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7-8 Published by: American Anthropological Association Stable URL: http://www.jstor.org/stable/647788 Accessed: 18/02/2009 01:54
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American Anthropological Association is collaborating with JSTOR to digitize, preserve and extend access to Medical Anthropology Newsletter.
WHAT MEDICAL IS ANTHROPOLOGY?
Contemporary medical anthropology is an outgrowth of several lines of research and application in the health sciences and anthropology which began to converge in the immediate post-World War II period. When the technology of Western medicine was introduced into the non-Western cultures usually studied by anthropologists, health teams turned to cultural anthropologists for advice on how to overcome perceived cultural barriers to the planned technological transfers. Studies of indigenous health beliefs and pracbeliefs and tices, nutritional patterns, reproductive behavior, the dynamics of sick role behavior and the legitimization of curing roles, all became critical to the development of public health and clinical care delivery systems designed to meet the needs of specific populations. As cultural anthropologists developed expertise in advising on the design of health delivery systems for non-Western peoples, it became evident that anthropological skills and approaches could be applied to the delivery of health care in modern, heterogeneous societies. Cultural anthropologists thus began to join their colleagues in physical anthropology who had long preceded them in medical school settings. Medical school receptivity to cultural anthropology did not derive solely from an interest in health care delivery across cultures. Medical researchers were concerned increasingly with diseases which no longer fit an earlier model of disease causation which stressed simple exposure to a particular micro-organism. Factors implicated in the etiology and prevention of heart disease, for example, such as diet, exercise, smoking, and stress, were related to the lifestyle and social interaction of the individual. These were research domains more familiar to the social researcher than to the medical researcher. It was recognized that by joining forces, social and medical researchers could contribute to a better understanding of disease etiology and prevention. Just as anthropologists looked upon other cultures and societies as natural "social experiments" for the study of cultural and social dynamics, medical researchers now recognized the validity of looking at other societies as natural "sociobiological laboratories." Medicine's increasing sensitivity to social and cultural variables also extends to problems in health care delivery. The growth of consumer and self-help movements directed towards changing some of the ways health care was being delivered, and the advances of medical technology into areas for which there were no cultural or social precedents, have also contributed to this trend. All of these concerns were given institutional recognition and a place in the curriculum with the development of a Behavioral Sciences section in the test conducted by the National Board of Medical Examiners, required of most medical students in the United States. 7 When anthropologists first became involved with medical programs, they rarely questioned the efficacy or appropriateness of the medical procedures being introduced. But over time, anthropologists began to collaborate with medical professionals in evaluating the suitability and impact of various established procedures. Thus, for example, basic and applied research has been carried out on the justification for, and effects of, separating the mother from her infant in newborn intensive care nurseries and in normal full-term deliveries. Research on birth control and family planning has been extended from how to get a given population to adopt a particular birth control technique, to the development of social or cultural specifications for the design of new birth control techniques which would be suitable and acceptable to a given population. Medical anthropologists concern themselves with the entire domain of health and medicine throughout the lifecycle. In the area of aging, for example, they are concerned with how the aged are treated in various cultures; the reasons for the differential status they are often accorded; questions about the relationships among physical functioning of the aged and their roles and functions in different societies; and with ways in which their health can be promoted and their care facilitated in our own and other societies. In the area of mental health, medical anthropologists are concerned with how various cultures define "mental illness"; the extent to which a stigma is attached to that label; the testing of various etiological hypotheses; the nature of the curing process in our own and other cultures; and how the treatment and social setting may help or hinder readjustment or cure. Medical anthropology has both applied and basic research interests. The applied interests are self-evident in the area of designing optimal care and public health programs, and measuring the impact of procedures and programs. The basic research interests overlap those of many disciplines. How are biological processes mediated and modified by the culture? What are the dynamics of maintenance and change common to all curing systems? How are people recruited as practitioners and patients in curing systems, and how are roles learned, carried out and changed? What is the relationship between health beliefs and health behavior? How does the curing system relate to other systems in a culture? What is the relationship between the pattern of life and the pattern of disease? Medical anthropology draws upon cultural and physical anthropology as well as related social science disciplines. Like many medical sociologists, for example, medical anthropologists have come to study the social organization of medicine, but they also have focused, more than the sociologists, upon an ethnographic understanding of the
perceptions held and shared by those within it. Medical anthropologists (most of whom started as cultural anthropologists) also have learned to build biological variables into their studies, along with more familiar cultural and social variables. Like physical anthropologists, medical anthropologists are concerned with adaptation and biologicalcultural interactions, but the time frame is shorter than that used by physical anthropologists, who are more concerned with evolutionary processes. The literature of medical anthropology is extensive and varied. Medical anthropologists publish their research in books, monographs and articles. The articles appear in specialized medical journals as well as in several journals specifically serving medical anthropology (e.g., Medical Anthropology; Social Science and Medicine; and Culture, Medicine and Psychiatry). In addition, there are a number of textbooks and volumes of collected articles available for teaching purposes, some directed to social science students and others designed more to meet the needs of health professionals. Medical anthropology is not a discipline separate from anthropology. The pioneers in the field were anthropologists who learned "on the job," usually by working in collaboration with health professionals. Over the last 15 years, however, a number of anthropology departments have developed programs which allow students to specialize in medical anthropology while receiving the PhD degree in anthropology. These programs emphasize, above all, a good grounding in anthropology as a discipline. In addition, they stress the learning of quantitative methods as well as the more qualitative clinical skills typical of ethnographic methods; the acquisition of basic biological knowledge if the
student does not have it; and supervised experience in the medical subculture. The Medical Anthropology Newsletter, published by The Society for Medical Anthropology carries out a survey every two years of departments which offer specialized training in the field. Other career training paths taken by anthropologists entering medical anthropology include the Master's Degree in Public Health, specialized postdoctoral fellowships, and the Master's Degree in Business Administration (with a specialization in Health Services Administration). In addition, a considerable number of medical anthropologists received advanced training in anthropology after being trained and working as nurses, nutritionists and other health care professionals. Students and professionals interested in learning more about this field are encouraged to join the Society for Medical Anthropology. The Society was founded in 1968, "To promote the study of anthropological aspects of health, illness, health care, and related topics; to encourage communication and utilization of the results obtained from such studies; and to aid in the education of persons who are or will be involved in carrying out these activities." The Society publishes quarterly the Medical Anthropology Newsletter, an up-to-date report on important meetings, publications, new research projects, training programs, and other developments in the field. The Newsletter also carries book reviews, newsworthy articles, editorials, and comments from readers. Free copies of this statement and membership information may be obtained by writing to the Society at the address below. The Society for Medical Anthropology, 1703 New Hampshire Ave., NW, Washington, DC 20009
Research on Massage
Mirka Knaster is researching the use of massage around the world since ancient times, consulting publications in the fields of medicine, history of medicine, ethnography, medical literature, anthropology, physical therapy, pregnancy and childbirth, religion, and art. She is interested in all aspects of massage, but in particular: who carries out massage, for what reasons, under what auspices, after what kind of training; is that person a full-time or part-time specialist, male or female, young or old, or is massage a component of a more general practice; what is massage used in conjunction with; what does its use reflect about a society's concept of health and illness; to what extent is it used; how successful is its use; is its practice confined to recognized practitioners or also employed in the home among family members; do midwives or other birth attendants include it in pre-natal, delivery, and postpartum care; is it used for abortion; is it used to enhance physical beauty, spiritual growth, general strength; how prevalent is baby massage? Preliminary research with written sources will be complemented by direct observations, experiences (in massage), and interviews, especially in Asia and the Pacific Basin. Information on references, contacts, and illustrations will be 8
gratefully received, for the U.S. and abroad. Please address to Mirka Knaster, 2033 Lone Oak, Napa, CA 94558, or c/o Napa College, 2277 Napa-Vallejo Highway, Napa, CA 94558.
Norge W. Jerome has been named Director of the newly developed Division of Community Nutrition in the Department of Community Health of the School of Medicine, University of Kansas College of Health Sciences in Kansas City. Dr. Jerome is a professor in the Department of Community Health. She believes that this is the only School of Medicine with a Community Nutrition Division and views the development as an opportunity to coordinate and advance the bidisciplinary research, teaching and consultant/advisory services of the Community Nutrition Laboratory which she heads. Corinne Shear Wood has been awarded a six-month grant by the University of Waikato, New Zealand, for continuation of her studies of health conditions among the Maori Biopeople. Her book, Human Sickness and Health-A cultural View (Mayfield Publishing Company, 1979), was awarded the Fifteenth Annual Book Award by the University of California, Irvine, Friends of the Library.
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