(Artikelnr: 79700-25)
Doing and living medical anthropology
Personal reflections
Rebekah Park & Sjaak van der Geest (editors)
isbn 97890 79700 25 7, 156 pp., paperback, € 25,00)
The essays in this volume consider what medical anthropology means in the academy and outside of it. Written by a diverse group of anthropologists, some of whom also work as doctors, public health workers, and NGO
Table of Contents




Preface - Sjaak Van Der Geest & RebekahPark




Chapter 1-  Doing and living medical anthropology: An introduction
RebekahPark & Sjaak Van Der Geest

Chapter 2 - Staking a middle ground between public health and medical anthropology to reduce health disparities in the USA
Emily Bhargava

Chapter 3 - A medical anthropology contribution: Participatory research with young people in Uganda
Paul Bukuluki

Chapter 4 - From revelation to reality: The struggle of a doctor trained in medical anthropology 
Laura Ciaffi

Chapter 5 - Medical anthropology and hiv prevention: Analyzing the use of condoms among gay men in Chile
Carla Donoso Orellana

Chapter 6 - A bump in the neck: From doctor to patient to doctor
Michael Golinko

Chapter 7 - From participant observation to reflection: Notes on returning from the field

Chapter 8 - Thick and thinned description: How useful can medical anthropology be?
Sjaak Van Der Geest

Chapter 9 Saving my soul
Els Van Dongen

Chapter 10 - We came, we saw, we misdiagnosed: How medical anthropology can enhance emergency medical relief programmes
Vanessa Van Schoor

Chapter 11 - Why medical anthropology matters: Looking back on a career 
Corlien Varkevisser

Chapter 12 - Journeying with medical anthropology
Shahaduz Zaman





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Chapter 1
Doing and Living Medical Anthropology
An introduction
& sjaak van der geest
This volume brings together essays written by people of extremely diverse backgrounds on how their study of medical anthropology has impacted their work and life – primarily outside of academia. It is our intention to shed light on how anthropology is practiced in non-academic settings through the eyes of those who are both within and outside of the university. Academics generally tend to regard applied anthropology as superficial, lacking theory and ‘thin’ in its efforts to gain attention from non-anthropologists working in public policy and clinical practice. Non-academics, in contrast, often regard the anthropology being practiced and taught in universities as slow, jargon-filled, and overly theoretical. These views underestimate the complexities of making research findings work beyond hypothetical scenarios, as well as the feasibilities of adopting an anthropological approach without working under the label of ‘medical anthropologist.’
By and large, the authors have avoided the tired debate between theory and practice. The essays address three themes: methodology, personal experience, and anthropological thinking. This volume is less engaged with academic texts as it is with the actual work and life experiences of those trained in anthropology. For this reason, the majority of the chapters deal with methodological challenges within multi- or interdisciplinary projects. Other contributors ruminate on how their anthropological training has impacted their personal lives as they recover from or succumb to illnesses. Others describe ways that people have integrated an anthropological view into jobs, which are not anthropological, and how they are still able to utilize their training regardless of limitations. In our contributions to this volume, we reaffirm the strengths of anthropological methodology.
The idea that applied research is theoretically thin is a misunderstanding (Bailey & Van der Geest 2009). Adding practical consequences to ethnographic data rather requires complex theoretical reasoning on agency, situationality and political leverage (see Bailey 2009, Oosterhoff 2009). It also requires cultural translation, one of the main ambitions of anthropology.
It seems that anthropologists struggle more with bridging the cultural gap between policymakers and health practitioners than they do between themselves and their research participants – even when they do not speak the same language. Anthropologists are more eager to capture the ‘villagers’ point of view than to delve into the culture of policymakers. Their unwillingness to transition into the world of policy may have to do with academic ethnocentrism (Van der Geest 1985), lack of accountability (Glasser 1988), and romanticization of the exotic (Hemmings 2005), or its corollary, what Blok (2001) calls “the narcissism of minor differences.” For Blok, narcissism hinges on the “idea that identity lies in difference, and difference is asserted, reinforced and defended against what is closest and represents the greatest threat” (Blok 2001: 123).
Thus, we present essays in which academic anthropologists reflect upon the utility and meaningfulness of their research findings to policymakers and clinicians, as well as writings by clinicians, public health workers, and policymakers who incorporate anthropological methods in their work despite financial, temporal, and ideological restraints.
The struggle to show that medical anthropology ‘matters’ is well described by veteran Dutch anthropologist Corlien Varkevisser who, in her retrospective essay, believes in the value of anthropology in the world of public health. She has continuously sought to share ownership of research projects with the people for whom the findings mattered, in hopes of ensuring that health interventions actually succeed in solving the problems at hand. Paul Bukuluki writes from Uganda about his work on a multidisciplinary team that initially rebuffed his efforts to incorporate anthropology into the research design. In the end, however, the team benefits from the nuanced insights gained from Bukuluki’s anthropological approach, which reveals that the concerns of their young subjects about teenage pregnancy took precedence over their feelings about /– a discovery that contradicts the assumptions about risk, fear, and stigma. Vanessa Van Schoor, raised in South Africa and Canada, reflects on her experience as newly trained medical anthropologist and emergency aid worker in Côte d’Ivoire. A long-time worker with Médecins Sans Frontières, Van Schoor credits her anthropological gaze as having helped her to take some distance from the hectic work in which she was involved, and thus identify her organization’s misdiagnosis of the situation.
Emily Bhargava, an American public health worker, discusses the role that anthropology played in a public health programme aimed at the elimination of health inequality in the Boston area of the United States. Anthropology, she asserts, provides a language and a framework for thinking about culture and difference in a neutral way that can help make conversations about disparities and cross-cultural partnerships more productive. Carla Donoso Orellana reports on the benefits and limitations of an anthropological approach to researching condom use among homosexual men in her home country, Chile. While her research uncovers important themes of love, pleasure and sexual experience in regards to condom use in homosexual relationships, she also finds herself limited by the epistemological gap that exists between her and her medical colleagues.
The uneasy relationship between theoretical and applied medical anthropology is the main issue in the essay by Dutch anthropologist Sjaak van der Geest. He argues for a rapprochement between both, and for a productive combination of qualitative and quantitative approaches in medical anthropology methodology. Reflecting upon his own past research, however, he admits rarely succeeding in ‘selling’ his results to policymakers or health practitioners (Shahaduz Zaman draws a similar conclusion in his essay.) Van der Geest’s main audience is overwhelmingly anthropology students and colleagues.
Laura Ciaffi, a physician from Italy, writes about her decision to study medical anthropology to better prepare for emergency relief work in various cultural contexts. Now, several years later, she is ambivalent about her decision. On the one hand, she experiences a kind of ‘revelation’, now viewing her clinical work from a broader perspective and seriously considering what is at stake for the people she works with in the field. On the other hand, she realises (like Orellana) that the gulf between the medical and the anthropological gaze remains wide. As a doctor in the field, Ciaffi uses anthropological insights when working in different cultural settings. She goes beyond what is spoken and considers her patients within their context. What is more difficult, however, is actually making use of an anthropological approach – even applied medical anthropology – in her clinical work.
Rebekah Park, who is in the early stages of her academic career in the United States, rediscovers an appreciation for participant observation, one of anthropology’s strongest methodologies in understanding the contradictions between what subjects say and do. Conducting research over a long period of time enhances an anthropologist’s relationships in the field, and also the quality of her data. Park suggests that anthropological methodology is not only limited to the way we conduct research, but also includes the writing process. Choosing how and what to write entails balancing the priorities of the local communities in which we conduct our research with those of the academic community that shapes our theoretical approaches.
In several of the contributions, personal life experiences intertwine with the professional sphere and anthropological research. Reflection on how medical anthropology affects personal lives is one of the major themes in this volume. The emphasis on the personal may be related to the pedagogy of University of Amsterdam’s Applied Master’s in Medical Anthropology program – where all of the authors have either graduated from or taught. Students from very different professional, national and cultural backgrounds are assembled together within an intensive course that forces them to be in each other’s company continuously for a full year. This diversity is, in fact, an important element of the course; cultural differences among the students are openly discussed and demonstrate the ever present but elusive concept of culture. Cultural sensitivity, therefore, is practically required and enhanced by frequent reflection on personal biography and experience among people of varying backgrounds.
We chose the overlap of research and work with personal life because we believe it to be a crucial but under-exposed space where medical anthropology is done. In their collection of essays, Athena McLean and Annette Leibing (2007) speak of the ‘shadow side’ of fieldwork, or how the unacknowledged – hence shadowy – combination of autobiography and personal experiences directs research and analysis. McLean and Leibing draw their inspiration from Michel Foucault who observes the following about his own analytic process:
Every time I have tried to do a piece of theoretical work it has been on the elements of my own experience: always in connection with processes I saw unfolding around me. It was always because I thought I identified cracks, silent tremors, and dysfunctions in things I saw, institutions I was dealing with, of my relations with others, that I set out to do a piece of work, and each time was partly a fragment of autobiography (cited in McLean & Leibing 2007: 6).
In this volume, we compare Foucault’s observation with our own experiences on the intersection of autobiography and fieldwork. Personal reflections on the mundane become a part of the analytic framework, yet how and to what extent they do often goes undefined. In this volume, we seek to capture this interaction.
In his book on the production of ethnographic knowledge in Papua New Guinea, Crook (2007) argues that the personal life experiences of anthropologists like Margaret Mead, Reo Fortune, Gregory Bateson, Fredrik Barth and Annette Weiner influenced their theoretical and methodological approaches in their ethnographic work. For example, the “temperamental ménage à troisin statu nascendi. unspoken ngo Medische Antropologie Medische Antropologie 21 (2): 215-221.
Blok, A.
1998 The narcissism of minor differences. In: A. Blok, OxfordNijhof, G.
21 (2): 257-275.
2007 Is it possible
Park & Van der Geest
AMB Publishers
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