Malaria in Sub-Saharan Africa

Malaria is a disease carried by mosquitoes. It is a protozoan, which basically means that it is not a bacteria or a virus but worse; it’s like a real live animal, only very small. The mosquito bites someone with malaria, lives long enough for it to develop, and then passes it on through another bite. In the region I have researched, Sub-Saharan Africa, the mosquitos are plentiful and love to feed off of humans, making it a very malaria-prone place. Once bitten, the infectious cycle takes only two days to full develop and is exhibited through uncomfortable chills and fever.

From the anthropologic perspective, malaria has more than just biomedical factors. For example, socioeconomic status plays a role. The level of healthcare in Sub-Saharan Africa is not at its prime. Poverty is widespread and access to doctors is very limited, especially in rural areas. Other cultural factors, such as the popularity of folk traditions and a slight resistance to biomedical science make treatment less probable. I read an article titled The Social Burden of Malaria that was extemely informational. It discusses how the situation has steadily been improving thanks to the valuable role anthropologists have played in devising a successful way of decreasing the number of malaria cases. By taking into account how the people react to western medicine practices, they have lessened the resistance to treatment, helping the doctors and the medicine do their jobs successfully.

I included a link to notes from a symposium in which Bob Gwadz lectured on Malaria. He worked on research in Sub-Saharan Africa and helped devised ways to help the problem. BY using anthropological techniques, he was working to improve the situation. I value his opinion and knowledge and really enjoyed the lecture. I think that an anthropological view is crucial in any situation related to this.

Sources:

http://www.ncbi.nlm.nih.gov/books/NBK3746/

http://www.aaas.org/international/africa/malaria/gwadz.html

Public Health and Medical Anthropology

This course has opened my eyes to just how important and functional the field of medical anthropology is. I previously was most intrigued by the field of archaeology but have slowly switched my focus over to this subject. There are currently an abundance of medical jobs in the United States which definitely has an influence on its attractiveness. Also the advancement in technology is soaring right now, making western medicine even more dependable and efficient. On the other hand, our country has admitted that the healthcare system we currently have is not so good at all. Even countries rated below us in terms of wealth, technology, etc., have longer average life spans. The reason for this may be the existence of universal healthcare systems, in which no citizen has to worry about not having access to sufficient health services.

After watching a video on the subject of healthcare systems earlier in the semester, I have drawn up a little dream scenario in my head. I wish I could come up with a solution to our country’s problem. It isn’t fair that a portion of our population is denied healthcare due to poverty, lack of insurance, and other hardships. And it isn’t just poor families suffering. I have friends who don’t have insurance because their parents’ plans have dropped them and they are unable to work a job that provides benefits or can’t afford to pay for another type of insurance and don’t qualify for governmental assistance.

In order to come up with a new medical situation for this country, I think that well-educated and passionate anthropologists are a vital part of the research team. They bring a culture-analyzing view. As professionals, they are able to take on an objective perspective, pointing out the important qualities of our culture that would affect a proposed system. Coming up with a new healthcare system isn’t just about developing one that seems good but shaping it so that it fits into our lives easily and naturally, ensuring its success. We may need economists, politicians, doctors, and other professionals to create a system but the anthropologists would be able to predict its success rate before it is even put into action.

Gay vs. Straight

Just like any other cultural institution, biomedicine can be observed and described using an anthropological view. The point is not to say which culture-specific medical systems are correct or incorrect. Rather, it is to draw comparisons, describe, and understand those systems. Biomedicine is just one type of medical system, and is used to refer to the structure in place here in the U.S. As described in the first lecture of this week’s materials, this is an important concept because it describes how we study one aspect of societies objectively.

Dichotomies are prevalent in every society. There are very simple and universal dichotomies, such as day/night, light/dark, or hot/cold. There are also more unique dichotomies, not only in the way they are termed but in what they represent. Women/man varies form culture to culture, as well as good/bad, right/wrong, or healthy/sick. How one describes the differences and similarities between two ends of a dichotomy varies according to the views they were taught and the lifestyles they have experienced. In the U.S., there is a pretty common distinction between gay vs. straight. Many people have trouble understanding anything in between, and therefore get frustrated with people who explore the world in between the two terms. Although it is becoming more accepted to be gay or bisexual, I think that the dichotomy is still a pretty clear one in our culture. In other cultures, it isn’t always referred to in the same way. Sexual acts between two males or two females aren’t always taken as seriously and categorized but can be more casual and not hold as much meaning. It is interesting to see how gender roles and distinctions between the sexes are viewed in different cultures.

I do believe that dichotomies are sort of innate in human nature. They are all around us, for one. It is very easy to draw distinctions between things such as night and day. At the same time, when approaching concepts that are more embedded in culture, we cannot say that the actual terms or meanings are completely natural. It is obvious that they vary across the world. The actual existence of dichotomies, though, is inevitable and instinctual in my opinion. You are born with the ability to compare things. The way you compare things depends on your surroundings and experiences. It is almost important to remember that the extremity of the use of dichotomies can vary from one culture to the next.

Depression

In the U.S., we have a tendency of taking blame away from a person suffering from a condition by attributing it to biological causes. Although personal choices can play a role in health, such as eating junk food and becoming obese, we have medications available to fix just about any situation. Depression, a mental condition, is the state of feeling alone, hopeless, sad, as well as many other emotions, to the degree that normal life becomes nearly impossible to enjoy or even just get through. There are a wide range of symptoms and outcomes, and it may even lead to suicide. I think that it is important and useful that we label it as a real disease because blaming the individual (who may be feeling hopeless) could be very dangerous and only worsen their situation. By clearly marking it as a mental illness and offering a wide variety of medications and treatments, the person is able to focus on getting better which is a very important source of hope. We label many diseases this way because we view all individuals as equal, not just under the law but biologically. Even those born with debilitating conditions are given the same opportunities, and so the condition is never their fault but just a sort of challenge that can be conquered with help from the health community, often in the form of medications or intensive treatment from a professional.

To treat depression, usually tricyclic antidepressants are prescribed. This type of medicine helps to improve the production of two chemical messengers, known as neurotransmitters, in the brain, norepinephrine and serotonin. Simply put, it helps the patient to feel happy and optimistic. There are a few other options if that type of medicine is not useful. I have included a link to a website of an antidepressant, Viibryd. It is made of vilazodone and comes in four different dosage sizes. Like just about every other antidepressant ad, it contains a photo of a woman who looks upset, with her eyes cast down, all by herself. This helps the depressed individual to relate to the character so that they feel understood. Other marketing strategies include optimistic statements and kind, soft messages rather than direct or cold ones. It’s important to connect to the audience on a level that is not threatening or offensive or invasive and to swoop them up and make them feel cared for and having a better future. This communication style is similar between doctors and patients, too, ensuring that the person feels important. The relationship is almost matching that between a mother and small child (of our culture), full of support and unconditional love in the form of tender care.

Advertisement for Viibryd: https://www.viibryd.com/viibryd-depression-treatment.aspx?WT.srch=1&guid=361624140&MTD=2

Information Source:

Web M.D., Depression Health Center. Retrieved from: http://www.webmd.com/depression/symptoms-depressed-anxiety-12/antidepressants

Post-Partum Depression

American media is constantly bombarding its onlookers with pictures of the perfect family. Although this idea continues to change, and is definitely not the same as it was maybe 50 years ago, it still stresses expectations of what “perfect parents” should look like and how they should behave, as if perfect is ever going to be attainable. At the same time, academic debates pop up constantly, arguing over the correct punishment/reward systems, successful education plans, and even how much a parent should play a role in helping his/her children make decisions. When the fascinating miracle of conception is discovered by a set of parents or a single mother, the pressures begin to escalate. It’s frustrating that we can’t make up our minds so easily on we would like to raise our own children because we are so concerned with the opinions of others, whether we will consciously admit it or not. We also have to be careful not to infringe on any child protective laws because losing a child to the government is one of the most painful things a well-intended parent can go through. Many expecting mothers are gifted with a book sometime during their pregnancy, titled, “What to Expect When You’re Expecting,” or something similar. And then finally, the baby comes along, and all of that planning must be put into action. As we all know, babies are a lot of work, and the slightest feeling of failure or disappointment or even just frustration can launch a parent into a tangled web of symptoms, what we have come to diagnose as a disorder, or post-partum depression.

I think that our society has a fairly positive take on the disorder. This is not to say that that is entirely a good thing, though. We place a high priority on keeping an eye out for the faintest symptoms and for reporting it. Expecting parents are told over and over again that it is a likely disorder to experience and that there is nothing wrong with it. While this makes diagnosis and treatment fairly simple and less stressful or embarrassing, it might have a bad effect on the number of cases. Our minds play a vital role in our well being, as we have been learning through course materials each week, and I think that the expectation of very possibly going through post-partum depression might increase the number of cases that are brought to attention. The placebo effect illustrates a very real and astonishing thing, that our minds can have actual effects on our physical well-being. Although I have no proof, I feel that I am currently experiencing a slight case of the placebo effect. I have a stomach condition, and have been prescribed a medication to help diminish the symptoms. At first, I was very reluctant in believing the doctor had prescribed me the correct thing and it didn’t help my case too much during the initial week that I started taking it. Slowly, I placed more trust in it because I wanted to feel better, and although I have not changed my dosage or any other aspect of taking it (and its reliability is not changed by time or consistency), my symptoms have almost completely subsided. Since we have been learning about the placebo effect while I have been going through this, I have started to suspect that I might be playing tricks on my body.

I worry that the placebo effect is going to have a negative effect on us eventually. If we place too much trust on medicine and treatment, will we start to put things in our bodies that we really don’t need, and could they only hurt us in the long run? Post-partum depression is  a serious disorder and deserves all the attention it is getting but I believe it is a disorder in which psychological guidance should be stressed over medication. I don’t think pills are necessary to treat something that so explicitly created in our thoughts to begin with.

True Life: I have PTSD

The episode I chose to watch was on Post-Traumatic Stress Disorder. As I was scrolling through the episodes, it caught my attention because I have recently wanted to find out more information on the subject but haven’t taken much personal action on that desire. I am currently in a relationship with a Marine Corps vet who has experienced PTSD. I have only heard very small traces of information from him on the subject as he does not like to talk about the negative experiences associated with his past involvement in the marines, which is entirely understandable. I was curious to hear a personal account of the disorder, and although I learned a little about how it can affect one’s life, I still retain a somewhat hesitant and sensitive view on it. I feel like it such a personal struggle for the person suffering from PTSD that I do not want to pry on the details of it. As for taking a medical anthropological take on it, I have done my best.

In the video, two cases were followed. Both were of U.S. war veterans and were fairly young. I think that documentary showed a combination of two narratives, chaos and quest. Restitution was definitely not relative because the individuals did not see the disorder as a quick, easily curable sickness. They both seemed frustrated and unhappy with their situations. I thought that the guy living with his parents seemed a little less optimistic, taking on the chaos narrative, while the other more directly took on the quest narrative. He was actually putting together an organization that promoted alternative medicine and therapies in treating PTSD in veterans, taking his unfortunate situation and making good use of it.

In the U.S., I think there is a slightly negative cultural stigma associated with PTSD. At least in my own experiences, it is not widely talked about or accepted, and viewed as a disorder bringing anger and frustration to the individual, shutting them off from the world and preventing them from living a normal life. The vets in the video actually gave similar accounts of the disorder but I think the general public takes on a shy reaction to the illness rather than tackling it and promoting understanding.

Although clinics offer treatment for PTSD and are readily available for vets, it was obvious in the documentary that the veterans didn’t hold too much confidence in the success of the treatments. I think that most of them feel as if it is something they must tackle on their own, and perhaps the coping mechanism taught to our soldiers greatly influences how they handle the war after returning home. I am not in agreement that such struggles should be held inside without psychiatric therapy or some other form of treatment.

I think the individual in the episode was on the right track in starting an alternative therapy organization for veterans suffering from PTSD. As addressed in the video for Lecture 1, I think a very important source of therapy is through shared narratives. Getting victims to talk rather than uphold their silent soldier personas would not only bring that sense of “I’m not in this alone” to light but would also create better understanding of the disorder to outside audiences, furthering our knowledge of the subject. Cancer and genetic disorders seem to be in the spotlight today, and while I entirely support the extensive research efforts in those areas, I feel like PTSD is not getting the attention it deserves…especially as we continue to send troops overseas, planting the disease in our own brothers, husbands and sons.

Pica

Pica is categorized as an eating disorder. It includes the practice of repeatedly ingesting nonnutritive substances. Although it most often is seen in children between the age of 18 months and 2 years, it is also seen in adults (though very rarely). In fact, it is sometimes seen in pregnant women, often indicating some sort of nutrient deficiency. It is not always a threat to the individual’s health but depending on the substances being ingested, it can be life-threatening and very dangerous. Some substances that the person may ingest include, but are not limited to, dirt, fingernails, hair, cigarette butts, feces, or even needles. As addressed by Medscape, what makes this a culture bound syndrome is the view that culture holds on ingesting nonnutritive substances. If the act is viewed as a part of normal practice (aka culturally sanctioned) then it is not a disorder. It becomes a syndrome when the act is viewed as strange and unacceptable. Another important qualification is that the behavior must be inappropriate to the developmental level of the individual. For example, if an American baby puts sand in his/her mouth, we do not categorize that as a disorder but rather a normal mistake that babies make. If that same individual ate sand habitually at the age of 23, we would then start to categorize it as a disorder.

Pica is not always associated with biological causes. If that is the case, it is not considered severe and may not be addressed medically. When paired with mental retardation or another disorder, it is considered more detrimental. It also must last over a month to be considered. Treatment includes addressing nutrient deficiencies, mild aversion therapy and positive reinforcement, and even medication in cases where therapy is not a possibility (such as when paired with mental disorders).

Sources:

http://emedicine.medscape.com/article/914765-overview

http://health.nytimes.com/health/guides/disease/pica/overview.html

Shamans of Mongolia

The assigned film, The Horse Boy, had a pretty heavy impact on me. Being honest, I thought it was so touching and it even made me tear up a couple of times. Not only was the story one of challenges and triumphs but it expressed two distinct views on the subject of alternative medicine. The father of the child was very open to the possibility of successful treatment from the shamans while the mother was skeptical (although not completely in opposition). I could see myself in both of them, and I think that’s why I enjoyed it so much.

The film followed a child and his parents as they trekked by horseback across Mongolia, visiting a string a shamans. In Mongolia, these shamans are respected and honored. The more talented ones are even hard to meet up with, increasing their value. In the film, they are shown as being fairly quiet and calm people (and were all men). It’s almost as if they have an unidentifiable power that draws people to them. Rowan, the autistic child, loved being around the shamans and usually calmed down and regained focus when they were near. The shamans seemed to tolerate his hyperactivity and fascination with them very well, too, letting him crawl on their laps and touch their clothing. In the cultural setting shown in the film, it is evident that shamans are the preferred “doctors”. They represent more than biological health. They are the gateway to becoming healthy in all aspects, not only physically but mentally and emotionally. They take all aspects of life into account, and I think this is what makes them so trusted. I can personally relate to that desire of being treated as a whole person, not just a physical body with purely biological symptoms. I recently switched doctors simply because I felt that my previous one lacked interest in anything beyond my physical state of being. He did not investigate the minor issues I expressed and failed to ask about my social life, etc. I now see a doctor who makes me feel more individualistic and important, which also indicates her concern for my well-being on a much broader level. Shamans don’t stop there. In treating one person’s symptoms, they may even include other family members. In The Horse Boy, Rowan’s parents are often asked to participate in healing ceremonies and practices. This helps bring the family together, and the parents state that even if the shamans don’t heal Rowan’s autism, they will treasure how the process has united them.

I may have been more like Rowan’s mother a couple of semesters ago but I am beginning to side more with his father after taking various anthropology classes and especially after watching this film. There are some things that are hard for us Americans to see, being so obsessed with logic and science but we much not forget to keep an open mind. We aren’t the smartest culture and I think we definitely are not the most appreciative of the life we are offered. We may be happy and healthy but I think we would be better off if we could acquire a more holistic view of life like the shamans of Mongolia.

Spirit Possession

I have to admit that the definition I first wrote down describing illness was not the same as when I finished doing the categorization activity. I found myself judging the various states of being on more conditions than the ones I had previously listed. I shaped my definition as I came to realize my personal beliefs. I ended up defining illness as ‘a state of being unwell or sick, either physically or psychologically or a combination of both, that arises due to environmental factors, as infection from bacteria, the presence of a virus or a disease.’ I still can see the fault in it because it contains culture specific terms but at the same time, I believe they can only be defined culturally. These terms or just the distinction between the two might not even exist in the languages of some people and therefore absent in their realities as well. I believe that all of our experiences are so deeply intertwined that you cannot pinpoint the source of these terms. Everything around us works together to shape our grasp on reality. American society, our foundation in science, the tendency to visit doctors on a regular basis, the media, all contribute to how we view illness and deal with it.

I had trouble with ‘spirit possession’ because I have no personal experience with it. I have experienced the flu, heard about cancer from friends, and seen people with old age but I have only read once or twice about spirit possession and it still lies so far away from my sphere of reality that I cannot come to define it at all. Shyness, on the other hand, was an easy one. I believe that it is purely a personality trait in American culture. It is a way someone behaves and communicates and it is not a bad thing nor should it necessarily be cured unless the individual feels the need to break out of their “shell”. Anxiety fell in the middle of the distinction for me. On the one end, it can be a temporary emotion, such as when an individual is nervous for a test or job interview. If it is something that starts to interfere with daily life and happens frequently and without obvious reason, then I think it begins to become a mental illness. This is when an individual in our own culture would think about seeing a psychiatrist in hopes of sorting out and dealing with his/her stresses.

Ethnomedical

If you picture an iceberg, you probably imagine a huge chunk of ice floating in frigid waters. We can think of an iceberg as a representation of culture. All the characteristics of one’s culture that we notice at first glance (such as dress, language, ethnic foods) can be related to that small part of the iceberg that lies above the water. The large mass underneath is all that we do not notice right away because our own experiences have clouded our perspective and/or they are not as obvious. Here lies all the meanings people associate with symbols in their lives, certain behaviors such as when it is polite to do certain things and what kinds of relationships are appropriate, etc. For the last anthropology class I took, I was assigned to read a book titled, “The Spirit Catches You and You Fall Down” by Anne Fadiman. It had an impact on how I view anthropology and the work that will be required of me as a professional. This true story follows the life of a Hmong girl, living with her family in California, and her struggle with epilepsy. Her life is constantly threatened by cross cultural miscommunication and even the lack of communication entirely. Although language barriers can be an issue, the most challenging situations involve conflicts in belief and way of life.

Even when we think we are being objective, we carry assumptions about the correct ways to live. In the United States, we strongly confide in science and biomedicine. Not all cultures share this value. When asked to choose an approach, I had to go with the ethnomedical approach. It takes into account the varied ways in which individuals describe health models as well as, “how individuals decide when they are sick and the help they seek out,” (according to lecture 1.2). Successful health plans and studies of populations cannot be put into place without taking into account the values instilled in people. When it comes down to it, who is to say who is right or wrong in this world? We are all so deeply affected by our histories.

The distinction between disease and illness is entirely cultural. In the US, although they are not clearly cut, I think we view a disease as being a long-term sickness and illness as a way of categorizing all periods of being “unwell”. Again, it depends on who you ask.

I did not catch onto the truth of the Nacirema article for quite a while. As I was trying to figure out what to write, I glanced over the other blogs and realized how subjective I had been. Although I thought I was keeping an open mind, I didn’t relate it to our own culture.

Now that i know the truth behind the article, I thought one interesting point was about the human body being ugly. As I read this the first time, I thought, “that’s interesting because we enhance our own bodies to look more natural and human than ever.” Now I feel so naive and American to have thought that. We constantly cover ourselves with make-up, cut and style our hair, and wear clothes that emphasize certain parts of our bodies while hiding others. I also liked the part about the shrines we keep in our houses. This represents our reliance on science and our obsession with quick, easy solutions to all of our problems. The hospital visits description is also interesting because it points out how we value their services so much while we fear them perhaps even more. This goes along with our tendency to place responsibility on someone else when trying to find solutions to our problems, no matter what the cost may be.