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margauxf

The Global Burden of Disease (GBD) study that the authors reference and model their call to action around is the worlds' largest scientific effort to quantify trends in health. It is lead by the Institute foe Health Metrics and Evaluation (IHME) at the University of Washington. It began in 1990 as a World Bank-commissioned study and is known for having introduced the disability-adujusted life year (DALY) as a new metric to quantify the burden of disease, injuries, and risk factors (or determinants), and enable comparisons. 

The 1990s were  a turning point for global health structures of governance and knowledge production, which the GBD study exemplifies. Global health experts began increasingly reframing health and healthcare in technical terms like DALY, removing health from public governance in ways that complemented and bolstered structural adjustment policies that were introduced in the 1980s (Janes 2004). As a result of these policies, the size, scope and reach of healthcare delivery and public health services were steadily reduced and downgraded. Anthropologists have been critical of these processes and other perceived failures in global health: the collapse of primary care initiatives fostered at Alma Ata in 1978, the resurgence of selective forms of primary care and vertical public health programs, and the ascendency of the World Bank as the principal health policymaking institution (Janes 2004, 2009).

Janes, Craig R (2004). "Going global in century XXI: medical anthropology and the new primary health care." Human Organization 63, no. 4: 457-471.

Janes, C. R., & Corbett, K. K. (2009). Anthropology and global health. Annual Review of Anthropology, 38, 167–183. doi:10.1146/annurev-anthro-091908-164314

Drawing the court hearing

tschuetz

When attending court hearings related to the Formosa Plastics Naphtha Cracker case, sociologist Paul Jobin frequently creates his own drawings. The drawings are necessary for legal reasons, since the court does neither permit audio recordings or photography, but written transcripts are allowed. The illustrations serve as supplements to the written notes, but also as devices to focus his attention on both interactions and language use. As civic data, the drawings point to the legal regimes that govern the creation of (legal) data in Taiwan and elsewhere.

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Sara.Till

Byron Good, Ph.D., is a professor of Medical Anthropology at Harvard Medical School. His primary area of research is mental illness and how social perceptions evolves around these issues, in terms of both treatment and social acceptance. Dr. Good has several works on these issues, including several that explore the perspective of bio-medicine in non-western medical knowledge, the cultural meaning of mental illness, and patient narrative during illness. His publications including several papers, books, and edited volumes; he is regarded as a major contributor to the field of psychological anthropology. 

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Sara.Till

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

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erin_tuttle

The author, Byron J. Good, is a Harvard professor in the department of global health and social medicine. He is the director of the International Mental Health Training Program, and has significant experience with field research that has led to many publications.

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erin_tuttle

The article’s main argument is that the narration of an illness is founded in the emotional connection it has to the sufferers life, the place from which they view the illness which includes individual and cultural aspects. Furthermore any lack of factual accuracy is an indicator of the social and cultural environment in which the illness presents itself and is revealing as to how it will be perceived and treated.

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erin_tuttle

The main argument is supported primarily through interviews with many individuals living in Ankara, through which they describe the first presentation of their seizures and in many cases the steps they tool to attempt a cure. Along with the interviews, statistics of the individuals interviewed and their diagnoses is used to provide a reference point to better understand their stories. Finally the article includes an analysis of narratives in a more general sense that can be applied to the narrative of an illness.

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erin_tuttle
  • “… illness narratives - both the corpus of story episodes and the larger life "story" or illness narrative to which they contribute - have elements in common with fiction. They have a plot; succession is ordered as history or event, given configuration.” (164)
  • “The diverse accounts of the illness in these narratives represent alternative plots, a telling of the story in different ways, each implying a different source of efficacy and the possibility of an alternative ending to the story. My point is not that persons having access to a plural medical system do not simply choose among alternative forms of healing but instead draw on all of them” (155)
  • “Predicament, human striving, and an unfolding in time toward a conclusion are thus central to the syntax of human stories, and all of these, as we will see, are important to stories about illness experience.” (145)

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erin_tuttle

Emergency response is not addressed in this article however it does provide emergency responders with insight into the stories those suffering from illness will have to explain their suffering. As emergency responders will often be working in societies and cultures very different form their own in the case of disaster response, it is important to understand that what may seem like fiction in a story cannot be dismissed without considering the deeper cultural significance of those elaborations.