From the perspective of the poor: An analytical review of selected works of Paul Farmer

Guest post by Megan Hogikyan

To label Paul Farmer as a practitioner or theorist of any one field would be a disservice to the multi-faceted nature of his commentary and points of view. A self-described physician and medical anthropologist by training (Farmer 2001 [1999], 2005), Farmer’s career experiences highlight his other important roles as an academic, humanitarian activist, diplomat, and voice of the poor. Evidence of each can be found when tracing the development of Farmer’s theories through analysis of selected works published since the 1990s. Depending on the function and audience of the work, and its place in his timeline of experience, each book highlights different concepts, practices, and forms of theory.

The categorization of Farmer’s writings into early, middle, and late periods helps to demonstrate the development and evolution of his core theories, how they build on each other, and how their progression is affected by each of his varied perspectives and audiences.

Analysis of selected works by Farmer traces the development of his main theories and arguments as they build on each other over time. Over the last two decades, Farmer’s central theories have evolved from studies of social suffering to practical analysis of political, social, and economic inequality and structural violence, and to pragmatic solidarity and the provision of tools of agency and targeted solutions to suffering stemming from tuberculosis (TB), HIV/AIDS, and poverty. The use of ethnography, local and international history, and the practice of actively bearing witness to violations of health as a human right facilitate what has become a collective, comprehensive approach and body of theory associated with Farmer. Consideration of his central concepts, writing style, and practical experiences serves to demonstrate how his unique approach came to be associated with the household name he is today.

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Society for Medical Anthropology launches newsletter

Welcome to the new quarterly electronic newsletter from the Society for Medical Anthropology: Second Opinion: News and Ideas. The first issue features details on a joint international conference with a thematic focus on “encounters and engagements” in Tarragona, Spain, recent awards and achievements of SMA members, and a new anthropology and medical health interest group.

Anthropologist of 2012

The cultural anthropologist most in the news in 2012 was Jim Yong Kim. Kim was trained as both a physician and medical anthropologist, one of the first students to go through Harvard’s joint Ph.D./M.D. program. Later he became chair of the Department of Global Health and Social Medicine at the Harvard Medical School and then president of Dartmouth College from 2009 to 2012. Along with Paul Farmer, he is co-founder of Partners In Health.

Jim Yong Kim. Source: World Bank website

When President Barack Obama nominated Kim for the presidency of the World Bank, policy insiders expressed widespread dismay, with much commentary pointing to his being an anthropologist as a discrediting factor for the position.

After his appointment was approved, however, talk of his anthropological credentials died down. In other words, a connection with anthropology was taken as a weakness by his opponents. Now that he is president of the World Bank, his identity as an anthropologist has been quietly erased.

Dr. Kim, president of the World Bank, physician and medical anthropologist, is anthropologyworks’ anthropologist of 2012.

Last year’s anthropologist of the year was David Graeber. Before that, anthropologyworks named Paul Farmer as the anthropologist of the decade, 2000-2009.

C.A.R. most notable recent collection award

Deadline for Nomination is May 15, 2012.

The Council on Anthropology & Reproduction (CAR) Award is one of very few awards given to edited volumes, yet it helped establish and foment topics of reproduction as central fields of anthropological inquiry. The “Most Notable Recent Collection” Award seeks to recognize and celebrate recent (published within 3 years of the nomination deadline) collections of anthropological works addressing: human reproduction, reproductive technologies, population policy, birth control and contraception, pregnancy, the study and application of genetics, childbirth, adoption, and the roles of parents, among others.

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Request for anthro literature

Anthropology in Action editor, Dr Christine McCourt, is seeking anthropological literature to aid research on aspects of medicalization in childbirth in Saudi Arabia and the experience of Afghan refugee women having a baby in the UK.

Any knowledge, resources, or assistance would be greatly appreciated and can be passed on to anthropologyinaction@yahoogroups.com

The grand challenges in global mental health

A consortium of social science and medical researchers, advocates and clinicians announced the major research priorities over the next 10 years for addressing mental illness around the world. They call for urgent action and investment. Medical anthropologist Arthur Kleinman, of Harvard University, is a member of the group. Nature carried a report on the consortium’s conclusions.

depression — Depression. Flickr/shattered.art66

Table 2 presents the 25 Grand Challenges related to mental, neurological and substance-abuse (MNS) disorders.

Cross-cutting themes:

research should take a life-history approach
suffering from MNS disorders includes family members and communities and thus requires health-system changes
all care and treatment interventions should be evidence-based
environmental factors such as extreme poverty, war, and natural disasters have important but poorly understood affects on MNS

In conclusion, the report notes that the greatest challenge would be the elimination of MNS disorders. A truly great challenge.

But a challenge that is not likely to be met in the next 10 years given the way things are going with the last factor listed above. Therefore, why not devote the bulk of the research funds to addressing the mental health risks from poverty, war and natural disasters? And, on the way, maybe we should do something about poverty and war?

Will travel for health

Miwok sweat lodge. Flickr/Jason Holmberg.

A special edition of the journal Body & Society is devoted to contemporary “medical migrations,” or travel in search of a medical cure for a health problem. Elizabeth Roberts and Nancy Scheper-Hughes, both medical anthropologists, are the guest editors.

In their introductory essay, they state that increasing numbers of people are now crossing national borders and travelling great distances for solutions to health problems. They construct a vast frame for “medical migrants,” which includes not just elites shopping globally for the best health care and newest drugs, but also victims of torture and human rights violations who seek to protect their health and prolong their life by gaining asylum outside their home country.

Also included are medical tourists who take risks to access illegal health services, such as organ transplants and the spiritually motivated travelers who make pilgrimages to American Indian sweat lodges in the desert. Medical trials that roam the globe in search of subjects are also in the frame.

The collection of essays promises to break new ground in thinking about “medicine on the move.”

Anthro in the news 6/27/2011

• The trauma of war and rape
In the first of a two-part story, CNN highlights the work of cultural anthropologist Victoria Sanford, whose research has involved listening to victim narratives of Maya women in Guatemala since her doctoral studies at Stanford University in the early 1990s. A Spanish speaker who had worked with Central American refugees, she befriended the few Maya in the area. “I was moved by their stories, but even more so because they were intent on someone hearing them,” she said, “And no one was listening.” She joined the nonprofit Guatemalan Forensic Anthropology investigative team and went to Guatemala. Sanford talked to the women, who told other women about her, and soon she was recording their stories. Over time, and after hearing many stories, Sanford suffered from a kind of “secondary trauma” including paralysis.

• Conflict in Uganda and a possible love complication
The New York Times quoted Mahmood Mamdani, professor anthropology and government at Columbia university, in an article about an ongoing bitter personal rivalry in Uganda that involves President Musaveni and his rival and former friend, Kizza Besigye. Things may be complicated, the article suggests, by a woman, Winnie Byanyima, who is married to the president’s rival but who may have had a romantic involvement earlier with the president. Other matters are likely part of the story as well. Mamdani comments that the government is “clueless” about how to deal with Besigye’s opposition movement. He didn’t comment on the love factor.

• Culture and asthma
Cultural context and behavior shape the diagnosis and treatment of asthma according to David Van Sickle, medical anthropologist and asthma epidemiologist of Reciprocal Labs in Madison, Wisc. Van Sickle’s fieldwork in India revealed that physicians were hesitant to diagnose patients with asthma because of social stigma.

• Treating autism: two cases in Croatia
Drug Week covered findings from a study conducted in Osijek, Croatia, which discusses the treatment of autism in a boy and a girl with risperidone. K. Dodigcurkovic and colleagues published their study in Collegium Antropologicum.

• Profile of a forensic anthropologist
The Gainesville Sun carried a profile of Michael Warren, an associate professor of anthropology and director of the C.A. Pound Human Identification Laboratory in the Department of Anthropology at the University of Florida. He has conducted hundreds of forensic skeletal examinations for the state’s medical examiners and has participated in the identification of victims of mass disasters and ethnic cleansing, including the attacks on the World Trade Center, Hurricane Katrina and the recovery and identification of the victims found within the mass graves of the Balkans. He recently testified in the Casey Anthony murder trial.

• Medieval persecution
The remains of 17 bodies found at the bottom of a medieval well in England could have been victims of persecution, new evidence suggests. DNA analysis indicates that the victims were Jewish. They were likely murdered or forced to commit suicide. The skeletons date to the 12th-13th centuries, a time of persecution of Jewish people in Europe. Professor Sue Black leads the research team. She is a forensic anthropologist in the University of Dundee’s Centre for Anthropology and Human Identification.
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Call for proposals for special edition of Culture, Medicine and Psychiatry

The journal editors, Brandy Schillace and Atwood Gaines, are calling for proposals for a special issue to appear next June on anthropologies of clinical training in the 21st century (PDF).

A special issue includes the guest editor(s)’ introduction, peer-reviewed articles and a final commentary that reflects on the pieces included.

According to the editors:

It may perhaps come as a surprise that the editorial staff did not originally plan to release a special issue each June. Rather, these issues have grown somewhat organically into a feature of the journal, and have earned their proper place in the yearly cycle. Special Issues have a useful and informative function for Culture, Medicine and Psychiatry and for studies in anthropology, psychiatry and medicine more generally. They allow us to more deeply engage a subject than is possible with single articles and indicate their relevance beyond the indentified topic.

It’s spreading: obesity stigma

Anthropologyworks cannot claim credit for helping an anthropology study rise to the top as a story, since no direct evidence exists to show that our March 29 Tweet played a role.

But it just might have.

The study is based on survey questions posed to people in many cultural contexts around the world. Findings indicate that social preferences for a slim body and negative views of a not-slim body are no longer confined to the U.S./”the West.”

In fact, preferences for a slim body, especially a female slim body, are now prominent in Samoa and Mexico, for example.

It is not often that an article published in the distinguished journal, Current Anthropology, makes it to the front page of the New York Times. And “not often” is probably inaccurate. More like: rarely. Or maybe: never? [Blogger’s note: please send in examples of CA articles that have attracted major media coverage in the past, via our comment button.]

And the story is gaining momentum as you read this post. The obesity stigma study is on a roll, with other mainstream media outlets chiming in. Maybe Alexis Brewer, the lead author who is a professor of anthropology at Arizona State University and author of Obesity: Cultural and Biocultural Perspectives, will be invited to the Daily Show!