The Margins Review · Culture-Centered Approach

I thought this is interesting as we are in health care to some extent. This video is less than 2 minutes long.

In a previous posting, I talked to some extent about a teacher I had in school who died of breast cancer. She never sought biomedical treatment for her disease. She was afraid. She never tried local/ alternative health care in terms of homeopathy or Ayurveda. She went for the religious healing that did not help her save her life. People subscribe to different ideologies and practices for their health outcomes. Their reasons are as varied as the ways they choose. But still, to a large extent the biomedical model has come to dominate the most of the world. As this week's readings elaborate more on this, we find out about the Flexner Report. The Flexner Report (also called Carnegie Foundation Bulletin Number Four) is a book-length study of medical education in the United States and Canada, written by the professional educator Abraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Many aspects of the present-day American medical profession stem from the Flexn...

http://video.nytimes.com/video/2009/03/28/health/1194838918148/translating-health-care.html?hp

A couple of interesting questions arose while reading this week. Let's start with Arakelova's article on healing practices in Armenia. Being somewhat close to this ongoing fight for years by being a German citizens and by experiencing cultural clashes between Yezidis and Kurds on a weekly basis, this article was especially interesting to me. At some point, when the article talked about ethno-religious groups, I started to think about the question we had discussed many times before: What defines identity? What does it take/need to be a culture of its own? Can a culture extinguish because the passing on orally of traditions fails? Another topic that evolved in this reading, but also in Kim's article on Korean elderly was assimilation or acculturation. Arakelova talks about "necessitated assimilation". I wondered, after moving to a new country, is assimilation a voluntary, mandatory, or automatic and completely subconscious process? Is it easier for some but nor for ...

The first question I want to raise is that "does pluralism means agency"?   Meyer's makes a substantive point with his poignant account of Beverly. Quoting him, "the ground upon which chronic illness is made meaningful becomes profoundly unstable when the conditions of experience fail to conform to standard disease categories and their symptomatology." We have come across this thread in previous readings too when we have seen biomedicine being applied and experience reduced to "measurable", "diagnosable" categories.  The other question is what else to do and how to reconcile? In today's world, when movements constantly take people across borders and translational locations, where people exercise their agency (do they?) to get into stultifying systems...what are the options to negotiate health? How do they then exercise agency? Beverly exerts agency when she decides not to apply for social security benefits as then she might be judged inca...

This week's reading discussed the possibilities of alternative ways of healing and health. The debate between traditional methods of cure/ preventing illnesses and the dominant biomedicine was the center of the discussions. With examples from different parts of the world, the authors promoted their viewpoints. Mansfield et. al (2002) focused their research on the religious practices and spiritual beliefs of people regarding health care in people from rural eastern North Carolina, USA. Their research says that "health professionals should consider the faith of patients, not only in God per se, but also in how patients believe that God may act through a health professional in the healing process" (p. 407). Without getting into any criticisms of the study, I would like to share something from this research that reminded me of a personal story about how during critical times of illness people may lean more towards the unexplained and spiritual that what is explicitly availab...

This weeks readings dealt with alternative ways of healing and knowing, wonderful readings that taught me about rituals of healing in other cultures, but also about the struggles that people from these cultures have to deal with on a regular basis due to the forces of Western medicine. Mansfield wrote about spiritual practice and beliefs related to healing. It sounded like a very promising article to begin with, but for some reason did the concept of measuring religiosity and believes in respect to healing NOT sit well with me. I don't understand why people are always trying to put everything within the frames of measurements - I do see that this will help them compare and in Mansfield's case, help to create a model (thinking about it, how stupid is that to begin with???) - but why is there this constant need to compare so one can look better than the other? You can tell from my strong reaction, I think Mansfield's article was maybe worth a big laugh, nothing more, nothing ...

What is a culturally appropriate intervention? What is a "culturally appropriate" AIDS intervention? What is a "culturally appropriate" safe motherhood intervention? How do we deal with the critique of "medicalization of sexuality" vs the "sexualization of consumption"? How do find the right path, the balance between a development - commercial - government - multilateral - private sector collaboration? Is the territory of health and sex still uncharted?  Are all local values and meanings "cultural" and should we consider all services, methods, models to be "appropriate"? What "can" be done and what "should" be done? Assessments of "can" and "should" are bound up with views of the "culture" in question, assessments of its boundaries, its integrity, its authenticity, its very location "in" some places, some practices and some knowledges but not in others. If this is tru...

"Believe it or not, rice can diagnose your ailment" Source : OTV Bureau published on : 3/18/2009 11:32:24 AM Rayagada: You must have heard of tribal people resorting to medicinal plants to cure themselves of different diseases. Witchcraft is another remedy for these illiterate inhabitants. Now, rice can also do wonders on patients.    Believe it or not, Dandasi Senapati, a tribal ‘doctor’, as he is widely called, of Sirikana village near the district headquarters town of Rayagada gave a queer definition of medical science by adopting the unique healing method - rice treatment - in the tribal dominated region. Be it superstition or firm faith, Senapati’s rice treatment has many takers in the locality.    Senapati’s healing style is quite funny. Patients are asked to bring a handful of husk-free rice and Rs 20 as doctor’s fee with them. And then Senapati prescribes medicine, mostly medicinal herbs and shrubs for any physical ailment.    What is more interesting is the diagnosis...

I grew up in a family of five that included my parents. I would say that it is an average family size in Bangladesh. Growing up, I was close to my parents, especially to my mother, although the idea of calling my mother my best friend (or even friend for that matter) never occurred to me. I was quite terrified of my father, as he would frequently ask me to memorize chapters from my text books all the time. For example, before going out to work in the morning, he would ask me to memorize chapters one through three in my physics, chemistry, and biology books. "When I come back form work in the afternoon, I will test you on your memorizations" he would say. So every second of the passing clock made me more worried as that would bring me closer to seeing my father again. But still, I felt close to both my parents - I loved them and respected them and I knew they will be there for me when I needed them. And still, they were not my friends in the way we use the word 'friend...

After going through this forest of pages, I am at a loss as to where to anchor my BLOG post and how do I articulate so that I am able to talk about many of the things I have read.  In the readings about Indian Ayurveda, dominant and erased cosmologies, local politics with global connections, Chinese geomancy, KFD as a disease of development, commodification of medicines, health services, identities.....what comes across is the complexities, the dimensions and their constant movement. Achieving a healthy status is a complex exercise. In our normal day to day lives, we unconsciously/ consciously perform a set of actions located within our culture, structure and agency and lay claim to our "health". The understanding of the complexity is important to us as health practitioners when we strive to improve the health of others through our campaigns, theories, arguments and other contritions.  Dutta (2008) in his "pathways to curing and healing" chapter lays down such case ...

Two things have been coming to my mind so far after having read all of the articles for this week: For one, all the stories that talked about health tradition and believes in other cultures reminded me of something we do in Germany when someone suffers from diarrhea. We are told to eat brezels and drink coca cola. I have not once in my life wondered if these two medical advices had a deeper biological meaning, with that said, you can tell I am already trying to relate to Westernized medicine because that's what I was brought up with. I came to thinking, the salt on the brezels might help the loss of water in the body, maybe the sugar in the coke is supposed to bring you easy energy? Or are those two medical advices supposed to even be closely related to anything physical, but are rather a tradition that has survived for many many years because people believed in their powers? Therefore, relating to the readings which I found very interesting, I learned many new things when it comes...

The story that I enjoyed reading the most and that probably stimulated my thinking the most was Hawkins' story about Dr. Lewis and Mr. Pearsall. I pondered for a while over the statement or rather justification that Dr. Lewis used to make himself feel better after he first told Mr. Pearsall about his treatment option: "He didn't lie to Mr. Pearsall about those side effects, because Mr. Pearsall didn't ask." It make me think about how may people I know that go by the motto "don't ask, don't tell" and the fact that they can live and deal with their consciousness of NOT telling. There has to be a cognitive process that fights your inner feeling of what is right (can we call that morals or maybe instinct) and justifies your actions. Are those morals/instincts learned or do they reside in all of us naturally? Do your emotions influence your decision-making and your justifications when you have to make choices in life? According to Hawkins in case of D...

The different narratives of a situation by the different people involved in it reminded me of a movie very close to my heart, Rashomon . As Connelly (2002) succintly puts it, the decision to retell a story will depend on the personal reasons/ motivations of the reteller. In today's world of health communication we have so many competing narratives. The search for the "real" or "right" narrative is not important but what's important is not to ignore these stories. Narratives provide us invaluable insights into a human beings life, suffering, existence, surrounding, health. In many ways it provides us a ground to move ahead, take decisions.  In emergency response, in the first 48 hours, usually teams do not find much records or information as most records are affected and the normal information channels are in a disarray and non functional. So, the way the response team moves ahead is by collecting narratives: "so please tell us how did the flood waters c...

Quintus Horatius Flaccus, (Venosa, December 8, 65 BC - Rome, November 27, 8 BC), known in the English-speaking world as Horace, was the leading Roman lyric poet during the time of Augustus. Horace said that literature should at once teach and delight. Narratives, as part of literature should do the same. Narratives "capture [an] incredible tangle of necessity and freedom in human life, and plot enacts it in the selection and ordering of events and in the quasi-casula implications of its telling" (Chambers and Montgomery, 2002, p.77). They argue the necessity of choice in our moral lives, but that our predispositions and options are always conditioned by our past and history. Russian formalists distinguish 'story' from 'plot', defining the first as actual set of events and the latter as the teller's viewpoints. Chambers and Montgomery further argue that there can never a story without a plot, and plots vary from situation to situation and thus also influenc...