FGM in Sudan

FGM, or Female Genital Mutilation, is a very serious problem
in some countries. It is seen as a way to help prevent women from losing their
virginity before marriage or from having extramarital sex. It is seen as a way
to protect a family’s dignity and promote marriageability. This is an article
about an experiment to see if FGM was actually an effective defense against
contracting STI’s for women in Sudan. http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2006.00896.x/full

The experiment concluded that Female Genital Mutilation did
not protect against nor aid in contracting STI’s and is therefore not
necessary. The article states that women in the study had one of four different
categories of mutilation.

  1. Excision of the prepuce and part or all the
    clitoris
  2. Excision of the prepuce and clitoris together
    with partial or total excision of the labia minora
  3. Infibulation. Excision of part or all the
    external genitalia and stitching/narrowing of the vaginal opening
  4. Pricking, piercing, incision, stretching,
    scraping or other harming procedures on clitoris and/or labia

There were 222 women in the study all between the ages of 17
and 35.

Women’s rights activists and children’s rights activists
have all been fighting against female genital mutilation. This article talks
about their fight against FGM in Sudan. http://www.wluml.org/node/5236

Ellen Gruenbaum is a professor at Purdue and is their chair of the anthropology department. “Gruenbaum spent over five years in Sudan and Sierra Leone, where the most severe forms of genital surgery are common, and has experienced how this practice is deeply rooted in the cultural traditions — in religious, moral, and aesthetic values, and in ideas about class, ethnicity, and sex.” according to this article, http://www.stop-fgm-now.com/medical-anthropologist-speaks-abolishing-female-circumcision

She also wrote a book about FGM in 2001 called “The Female
Circumcision Controversy”. She has spent much of her time invested in FGM and
bringing awareness to help fight female circumcision.

Clinical Medical Anthropology

I chose clinical medical anthropology because I am currently
studying to be a Physician Assistant and so I plan to one day work in a clinic
or a practice to help treat patients, but I also would be interested in working
in the hospital as well.

It would be useful to use an anthropological approach when
treating patients in hospitals, clinics, or practices because especially in
America, not everyone is the same. People have all different beliefs and
viewpoints on health and the ways they would like to be treated. If you do not
know about other cultures or beliefs from around the globe then it is difficult
to satisfactorily help treat a patient. Doctors can sometimes make a quick judgment
about how to handle a situation and while maybe it is a right decision overall, it could be the wrong solution for an
individual.

In one of the articles from this week called “Anthropology
in the Clinic”, it says that “Cultural factors are crucial to diagnosis,
treatment, and care. They shape health-related beliefs, behaviors, and values”.
It is obvious that someone’s culture and their background shape their health so
it should definitely be a part of someone’s treatment. Anthropologists can also
be useful when trying to break stereotypes in health. For example, in the
article is says that a Mexican man is not bringing his son in to treat his HIV.
The doctor assumed he did not know much about the disease, being Mexican, but
it turned out that the man just worked nights and was not able to take his son
in as often as the doctor would have liked.

I believe that anthropologists are very useful in clinics
because doctors are not and cannot be trained to deal with each and every type
of culture there is. That would be near impossible. An anthropologist could give
some insight as to what the patient is feeling and how they would like to be
taken care of. After all, that is the point of doctors, to take care of the patients
and to make them feel comfortable.

Life/Death

The culture of biomedicine is important because it helps us
better understand patients and how to care for them. There are three main parts
to the culture of biomedicine which are the history, language, and rituals used
in healthcare. In the article called “Rituals in the Operating Room: Are They
Necessary?” the rituals that are used in the operating room are discussed.
These rituals are important because they are like unspoken rules of the
operating room and because they keep the patients safe and healthy.

I think that dichotomies are hard to analyze and are
controversial because not everything is black or white. Most things do not just
belong in one category or another. There has to be a little room for adjustment
when making judgment calls on these types of issues. It is sometimes extremely personal
too so telling someone that something is one way or another way is hard when
they want to see it their own way. I think my views on dichotomies came from
the fact that I’m so indecisive. It’s easy for some people to make a quick
choice and place things into one group or another and for me it’s not that easy
to do that.

I chose life/death because it is an extremely controversial subject
since it is literally the difference between life and death. I think abortion
is a huge topic in America because it is a hard subject when you’re trying to
decide if someone is alive from conception or if birth is where your life
begins. When you consider the abortion debate, the people who get abortions
clearly consider the fetus as not being alive at conception because if they did
they would not abort them or else they would feel remorse over their decision. I
believe the life/death dichotomy is accepted in the US because people want to
feel better about their decisions. If someone is considered “brain dead” we
usually will consider them dead and take them off of life support because it is
not really living. But if you think of them as still being alive and taking
them off life support would kill them then you would feel incredible guilt and
would not be able to do it. Death is also not a topic most people like to
discuss because death is seen as scary to many people, so making a quick
decision is sometimes easier than dragging it out and having to think or talk
about it.

Alcoholism

I think that today Alcoholism is now seen as an illness
because of the vast amount of people who face this problem. I also think that
our lifestyles today make it seem like it is a bigger issue to be a heavy
drinker. Many years ago it was typical for someone to drink daily but with
today’s standards of living it is more often frowned upon. You need to be
dependable in order to get a good job and make money to support yourself and
your family, and if you are known as being a heavy drinker then people are not
going to want to hire you for fear of you being drunk during a time that they
are depending on you to do your job to the best of your ability.

As the Conrad article says “these diagnoses have been
promoted actively by sufferers and their advocates” which I agree with. The start
of groups like AA has made alcoholism really aware to the public. I think
people actively stating that they have a problem and showing how difficult it
is to overcome this illness has also proven to the general public that this
really is an actual sickness and should be treated like one.

http://www.drinklessnow.com/
alcoholism cure

The strategies of this advertisement are to make it seem
like a quick fix to your problem which all Americans appreciate. It says no
meetings and no side effects just by adding this drop of medication to your
water. It claims to stop cravings for alcohol. One of our values in society is
time, and to have the ability to save time and just take this medication it
makes life so much easier which I think is the ultimate goal of this drug. Also
if you don’t have to go see a doctor to order it then it saves you a trip to
the doctor and possibly the embarrassment of telling your doctor you have a
problem. This medication claims to be completely anonymous. The website shows
results to be 84% successful which makes you believe that it could definitely
work. I think that a lot of Americans would turn to this medication in hopes of
a quick cure.

True Life: I Have Orthorexia

In this episode of True Life it shows three people who are
suffering from Orthorexia Nervosa which is an eating disorder where you only
want to eat the healthiest food possible. Spring is a wife and mother who
started this eating disorder when she became pregnant because she wanted to
have her daughter get all of the nutrients she needed. Now Spring only eats raw
food and cooked food actually makes her sick to eat them. Lauren is a 20 year
old college student who started eating healthy before she went off to college
because she wanted to lose weight. However, she lost too much and became
diagnosed with anorexia. Now she eats only 15 foods that she deems healthy so
that her weight is stable and healthy. Andrew is also 20 who started eating
healthy after learning about preservatives in food in one of his college classes.
He slowly started giving up certain foods like dairy and meat and eggs and now
is obsessed over what he puts in his body for fear of it polluting his body. He
thinks that eating those foods will give him diabetes, cancer, or make him
obese.

I think that this illness should be characterized as a restitution
narrative because they all act as if they want to get over this illness. I
think that they are telling their stories to show people that they want to get
better and show just how hard it is to go back to “normal” eating behavior once
you’re so far into this disorder. In our culture I think that this type of
illness would be seen as abnormal but believable because of how many people suffer
from eating disorders in the United States.

On the show Andrew goes to see a dietitian to help his
disorder and to see if what he is eating isn’t enough. She told him to add more
protein to his diet. Spring talks to her mom who is a nutritional therapist,
about her Orthorexia. Lauren also sees a therapist and they all start to
improve their diets.

All of them take responsibility for their eating disorder
and don’t try to be babied or look for everyone to feel bad for them. They do
however ask for support and help trying to get over this disorder because they
all think that they can get over it.

I think that illness
narratives are really important for family members and healthcare providers to
understand what the patient is going through and what they are thinking. I
think that it also helps the patients to better understand what they are
thinking themselves so that they can improve their lives.

This is shown in the article from this week “Illness stories
on self and shame in women with chronic pain” because it demonstrates how people
sharing their feelings about their illness can really make them understand that
they aren’t just making it up. It’s a serious problem.

PTSD: Post Traumatic Stress Disorder

PTSD, or Post Traumatic Stress Disorder, is an illness that
is prevalent in people who have just come out of a traumatic situation and are
having difficulties getting back to their daily lives. They may have flashbacks,
nightmares, or be jumpier than usual.  PTSD
is predominately known in this country as being an illness for people in the
military. Coming back from war they tend to have a hard time adjusting to their
civilian lives and therefore PTSD can form. Culture and biomedicine can
influence this illness because so many soldiers are told that they will probably
get PTSD nowadays in America that they may report having symptoms because they
think that they are going to have it no matter what due to the Placebo Effect. If
you believe that you do or will have an illness you may very well just get it. Culture
can also influence this because people may not report having it for fear of being
treated differently or because they think it will just go away on its own.

My best friend’s cousin came back a year or so ago from his
tour in Afghanistan and since he has come home he has definitely changed a lot.
He now has a room in his house where he stores survival supplies. He has about
a year’s worth of food such as granola bars or dehydrated meals, tents, knives,
clothes, and just anything that you would think you would need to spend a year
in hiding. As much as he says that he is fine you can tell that the war has
made him think that he needs to be doing things like this. I think that it’s a
very serious illness that no one wants to believe that they have. Especially
soldiers because they are supposed to be stronger than the average person and
they don’t want to be defeated by this type of disorder.

I think that the treatment of this disorder is definitely a
lot of therapy and sometimes different types of medication that people would use
for other anxiety type disorders. In our culture most things are treated with
pills, if you have a headache you take a pill, if you have a cough you take
medicine so I think that culture influences the treatment because we just want
to take pills and be done with it. It seems much easier in such a fast paced
lifestyle that Americans have to take drugs for every problem.

Belief and healing I think for sure go hand in hand. Like I said
earlier, if you believe you are going to feel a certain way chances are you
will. For example in the Placebo video the woman who was depressed was given that
placebo and she was cured, even her brain scans showed improvement. This would
be I imagine good information to have when treating PTSD because depression can
sometimes be associated with it.

The sources I used were http://maketheconnection.net/conditions/ptsd?gclid=CIXs5tDnsrECFYTAKgodpT0AXw

And the Placebo Effect video from this week.

Dhat Syndrome of the Eastern World

Dhat Syndrome is described as a culture bound sex neurosis
in the Eastern parts of the world such as India and China. It is marked by a
whitish liquid found in urine thought to be semen. The effects of this syndrome
are impotency, noticeable anxiety, general weakness, premature ejaculations and
hypochondriasis. The condition was found in people of either average or low income
or economic status. It is often seen in patients between sixteen and twenty
five years old.

In ancient
Indian culture there are seven “Dhatu”, semen being the most important one
because it is the basis of life. The Dhatu are what determine your susceptibility
toward disease. A study on Dhat Syndrome showed that 52% of those inflicted
were depressed. The patients with this disease believed the causes of their
syndrome to be masturbation, pre-marital sex, extra-marital sex, homosexual behavior,
or sex with prostitutes.

In a study done fifty patients
who believed to have Dhat Syndrome were put into a test. They were of different
ages, marital statuses, and believed their syndrome was caused by different
things. Some patients pursued treatment from sex specialists, some from venereal
or skin disease specialists and others from general practitioners. All patients
in the study were then treated with minor tranquillizers and assurance that
they were indeed okay. They were told that nocturnal emissions, the loss of
semen, and masturbation were all natural and they need not be worried about
losing semen. After a one year check up 66% were seen as fully cured of their
syndrome while 22% improved and only 12% remained the same.

I feel
that this is definitely a cultural based syndrome because I have never heard of
such a thing happening to anyone in the US and it seems as if it has a lot to
do with how a culture feels about different forms of sex, such as pre-marital.
I think that these men seemed so ashamed of what they had been doing that they
actually turned it into a condition.

Reference:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3012257/pdf/IJPsy-26-76.pdf

 

Shamans in Merced, California

The article called “A Doctor for Disease, A Shaman for the
Soul” is about the integration of Shamans into hospitals in Merced so that the
people who really need help from a medical doctor can get that help without
having to give up their beliefs. The Shamans come into the hospitals and do
nine ceremonies that are allowed by the hospital, to patients who seek Shaman help.

The hospital is trying to integrate the two together so that people will trust
western medicine and can get the surgeries, anesthesia, blood transfusions or
the type of help that they really need. The types of ceremonies they are
allowed to do involve soft chanting and “soul calling”. The Shamans are seen
very highly by the patients and the patients respond very well to the Shamans, otherwise
they would not have a problem going to the hospital without one present. However,
the Shamans do not get paid by these people for their services because they do
not accept payment other than a live chicken in some cases.

The Shamans administer their medicine through ceremonies involving the soul. For example, a ceremony was done after the birth of a baby in order to ward off evil spirits
from his soul. The ceremony was done in the baby’s grandparent’s house because
they used a sacrificial pig in the ceremony and the hospital does not allow
ceremonies with animals.

The Hmong people of Merced use the Shamans as their main form of healthcare so by integrating them into the hospitals, the Hmong people can get the medical help
from their doctors while also getting the Shaman help they feel they need for
their souls. I think that a lot of the positive outcomes of the use of a Shaman
are due to the Placebo Effect. They believe they are being healed and indeed
they are getting better just by thinking they are. I have no idea whether the
Shamans actually are healing the patients or if is just in their heads, but
either way as long as the patients are getting better that’s all that matters.

 

White American Women With Addison’s Disease

Addison’s disease is a disease caused by gradual damage of
the adrenal cortex. The glands do not produce enough cortisol or aldosterone. Of
all the cases diagnosed in the United States, 75% of them are women. I believe
that White American women are at the highest risk for this disease because a
couple of the causes of the disease are breast cancer and radiation therapy
which is very prevalent in American women.  Another cause is from the use of ketoconazole
which is a medications used for yeast infections which again is prevalent in
American women. Stress can also be a risk factor for the disease which is very
high in all Americans. Another risk factor is hypothyroidism or hyperthyroidism
which is very common in women. In fact, my mother and my grandmother both have
thyroid issues.
Race is basically how you identify yourself, because there is no test you can do to
test what race you are, so although different races such as the Pima in the US have
a greater chance of having Type 2 diabetes, it is diet and exercise that has
proven to be the bigger cause of getting Type 2 diabetes. The Pima in Mexico
had far less cases of diabetes than in the United States because of their type
of lifestyle is much different from ours. Race and racism has been an issue in
the United States for years and years, but I think that coming out with
medication directed toward only one race is just taking things too far, which
is what BiDil is doing. There is no reason why a certain medication should work
better for a certain race. The only thing that tests like the Tuskegee Syphilis
study did was infect hundreds of innocent black men with a disease that they
had no way to control themselves. Race and health will probably always being
associated with one another but in reality it should be our genes and health
that are connected to each other.

I used these websites:

http://www.empowher.com/addisons-disease/content/addisons-disease-prevalence-among-white-women

http://www.emedicinehealth.com/script/main/art.asp?articlekey=110096  This is a picture of how Addison’s Disease can alter the pigment of your skin by making it darker.

Not Just a Paycheck

I would say that I could’ve definitely done better. The
first couple questions I knew from one of my ISS classes I took, but I was shocked
by the majority of the rest of them. I missed about half of the remaining. The
statistic that I found the most surprising is that recent Latino immigrants are
healthier than the average American. These seems really odd especially since
the wealthier you are generally the healthier you are going to be. It also
amazed me that there is up to a 33 year difference of life expectancy between
people that are both living within the United States.
In the episode “Not Just a Paycheck” it shows how closing an Electrolux factory in
Greenville, Michigan in 2006 has caused so many problems for the former
employees, not just their amount of income, but also their health. The
Greenville hospital has now seen more and more cases since the closing of the factory;
in fact the amount of patients has tripled. The workers are now mostly
unemployed and trying to live off of what they currently have, which is close
to nothing. The inability to support themselves with their paycheck has now
caused their health to decrease. There is more abuse, stress, suicide, and
homicide now because of all of the unemployment. People like the CEO of the
company are living lavish lives with huge million dollar houses and the workers
are living in small falling down homes that they can’t take care of and can
barely afford to live in. The bridge between wealthy Americans and the average American seems to only be getting bigger

Politics can influence the cause and spread of illness based on what type of political
conflict is going on. If there is such a conflict where you are living then there
can be a number of circumstances that can cause illness such as new people
being introduced to an area and bringing disease with. If the economy is bad then
it is hard to fund for vaccinations for people or to have clean and safe
drinking water, which is also based on environment. Some people live in areas where
there isn’t safe water available or where there’s no shelter from mosquitos
carrying Malaria. Some people’s culture also influences whether they seek help
for illnesses. In the video on Schistosomiasis, people saw boys having blood in
their urine as sort of a rite of passage. Some, like in the Malaria clip are
born with no ability to fend against Malaria if they inherit the same gene from
both parents. Spreading illnesses is someone’s own choice sometimes whether or
not they choose to go to a hospital or if they choose to have sex with someone
while infected with a disease.