Ebola in Uganda

Ebola is a disease that originated from a river in the Democratic Republic of Congo, which is responsible for the name. If originates from contact with the bodily fluids of an infected animal. Originally, this was how it was transmitted, but human-to-human contact is also responsible for transmission. The ebola virus results in “the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.” (Ebola Fact Sheet). The fatality rate of the virus is typically around a staggering 50%, and in some cases as high as 90%. There are no known treatments or vaccines for ebola. For these reasons, ebola is a very dangerous epidemic, and it occasionally flares up in Uganda, even as late as 2012.

http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/3644-ebola-outbreak-in-uganda.html

Above is an article linking to a recent outbreak from July. At the time of the article, 14 out of the 20 shown to have ebola died from it. However, they mention that a few tasks force have been dispensed in an attempt to control the outbreak. However, the World Health Organization “does not recommend that any travel or trade restrictions be applied to Uganda.” So, while dangerous, it does not appear to be too dangerous to travelers, simply poor residence around affected regions in Uganda.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033100/

Here is an article written by Barry S Hewlett, a cultural anthropologist. in it, he describes how there was an ebola outbreak in 2000-2001, and how they culture (specifically the Acholi people) dealt with the outbreak. I found his article fascinating because he gave surveys to the population, and will attempt to use their answers so that treatment, or at least outbreak prevention, can be controlled in the future, while still being culturally sensitive to the Acholi people. They believed that the outbreak was caused by a bad spirit, and they had a variety of methods of driving away these spirits, from wearing a dried banana bracelet, to chasing the spirits back to the Nile by loud noise. They also had procedures to sick people so they could get better, such as not dancing and refraining from sexual activity. However, they did share many similar ideas that we find basic, such as isolating those that are affected. Hopefully, by being mindful of the culture of these people, we can still effectively treat or prevent an ebolic outbreak.

Global Health and Medical Anthropology

I chose this intersection because I feel that global health is not up to par. Especially when you consider what technologies are available to us, as well as how easy it is to have a global presence, we are not helping out the needy as much as we could be. It seems to me that the saddest bit is that politics and personal interests play the most into this, rather than selflessness. As we saw in the class video about the medical anthropologists Dr. Farmer, many called him crazy for trying to help the poor population of Haiti. I found this sad, because rather than encouraging him, people seemed to discourage him and felt that the Haitians were a lost cause. I believe that no one should be considered that, and that everyone should have a chance at a healthy life. Hence my interest in global health and medical anthropology. It wouldn’t be about making the most money for a corporation, but rather helping fellow humans enjoy life to their fullest. After all, that is what being an anthropologist is about: respecting fellow humans.

I would use some of what I had mentioned previously if I were working for someone that isn’t an anthropologist. Again, I feel that it’s about corporations making many, especially in western medicine. I feel this is morally wrong, as we are trying to treat fellow human beings, not put money into the pockets of corporations. Through anthropology, we can gain an understanding of various human cultures and their behavior, and use that to aid them and make them healthier. One specific method of treatment does not work for everybody, and this is very apparent when you are traveling around the globe, and observing how other cultures and people view medicine. We need to keep a worldview, or holistic approach, if we have any hope of increasing global health.

Depression

Let me first start off by saying that I do believe depression is real. I myself believed I was depressed for a long time. However, I do also believe it’s one of the most over-medicated conditions to exist in western medicine. When you see a commercial for an anti-depressant, they talk in very general terms: do you have anxiety? Feel like doing nothing? Lack motivation? Well, I ask, who hasn’t felt that way? Who hasn’t had anxiety before an exam or when money is low, and who hasn’t felt just bored and nothing seems fun? Sure, these may be signs of depression, but they’re also completely normal moods that everyone experiences. Take this commercial for instance:

Everyone is sad, the music itself is depressing, and the commercial implies that you can’t be happy unless you pop down some Cymbalta. Boy, let’s hope that laundry-list of side-effects doesn’t make you feel worse though! Everywhere on television you’ll see ads for anti-depressants. It seems the most common and accepted form of treatment, so people just go ahead and take anti-depressants rather than face their condition. I believe this is a mistake and may cause more harm than good. I’ve seen friends begin taking anti-depressants and feel much worse on “off-days” or they relapse into a much deeper depression if they’ve forgotten to take their medication. It creates a dependance, and doesn’t tackle the issue head-on.

http://news.softpedia.com/news/Depression-Should-Be-Embraced-Not-Medicated-102005.shtml

I found the above article very interesting because it gives people with depression more power. Typically, people with depression tend to feel powerless. However, should they just talk with someone about the issue, or focus their own thoughts on it, rather than pop a pill and forget about it, maybe the condition will actually be treated or alleviated. I believe that medication simply creates dependance, which is counter-active to anyone suffering from it. Rather, depression should be embraced, as the article states, and not shunned or seen as a medical condition that needs to be treated through pills, as the pharmaceutical companies want.

http://www.helpguide.org/mental/medications_depression.htm

Finally, this article outlines many of the pros and cons of antidepressants. However, it states many things that are definitely cons and work against the gains of antidepressants. For one, doctors like to throw around your serotonin levels as an indicator of your happiness. Though, as the article states, this isn’t a quantification, and there’s no evidence in hard numbers. We can’t measure serotonin levels, we just believe they’re low, and that leads to depression. But, increasing serotonin levels is by no means a guarantee to cure depression. In fact, the article says “A major U.S. government study released in 2006 showed that fewer than 50 percent of people become symptom-free on antidepressants, even after trying two different medications. Furthermore, many who do respond to medication slip back into depression within a short while, despite sticking with drug treatment.” To me, this shows a problem, and that issue is that the solution isn’t a solution at all. Maybe it means that depression is much more serious, or maybe it means that it can’t simply be combated by biomedicine: it needs to be fought with support from others, a strong mind, and society not telling you that it’s wrong to be depressed, but that it’s okay to feel sad.

Body/Mind

The culture of biomedicine in my opinion refers to biomedicine specifically in western culture and medicine. We tend to view biomedicine as absolute and correct, because there is science behind it and it is based on physicality. There is no voodoo or uncertainty in biomedicine, and I believe this contributes to our view on it. Typically when we see new medicines come out, or new procedures, we tend to think that this is absolutely the only way, or the best way, to cure something. As shown in the lecture “Culture of Biomedicine”, one of the aspects is the hospital as a symbol. I find this important to the culture of biomedicine because nothing seems so absolute in our minds as a hospital, yet many hospitals act more like businesses. So while rooted in helping patients, many hospitals still exist to make money, and they will continue to create treatments based on biomedicine that are also very expensive and will end up costing a pretty penny on your hospital bill.

This ties into the dichotomy of body and mind. The hospitals definitely seem to treat patients’ bodies only. They won’t treat our minds typically. In fact, separate doctors exist for that: psychiatrists and psychologists. However, I believe that the body and mind can be more related than they are treated in biomedicine. The placebo effect is a great example. Through our own minds we can make pain seem less painful, or even have someone trick us into believing that a procedure works because we believe it does. I think this shows that the body and mind are much more inter-related. However, should hospitals rely less on this dichotomy, how can they make money? People won’t spend money on “maybes”. You’re not gonna see someone shell out cash to be hypnotized into getting better. In our society, people who do go through things like this are labeled as weird or crazy. There’s not an initiative in our culture to say that they’re simply treating themselves in a different way. Though people will spend money on a procedure that has been effective in 80% of cases, however. I’m not saying one way or the other is more effective at treating patients, but one will certainly give the hospital more money.

I Have Schizophrenia

This episode followed three sufferers of paranoid schizophrenia. One of them is a male who self-medicates using marijiuana in order to cope. Another sufferer is a girl currently going through college who sees a therapist for treatments. Finally, the last person showcased lives at home and is currently dealing with his illness by going to support groups and taking medication.

Firstly, you see the signs of restitution, chaos, and quest within each of these sufferers. Restitution is seen amongst each of them in that a therapist, medicine/pills, or talk of a mental institution is used as methods in order to fix or alleviate each of these peoples’ disorders. Chaos is seen in each as well, perhaps the most. The first person has constant conflicts with his mother about his well-being, and he also has issues about where he my live as he is kicked out of places. The second person, in college, has to take a speech class, and is unsure about whether she should perform in front of a group for fear of her symptoms returning. The last person has a definite chaos narrative: both his father and grandfather suffer from cancer, and his grandfather dies in the course of the episode. His family fears that he’ll fall into a depression and relapse into his condition. Finally, each does have a quest narrative. The first sufferer who has rejected all attempts at help, finally ends up finding a place to live where he’ll get help for his condition. The other two sufferers end up going to or to go to support groups, who help them come to terms with their conditions as well as realize that it is not their fault, and that they do have others they can talk with in order to help them out.

Typically, none of these sufferers have any responsibilities. But it’s interesting in that the latter two end up taking on their own responsibilities. For example, the girl who goes to college does so of her own accord and will, and the last man has plans to go to college when his condition is lessened. They do all experience issues with culture as well. For example, the first man with the condition argues with his mother, who does not seem to be supportive and wants simply to put her son in a mental institution. She almost sees him as “crazy” and doesn’t have much regard for helping or taking care of him herself. The other two have issues being in public, no doubt tied to the social stigma of being in a very socialized culture. This puts a lot of pressure on people who become paranoid in large groups of people. However, part of their quest narratives involve them eventually going out in public and being around large groups of people in an attempt to become comfortable in that situation.

I would say that illness narratives are very supportive to the patients, especially as shown in the sufferers of schizophrenia in this episode. The first man actually did not want to be “cured” because he enjoyed talking to the birds, because he feared that there would be voices if he were totally alone. He preferred talking to something as opposed to nothing, even if he knew it was part of his condition. The second patient would talk to her therapist, often gaining support from her in decisions as to what to do in school. Finally, the last man goes to support groups, as mentioned. However, he is not forced to – he chooses to. He finds it incredibly therapeutic and it shows how a narrative can help a person cope with what condition they may be suffering from.

Bipolar Disorder

Bipolar disorder is a mood disorder in which the individual may alternate between periods of depression and mania, with the occasional normal period in between. Those in a depressive state typically will sleep often, feel depressed, have a lack of motivation, and in rare cases may have delusions. Those in a manic state feel euphoric, energetic, have little need for sleep, and is often considered the opposite of their depressed states. However, in both situations, there exists the rare chance for delusions and hallucinations.

I would say that culture is insensitive to those suffering from this disorder. In our culture, we are quick to dismiss these people as “crazy” without thinking of the inability of the sufferers to control their own mood swings. This may often make the sufferer think there is something wrong with them and begin to blame themselves without realizing that they have a mood disorder. I myself had a friend’s uncle have schizophrenia and bipolar disorder, and for years he had been in trouble with the law. In many cases he was in trouble for things that were out of his control due to his disorders. He would often see hallucinations, and the more trouble he got in, the more stressed he would become, and the worse they would get. The police dismissed him as a “troublemaker”. It took years for anyone to identify him as suffering from mental disorders due to the negative associations of his conditions.

In my opinion, belief is the main healer. Despite any doctor, pill, or surgery we may have, if we don’t believe in it and don’t maintain a positive attitude about it, we won’t get better. The film “Placebo: Cracking the Code” shows that belief may be one of the most powerful healers. The story about the depressed woman is a good example. She was given a placebo antidepressant to cure her depression, and it completely worked on her, to the point where she refused to believe she was given a placebo at first. I believe this is due to the human mind being unable to use itself to heal; we have to refer to an outside source or healing method to “know” that we are getting better. Placebos allow that to happen. Especially the case with depression or bipolar disorder in which the person may blame themselves irrationally for things. They can’t will themselves to get better, but should they believe that they will be treated, it will benefit them. As shown above, the man’s hallucinations became worse the more trouble he got into. And simply being labelled as a troublemaker only served to cause him to blame himself more. However, when he finally received help, he was able to reduce the affects of his conditions, and today is in a much healthier mental state than before he was treated.

Taijin kyofusho – Japanese CBS in a Black American Woman

Taijin kyofusho is a Japanese culture-bound syndrome in which the sufferers have a variety of types of social anxiety and prefer to avoid social contact. However, this isn’t in the traditional sense. Sufferers typically are afraid of offending others, so they avoid social contact due to fear of their own social ineptitude. Often, sufferers are afraid of others being offended at their body odor, eye contact, or even their ugliness/physical deformities.

I read an article though that describes this CBS in a black American woman. I thought this was interesting because it’s obviously something that affects others in the world is not necessarily specific to Japan. In the article, a 34-year-old black American woman has a specific type of taijin kyofusho (TKS) in which she is afraid to communicate socially because she has a fear that she may inadvertently look at someone’s genitals mid-conversation and offend them. I found this interesting because it isn’t something so ridiculous: we may all have that moment where we attempt to make eye contact then slip up on accident, and suddenly become paranoid about what the other person may be thinking about us.

The woman was also shown to have OCD. She would do things in a left-to-right fashion like putting on make-up or shoes, would not drive under suspended train-rails, and would not use toilet paper from Chicago. She had developed these symptoms when she discovered that her husband may have been having an affair. The writer of the article begins to describe that TKS may not be a CBS but rather a simple social phobia. He also explains that TKS is simply more stressed in Japanese culture due to the stigma associated with offending others within their society. It shows that a small problem in many other cultures is a bigger problem in another due to their beliefs, not necessarily that the only place TKS can occur is in Japan.

For the woman’s treatment, she had to converse with her doctor/psychiatrist, while the doctor placed fingers in his lap. The woman had to count the fingers the doctor had out, which put her eye contact right at her doctor’s genitals. He also had her perform actions out-of-order to attempt to help with OCD. He even had her go to shoe stores and try on shoes, putting the clerks’ genitals within her vision. Unfortunately, after a few treatments, the woman reported TKS returning after a few months.

Source: http://www.sciencedirect.com/science/article/pii/0887618590900255

Hmong Shamans in the United States

This is based on the article that was listed in the week 3 section, and another article about a Hmong Shaman in California. I chose Hmong Shamans in the US because I have read “The Spirit Catches You and You Fall Down” for an IAH class. It was a very interesting read and showed to me that medicine is not about the person treating you. It’s actually about your own beliefs and spirituality. If you believe that you are being healed, no matter how it’s done, it increases your health in some way. The articles showed how the Hmong are a very spiritual people, and how many illnesses are caused by what they believe to be “evil” or “bad” spirits. The shamans will enter trances and negotiate with the spiritual world to remove or replace evil spirits in a person. Often, these spirits need another body to occupy – hence why animals like chickens, pigs, and cows are often used in their rituals, either alive or dead.

The articles showed how the Hmong with these very spiritual beliefs are incorporated into western medicine and western healing through the use of official Hmong Shamans in hospitals. This allows the patient to be more familiar and comfortable with western medicine, as well as allowing our own doctors to work with the Hmong and understand how they are traditionally healed.

I would say the shamans traditionally fall into the folk sector. This is because it focuses on very natural and cultural healing methods. The afflicted don’t go to professionals first, they tend to go to the shamans in order to get treated. Any sort of sickness is, again, described as bad spirits and treated as such. In the book “The Spirit Catches You and You Fall Down”, the sickly girl the story is centered around suffers from epilepsy. The medical doctors give her pills, not realizing that the parents don’t understand how pills make bad spirits go away. The child is unsuccessfully treated because the Hmong are used to healers in the folk sector. However, since Hmong Shamans are now incorporated into the hospitals themselves, they are drifting towards the professional sector, and often suggesting patients of theirs see a doctor BEFORE they attempt to perform any rituals.

Sources:

http://www.theworld.org/2012/05/hmong-shamans-medics/

http://www.nytimes.com/2009/09/20/us/20shaman.html?_r=2

Bad Sugar

I got 6 out of 10 questions correctly on the quiz. Not a great score, but it shows my naivety. What shocked me was how low our quality of living was. However, the quiz is a little dated. Looking again, our life expectancy in the US has dropped even lower: We are now ranked 50th. (Source: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html). This shows how quickly we are dropping. However, in comparison to life expectancy hundreds of years ago, it is a bit higher. Although we should still be mindful, active, and healthy in order to increase our life expectancy.

I watched the video “Bad Sugar” and it was essentially showcasing the growing epidemic of type 2 diabetes among Native Americans, particularly the Tahona and Pima (sp?) tribes in Arizona. These tribes lived along a river that provided for them, and their ancestors engineered along the river to create farms in a desert environment. However, this river was diverted through dams and in typical American fashion, those who used it the most and benefited the most received it the least as a result. Now expectancy for type 2 diabetes to develop among these natives is nearly twice as high as for other races. This is due to the large amount of the native population in the area (50%) being below the poverty line. This means they aren’t eating healthy. Their best and cheapest choices for food means the most sugary and unhealthy food possible. This leads to diabetes quickly. Stress also leads to increased blood sugar, which means increased diabetes. Stress can easily be caused by living in difficult conditions, and living in poverty would definitely count as “difficult conditions”.

It can certainly be said the the development and urbanization around these native tribes has lead (nearly directly) to their diabetes problem. Yes urbanization means we can help treat diabetes, but only typically for those that can afford it. In this case, it won’t be natives living below the poverty line. Their culture has contributed somewhat, however. In the beginning of the episode, they mention that diabetes was almost a way of life. Everyone knew they would get it eventually, so why bother trying to change your lifestyle to avoid it? The elders would almost dismiss the disease, simply referring to it as having “bad sugar”.

Testicular Cancer Among White Males

Being a white male of age 22 puts me at the most risk for testicular cancer. Testicular cancer is most prevalent among white males in my age group, especially compared with other races, specifically blacks. Here are a few graphs demonstrating this (these reflect the average percentage of life lost in the Greater Bay Area):

Average Percentage of Lifespan Lost Among White Males

 

Average Percentage of Lifespan Lost Amongt Black Males

(Source: http://www.cpic.org/site/c.skI0L6MKJpE/b.6148445/)

Even between these graphs you can see the disparity is very apparent. In fact, testicular cancer doesn’t even show up for black males in terms of lifespan lost. Keep note that these graphs don’t show the amount of each population that are diagnosed with testicular cancer, but simply the average percentage of lifespan lost due to various cancers. But it’s still noticeable that it means white males are much more susceptible to losing their lives due to testicular cancer, making it much more dangerous among my age and race group.

I believe there is such disparity because white males are among the more wealthy in the United States. They are also typically the ones that hold white-collar jobs, not usually manual-labor. And it has been shown that those that hold white-collar jobs are more likely to develop testicular cancer than those that have blue-collar jobs. It is also likely that, at least in the United States, blue-collar jobs are more often held by people of other races, meaning that they are less susceptible to testicular cancer. It shows that there is something within our culture leading to this particular health disparity, not necessarily genetic factors in my opinion. (Source: http://www.health.ny.gov/statistics/cancer/registry/abouts/testis.htm)

To me, race, genetics, and health can all be intertwined. In the first lecture we were shown a video about malaria and how genetics factor in. I believe this is a very good example of how these three elements are related. It shows that, due to years of dealing with the disease, people in the area had begun to build immunities to it. This has then been passed on through genetics. So, this race of people has built up an immunity over time because they have breed with each other and passed on the gene that allows for this. As a consequence, an outsider who has no immunities due to genetics is going to be very likely to contract the disease. This leads to health disparity because they are likely of a different race (or culture) and should the trend continue, races who are NOT native to the area are more likely to contract malaria due to similar circumstances.