Tuberculosis in Russian Prisons

During the 1990’s, after the collapse of the Soviet Union, Russia began to experience a tuberculosis epidemic within their prison system.  During much of the Cold War period the Soviet Union and the United States shared the position of having more people incarcerated than any other country on earth.  In fact, after the fall of the Soviet Union it was found that the Jackson Prison was the largest prison on the planet until the 1980’s when the state divided the prison into smaller prison units due to rioting.  In Russia however things only became worse after the collapse of the Soviet government.  People began to be sentenced to prison for minor infractions and the prison population expanded to an all new high.[1]  Because of prison overcrowding, and reduced funds being spent on the Russian medical system, tuberculosis had taken hold within the prisons.  It was found that one in ten prisoners had active tuberculosis and this number was only going to increase as these prisoners infected other prisoners and possibly even their families after their release.  It can also be said that being sentenced to prison during this time period included the sentence of tuberculosis.

In response to the epidemic The Public Health Institute (PHRI) and Partners in Health (PHI), which was founded and run by Dr. Paul Farmer, established medical facilities within Russia to manage the threat of tuberculosis for both prisoners and the general public.  “Accomplishing this aim required the establishment of collaborative working relationships with a variety of partners in Russia, building a laboratory infrastructure virtually from scratch, training laboratory and medical personnel, implementation of TB control procedures, provision of appropriate first and second line drugs, advocacy to convince TB and governmental leaders to proceed with the program, and a myriad of additional tasks, all taking place in a highly charged political atmosphere.”[2]

The political atmosphere of Russia during this time period made it difficult for westerners to affect change.  Dr. Paul Farmer was forced to meet with many political members of the Russian government and argue the need to treat the people suffering from this disease including the nation’s prisoners.  A colleague of Dr. Farmer who witnessed Farmer’s heated exchanges recollected an argument at “a congenial dinner with a famous personage in public health. By day Paul had been arguing with him. The fight had to do with milk. Paul wanted Russian prisoners with TB to get a glass of milk each day, and the public-health expert didn’t think this was necessary.”[3]  These heated exchanges were common for Dr. Farmer while he attempted to gain a support for the medical centers and tuberculosis treatments.

By 1997 PHRI had successfully established effective tuberculosis controls in Russia for both the civilian and prison population.  The PHRI then turned over management of the program to Dr. Paul Farmer and the PHI.  Because of the efforts of world health organizations such as PHRI and PHI and medical anthropologist and physician Paul Farmer tuberculosis is now controlled and treated within the Russian prison system and the sentence of tuberculosis has also been eliminated from the Russian criminal justice system.


[1] Paul Farmer, “Russia’s Tuberculosis Catastrophe,” Project Syndicate, January 18, 2001, accessed August 9,2012, http://www.project-syndicate.org/commentary/russia-s-tuberculosis-catastrophe.

[2] The Public Health Research Institute Center, “The PHRI/Soros Russian TB Program: Treating MDRTB in Siberian Prisons,” The Public Health Research Center, Accessed August 9, 2012, http://www.phri.org/programs/program_russiantb.asp.

[3] Tracy Kidder, “Paul Farmer Is Revolutionizing Medicine,” The Daily Beast, May 5, 2010, accessed August 9, 2012, http://www.thedailybeast.com/articles/2010/05/06/paul-farmer-is-revolutionizing-medicine.html.

Global Health and Medical Anthropology

One of my required readings for ANP 201 was Paul Farmer’s book “Pathologies of Power: Health, Human Rights, and the New War on the Poor.”  This was where I first began to understand the importance of global health and how anthropology fits within the system.  I loved the book and Paul Farmer became a huge hero to me.  For some reason the fact escaped me that he was a medical anthropologist.  I knew he was a medical doctor and an anthropologists but for some reason I didn’t make to connection to medical anthropology.  Maybe I didn’t know what medical anthropology was at the time and therefore it eluded me.

I do not see global health or even medical anthropology being a part of my future career, although I do have a very strong interest in global health and my heart breaks whenever I hear about the many disparities people are forced to suffer through in developing countries and certain parts of our own country.  I, like Paul Farmer and most other developed countries, believe that medical care is a basic human right and should be available equally to all people.  The fact that the majority of my anthropology education has been focused on archaeology, and not medical anthropology, and I graduate after next semester may prevent me from obtaining a job in this field due to my lack of knowledge.  Maybe if MSU had offered this class sooner I could have focused my energy in this field of study.

I believe understanding a patient’s culture, worldview, and beliefs about science and medicine is extremely important in the medical system.  Anthropologists have the knowledge and ability to moderate between doctors and patients through the use of ethnography and other methods.  An example of a situation where anthropologists intervened was that of Ms. Lin who was from China but moved to America in order to attend school.[1]  After refusing to take her medications for anxiety, an anthropologist became involved to find out why.  The anthropologist found that China has a very strong stigma associated with mental illness and by the doctors describing her condition as an anxiety disorder, and the stigma associated with a mental disorder in her culture, she refused to participate in that role.  The anthropologist discovered that the Chinese call this condition neurasthenia which is considered a stress-related condition and not a mental disorder.  After discovering this about the Chinese culture medical staff began to call her condition neurasthenia instead of anxiety disorder and Ms. Lin began to take her medicine.  This may not have been discovered unless there was a person set in place in the medical system who had the knowledge to ask the right questions.  In this way acting as mediator between doctor and patient an anthropologist role is invaluable.

 


[1] Arthur Kleinman, Peter Benson, “Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It,” Plos Medicine, http://anthropology.msu.edu/anp204-us12/files/2012/06/6.-Kleinman-and-Benson-Anthropology-in-the-clinic.pdf.

Erectile Dysfunction

In 1998 the Federal Drug Administration approved the drug Viagra to treat men with erectile dysfunction.  Erectile dysfunction is a condition were a man cannot achieve an erection to have sex or cannot keep an erection long enough to complete the sex act.  At one time this condition was called impotence.  Erectile dysfunction may occur at any age but it is most often found in elderly men and men experiencing other illnesses.  Viagra was initially marketed to older men who had trouble obtaining or sustaining an erection but Pfizer, the producers of Viagra, soon broadened its intended audience to include nearly all males.  Pfizer’s marketing campaign changed the direction of the drug by depicting men performing “masculine” activities such as “professional athletes likening sexual function to consistent batting practice or race car drivers smashing through barriers marked ‘erectile difficulties”[1]

The drug was no longer seen as just a treatment for older men but now seen as a treatment to enhance sexual performance in all sexually active males.  The notion that the drug would enhance masculinity, which is brought to the customer through enhanced sexual performance, increased the user base and increased profits for Pfizer.  The pill and the pills name even displayed the powerful potential of the drug.  The name Viagra has been interpreted as a combination of the words “vigor” and “Niagara” creating a theme of power, potency, thunder, and force surrounding the pill.[2]  Viagra is also the color blue which is the color of masculinity.  Pfizer’s marketing for the drug promotes a “normal” or “ideal” body and sex life including the idea of “sex on demand, sex for everyone, and sex for life.”[3]  Pfizer’s construction of normality is the key component of its medicalization strategy.  Such marketing has brought a new meaning to erectile dysfunction.  It no longer just applies to an elderly man who can no longer have sex but also includes younger adults who want to invigorate their sexual performance to levels they had in their youth and to which they see is “normal.”  All of this, according to Pfizer, will make them manlier and more successful.

A Viagra commercial that implies the success a man can have after taking Viagra was air in Canada in 2003.[4]  I found this commercial to be interesting because of the strict guidelines attached to pharmaceutical advertising in Canada.  Apparently the name of the drug cannot be said out loud during any pharmaceutical commercial which makes the consumer look more at the hidden content.  The commercial begins with an extremely happy man hopping and bouncing out of his front door and into the street.  His house and neighborhood looks like something straight out of “Leave it to Beaver” or “Father Knows Best.”  The neighborhood appears to be abnormally “normal.” The man is dancing in the street and is apparently astatic over his new found sexual normalcy.  All the while, since the beginning of the advertisement, the song “We are the Champions” by Queen is playing in the background.  As he dances in the street we see a neighbor woman watch with disbelief as she waters her garden with a limp hose.  Soon, every middle aged man in the neighborhood is dancing in the street including a man in a wheelchair.  Just as the word Viagra is displayed on the screen the lyrics of the song “no time for loser’s because we are the champions” is heard.  The Viagra logo fades out and the words “talk to your doctor” appear on screen.  This was an attempt to display the happiness and confidence that come with erectile normalcy.  By living the sexual “normal” life you will become more popular, confident, successful, and more manly.  Anyone not living this life and not taking Viagra is a “loser.”  By making men feel as if they are less manly, popular, or even a looser if they suffer from any erectile problems they could possibly increase consumption and profits.

Funny Viagra Commercial 2


[1] Loe, Meika, “The Rise of Viagra: How the Little Blue Pill Changed Sex in America,” New York: New York University Press, 2004. P. 58-59.

[2] Loe. P. 53.

[3] Loe. P. 169.

[4] “Funny Viagra Commercial 2.” 2010. YouTube Video, 1:02, Posted by “PharmaOnline2010.”   Aug 12, 2010. http://www.youtube.com/watch?v=btRVajYQm80.

True Life: “I have an Embarrassing Medical Condition”

The True Life episode “I have an Embarrassing Medical Condition” provides us with narratives of two girls living with chronic medical conditions.  Allyssa who is eighteen years old is suffering from Tourette syndrome and Krystal who is also eighteen years old suffers from hyperhidrosis.  Both narratives would be categorized as chaos narratives as both girls have chronic conditions and attempt to explain their struggles fitting in with their peers and the social isolation brought about from their illness.

Allyssa was diagnosed with Tourette’s syndrome when she was fifteen years old.  She commonly experiences uncontrollable outbursts which includes yelling and swearing.  Allyssa also experiences fainting ticks, self-choking ticks, hitting ticks, and ticks were she stops breathing and requires assistance from others to start breathing again.  She has been prescribed five medications by her doctors which she takes daily.  Three of the medications treat the ticks associated with Tourette’s syndrome and the other two medications are for anxiety and depression.  Allyssa stated that the medications make her feel light headed and also make her feel as though she is not connected to this world.

Because of the embracement she feels when she experiences these uncontrollable ticks and the care she requires while experiencing these ticks Allyssa does not venture out of the house as much as she would like to and has become more isolated than she would like.  She stated “It’s like taking a two year old to the mall without a leash” and she becomes embarrassed when people stare at her. The friends she made prior to the onset of her condition have remained her friends and assist with her care.  Allyssa has experienced limited success in obtaining new friends since her diagnosis and expresses great fear for what will happen to her when she leaves her friends and family to go to college.  She has fears about fainting and falling on her head but also has fears of being excluded from people socially.  She is afraid people will see her as a “freak.”

Once at college Allyssa explained her illness to her dorm mates openly and honestly.  She made numerous jokes about her illness and invited laughter of her condition from others.  She did this to ease their tension about the illness and assumed the comedian role amongst her new college friends.  This has brought a new group of people together who are willing to assist her with her illness.

The other narrative involved an eighteen year old girl from Florida named Krystal.  Krystal suffers from hyperhidrosis and was afraid of letting her friends know about her condition.  She believed there was a social stigma attached to “sweaty girls” and did not want to be teased.  She altered her appearance by transitioning herself from looking “preppy” to looking “Goth”  The dark colors of Goth fashion helped hide her sweat marks but she never felt comfortable this this new fashion.  Krystal visited a plastic surgeon to receive a treatment that would reduce her sweating but found that the treatment was too expensive.  She then decided to inform her friends of her condition and why she always wears dark heavy clothing and her friends accepted her for who she was.

Illness narratives help to empower people suffering from illness by providing an outlet for their suffering.  The use of narrative may also help people suffering from illness make sense of their suffering by putting their experiences into words and chronological order.[1]  This may help family member and health providers understand what they are experiencing and help health care providers in discovering diagnosis.  For other’s this is information we can all learn from.  It may inform someone going through a similar illness that they are not alone.  For someone like me, who has never known anyone with Tourette’s syndrome, it has provided me with new empathy for their suffering.


[1] Lecture, Tazin Karim. “Illness Narratives,” online lecture viewed July 24, 2012.

Bipolar disorder

Bipolar disorder is a condition in which people experience mood swings at a heightened level.  A person can change from feeling very good and energetic to weak and depressed in a very short period of time.  “Bipolar disorder affects men and women equally. It usually starts between ages 15 – 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.”[1]

After many of the other social stigmas (class, homosexuality, gender) have been addressed in our society mental illness has not.[2]  In many ways people are still looked down on and made fun of for having a mental illness.  We hear jokes about the mentally ill and see homeless people talking to themselves as they walk down the street.  Although much of this is examples on how our system has failed these people negative stigmas are still attached to mental illness.  Many people who suffer from bipolar disorder wish to avoid the stigma of mental illness and refuse help.  They do not wish to play the role of a mentally ill person and instead some self-medicate through drugs and alcohol.

I’ve known two people with bipolar disorder.  One was my aunt who after maxing out her limit of days in a psychiatric hospital, set by her insurance company, she was released.  The day after her release she killed herself by hanging herself in a tree in her back yard.  I will not talk too much of this because it is an example of the total breakdown of or medical system and would make this blog much too long.  The other person, named Steve, I worked with for many years.  I was Steve’s union representative at the Jackson prison.  During this time he was in trouble with our employer on numerous occasions.  He seemed to have difficulty controlling his statements often saying offensive things to coworkers and prisoners.  After work he drank alcohol to calm himself down.  On one occasion he was arrested by the police for public intoxication and he often came to work with bruises on his face after getting in bar fights.  I’ve talked to Steve on several occasions about his behavior.  Being that I was his union representation it was my job to council him on his behavior and give suggestions of alternative ways to handle situations that would not end with him getting in trouble at work.  Steve knew his behavior was not acceptable but felt as if he was out of control.  He admitted to me that he was an alcoholic and drinking alcohol was the only thing he could do to calm himself and be able to sleep at night.  I suggested to him that he should see a doctor about his anxiety and inability to sleep.  Steve strongly refused going to a doctor.  He stated that when he was in high school his mother committed him to a juvenile psychiatric hospital and he would have nothing to do with doctors again.  To Steve it was the social stigma associated with being considered mentally ill as well his own ego that prevented him from seeing the doctor.  He didn’t want to be labeled as mentally ill because of the way it made him feel about himself.  He had already gone through that once when he was in high school and it must have made him feel pretty bad.

Since this time Steve has graduated from Lansing Community Colleges Nursing program and is studying for the licensing exam.  After being diagnosed with pre-kidney failure, due to his heavy drinking, he finally went to a psychiatrist and was diagnosed with bipolar disorder and given medications to deal with the illness although he is still drinking.

The use of placebo seems like a worthy area of research, although I think some of the studies may be ethically questionable.  I don’t like seeing scientists use our veterans like they are guinea pigs .  I think they are done enough for our country already.  Maybe they could use patients from a hospital in the suburbs?  I also think using experimenting placebo on hypertension is also ethically questionable because any damage done by non-treatment can create permanent, life threatening damage to patients.  I think what we should be looking at is the possible placebo created by doctors.  If doctors learn to make positive statements about diagnosis and treatment this could benefit the success of the treatments and the health of patients.


[1]PubMed Health, “Manic depression; Bipolar affective disorder,” PubMed Health, Last reviewed: March 25, 2012, accessed July 25, 2012,  http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001924/.

[2]Olwen Glynn Owen, “Patient Groups Tackle Stigma Attached To Bipolar Disorder And Other Mental Illnesses With New Tools,” Medical News Today, October 23, 2008, accessed July 25, 2012, http://www.medicalnewstoday.com/articles/126603.php.

Ghost Illness amongst Native Americans

Ghost illness is a culture bound syndrome where spirits or “ghosts” are viewed to be directly or indirectly linked to a person’s illness.  Ghost illnesses are very common in many Native American cultures and this belief still hold true today in many Native American communities.  In western societies we have witnessed increased mortality amongst people who are grieving the death of a loved one and this is especially true when the loved one was a husband or wife.  This high mortality of grieving persons would be considered a type of ghost illness in many Native American cultures.  With these deaths it is believed that the dead loved one caused the death of the person left behind in order to bring them back together.[1]  It is also believed that the spirit of deceased loved ones can cause disease and illness to the living.

Dr. Robert Putsch outlines several clinical examples of patients who have suffered from ghost illness in an article “Ghost Illness; A cross-Cultural Experience with the Expression of a Non-Western Tradition in Clinical Practice.”  Here, Dr. Putsch outlines patients suffering from ghost illness from the Navajo and Salish cultures.

One clinical description was of a 27-year-old Navajo woman who was suffering from bilateral accessory breasts, postpartum depression and severe family problems.  After giving birth to her first child the woman complained of experiencing severe pain and swelling in both armpits.  Her family doctor advised her that her pain was caused by the “enlargement of accessory breast tissue, and he had counseled her to avoid breast-feeding in an attempt to further enlargement.”[2]  She was also experiencing postpartum depression and feared that she was “going crazy.”  After giving birth to her child the woman began having dreams where she was being visited by her dead father.  In the Navajo belief system the visitation of the dead in a person’s dream is a form of bad luck and these dreams may be followed by illness or even death.  The woman believed the inflammation to her breasts and depression was caused by her dead father and this belief was also shared by her family and community.  Her family also felt that some of her “crazy” actions, like driving too fast, were also caused by her dead father.  Medical staff treated her inflamed breasts and depression with medication.  They treated her illness through the use of family counselors and eased her mothers and husbands concerns of being harmed by the dead.

This paper was twenty pages and I found it difficult to adequately outline it in 400 words but what I found interesting was the integration of the biomedical system into their belief system.  At no point did the woman question the diagnosis made by the doctors.  What the woman and her community gave was the reason why she is experiencing the disease.  They seemed to only fill in the blank often left out by bio-medicine.  Western culture does this as well with many diseases.  People seem to assume that a person suffering from lung cancer was a smoker or that all people with aides are homosexuals.  I think this shows the individualism within our culture indicating that we see disease as being the fault of a person living a certain lifestyle.  The Navajo see illness as an attack from an outside source.  The person affected with illness in the Navajo culture is seen as a victim.


[1] Robert W. Putsch, “Ghost Illness; A Cross-Cultural Experience with the Expression of a Non-Western Tradition in Clinical Practice,” Drumlummon Views, Fall 2006-Winter-2007, accessed 7-20-12, http://www.drumlummon.org/images/DV_vol1-no3_PDFs/DV_vol1-no3_Putsch.pdf. Page 127.

[2] Putsch, Page 127.

The Horse Boy; Shamans in Mongolia

The movie “The Horse Boy” is a documentary of a single child wealthy couple from Texas who are struggling with the lifestyle of having an autistic child.  After using the biomedical system here in America they became frustrated with the lack of improvements made to their child and their current living condition.  The couple also missed the ability to travel and experience the adventures that they once grew accustomed to.  The couple decided to travel to Mongolia to seek treatment for their child from nomadic shamans.  While in Mongolia the couple experienced difficult living conditions and had time to bond with one another and their child.  They were also given time to complain and cry about their life being parents to an autistic child.

During their visit to Mongolia they located a large assembly of shamans.  This was the largest assembly of shamans since the fall of the Soviet Union.  Although the video did not speak of the shamans social and economic status they appeared to be poor with very worn clothing but well respected amongst the community.  During a ritual with one of the shamans the couple learns that the spirit of the mother’s grandmother had attached herself to the child and this is the causation of illness in the child.  The mother underwent a cleansing ceremony and both father and mother were whipped while the child was prayed over.  The ritual seemed to have worked for a short time period of time as the child became increasingly social with the people around him but the temper tantrums and incontinence continued.

The couple then traveled further to the Shaga Lake region to meet with the “Shamans of the Reindeer People.”  These were a nomadic people who greatly respected and protected their shamans.  The Reindeer people are very poor but have great faith in the ability of their shamans.  After an evening ritual with a shaman the couple was promised their child will become less autistic as time goes by and will be healed from the illness within three years.  The couple found some of this to be true.  After the ritual the child was no longer incontinent and within two weeks was riding a horse by himself.  The couple began seeing great improvements.

There appeared to be very little biomedical support within the nomadic peoples of Mongolia.  Health care is provided by their shamans who practice a holistic whole body approach.  During the rituals the parents and child were included into the community.  They obtained emotional support, guidance, and prayers from the indigenous people.  I believe through this support the parents were finally able to accept their child’s disability and finally became a supportive family unit.  Through this patience, understanding, support, and guidance positive behaviors began to emerge from the child and the parents.

When the Bough Breaks

I passed the Health Equity Quiz with a modest 1.0 grade after guessing six of the ten questions correctly.  I found it to be a very interesting quiz but the question I found surprising was the question about life expectancy of African American males living in Harlem.  I could not believe that people in Bangladesh have a better chance at reaching the age of 65 than African American males in Harlem!  That really shows how socioeconomic status in America effects health.  It also shows how America perceives the worth of people living in Harlem by not doing anything to improve their conditions and keeping silent about their situation.

The video “When the Bough Breaks” explains how the chronic stress that is associated with racism raises the infant mortality rate amongst African American women.  African American’s have a much higher infant mortality rate than any other race in America.  The video states that the unequal treatment of African Americans in America accounts for the low birth weights and premature deaths.  What is unusual is that raising the socioeconomic status of an individual does not improve the chances of giving birth of a healthy child.  The infant mortality rate for African Americans with a college education is 10.2 per 1,000 births.  The infant mortality rate for European Americans is only 3.7 per 1,000 births.  College educated African Americans have a higher infant mortality rate than European Americans without a high school diploma which is currently at 9.9 per 1,000 births.

The video claims the reason for this is the stress that is induced through racism.  This chronic stress causes health problems for the mother as well as the baby through the bodies stress hormones.  These stress hormones can reduce blood flow to the placenta which can induce labor or damage the baby’s organs.  The video calls the chronic stress of an African American “Live Course Perspective.”

How politics, economics, environment, culture, biology and individual choice influence the development, spread and treatment of illness is a huge question.  First off, as we see above racism within a culture can have large impacts on people health and infant mortality rate.  Sadly many of these racist ideals can spread into politics and racist policies make it harder for minorities to obtain adequate health care and medication.  These same racist ideals can also work their way into environmental policies by placing factories and sewage treatment plants into neighborhoods occupied by minorities and thus reduce health by polluting the air and water.  In America where health has been turned into a commodity people who do not have the economic means to pay for their healthcare either do not receive healthcare or receive a inadequate level of healthcare which negatively effects their overall health.  Low income areas tend to have more fast food restaurants and bars than any other area in town.  This possibly racist zoning leads residents into making poor choices in eating and drinking thus leading them to poor health.

Diabetes among Native Hawaiians

(Self-reported Diabetes in Hawaii: 1988-1993 http://www.aloha.net/~mattman/diabetes.html)

Native Hawaiians have the one of the highest rate of diabetes than any other culture or race.  Hawaiians are five times more likely to develop diabetes between ages 19 to 35 than any other culture on the planet.   Eleven percent of Native Hawaiians develop type two diabetes between these ages compared to only two percent seen elsewhere in the world.[1]  At one time in American history Hawaii was viewed as one of the healthiest states in America but today Native Hawaiians have a lower life expectancy and higher mortality rates for heart disease, cancer, and diabetes than any other culture in America.[2]

Many studies have been conducted by scientists trying to determine what it is that makes Native Hawaiians more susceptible to diabetes.  Of course, many Americans thought genetics played a part in the ill health of the Hawaiian people but none of the research could prove it.  Anthropologists on the other hand have located several problems that may have led the Hawaiian people to poor health.  Anthropologists have found that removing the Hawaiian people from their culture is one of the biggest problems Hawaiians face deteriorating health.  Part of the culture involves the importance of land and this aspect of their culture has been taken away from them.  Juliet McMullin describes the causes of Native Hawaiians health in her book “The Healthy Ancestor.”  McMullin states “The introduction of capitalist modes of production resulted in the subsequent alienation of the Native Hawaiians from their land and their methods of subsistence, and the subjugation of their knowledge.”[3]

By removing the land from the Hawaiian people they lost a large part of their culture.  They were no longer able to grow the foods that were native to the islands once the land was taken from them.  Land is also a large part of their religious and cultural identity.  Once these things are removed chronic anxiety can ensue which increases many potential health problems.

As was discussed in class this week race was originally believed to be the factor behind these health problems.  Thankfully, more and more scientists are beginning to show that there are no such thing as “race” diseases and only specialized genetic adaptations have been found in people living in specific parts of the world.  An example of this would include people who live in Western Africa and South America who have developed the sickle-cell gene.  This adaptation occurs when humans live in areas of the world with a high prevalence of malaria.  Although genetics are involved with this trait race does not.  Although western scientists and doctors have developed eugenics programs to eliminate the bad genes of a society we can see the only thing wrong was society itself.  Culture and cultural practices, discrimination, socioeconomic status has more to do with health within a population than anything that can be found in genetics.


[1]APIAHF, “Native Hawaiians,” Asian and Pacific Islander American Health Forum, last revised August 2003,  accessed July 12, 2012, http://www.hawaii.edu/hivandaids/Native_Hawaiians_Health_Brief.pdf.

[2]Juliet McMullin, “The Healthy Ancestor,” Left Coast Press Inc, Walnut Creek, California. 2010. Print. P. 16.

[3] McMullin. P. 162.

Ecological Approach

In my opinion this is the most dynamic of all the approaches.  The way in which power, political economy, Industry, environment, and poverty all seem to interact with one another to produce suffering throughout the world is an important field of study.  It all seems to boil down to greed.  Whether it’s The World Bank holding developing nations natural resources as collateral, or the polluting of waterways by industry, people seem to always suffer through poverty, hunger, and disease.   I find this approach interesting because it studies issues that are horrific but changeable.

The distinction between disease and illness I found interesting.  I have never thought about these distinctions before this week.  My understanding of these distinctions is; a disease is the medical definition assigned to distinct signs and symptoms of a physical or mental abnormality and an illness is the perceptions and experience by people caused by the abnormality.  Disease is a clinical definition where illness is a psychological and cultural definition.

The culture Miner is describing in his article is America.  I realized this as soon as I saw the article because I read it in ANP 201.  One important ritual in the article was visiting the charm chest.  The charm chest is a medicine cabinet.  It is filled with magical charms (medicine) that people believe they would die without.  It shows the importance Americans have placed in the biomedical industry.  People believe without having pharmaceuticals for every potential abnormality that they will surely die.

Below the charm chest is the Water Temple (sink) where people bow and sprinkle holy water on themselves.  Here also is another interesting ritual called the “mouth rite” (brushing teeth).  This rite was given to them by the “holy-mouth-men” (dentists).  This rite shows the lengths people will go through to keep themselves healthy and the trust they have in the medical industry by believing the dentist that spending time by brushing ones teeth will prevent disease.

Another rite in which the “holy-mouth-men” are involved is the “exorcism of the evils of the mouth” (dental cleaning).  Here people go through “unbelievable ritual torture.”  Not only are the Narcirema people willing to spend their time and money on their oral fixations of health but they are also willing to undergo torture as well.  This shows the commitment of the people to following the recommendations of the medical industry even if such recommendations are known to be painful.