Mohan Dutta: Culture-Centered Approach

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

This week’s readings once again created a very emotional response…I am usually a very optimistic person but the readings are trying to make me turn 180 degrees. Dutta illustrates in chapter 7 how there are many more marginalized groups, not only the ones we have so far talked about. The fact that your mere gender, age, or race can be reason for marginalization is very sad. The reason for my rather pessimistic outlook after reading has to due with the fact, that to me it seems like, most of the dominant structures are not seeking any change. Why would they? For them the world is a little happy place with food on their plate, a roof over their head at night, access to medical services, etc. Is there even a chance to change these structures if the people who run them and create them are the ones that don’t want change and at the same time fear change because they could/would mean they had to give up parts of their little happy world in order to help others? The connectedness of agency, st

Wilkins (1999) says that "development communication refers to the strategic application of communication technologies and processes to promote social change" (p. 197) and that all future trends in this field needs to focus on the issues of power - both in theory and in practice. Wilkins says that power as a variable should be central to policy developments, and that it is imperative to understand how the power framework effects social change. Using Simmel (1986) and Foucault (1986), Wilkins says that "power is unevenly held but established through interaction within existing networks" (p. 198) and institutional discourse helps promote agency in people and cannot be apolitical. Governments and other agencies try to promote social changes using political, economic and ideological power and institutions. However, such policies/programs look at interventions in a sort of us versus them way. It is more of a foreigner perspective on things local. This links well with the

After reading Farmer's account, I stayed silent for a long time; it pushed me into deep introspection. It reminded me of the displacement colony in Koraput. There are some unique tribal families living there in the colony. They were once very prosperous with acres of land and beautiful home in the ravine land irrigated by the Kolab river. Then came "Pembangunan". Orissa constructed the Upper Kolab hydroelectric project to electrify the capital towns and business hubs thousands of miles away and these families' houses, lands and villages  were submerged by the Kolab dam reservoir. The villages are still visible when the water goes down, an eerie, beautiful sight. The families moved to a nearby place. They again dug up foundations and built their houses. "Pembangunan" came again in form of a huge factory which manufactured aircraft parts; the proud leaders declared that we have been blessed with the important project by the Indian government. It produced jobs,

Marginalization and related articulations comes across strongly in this week's readings. Dutta (2008) writes marginalization as" being at the periphery of a dominant system and that marginalization is embodied in the position of being under, of being silenced, of being without a voice and of being without resources". Marginalization can be caused by poverty, ignorance, location, access, positionality in the societal and economic system (pecking order!!) and in God's own country, insurance!!  From a critical cultural perspective, marginalization occurs from basic structural deprivations, created and sustained by structural inequities and unequal distribution at resources, further created and sustained by unhealthy practices which are in turn created and sustained by those in positions of power (Dutta, 2008). True, and I feel this is ingrained in our lives. The principle and declaration of human rights (1948) say "all human beings are equal...etc...". There ca

Once again we see and read about the necessity of putting the participant voice in decision making, especially on issues related to health outcomes. The narratives of the Santali lives and views on health was immensely powerful in describing the above need. Academicians and policy makers tend to make marginalized populations as the subjects of health interventions designed by them, primarily from Eurocentric and post-positivist ways which do not seem to answer the question of essence properly. And yet, most research found on health issues and policy developments are designed by people who do not participate in the living experiences of the group being worked on. Here lies the key - policy makers are working on the people and not with the people whose voices are absent from the main stream. It is foreseeable that an all White group of policy developers may not be able to realize how the tribal population of Nepal (for example) negotiate their beliefs of healthy living. Many studies have

I enjoyed (enjoy is probably the wrong word in this context, because once again these readings made me look at the world with disgust) the readings for week 5, I felt they were a great summary of what we have been talking so far. The book chapter on culture and marginalization got me into thinking about what constitutes a marginalized group. Dutta defines marginalization as "at the periphery of a dominant system." What about a population that is not at the periphery, but yet the health issues that this population is concerned with is not addressed? I even want to take it as far as: the dominant system knowingly doesn't inform this population of certain health threats they face. Are we talking of a marginalized group here as well? The articles on the Santalis and the FM patients once again served as a great example of how the voices of the marginalized are unheard and not cared for in the main stream. When coming across Nietzsche's quote (see headline) while reading I

The readings from week four had two distinct branches for me. One dealt with the construction and negotiation of pain, and the other with the need for participation and solidarity to improve life. How do we negotiate pain? For a vast majority of us, it may be safe to say that we think of the physical aspect of pain when we think about it. One can easily point to the location of pain, as in arms, legs, stomach etc. But can this pain be actually objectified? Most people would agree that we cannot see pain. Can pain be pin pointed? Perhaps not. Then how are we constructing it as a physical element? If we take a more post positivist approach we can perhaps define pain as electrical impulses to and from the brain. In that case, why do we not consider pain as a brain manifestation? I witnessed first hand the tendency among the Western doctors to quantify pain - tell me on a scale of 1 to 10, where your pain is right now. I wonder how effective such a statement can be, as it is easy to poke h

This week's readings has many points to start a discussion. Many notable ones talk of pain as a human experience and situated in the body. Indeed, how do we manifest pain or is pain itself a manifestation? The health communication concern and the concern of the many health organizations in the US it to create constructs around it, quantify it, isolate it and advertise and sell treatment for it, the fancy "disorders" patented under exotic names. This is what Kleinman et.al., (1992) call the political economic transformation of pain and its treatment. I found myself wondering, of course we all agree that converting socio-somatic processes into biological terminology is reductionist but hasn't that been the enterprise of much of the positivist scholars and yet alive and kicking now in NSF funding criteria and erstwhile "Bush" science (St. Pierrie, 2006). My primary education being in Physics and Management, I am very amused to see all these scholars studying hu

I was excited about reading the Basu/Dutta article on sex worker in India. Not only because this topic partly falls into my own research area, but also to see a first usage of the culture centered approach. I was shocked, but really not surprised, to read how many people in the process of setting up e.g. SHIP are throwing themselves in the way of people who are only trying to improve their own living condition without really interfering in anybody else's life. I can see now, once a program like SHIP is in place, it is not all peace and happiness. I can see now, how the struggle and fight is not over and how people in marginalized spaces have to keep fighting for their rights/health/dignity...on a daily basis still. Beck's article reminded me once again of the categorical imperative, I believe he even quoted Kant somewhere along the way. I still can't make up my mind about progress, decisions that have to be made and risks that need to be taken in order to achieve progress,