FGM in Sudan

Female genital mutilation is defined by the World Health
Organization as “all procedures that involve partial or total removal of the
external female genitalia, or other injury to the female genital organs for
non-medical reasons. There are serious life threatening complications with
cultural atrocity. These include but are not limited to sever pain, infection,
shock, injury to adjacent organs, broken bones, acute urinary infection,
tetanus, and death. According to Regent’s College, eighty million girls and
women, that are living today, have been subjected to this inhumane procedure.
The number of women who have died from or as result of complications from the
procedure is unknown.

The origins of the practice go as far back as Ancient Egypt.
The factors that facilitate the procedural ideology center around the belief
that female genital mutilation is necessary to raise a girl correctly. Female
genital mutilation, according to followers of the practice, allows women to rid
themselves of all male body parts(clitoris) which allows them to become a
complete woman. The Research, Action and Information Network for the Bodily
Integrity of Women, also known as RAINBO, have been instrumental in attempting
to change the belief system that has been ingrained throughout the country. The
idea that achieving the ultimate level of motherhood is necessary by FGM, has
been the main opposing belief.

The research that I found was conducted by several
physicians. The principal physician was Dr. Almroth. Their research focused on
determining the relationship between FGM and primary infertility. They believed
that infections that occur from FGM could possibly ascend into internal
genitalia. This can cause inflammation and scarring which leads to tubal-factor
infertility. After examining 99 infertile women, almost half of the women fit
into their hypothesis. They concluded that FGM and primary infertility had a
strong positive association. Their research will be another instrumental
component to fighting the current cultural norms in Sudan.

http://www.unicef.org/protection/sudan_29886.html

http://www.bmj.com/highwire/filestream/353202/field_highwire_article_pdf/0

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67023-7/fulltext

 

 

 

 

Erectile Dysfunction

I have chosen the condition of erectile dysfunction. The
reasons for erectile dysfunction being biomedicalized are vast and
multidirectional. In terms of culture, there is a premium and expectation
placed on sexual performance, especially when speaking of gender roles. There
are female sexual “enhancers” on the market, but overwhelmingly, when it comes
to sexual performance, the focus is on men. There is a large market for men who
feel pressure to perform. Erectile dysfunction drug companies capitalize on
this market very well with promises of “mind blowing” enhancement. When
discussing any kind of pharmaceutical, politics seem to be involved as well.
Drug companies back specific candidates and parties with promises of policy
reform or economic favors. Defining erectile dysfunction or any kind of ailment
for that matter as an illness has benefits for many groups. Economically, any
kind of illness is profitable for drug companies. The more legitimate an illness
seems to be, often the more profitable the drug will be.

The link that I found was for the drug Viagra. Viagra is probably
the most common and well known treatment for erectile dysfunction. The
advertising strategy was direct and obvious. Take Viagra, and your life will
essentially turn around. You will be running up and down your street full of
joy and all of life’s other problems will seem obsolete. Again, the cultural
value of men performing sexually is a big player in the advertisement. Most of
the men in the commercial seemed to be successful average guys.  The commercial showed middle aged men to elderly men. This makes sense as this is the common age range of men with erectile dysfunction. Medical information was absent from the advertisement. This was not surprising considering what the advertisement was even for, did not show up until the end. The statement, “talk to your doctor”, ended the video adding to the assumed legitimacy of the drug.

http://www.youtube.com/watch?v=Xk9JwV8sZTs

http://ukpmc.ac.uk/abstract/MED/11416833

Male/Female

Biomedicine was intended to be founded on objectivity and
universality.  However anthropologists
have determined that biomedical knowledge has been culturally constructed and
amended over time. The acceptance of germ theory, the mass production of antibiotics
and genetics, all have been influenced by culture. Culture has also reorganized
medical education in the U.S., as stated in lecture. The creation of local and
national medical societies is another example of the alteration of biomedicine.
The concept of culture influencing biomedicine is so important because, it
determines how we view and treat disease and interpret health as a whole. The
culture of biomedicine is what our health system has developed into and
continues to evolve in result of. Essentially, social factors, a large aspect
of culture, have a large effect on biomedicine.

I believe that certain dichotomies are essential in our
society. However, there are cases in which dichotomies have been used
incorrectly and unnecessarily. Valid dichotomies allow us to establish a norm
and have allowed us as a society to compare many aspects of life. Determining
things such as life and death are an essential use of dichotomies. My views on
dichotomies have come primarily from my environment. My family and education
are the main sources.

The dichotomy of male and female is an example of
dichotomies being correct while having numerous gray areas. Biologically
speaking, the dichotomy of male and female on the surface seems pretty clear
cut. Males have specific anatomical characteristics that are usually very
distinct from females. Hormonally, males and females differ greatly as well. In
the past, we have used the male and female dichotomy to assign gender roles. In
my opinion, this was an incorrect use of the dichotomy and many of these gender
roles have evolved greatly over time.  Physically, the dichotomy made sense with the
male gender being dominant in terms of strength, but where it fell short was in
mental ability. Females and males have the same ability, in terms of intelligence.
This has become apparent and realized more recently than some would care to
admit.

I’m an Alcoholic

The True Life episode I chose to watch centered around two
individuals name Casey and Christina. They both are dealing with extreme cases
of alcoholism. Casey is a twenty one year old woman from Boston. She just moved
to Las Vegas.  She has already lost
multiple jobs due to her drinking and is essentially living off of her friend. Casey
started drinking at the age of 14. She has gotten multiple DUI’s and drinks
every day.  At one point in the episode,
she states that she has been drunk for the last seven days straight. Drinking is
destroying every aspect of her life. She knows this is happening yet doesn’t
seem to be able to take steps to deter the inevitable. Christina is a 24 year
old woman from Northern California. She started drinking when she was 16 and at
the age of 22, she began drinking every day. She states that she is dependent
on alcohol and can’t go a day without it. Like Casey, She has gotten a DUI. At one
point in the episode, she drinks the morning after a night out to “cure” a
hangover. In the end, Christina was proactive and seemed to have turned her
life around. She’s now engaged and has maintained her sobriety for 2 months.
Casey on the other hand, went the other direction. Her father offered to pay
for rehabilitation but she refused. She stated that her problem isn’t that bad.

I believe that Casey’s case correlated well with the chaos
narrative. Her attempts to combat her disease were futile and in the end, her
addiction continued. She never truly seemed to want to get better. Christina’s
case matched up well with the quest narrative. She seemed to have truly gained
valuable life experience through her struggle with alcoholism. Her acceptance
and realization that she had an illness, seemed to empower her and give her the
ability to act proactively.

The episode didn’t show any direct experience with medical
professionals. Both individuals went to Alcoholics Anonymous meetings as a form
of treatment. Casey disregarded most of the valuable information given at her
meeting while Christina seemed to benefit greatly from hers. I believe
Christina took on more of the sick role and that greatly enhanced her chances
at achieving sobriety. AA is an example of the shared narrative in which people
share similar experiences in order help recover and understand how others have
beaten or coped with their like disease. The shared narrative was very useful
for Christina.  It’s actually what seemed
to turn her life around. Her new found love also played a big role. Illness
narratives can help family members deal with their loved ones problem. Illness
narratives also provide healthcare professionals with a viable pathway to treat
and cure individuals with a wide variety of diseases.

RLS

Restless Leg Syndrome is a condition in which a person’s
limbs become extremely uncomfortable during periods of inactivity. It is most
commonly associated with lying down and sitting at night time. The disorder is
also known to effect individuals during the day as well. Culture and
biomedicine have a large effect on the illness experience of Restless Leg
Syndrome. American culture seems to be more accepting of “conditions” like RLS.
Internationally, RLS is not as accepted and often looked down upon as a fallible
disorder. Even in the U.S., as indicated in lecture, RLS has a garnered a good
amount of skepticism. People question the validity of the disorder, in my
opinion, because there is not an accurate or precise way to technically
diagnose it. Patients come in and describe symptoms, and are essentially
diagnosed based off those symptoms. There isn’t a way to test for RLS.
Diagnosis is strictly based off the patient’s description of his or her
experience.

In terms of biomedicine, there are drugs on the market for
RLS. Iron deficiency is sometimes correlated with RLS. A common treatment
centers around taking iron supplements which has improved the condition in some
cases. However, the treatment has not been consistently proven effective.
Doctor’s recently have also treated RLS with Parkinson’s disease drugs. This
type of treatment affects dopamine levels and is believed to have a calming
effect geared towards the extremities. In my opinion, the cloudiness and grey
areas surrounding the science and behind RLS greatly affect how RLS is treated
and perceived. The medical community has not committed or agreed upon an
effective treatment of RLS and therefore the jury, I believe, remains out on
RLS.

I believe there is an enormous and currently unknown effect
behind belief and healing.  We have studies that clearly indicate the effects of placebos, yet we don’t know why they are so effective. What causes a person, biologically, to heal from fake surgery as in the film? Why would taking a pill that has no physiological or chemical effect on a person, cure one’s depression? Personally, I have had a number of
sports related injuries. Having a positive attitude and belief that I would
return to full strength, certainly aided in my healing process. Understanding
the depths of the immense effect belief can have on healing and health is
something the science has been unable to understand thus far.

Source: http://www.mayoclinic.com/health/restless-legs-syndrome/DS00191/DSECTION=treatments-and-drugs

Obesity In America

In a study
done by Dr. Philip T. James called, “The Worldwide Obesity Epidemic”, Obesity
and BMI are examined globally. The study focuses on BMI data to create an
analysis of regional obesity across the globe. The prevalence rates for obese
individuals vary widely from country to country. The Middle East, Europe and
North America have the highest obesity rates. Also, women in most countries
have a higher BMI distribution and higher obesity rates when compared to their
male counterparts. Another part of the study indicates that individuals who
have abdominal obesity have enhanced morbidity. These individuals were also
found to have early childhood stunting as well low birth weight rates.

Biologically, individual body chemistry varies widely. Metabolic rates are not constant from person to person and can cause one person to become overweight easier than
another. In terms of culture, obesity in the U.S. has become part of our
culture. The foods that have become staples of the “American Diet”, contribute
greatly to the obesity epidemic. The average American diet consists of high
fat, sugar, and sodium content. On an individual basis, obesity can be combated
with a disciplined diet and physical activity. Environment can inhibit both of
these factors in some cases. As we learned in last week’s material, lower
socioeconomic communities are affected most.

Treatment has recently become centered around preventative action. Body Mass Index, or BMI, is the main scale used to measure and evaluate obesity. The normal BMI
should remain within 18.5 to 24.9 kg/m^2. Individuals outside of the normal BMI
had increased prevalence of diabetes, hypertension, gall stones, and coronary
heart disease. Evaluation of obesity has also recently focused on children just
over the age of 3 years old. Childhood obesity is a strong precursor to adult
obesity and increases the prevalence of the diseases mentioned. In the popular
sector, drugs and “quick fix” fitness plans seem to be an ever growing form of
treatment. In the professional sector, diet plans and fitness regimens can be
prescribed.

Source: http://www.nature.com/oby/journal/v9/n11s/full/oby2001123a.html

Hmong Shamans

I have chosen to summarize the article, “A Doctor for Disease, a Shaman for the soul.”
The article is covering a form of alternative medicine practiced in Hmong
culture. At Mercy Medical Center in Mercy, CA, Hmong Shamans are being
incorporated into the care of Hmong patients. A training program has also been
implemented to try and decrease the fear and negativity garnered towards western
medicine that is common among Hmong people. This fear and negativity originated
or was created as a result of the Vietnam War. Shamans, also known as healers, have a very high social status within Hmong culture.  This is due to traditional Hmong people’s tendency to rely on spiritual beliefs to get them through illnesses. The social status among U.S. medical doctors is still a work in progress as many doctors are not sure of the effectiveness of Hmong medical and spiritual practices.  Another interesting
and concerning aspect of the article discusses the unfortunate and unnecessary
outcomes of the inability to communicate between Hmong people and U.S.
healthcare providers. This problem is being alleviated with cultural training
programs.

Hmong Shamans interact with their patients directly and spiritually. Techniques and
apparatuses used to treat patients, according to this article included: spiritual
ceremonies, gongs, finger bells, and boisterous spiritual accelerators. Also, a
man with diabetes and hypertension had his spirit treated by looping a coiled
thread around his wrist. This was said to improve the healing process of a
runaway soul. Shamans operate within the Folk Sector, in terms of U.S.
practice. They are being incorporated into the professional sector and one
could also argue they are a part of the popular sector.  Shamans deliver healthcare traditionally at patient’s homes but have moved into hospitals. Shamans believe that the origin of illness and disease is directly related to the soul. They treat the soul and
spirit in an effort to allow the body to combat the diseases more effectively. With
the widespread incorporation of alternative medicine through the U.S. on the
rise, Hmong Shamans and the like will continue to gain higher levels of
acceptance and respect among the American medical community.

Cystic Fibrosis- Caucasian Americans

Cystic Fibrosis is a disease of the mucus glands. It commonly
has a cumulative effect on numerous body systems due to the importance of lubrication
throughout the body. Damage to the respiratory system and chronic digestive
problems are the main concerns with the disease. Essentially, individuals with
cystic fibrosis produce an abnormally viscous and sticky mucus.  This abnormal mucus blocks airways, distribution of key enzymes and hormones, and decreases pancreatic function. Another common result of Cystic Fibrosis is infertility in males. The disease
occurs in approximately 1 in every 2,500 white people. African Americans have a
less common incidence of only 1 in approximately every 15,000-17,000
individuals. In order to inherit the disease, an individual must inherit two
recessive genes, one from each parent. Often, both parents of offspring with
Cystic Fibrosis will only carry one recessive gene and therefore not express
the condition. As to why Cystic Fibrosis is prevalent in Caucasians: I believe
it is along the same lines of Sickle Cell in African Americans. Carrying the
recessive gene for Cystic Fibrosis probably protected Caucasians, primarily of European descent, from another disease or condition. I read in a non-scholarly article
that diarrheal diseases were rampant in Western Europe and that this lead to
the evolution and prevalence of the disease. Carrying the recessive gene for
Cystic Fibrosis made individuals immune to a number of diarrheal diseases.

http://www.lung.org/assets/documents/publications/solddc-chapters/cf.pdf

The relationship between race, genetics and health is complex
and difficult to analyze. Race is certainly a social construct and has been
exploited to benefit a hierarchical system ever since it came into existence. It
has no relevance in treating disease. Unless you are talking about distribution
of disease, in which it can then be useful. Certain racial groups are more
likely to have specific diseases, but they are not due to skin color which is
essentially what determines race. Skin color was determined geographically.
Your proximity to the equator and exposure different levels of sunlight determined
your complexion. Genetics, which is a result of inheritance, can predispose you
to certain health issues and disorders.  For example, the Pima Indians lived in an environment in which food was often scarce.  As a result, they evolved
to process sugars and store fats at a higher rate. This obviously was very useful
in terms of survival in the past.  In today’s world, the mutation still persists but their environment has changed. The result of the mutation has become a high prevalence of Type II diabetes and obesity. In conclusion, genetics is a more valid determinant in the study of health.

Sources: http://www.lung.org/assets/documents/publications/solddc-chapters/cf.pdf

http://ghr.nlm.nih.gov/condition/cystic-fibrosis

“Place Matters”

I scored an 8 out of 10 on the Health Equity Quiz. I was most
surprised by recent Latino immigrants having the best overall health in the
U.S. A large number of Latino immigrants are coming from difficult
socioeconomic conditions with aspirations of improving their lives and the
lives of loved ones. However, according to this study, their overall health is
being undeniably diminished. The longer they are in the U.S., the worse off
their health becomes.

In “Place Matters”, Richmond, CA is analyzed. Richmond is a town
that was at one point booming due to World War production and manufacturing.  The war created a surplus of jobs and opportunity. After the war however, those jobs left and so did the abundance of opportunity. The overall quality of living greatly decreased.  The availability of healthy foods became almost non-existent with essentially liquor stores and fast food chains being the sole source of “nutrition”. This directly correlated to high rates of heart disease and cancer rates. Violence and crime rates also increased well over national averages. The stress of not feeling safe to even walk outside in your
own neighborhood can have an immeasurable effect on your health. Towards the
end of the film, the town of High Point was analyzed. High Point had similar
conditions to Richmond. However, High Point was able to obtain federal grants
to essentially rebuild the community. New housing, public libraries, community
centers and fresh produce gardens were just a few things implemented that
greatly increased the overall health and quality of life in the community. In
summary, your environment is one of the most important, if not the most
important, determinants of overall health.

Politics greatly affect the illness realm. Public policies can
make the difference and improve or squander the overall health of communities.
In terms of economics, having wealth allows an individual to acquire adequate
treatment and healthcare. Economics also determines what you have access to in
determining the environment in which you live. Culture can also determine what
is or isn’t an illness and what is acceptable in terms of treatment. Biology,
which to me points towards genetics, will predispose you to certain illnesses
and affect your body’s overall ability to combat. If you make healthy
individual choices you can increase the likelihood of having good health.

Sadness

My definition of health is broken down into two broad categories that can be related and often are.  First, mental health, which can have internal and external determinants. Internally, your body is obviously a complex system that involves an incredible amount of processes, hormones, enzymes, etc. Take depression as an example. It is often related to internal imbalances as well environmental factors that you are exposed to. Physical health has more to do with how well your body is “inline” with homeostasis.  Any irregularities or deterrents to homeostasis, with few exceptions, could likely have a negative effect on personal health. An aberration in physical health can often lead to a mental health issue.

Illness is of course negatively related to health. To me, illness can be defined as any condition, disease, or sickness that has a negative effect on one’s mental or physical health. Determining what qualifies as an illness has become increasingly difficult in society today. Due to misplaced motives, validating “conditions” has become big business for unacceptable and inhumane reasons.

My ideas and definitions to health and illness have come from a wide variety of places.  I’m guessing some of my views and opinions have been influenced from sources I’m not even aware of. I’d like to think that the majority of my views come from my education and personal experiences.

Cancer- This to me, is definitely an illness.  It requires treatment and threatens life.

Menstruation- This was a yes and no for me. In most women, it’s a natural process.  So in that regard, I would say no. However, it does cause discomfort and symptoms of illness. Because of this, it could be considered to be an illness.

Old age- This was a somewhat complicated decision. Initially I thought no, wavered, and ultimately concluded no. It’s a natural process and in the past I haven’t though of it as an illness. Thinking about it in depth now, old age is often associated with illness. The likelihood of illness increases with old age. Therefore, I would lean towards old age being more of a precursor to illness, not an illness in itself.