.com/article/17608-obesity-causes-diabetes/

 

Male/Female

The culture of biomedicine has many different aspects. As stated in lecture, it has two different perspectives. The University perspective states that biomedicine is a direct reflection of nature and is a representation of universal truth. The objectivity perspective states that value, neutral, and autonomous from cultural contexts and human influences. In Western culture, biomedicine primarily reflects on mainly the doctors and anyone in the medical field that has an influence of the patient and their health. Doctors primarily determine how you’re treated.

It might be through placebo effect, medicine, or some type of therapy. No matter what the case, most of the time, its up to the doctor in western culture. The dichotomy that I chose was Male/Female gender. This is a very touchy subject in society today. Many people think that sex is what you’re born with genetically and gender is the actual role that we choose to play within society’s social norms.

Some think thats its just all genetic period and that society does not have an influence. It all depends on how you look at it. Therefore, this subject is very subjective. It takes on the role of both objectivity and university simultaneously. In my opinion, I think that Male/Female is the sex that you are born with and gender is what we adapt to according to society. For example, how do we know if somebody is acting in a boyish or girlyish way? When society sees a girl that plays sports, handles things roughly, or does not have a dainty walk, we consider her as a “Tomboy.” Society considers her a tomboy because there are specific social norms when it comes to the role of a female.

This dichotomy is accepted as true in society because, as you can see, the hot topic of today’s society is homosexuality. If we did not have gender roles of society, homosexuality would not even exist. If everybody strictly was born a male/female and was not told how to act, then your sex would just be your sex. I think these views came from knowing the views of biomedicine from this course and the university aspect of it all.

I have Diabetes

This episode of True Life was about three Teenagers and their challenges with Type I and Type II Diabetes. Type I diabetes is when the body does not produce any insulin. Type II is when the body produces insulin but the body does not use it properly. The first person was a guy and he had just finished up his sophomore year of college. He had Type I diabetes and he had to take insulin shots daily. His hemoglobin A1C level was about 7 when he found out he had diabetes and got it under control. Hemoglobin A1C is a test that shows your glucose readings over the previous three months from the doctor visit. Normal Hemoglobin A1C levels should be between 4 and 6. Therefore, his reading was not that bad. However, when he got to college, he began to drink excessive alcohol and this caused it to go to 8, which is not a good thing.

The other two people on the episode had Type I and the other had Type II. One of the girls was pregnant which puts the baby at a high risk for sugar through the placenta and also puts the baby at higher risk for being overweight (Crandel, Zanden). The other girl used an insulin pump and it costs her so much that she had to move back in with her parents just to pay for a new one.

I think that the stories that the people told were considered Quest Narratives because they were all telling their stories and how they were going to live a better life while dealing with diabetes. Quest Narratives always views the illness as a tough journey but also the opportunity to improve based on certain lifestyle changes (Lecture 2). For these testimonials, they were just that. All of them were working towards making their diabetes in better shape by eating the right kinds of food and carefully monitoring blood sugar levels. Throughout the episode, they went to several doctors appointments.

They all seemed to have pretty good experiences with the doctors. The doctor focused a lot on what they were doing socially. For example, doctors often asked if they drank alcohol excessively, if they ate out a lot, if they were getting enough rest, etc. There was not much culture emphasis within the video. Each one of them seemed to handle the diagnosis and treatment quite similar. They obviously believed in taking medication because they all took meds for their diabetes.

They also did not discuss a lot about when they were first diagnosed with the illness. Therefore, the sick role is quite difficult to discuss in this case. However, I am a Type II Diabetic myself and I had several symptoms when I suspected that something was wrong. I had frequent urination, headaches, fatigue, my hands were shaking when I waited too long to eat. As far as the sick role, it was my responsibility to seek medical attention for these symptoms.

Narratives are important for the patients, family, and healthcare providers because they are ways to describe how intense the medical situation is and how the patient feels about the symptoms they have been having and the overall situation.

References

Crandell, Zanden. Human Development. 2009. (160-165)

Lectures 1 and 2

True Life “I have Diabetes”

Bipolar

Bipolarity is a very subjective condition. Bipolar disorder is an affective disorder characterized by periods of mania alternating with periods of depression, usually interspersed with relatively long intervals of normal mood (dictionary.com). Culture and biomedicine can have major influences on the experience of the illness. For example, in lecture, culture was discussed in a sense that people do not believe that subjective illnesses such as bipolar and many other illnesses are legitimate illnesses. Just as the example about RLS (Restless Leg Syndrome) was given in the lecture, some people think the same thing about bipolar disorder.

In the youtube video, “My Story”, the guy was explaining how his friends would just make fun of him and tell other people to pay him no mind because he is just eccentric. He also explained how even after he explained to them that he was bipolar, they still have a very difficult time understanding the illness. At the beginning of the video, he also mentioned that he did not know that he had bipolar disorder. He experienced strange symptoms in his freshman year of college. He was very fatigued, did not want to go anywhere and do activities, he was very isolated and became very paranoid of people and was always looking over his shoulders.

This is the perfect example of “The Sick Role.” In order for the guy to even go see a psychologist, he experienced some very strange symptoms that made him question whether he was sick or not. Culture and biomedicine can influence the management and treatment of biplolar disorder in the respect that some people will be treated with medicine while others will go about treating it a different way according to belief.

For example, many doctors are now relying on the placebo effect to treat numerous patients. In the video, “Placebo: Cracking the code,” surgeons had done surgery on the patients knee but it was not actual surgery. The placebo aspect of the surgery was that doctors just cut the knee open and did the same thing that they would do with any other procedure. They scraped some of the damaged cartilage of the knee and sewed it back up. The patients that had this placebo procedure done did not complain about their knee after the surgery. In fact, they said that their knees no longer bothered them anymore. Therefore, the same thing can be done with bipolar disorder. In my opinion, since a lot of doctors are not switching over to placebo effect, they can do it with bipolar disorder as well.

This is why culture effects subjective illnesses such as bipolar disorder. Some people just think its all in your mind while others think that it is a real illness because they are experiencing symptoms. However, if it can be treated with placebo effect, I honestly think it is all in your mind.

Sources

http://dictionary.reference.com/browse/bipolar+disorder

Breast Cancer In Caucasian Women

There has always been a major concern with breast cancer in the United States. Caucasian women are said to have breast cancer more than any other race. This article outlines a study done for specific risk factors while scientists try to dissect the causes of high rates of breast cancer in Caucasian women. Increased risks have been associated with age, first pregnancy, early menopause, and breast cancer has even been associated with a fatty diet.

During the study, 785 women were interviewed at several different hospitals in New York City. The main focus was on women who were in pre and post menopausal stages. This was also considered the control group. Some of these women were coming into the hospital for various issues such as cancer (skin, lungs, etc.). The patients being studied were in the hospital specifically for a confirmed diagnosis of carcinoma of the breast. Carcinoma of the breast is malignant tumor of the breast (arising from milk glands and ducts).

All of these patients were interviewed after being classified as post or pre-menopausal. In the interviews, they discussed symptoms that they had been having over the past couple of months (pre-menstrual syndrome, spotting, etc.). Scientists found that these women were between the ages of 25 or older.

They also tested fertility rates in these women as well. For example, some people have children at a later age due to fertility difficulties. In both the menopausal and fertility factors, scientists found no biological difference between the control group and the group being studied. Breast cancer is being treated with chemotherapy and/or surgery to try to catch cancer early before it spreads in the body. The article was not specific on any particular cultural differences associated with the disease more in this race than others.

However, there are several individual dimensions to try to prevent breast cancer; self-examination every month, and going to get a mammogram at age 40.

Sources

http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(197806)41:6%3C2341::AID-CNCR2820410637%3E3.0.CO;2-N/pdf

http://books.google.com/books?hl=en&lr=&id=9IVU8U5XovEC&oi=fnd&pg=PA7&dq=how+to+prevent+breast+cancer&ots=6iCmEQpwQs&sig=VdctYpMXMHbIEVZrdMa490AGHTg#v=onepage&q&f=false

Clown Doctors: Shaman Healers of Western Medicine

This article is about “Clown Doctors” in the New York City hospitals. Clown doctors are primarily people who dress up as clowns to entertain sick children in the hospital or distract children to make them more at ease in a difficult or painful procedure in the hospital. They also entertain the parents and other people in waiting rooms to ease their mind of any anxiety while waiting on the patient to be treated and/or come out of surgery. These clown doctors identify with the non-western healers; Shamans especially.

They believe in cultural and natural remedies in helping both the family and patient during the time of illness. They incorporate culture into the performances that they do for children. They identify with temporary styles of healing unlike the western culture. Western culture practices treating patients with an allopathic approach. Whereas, non-western cultures seek a patient’s social condition of the illness.

In this article, the methods of the clowns were observed and the audiences reactions were also observed to compare this method to western cultures of medical treatment and to also see if this method is effective.

The clowns work in groups of two or three with one clown being designated as the supervisor for that day. The clowns encounter several people while passing through the halls and they entertain patients or visitors of the hospital by exchanging different gags. After doctors talk to the patients about their symptoms or a procedure that is about to take place, doctors tell the patients that they have a specialist that will see them. At this time, doctors leave the room and the clowns enter to entertain the patient and the parent. They perform magic tricks, blow bubbles, and sometimes draw things with great humor to ease the patients.

This method of treatment is not said to cure anything. As a matter of fact, they do not try to cure anything at all. The goal is to try to create a more child-friendly environment for the children in the hospital. The body and symptoms of patients are not directly dealt with this non-western method. However, this method is said to ease patient anxiety and result in more positive clinical outcomes.

Bad Sugar

The Health Equity quiz did not go as good as I thought it would. I thought I knew a lot of the answers but I did not even know half of them. I was VERY shocked with the first question which was “How does American Life Expectancy compare to that of other countries?” I thought that the U.S. would be number 1 for life expectancy since we have a lot of resources at our advantage compared to a lot of other countries. However, it turns out that Japan has the highest life expectancy.

The “Unnatural Causes” episode that I picked was “Bad Sugar.” The video was about how Pima Indians have a 38% susceptibility to Type II Diabetes. There is research being done on this claim. However, scientists have actually come to believe that it is something in the biology of Pima Indians that stands out from others races of people. There was a famine long ago where the Pima Indians were the people who survived it the most during that time. This is because Pima Indians are somehow able to store more fat and for longer periods of time than other races. Therefore, since there is more access to food and the famine is now over, Pima Indians are storing more fat because now they have access to food. Scientists are claiming that Pima Indians were naturally selected during the time of the famine and storing fat will eventually turn into obesity and the obesity leads to Type II Diabetes.

In the video, they also show how some of the Pima Indians live. Most of the Pima Indians live below the poverty line which can also be a factor of why Type II Diabetes is so high. As your can see, politics and economics kind of goes hand in hand when it comes to disease. People with higher socioeconomic status are said to be healthier and they have healthier diets most of the time (ije.oxfordjournals.org). Culture and individual choice also play a role in the treatment and spread of disease. Pima Indians were deprived of water for centuries due to changes made to the Gila River for water projects which made Pima Indians suffer more than any other tribe of Indians. Without water, it is very difficult to remain in good health status. Mexican Indians were also studied and they were overall more healthy than the Pima Indians because they had more access to healthy foods and water. Therefore, they were able to make smarter diet choices. Thus, the individual choice of exercise and eating a healthy diet is also a factor in the spread and treatment of disease. It is very interesting to see how all of the different factors effect the health of people in our society.

Sources

“Bad Sugar” video clip

http://ije.oxfordjournals.org/content/30/2/334.full. July 12, 2012.

Type II Diabetes among Pima Indians

38% of Pima Indians are said to have Type II Diabetes (Lecture 2 Video). This is the highest among all other races having Type II Diabetes. I chose this topic because I am a Type II Diabetic myself and I found it very interesting to find out that it is the highest among the Pima Indians. Many people ask why is this so. As we know, there are many factors in determining why certain people have illnesses or diseases more often than another group of people. With that being said, the factors to be considered are the family history, the environment, socioeconomic status, and the overall genes of this race.

In the lecture two video, we are informed that Pima Indians went through a period in their history where there was a huge famine and based on the biology or genetic make-up of Pima Indians, they are able to store fat longer than other people could during that time. Thus, Pima Indians were able to survive during the famine. Stored fat as we know it, will eventually cause obesity. Obesity leads to other things such as heart problems, high blood pressure, and could even eventually lead to diabetes.

During the famine, the Pima Indians actually needed the stored fat in their bodies to survive. However, there is no need for as much of the stored fat any longer because they now have access to foods that they need to survive. Thus, having the stored fat plus the food that they eat daily, once again, causing obesity. To support this claim, there was a study done on the Pima Indians’ BMI to see if there was an increase in their BMI over several decades. The following shows the graphs of the increase in BMI in Pima Indians from the mid 60s to the early 2000s.

http://care.diabetesjournals.org/content/30/7/1758.full.pdf+html

You will find that the BMI of Pima Indians increased over time. By looking at this situation, it seems as if the Pima Indians were primarily naturally selected due to their ability to store fat during the time of famine (Lecture 2). Therefore, the factors of natural selection, and gene flow were selected. The flow of the genes obviously stayed in close proximity in the Pima Indians in the United States.

In the lecture, the role of race in medicine was discussed. The medicine “Bidal” was used for hypertension in African Americans. It was said to be more effective in African Americans than non-African American people. In the long run, the FDA and other researchers found this to be false because there was no control over other racial groups (Lecture 2). Race actually brings a lot of stress on the body and causes harm in itself. Some races have certain illnesses or diseases more than others but, in biology, there is no such thing as biologically discrete races (Lecture 2). Other factors can be measured in medicine such as socioeconomic status, neighborhood, age, etc. However, race alone cannot be the determining factor for treatment and research of the illness or disease.

Sources

Lectures from class

http://care.diabetesjournals.org/content/30/7/1758.full.pdf+html. 7/11/2012.