W6 Activity Post: HIV/AIDs in Malawi

HIV/AIDs in Malawi

AIDs is the leading cause of death for adults in Malawi (Avert). Malawi’s first AIDS case was reported in 1985 (Avert). The government at the time implemented only a “short term response” which included blood screening and HIV education programs. Between 1964 and 1994 Malawi was under the rule of President Hastings Banda, who paid little attention to HIV/AIDS. “His puritanical beliefs made it very difficult for AIDS education and prevention schemes to be carried out, as public discussion of sexual matters was generally banned or censored, and HIV and AIDS were considered taboo subjects” (Avert). During his “presidency” from the first reported case to a year before he relinquished power the HIV prevalence among women tested at urban clinics increased from 2% to 30% (Avert).

In 1994, Banda stepped down following many protests and international condemnation allowing Malawi to become a multiparty-democracy. Malwai then elected President Bakili Muluzi who made a speech in which he acknowledged that the country was undergoing a very severe epidemic and stressed the need for a unified response. By this point AIDS had already “damaged Malawi’s social and economic infrastructure” (Avert). Farmers couldn’t farm to provide food, children could not attend school, workers couldn’t work to support their families. The epidemic was a large factor that contributed to Malawi’s worst famine in 50 years in 2002. A report during that famine said that 70 percent of hospital deaths at the time were AIDS related (UN Aids 2002).

An anthropologist working on the HIV/AIDs crisis in Malawi is Anat Rosenthal. She researches the affects of HIV/AIDs in poorer countries, rural communities, families, and children in those contexts (Boh). Dr. Rosenthal has participated in over a year of work on the field with nearly 50 personal interviews with those affected by the crisis. She works to strengthen families affected by HIV/AIDs and improve community responses to cases of HIV/AIDs (Boh). Funding for treatment, awareness, and social improvement have been made available by the World Bank, the World health organization, UNaids, and the government of Malawi (Avert).

HIV & Aids in Malawi
UN Aids 2002
Boh, Patricia

Medical Anthropologist promotes Aids awareness in Malawi

W6 Reflection: Medical Anthropology, Health Economics/Management and Policy Making

Medical Anthropology, Health Economics/Management and Policy Making

At a time of health reform including the expansion of medicaid and the redoing of hospital/physician compensation health economists and healthcare managers are dealing with possible organizational reformations and changes in the way they think about healthcare delivery in America. It is important for medical anthropologists to weigh in on these changes because switching from a per treatment payment system to one based on patient output (efficiency) and satisfaction (quality) will affect the manner in which patients wade through the hospital/healthcare system. I chose this topic because I study health economics and plan to pursue a career in the management of healthcare.

An anthropologist working for a non anthropologist such as a healthcare consulting firm or policy making body would need to get used to terms such as cost-efficiency and patients being referred to as healthcare consumers (Horton). It is important for an anthropologist to challenge or at least soften the tone. Healthcare decisions are not made by “rational consumers” honestly very few decisions are in general, but most economists and decision makers treat any situation in that manner. Decisions by policy makers would change the availability of healthcare, and most likely in an unequal manner. Anthropologists can study the ethnography of policy consequences (Pui). The idea of a rational, health-maximizing individual who experiences illness, consults with his or her referral network, reviews the available resources and then rationally chooses from among them has been for quite some time the way health economists and policy makers have thought about patients. Medical anthropologists have pointed out this idea’s ethnocentrism. “The model of the rational, autonomous care-seeker … serves best when used to study middle-class Americans who have health insurance and are seeking care for relatively minor problems.” (Good). In my opinion anthropologists or at least some anthropological thinking are needed in policy making.

Horton, Sarah
A call to an Anthropology of Health Policy
Anthropology News; January 2006

Pui, Jasmine
Medical Anthropology

Good, Byron
Medicine, Rationality, and Experience

W5 Activity Erectile Dysfunction

W5 Activity- Erectile Dysfunction and Viagra

“Manliness” has always been important to most cultures. Some would argue that modern manly character was only created to contrast with culturally desired female characteristics at the dawn of feminism and female empowerment. Men are culturally deemed as “doers”, they are expected to be practical and macho. The medicalization of sex, especially male “sexual dysfunction” has played out very profitably for pharma. Consumerism is the bedrock of our era in the west and is pervasive in all aspects of life. The language of customer and producer is found in the arts, education, government and healthcare. Erectile dysfunction is biomedicalized in U.S. culture because: it is profitable, it treats neuroses in contemporary men, it is a continuation of our attempts to control nature. Medicalization is rampant because the same industry that produces a treatment also defines the condition it is meant to treat (Baglia, pg 6).

The etiology and language surrounding erectile physiology has changed in the last century. For the most part of the last century researchers and therapists believed that “impotence” was caused by psychological concerns such as the fear of being unable to produce an erection i.e. “performance anxiety” (Baglia pg 3). Impotence was thought to be caused by things such as stress, fear, and depression. Now we see psychology gone from the etiology and a more masculine structurally based rhetoric of “dysfunction” used (Baglia, pg 3). Even the term “performance” brings with it airs of roles, acts, and scripts. It meddles with how men ought to act and the character they ought to have. To not perform well sexually means a man is not in line with his role as a man.


“This is the age of taking action, Viagra.”

http://www.viagra.com/viagra-tv-commercial.aspx (Pfizer)

For anyone who clicked the above link and watched the middle aged man “taking action” to “fix” his Camaro’s overheating radiator, let me tell you this: please, please do not pour a bottle of water into your overheated radiator that is the perfect way put a crack in it. Anyways the “age of taking action” campaign did not give very good car advice but it did sell lots of drugs. The advertisement used symbols of masculinity and maturity; a muscle car, sweat/hard work, stubble/grey hair, and independence. The script also subconsciously invokes shame by asking (I’m paraphrasing, but it is very close to this) why haven’t you done anything about your manhood, so many men already have why are you being lazy and not taking action?. It then “legitimizes” it as a medical condition by telling you to go see your doctor. It does not give a medical reason for why someone experiences erectile dysfunction besides their not “taking action” like “20 million men who already have”.

Baglia, Jay
The Viagra Ad Venture: Masculinity, Marketing, and the Performance of Sexual Health

Viagra TV Commercial

W5 Reflection- Nature and Culture

W5 Reflection Post

Nature and Culture

Biomedicine is a cultural trend, a perspective for conducting healthcare as well as altering biology. It is a hallmark of modern western culture and has become tied up with other cultural hallmarks of our time such as consumerism. The things that biomedicine concerns itself with and the manner it addresses certain people and populations is entrenched in its culture and that of the society it is operating in. Biomedicine bases its authority on claims of universality and objectivity (Week 5 Lecture 1). We can study the culture of biomedicine by examining its institutional history, language and rituals (Week 5 Lecture 1). These things have been shaped by many social factors such as those groups that are in power, the structure of medical education and professional groups (Week 5 Lecture 1).

There are always discussions of nature versus nurture, natural versus unnatural, choice vs destiny. In medicine the dichotomy of nature versus culture is an important one. Biomedicine can scientifically find ways to change physiological behavior but the essential questions of when should it be used, for whom, and for what purpose or why should it be used are all subject to culture and often run counter to what is natural. Indeed what we deem natural essentially runs downstream from our culture. Take for example the use of viagra or cialis for erectile dysfunction or “impotence” in men. The first term suggests abnormal physiology while the second has an air of weakness attached to it. In our culture men are expected to be ever ready for a romp, but the same is not expected of women (Pill Poppers Part 2).

Those who conduct biomedicine or participate in it often assume a clear cut difference in nature and culture and believe that biomedicine addresses biology and the nature of disease while keeping culture at bay. You can not study the body independent of social and cultural contexts. Politics, culture, individual choice and the environment play a large role in pathology and illness. I think that the dichotomy should be downplayed for the sake of patients and the public health. Culture must be addressed to effectively conduct preventative healthcare which will soon be the only viable way to successfully conduct health care

Works Cited:

Week 5 Lecture 1 Video


Pill Poppers Part 2



W4 Activity Post: “I’m Allergic to Everything” True Life

“I’m Allergic to Everything” True Life

Many people have one allergy or another. Some people can not consume dairy without metabolic difficulties while others` lives are endangered by any nut containing foods or items. There are some though whose lives are curtailed by their allergies. Raelyn and Zeke in this episode of True Life are teenagers that must deal with their numerous food allergies on a daily basis.

Raelyn is diagnosed with idiopathic anaphylaxis (IA), “a rare, frightening and poorly understood disease” (IA information center). Anaphylaxis is a life threatening hypersensitive reaction; those that are defined as idiopathic have no known allergenic cause (IA information center). Raelyn must be careful with anything and everything she ingests or even exposes herself to. She must arm herself with epi-pens and bottles of benadryl to combat her condition. When IA gets the best of her she experiences seizures and often requires a trip to the hospital’s emergency room. She was satisfied with biomedical treatments and consulted a homeopathic physician who was able to provide satisfying results.

Zeke, has many known food allergies and many, many more that he is yet unaware of. His diet is so limited that he must take nutritional supplements in the form 42oz [~5.25 cups] of a liquid formula every single day to nourish himself. With the assistance of physicians and allergists he constantly runs food/allergy tests. He does this in efforts to decrease his dependence on the nutriteinal forumula and to enjoy more whole foods.

Both of these teens face a lot of inconvenience due to their conditions and must act with a discipline and responsibility difficult for even adults to go through. In my opinion this episode qualifies as a quest narrative. I decided this because Raelyn and Zeke are facing a long term struggle where they are doing everything they can to learn to cope with a confounding and severe condition; all they’re aiming for is a normal life. Narratives like such as this one, provided by popular media are helpful in spreading awareness and knowledge.

IA information Center

W4 Reflection Post: Restless Leg Syndrome

Restless leg syndrome (RLS)

This condition “is a disorder in which there is an urge or need to move the legs to stop unpleasant sensations” and occurs most often in middle-aged and older adults (PubMed Health). It is interesting that many of us in America did not know what restless leg syndrome was until we were bombarded by pharmaceutical marketing and soon after that stand ups and parodies which mocked its validity (Week 4: Lecture 1). Biomedicine does not have any specific tests or cures for restless leg syndrome, instead it treats simply treats symptoms (PubMed Health). The fact that doctors must solely rely on patient reported systems makes diagnosis imprecise. It shifts medicine from being a science of pathology into something of a therapy for feeling good. It makes the physician a provider of consumer goods. It is peculiar to healthcare where the provider of a good is also someone trusted to look out for your own good. We understand that the salesperson at your favorite department store is there to make you purchase, their recommendations are biased. But we trust our physician to be our representative when it comes to finding treatments, operations, or biomedical products such as prosthetics.

In my opinion there is definitely a connection between mind and body mostly in the relationship between perception and appraisal. This is seen in medicine between beliefs and healing. When you’re in a negative mindset it’s difficult to appraise things positively. When you are used to certain attributes belonging to a thing you will just recognize it as such even if those attributes are unrelated to that thing but something else entirely; this occurs in medicine with symptoms being attached to a disease when they can be related to any number of other conditions. With restless leg syndrome physicians often make their diagnosis by simply testing against other conditions (PubMed Health). If they rule everything enough conditions besides RLS out they will settle with diagnosing someone with Restless leg syndrome.

PubMed Health; Restless leg syndrome

Week 4: Lecture 1

ADD/ADHD in North America

Chosen peer review article: Timmi, Sammi ADHD is best understood as a cultural construct; The British Journal of Psychiatry (2004) http://bjp.rcpsych.org/content/184/1/8.full

          It is difficult to describe a condition as culture bound without a lot of criticism from the culture it is tied up in. Attention deficit disorder and Attention Deficit Hyperactivity Disorder (ADD & ADHD) were unheard of before the 20th century (History). According to the article I chose “There is still some debate in the literature whether Attention-Deficit Disorder/Hyperactivity (ADHD) is best conceptualized as a biological disorder or if it is best understood as a cultural construct.” (Rhode et al.) ADD/ADHD has varying biological, cultural, and individual dimensions. Its evaluation/treatment also varies in different cultures. I will discuss these things and more.

          There is a biology to everything, even culture bound syndromes. Different nations and ethnicities may have very similar or even very different cultures but their similarities may present similar factors that create a certain illness/behavior. According to research, brain scans of people with ADD/ADHD have similarities that are different from those not diagnosed with the disease, but not everyone diagnosed is given brain scans (Malloff). The frontal lobes, the area responsible for executive functions such as “attention to tasks, focus concentration, make good decisions, plan ahead, and learn and remember what we have learned” is impaired (Maloff). Current treatment is generally amphetamines which stimulate the frontal lobe. Alternative therapies include: diet changes, behavioral therapy, counseling, family therapy, and biofeedback (History).

          My chosen article states that “immaturity of children is a biological fact, but the ways in which this immaturity is understood and made meaningful is a fact of culture.” There are many personal and ecological factors that negatively influence the mental health of children such as the loss of extended family/family support, pressure on schools, academic pressure, a breakdown in the moral authority of adults, disciplinary confusion, hyperactive family life, and a competitive economic market that value certain behavioral norms. “Throw in the profit-dependent pharmaceutical industry and a high-status profession looking for new roles and we have the ideal cultural preconditions for the birth and propagation of the ADHD construct.” (Timmi)

Works Cited

Timmi, Sammi; ADHD is best understood as a cultural construct; The British Journal of Psychiatry (2004) http://bjp.rcpsych.org/content/184/1/8.full

History of ADHD; https://www.hellolife.net/add-adhd/b/history-of-adhd/

Rhode et al.; Rohde, L. , Szobot, C., Guilherme P., Marcelo, S., Silvia, M., & Silzá T Attention-Deficit/Hyperactivity Disorder in a Diverse Culture: Do Research and Clinical Findings Support the Notion of a Cultural Construct for the Disorder?; The Journal of Biological Psychiatry; Volume 57, Issue 11, 1 June 2005, Pages 1436-1441; http://www.sciencedirect.com.proxy2.cl.msu.edu/science?_ob=ArticleListURL&_method=list&_ArticleListID=2064121307&_sort=r&_st=13&view=c&_acct=C000051676&_version=1&_urlVersion=0&_userid=1111158&md5=3924626c7f44168c8054a42d99a24d42&searchtype=a

Neufeld & Foy; Neufeld, P. and Michael, F.; British Journal of educational studies; Historical Reflections on the Ascendancy of ADHD in North America, c. 1980-c. 2005 http://onlinelibrary.wiley.com.proxy1.cl.msu.edu/doi/10.1111/j.1467-8527.2006.00354.x/abstract

Maloff; Maloff, Jared; the Biology of ADD; http://www.iser.com/resources/ADD-biology.html

British Healthcare

The PBS show “Frontline” filmed an episode on the “Sick around the World”. The program’s correspondent T.R. Reid, flew around the world to take a look at five other healthcare systems; the United Kingdom, Japan, Germany, Taiwan, and Switzerland. He spoke to doctors, citizens, and health economists about the levels of coverage, the amounts of uninsured, doctor salaries, patient premiums, and if their citizens ever go bankrupt as do ours because of their medical bills. Near the end of the episode he explained what he thought to be the three most important similarities between the healthcare systems he examined:

          1) Insurance companies must accept everyone and can’t make a profit

          2) Everyone must purchase insurance while the poor are subsidized

          3) Health providers must deal with fixed prices.

Medical bankruptcy is unheard of in any of those countries examined. Most of those countries had a system somewhere in-between government or market run. Britain’s healthcare is run as a part of the government with its employees on a government payroll. Other countries such as Switzerland were largely market run but with government interventions designed to keep healthcare affordable and available for all. Japan’s health system is private; with private doctors and private hospitals but prices are set and coverage is universal. The German healthcare system is covered by different sickness funds which employers sign up for. The Taiwanese healthcare system was designed much later than the rest and has facets from all of the above. I want to discuss Britain’s healthcare system more because it is so different from our own.
The healthcare system of Britain is a bureau of the government; the National Health Service (NHS). Physicians are government employees who enjoy six figure salaries while still able to enjoy extremely generous bonuses (~$180,000) if their patients enjoy better health outcomes. In the British model a citizen seeking healthcare must first see their general practitioner (GP) who acts as a “gatekeeper” into the healthcare system. While the general practitioner in America has been facing hardships and isn’t a specialty considered by very many medical students because of its historically lower salaries, the British GP “…can’t complain”; they are responsible for on average 1800 people. There is hardly any wait to see a GP but operations can have wait periods of a couple months. Britain is a western and technologically advanced country. Its medicine is biomedically founded just as ours is in America. But while we generally see a physician when we feel sick, Britain’s see their physicians much more regularly. Preventative medicine is key in their country and GPs promote a plethora of health behaviors.

All information/facts/figures come from:

Frontline: Sick Around the World, Public Broadcast Station,


It’s about “More than just a pay check” it’s about lives (W2 Activity)

Seeing as I’ve spent years studying health and society I would have been disappointed if I didn’t do as well as I did on the Health Equity quiz [9/10]. The most eye opening statistic from it was the differences in life expectancy between zip codes.

The video-clip that I chose to discuss is “More than just a pay check”. It’s about the lives of workers and the loss of livelihood. It’s about the desire to compound the bottom line and the despair of falling below the line, of poverty. We live in America where the choices of few ravish whole towns and force people out onto the streets, create addictions and dysfunctional families. This is not the America our founders died for. In 1773, they donned warpaint and destroyed the property of a giant multinational corporation; the East India Trade company who ran global commerce with generous subsidies from the British Crown and destroyed homegrown businesses and local economies (Harmann). Enough about the past; you can learn a lot about it from the present. Here is the story of one plant and many lives in Greenville, MI.

Electrolux- Greenville, MI, USA

The closed Greenville manufacturing plant - Current TV(Outsourcing Greenville)(Mlive)

Electrolux- Juarez, Mexico (Cephas)

Electrolux demolished its Greenville, MI plant and relocated operations to Juarez, Mexico. The video camera followed the rubble into the neighborhoods and homes of the men and women who had to step out of that building for the last time. Seeing their livelihood crushed by a wrecking ball they fell victim to depression, anxiety and stress. According to hospital reports; three times as many people took their lives following that plant closing than previous years. Three times as many homes fell victim to domestic violence as well. It’s was a grim storyline in our state of Michigan. Across the Atlantic in Swedan, there was a story similar to that of Greenville’s but different in all the ways that matter. I suppose you could say the only similarity was an Electrolux plant shut down. The things that matter, the people, were treated with dignity. In Sweden, Electrolux Emploees were guaranteed 80% unemployment as long as they were pursuing work or an education. The government of Sweden along with its powerful labor unions pressured the company into investing in the creation of other jobs. Back home in the Mitten, in Greenville, most were left without a job, or any benefits.

           An average CEO earns more before lunchtime (~2 hours) on the very first day of work in a year than a minimum wage worker earns after a year of work (Mishel). People can not live off of minimum wage. If the minimum wage rose at the same rate as the average CEO’s salary it would atleast in the $20’s (Nation of Change). If only it would keep up with inflation it ought to be $10.50 (Nation of Change). We should look at successful politics, economics, and cultures and how they conduct business. Serious regulation of unethical business practices must be devised. Organized Labor must be strengthened, the government should work for the people instead of working the people. Hard working Americans ought to demand their rights. The health issues ought to be addressed by social workers and public health departments; unethical business has become pandemic.



Mishel, Lawrence: CEO-Minimum Wage Ration Soars

Hartmann, Thom: The Real Boston Tea Party was an Anti-Corporate Revolt

Outsourcing Greenville






Nation of Change
Make Work Pay For US- CEO Pay Vs The Rest of Us


Familial Mediterranean Fever (W2 Reflection)

Whenever I’m presented with a series of confineing boxes to check off race, I’ll smudge some graphite into the “other” box if I’m lucky enough to have that option. Sometimes they’re generous enough to give you a blank space to jot down your identity. That’s when I like to write in “human” and that just makes my day. Being from the largest ethnic group in the world without an internationally recognized nation-state makes me slightly apathetic to race and nationalities (Kurds). The fact that there are greater genetic differences within Africans than between Africans and Eurasians only reinforces my belief that race is somewhat overrated (Genetics). The U.S. Census and some other forms like to inform me that I am White via parentheses that include “any of the original peoples of Europe, the Middle East, or North Africa”. It’s interesting that prior to 1944 Middle Easterners and North Africans were ineligible to obtain citizenship because they were not considered White at that time (Lopez). In my opinion those designations of race were much more political than health-minded; they were designed to determine citizenship rights not health outcomes. That is why I refuse to use my census ascribed race to address my chosen health issue. Let’s put all that history and personal commentary aside while I address a disease much more common among Middle Eastern/Mediterranean Americans than those of other lineages; Familial Mediterranean Fever.

Familial Mediterranean Fever is an inherited condition characterized by episodic fever, rash, and painful inflammation of the abdomen, chest and joints (Counsyl). Approximately 1 in 16 Middle Easterners carry the Mediterranean Fever gene [MEFV] (Counsyl). Mutations in the MEFV gene are mostly responsible for the condition. The MEFV gene produces a protein called pyrin which inhibits chemotactic factors that are produced in response to inflammatory stimuli. Those with the MEFV gene mutated
lack that ability and experience uninhibited activity and episodes of inflammation with fever.
Aside from the biological origin i.e. the random genetic mutation that caused the diseased, I think that cultural factors are mostly responsible for its spread and concentration. To survive ethnic and religious persecution, many Mediterranean families converted to other religions or intermarried members of other ethnic groups, thus carrying the MEFV gene with them (Medscape). It is not uncommen in these cultures to marry a blood relative such as a second or third cousin (Counsyl). That practice increases the likelihood of the trait being passed on and/or expressing itself. (Textmed)(Textmed)

Race, Genetics, and Health

Certain genetic mutations are more common in certain populations. Genetics are one of the several factors including environment and behavior that determine disease manifestation. The prevalence of diabetes among the Pima indians residing in the United States can help explain the relationship between those factors. The ancestors of the Pima lived in an environment where food was not consistently available. These ancestors developed a genotype that is better at processing sugar and storing storing fat (Week 2: Lecture 2). That mutation was passed on through their generations, remains in their population until today and results in high rates of obesity which leads to type II Diabetes. It isn’t that simple though because Pima populations in Mexico which have a nearly identical thrifty genotype do not experience such levels of diabeties. That is because their diet and physical behaviors reduce their risk for developing obesity and diabetes. Many people attempt to study the effects of genetics by examining disease prevalence by race. This is not reliable because race is overrated (Roberts). The phenotype that we use to determine race is a nearly unidentifiably small and insignificant part of our genotype (Roberts). It is important to study genetic drift and heredity lineages but using race as a proxy is unreliable.



The Kurds- A Nation without a State



Larger Genetic Differences Within Africans Than Between Africans and Eurasians Genetics, Vol. 161, 269-274, May 2002 http://www.genetics.org/content/161/1/269.full


How the U.S. Courts Established the White Race: White By Law

New York University Press, 1996


Familial Mediterranean Fever

Familial Medierranean Fever



Week 2: Lecture 2


Dorothy Roberts: Race and the New Biocitizen – Tarrytown 2010