HIV in Malawi

The global health problem I chose to discuss is HIV in Malawi. I just wrote a paper about AIDS for another class so I’m well caught up on the subject so that’s why I chose this topic. The first case of AIDS in Malawi was in 1985. Because of the poverty and famine in Malawi it continues to still be a problem today, and is actually the leading cause of death in adults. The government has formed many policies to help fend in the fight against HIV but the number of cases continue to grow despite the efforts. Not having a financially stable government means that money for ads and prevention programs fall short and are sacrificed for things that are more important in their eyes. There are programs to educate people on HIV/AIDS and to teach them to be cautious but with limited resources it is sometimes not possible to avoid a situation in which they could be infected because the need to survive is greater.

An anthropologist working in Malawi is Dr. Anat Rosenthal. She started out by hearing about the HIV/AIDS epidemic in Malawi from women who lived in Tel Aviv who were HIV+ and decided that she wanted to do something about it. She now aids in the effort to prevent the spread of HIV/AIDS. She researches the impact that HIV/AIDS has on communities and focuses most of her attention to the children. She looks at the health status of children who have been orphaned by HIV/AIDS and who will raise them after this has happened. She has done twelve months of field work, used participant observation, and has several interviews to help aid her in her work. She recently spoke at SMU (Southern Methodist University) in Texas to get word out about her efforts and to hopefully encourage people to follow in her steps and to realize the problems these people face.

http://www.avert.org/aids-malawi.htm#contentTable0

http://www.smudailymustang.com/?tag=anat-rosenthal

Clinical Medical Anthropology

The area of applied medical anthropology I chose was clinical medical anthropology. I chose this because my degree deals with the health field so I have learned a lot about the subject and it interests me. Taking an anthropological view in a clinical setting is important because it covers topics and situations that doctors, nurses, specialists, etc. were not taught. Physicians are taught to take care of a patient and make sure they get better, and basically treat them like they are the disease they have. They don’t really find out much personal information, or any cultural information. This is where a medical anthropologist would come in. They would look at other things other than the science behind the disease, and actually take into account the cultural morals and values that one may possess. It would be a lot more personable and could definitely make someone feel a lot more comfortable in a clinical setting, especially if they are from a different cultural background than their physician. A clinician and a medical anthropologist could work together to decide the best way to treat a patient that would cure the illness all while taking into consideration the needs of the patient. Medical anthropologists could also talk to patients to find out their perceptions of the care they are getting and how they interpret it to better the environment in which the patient is in. This could help the clinician to ease the process of healing and be more comfortable with a patient. I think an important part of medical anthropology is asking questions and interviewing people. This way you get to know the person and how they feel in certain situations, what they like, what they don’t like, and you don’t have to guess. This makes it very personable for the patient because every person is different and reacts to things in different ways.

Erectile Dysfunction

I think this disorder is medicalized because it’s just another easy way for pharmaceutical companies to make money off of people. I also think that once so many people complain about a certain issue physicians and scientists want to find a way to help so they try to find a solution. A plus side to something being medicalized is that it makes people feel like they’re not alone, and that they aren’t the only person who has this issue. I think that makes it easier for people to admit they have a problem and easier for them to get help if they choose to do so.

The commercial that I found was for a drug called Cialis. The type of advertising they use is direct to consumer. They are trying to get new patients and potential customers to buy their drug because it’s better than all the rest. They definitely make it seem like erectile dysfunction is bad, and it means something is wrong with you and that you should get it fixed immediately. I’ve always thought it was funny how every commercial for a certain drug on TV has more serious side effects than the actual “disorder” you’re starting out with. Just like in this commercial, it says that the side effects can include headache, muscle ache, drop in blood pressure, and you have need to seek medical attention. All of that sounds a lot worse than having erectile dysfunction to me. All throughout the commercial they are showing two people who are clearly in love having a good time, and they do that so it will distract you from all the health conditions that can result from taking their medication. At the end they tell you to talk to your doctor so when the time comes, “you can be ready.” It’s a very cheesy commercial.

Life/Death

Biomedicine is a big part of western culture, and is thought very highly of. Even inside the biomedical system, physicians and other practitioners have a culture of their own. As it showed in lecture there are certain ways rites of passage that medical school students must go through in order to be included in the culture. Procedures must be conducted in certain ways, and there is even different medical terminology that physicians use, that other people would not. They form their own systems within a hospital, and status is given to people who work there. I think it’s important to have culture of biomedicine because it makes patients and visitors more trustworthy of their physicians because they know it’s so much work for them to even get in to medical school. I also think this could go against the patients because they might not be able to understand what their physician means, and might have to have the doctor explain in a way that they will understand. I definitely think trust plays a big role.

I think dichotomy’s are culturally constructed and definitely depend on your beliefs. With the dichotomy of life/death, it is easy for some people to believe in this, but for others its not so easy because not all cultures believe in death. Some cultures believe that you never die, and that your soul just cycles through into life again. In western culture, I think this dichotomy is seen as natural because people believe that these two are opposites. I think the words are easy to use, even though they might have different meanings to people. Even if someone thinks that the soul lives on after someone passes away, they still say that the person has died, but their soul will live on. This has to do with another dichotomy of mind/body.

True Life: I have Orthorexia Nervosa

The episode of True Life that I watched was about three young people to have a disorder called orthorexia. This disorder is when you have a big obsession with food, so much that it starts to take over your life. Although there were three people I thought that it would be easier to focus on one person, so I chose Lauren. She was overweight as an adolescent and later developed anorexia. She realized that she could no longer live that way because it was unhealthy, so she used a new form of diet. At twenty years old she would only eat around 15 foods that she deemed were “safe”. She was very into planning her meals at the beginning of the day and when she ate what she planned she would feel very good about herself. Her disorder was mostly a secret, especially to her girlfriend for almost 4 months. In the end, she didn’t really improve much even though she tried to see a therapist about her problem.

The type of narrative I classified this as was chaos, because it interfered with her social life. She said that she didn’t feel normal, and that she wishes she didn’t have to worry about food like she does. When going to parties with her friends she feels that it is very hard to turn down her friends when they offer her food that she won’t eat, and finds it hard to fit in. She also said that she is sick of putting food first, and having it as a priority. I think that a big part of her problem is the stigma that our culture puts on being overweight. If being overweight wasn’t looked down upon, she probably wouldn’t be having such a hard time dealing with her weight. So many young people feel that they are inadequate because of their weight, or how they look, and it’s all because the way we think we are “supposed” to look. Lauren’s experience with her medical professional didn’t work out to well for her because she realizes that she has a problem, but she isn’t willing to change the way she eats because she is too fearful of gaining weight. She knows she has a problem, and owns up to the fact that she does, but she just can’t change the way she eats at this point in her life.

Restless Leg Syndrome

Restless leg syndrome is when someone has the urge to move their legs because of an unwanted sensation. It’s funny to me because I used to think of this disorder as socially constructed, and something that people just used as an excuse until it started happening to my mom. She would wake up in the middle of the night and just have to walk around because the sensations in her legs would make it hard for her to sleep. I also have these sensations sometimes, and although I don’t have to get up and walk around, I fear that one day I might have to. However, because there is no cure or I feel that biomedicine doesn’t have that much of an influence on it. I think culture has a bigger influence because with everything, once a group of people complain about something it becomes a disorder and then the medical and pharmaceutical field tries to come up with treatment for it. The form of treatment for restless leg syndrome is to reduce stress, and try to find ways to relax your muscles. There also are a few medications that people can take if it gets too bad, but I think that a lot of times pharmaceutical companies just put out new drugs because they can make money off of them.

To me, belief and healing are connected in a lot of ways, i’ve always believed the in the placebo effect. I think that if you believe something will work, it has a lot better chance of working than if you don’t believe in it. I think this goes for everything including doctors, because if you believe the doctor will cure you and you have a good attitude about treatment, the likelihood that you will recover is greater. Just like in the video, a man’s knee surgery is cured by a fake surgery. I learned about this in anthropology 320, and it’s stuck with me ever since. Our own belief in certain things can be helpful in ways we have never imagined.

Dhat Syndrome in Indian Culture

Dhat syndrome is the fear of semen loss from the body, and can cause severe anxiety and hypochondria. They fear nocturnal emissions, and think that the loss of semen in a sin. They believe that semen is the elixir of life, both physically and mentally, so any loss of it is seen as a bad thing. They did a study of this disorder and found that it is seen mostly in lower socioeconomic classes, and they believe that once people are given a better education they won’t believe in it as much.

Biologically this is not really a problem, because with the proper education we know that the release of semen is not harmful and is not a bad thing. Culturally this is what the people believe and it is socially accepted as a real disorder. As they stated in the article once people are more well educated the amount of cases will probably decrease. They associate the loss of semen to many things such as diabetes, excessive venery, and they also believe that the semen will mix with urine. Individually people who have Dhat syndrome are said to think about sex too often have too many sexual preoccupations.

While about thirty percent of people believe that this will pass and should not be treated, but about twenty six percent of people thought it should be treated. Treatment mostly includes alternative medicine such as Ayurvedic, homeopathic, or allopathic. They also believe that people who suffer from this disorder should be persuaded by friends and family to not masturbate, not think about females, and should stay away from bad company. They should also avoid hot foods and spices, and avoid anything that may cause masturbation. Foods that would have a cool effect were recommended. These were things such as almonds and buttermilk.

Source:

Dhat Syndrome: A Culture-Bound Sex Neurosis of the Orient

http://www.springerlink.com.proxy1.cl.msu.edu/content/p58n410147611202/fulltext.pdf

Shamans in California

The article I chose was called “A Doctor for Disease, a Shaman for the Soul.” It tells how shamans are now a part of the medical system at Mercy Medical Center. They are allowed to have unrestricted access just like the other physicians, and are allowed to perform some of their healing processes. This hospital treats many Hmong patients who have migrated to Southern California and believe that when someone is ill, their soul has left their body and that the shaman is the only person who can bring their soul back. This is why they are said to treat the soul while physicians treat disease.

The healers, as stated before, are called shamans and they help with the loss of souls. They have many healing techniques including putting swords by the door, using trance, and string as symbolic of a soul catcher however there are some rituals that are not allowed in the hospital such as burning of paper, gongs, and paper bells. Some shamans will even accept chickens as payment, which I thought was pretty interesting. The shamans are respected by their patients, and they also respect their patients. The shamans are only called in if the patient wants them to help so if someone requests one they already believe they can help.

In this system, healthcare is mostly delivered by shamans but many people still go to the hospital. Since there are now shamans in the hospital it makes the Hmong feel more comfortable with the hospital setting and puts them a little more at ease with Western medicine. Most shamans do work outside of the hospital, because many healing techniques are not allowed inside. Sickness is seen as soul loss, because the Hmong believe that the soul is capable of leaving the body. The symptoms are all seen a result of soul loss. Like in the book, “The Spirit Catches you and you Fall Down,” every time the child had a seizure, the parents would say it was a result of her soul loss when her sister slammed the door.

When the Bough Breaks

I didn’t do so well on the health equity quiz, even though I’ve seen those statistics before in other classes that I’ve taken. I ended up getting 6/10. The statistic that I always find to be the most surprising in where the United States rates in life expectancy compared to other countries. People think that because the U.S. is such a developed country and we supposedly have all this great technology that we would be higher on the list than number 29.

When the Bough Breaks is about the premature births among African American women. It tells the story of a woman named Kim Richards who is a well educated, middle class, African American woman who’s daughter was born two and half months early. It tries to determine what factors could cause a pre term birth even though she exercised, ate right, and received good prenatal care. Two doctors did studies and found out that the underlying cause of these pre term births among African American women was racism. They say that it puts a lot of stress on women throughout their whole life and stress can lead to major problems in pregnancy. These doctors say that even though an African American woman may be economically stable and healthy, racism can override these things to cause the stress. They believe that chronic stress is the underlying cause.

Many things can lead to illness including politics, environment, and culture. If you live in a country that provides universal health care there is a better chance for you and your family to receive the specific care that you need. This also leads to less stress of having to worry about saving money for your child or other family member to see a doctor. Where you live also can affect the amount of care you receive. Whether you live in a rural part of the United States or a rural part of Africa, you still need to have transportation to get to the doctor or nearest clinic. Many people cannot afford to even physically get to the doctor. Also, many cultures do not believe in western medicine and may refuse medication or treatment from their physician. Also, some cultures find it shameful to admit you have a problem so this makes it difficult for someone to talk to a psychiatrist when they know their family will not agree with their choice to do so.

White Americans – Breast Cancer

source: http://ww5.komen.org/breastcancer/statistics.html

The health disparity I chose to talk about is breast cancer. When I was looking on the internet it was the most talked about disparity among white american women so I figured it would be a good choice. As with other cancers, breast cancer is when cells divide and grow without normal control, and 50-75% of all cases will start in the ducts. It is the most common cancer of women in all ethnic groups, but it is still the most prevalent in white women. I found it interesting that the website also provided the mortality rates for breast cancer and Michigan had a rate of 24 deaths per 100,000 women. I think it is prevalent among white women because of genetics, since you are more likely to get it if you have a close relative who has had it. I also learned from one of the websites that hormones play a role in the development of breast cancer so this could also be a reason.                  sources: http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-what-causes ; http://ww5.komen.org/understandingbreastcancerguide.html

Health can be related to many more things than just race and genetics. Things such as environmental factors also play a big role is determining the health outcome of a person. Another thing to point out is that the term race, cannot be defined very well and many people have different meanings for this. This makes it hard to categorize people, because some people identify with more than one group. Another point is that if you do decide to group people by race, this doesn’t mean that there genetics are the same and that they will respond the same way to certain treatments. Some populations are more prevalent in a certain disease, populations differ in genetic variants. It is also good to point out that no one disease is exclusive to one group. This means that we cannot just assume the health of a person based on what group they associate themselves with.