Mohan Dutta: Culture-Centered Approach

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, ...

In the rather excellent readings this week, I discovered many theories, the postulates and positions of which I have often discussed but not the names. An interesting one is the "Dependency theory". The theory posits that Euroean development was predicated by the under development of the non-European world (Peet and Harwick, 1999). Certainly, the theory holds water if we trace the development of the world since the renaissance, the emergence of the industrial revolution, and parallely the enlightenment. Many scholars opined that this does not hold true anymore and Peet and Harwick mentioned the World Systems theory. But I would argue even today, the dependency theory can be applied to myriad contexts and used to explain them, though we have to replace the "European" with the "Western" and use the framework of even newer theories. Development aid is an area which offers itself to such critiques and indeed is rife with discrepancies and anachronisms. I was r...

I am often asked what I am studying here at Purdue University. Upon hearing Health Communication, I am always asked what might that be. So I tell them that in easy terms, I study the interaction between doctors, patients, hospitals, governments, and other policy-making agencies. I then have to look into the person’s expressions and follow my answer up with an example. “Think of a time you went to a doctor and had a really bad experience with him/her,” I tell them. “And now think of a time when you really liked your doctor.” “What changed? What influenced your experiences? To a big extent, this is what I study.” I use the above explanation not only to share in an easy way what I study but also to remind myself what got me interested in this field. Reading some of this week’s contents reminded me the practicality of such explanations. Teal & Street (2008) shares in a simple yet insightful way about the need to have a cultural competency in a doctor patient relationship, treatment, a...