Med Anthropol Q
· 2024 Mar · PMID 37824820
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Assistive devices serve as vectors for the ideals, judgments, and goals that their society of origin has towards people with disabilities. For some Ugandan inventors and prosthetists, familiarity with sociocultural norms...Assistive devices serve as vectors for the ideals, judgments, and goals that their society of origin has towards people with disabilities. For some Ugandan inventors and prosthetists, familiarity with sociocultural norms and consistent feedback allow them to design prosthetic limbs as technologies of care that specifically meet the needs of Ugandans using these devices. In contrast, many biomedical engineers living in the United States rely on what I call the "engineering imaginary" to produce universalized forms of assistive technology intended for people living in an essentialized Global South. Drawing on research with engineers, prosthetists, and people living with limb loss in Uganda and the United States, I investigate the social and cultural aspects of prosthetic limb design and argue that there is a cross-cultural mismatch about what a prosthetic device does and what kinds of limbs it should fit. This mismatch becomes inscribed in the prosthetic device itself.
Med Anthropol Q
· 2023 Dec · PMID 37703403
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In siloed discussions of antimicrobial resistance, antibiotic use on farms in the Global South has emerged as a key site for intervention. The antibiotic consumption targeted is not all consumption, but "irrational" cons...In siloed discussions of antimicrobial resistance, antibiotic use on farms in the Global South has emerged as a key site for intervention. The antibiotic consumption targeted is not all consumption, but "irrational" consumption. This concept of irrationality is neither new, nor true, but rather is a long-standing form of maintenance work within global health systems. Via an attention to chickens and the antibiotics farmers use to raise them in the suburbs of Kampala, we suggest that claims of irrationality are a central part of constituting what Tania Li has called the 'deficient subject'. In other words, irrationality, like the chicken and the antibiotic, is itself a humanitarian device that maintains a certain condition of governance where 'Africans' are imagined as being in deficit of rationality and good behavior. Claims of irrationality justify (and mask the political nature of) intervention.
Med Anthropol Q
· 2023 Dec · PMID 37665507
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Between the late 1970s and 1990s, many indigenous Lisu people in the Nu River Valley, an Eastern Himalayan region of China bordering Myanmar and Tibet, underwent what they referred to as "doing medicine"-abortions, vasec...Between the late 1970s and 1990s, many indigenous Lisu people in the Nu River Valley, an Eastern Himalayan region of China bordering Myanmar and Tibet, underwent what they referred to as "doing medicine"-abortions, vasectomies, and tubal ligations-as part of China's Birth Planning Policy. Lisu, who endured these procedures, struggle with strength loss, nervousness, and pain. Government discourses diminish the Lisu experience, arguing that the policy was lenient toward them. Lisu themselves are reticent to share their experiences but have devised new practices to care for those affected. Drawing on long-term ethnographic fieldwork, I argue that these chronic illnesses and accompanying care practices constitute everyday forms of remembering through which Lisu give shape to their experiences of cultural loss under Chinese colonization while generating new social relationships. This analysis sheds light on Indigenous experiences of birth planning in China with broader implications for understanding the bureaucratic violence of medicine.
Med Anthropol Q
· 2023 Dec · PMID 37656832
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The United States approached the COVID-19 pandemic with inconsistent responses that varied by state. In Florida, legislators passed laws contrary to mitigating the pandemic. These laws included banning county and municip...The United States approached the COVID-19 pandemic with inconsistent responses that varied by state. In Florida, legislators passed laws contrary to mitigating the pandemic. These laws included banning county and municipal efforts to control the spread of COVID-19 through mask mandates, social distancing, and prohibiting vaccination mandates during infectious disease epidemics. Moreover, the Legislature simultaneously prioritized policies of social exclusion, passing bills that constrained the rights of transgender individuals, Black Lives Matter protestors, and educators. In this article, I use the perspectives of critical medical anthropology and "governing through contagion" to examine Florida's COVID-19 response. I argue the COVID-19 pandemic provided an opportunity for legislators to obfuscate their political power and advance a politics of social division while simultaneously passing policies that undermined human health. I refer to this process as governing with contagion: Using a pandemic as a politically expedient backdrop to conceal power and simultaneously harm human health.
Med Anthropol Q
· 2024 Dec · PMID 37555346
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Emerging from experimentations with form during our 2021 inaugural BFHSS Collaboratory, this article dabbles in redaction while examining logics of race and aesthetics embedded in how health is defined, measured, and dep...Emerging from experimentations with form during our 2021 inaugural BFHSS Collaboratory, this article dabbles in redaction while examining logics of race and aesthetics embedded in how health is defined, measured, and depicted. I also examine logics structuring who is legible as a producer of knowledge, whose body is one from which knowledge is extracted, and who can be given access to population groups for study. Form in this article offers a reflection on the appropriateness of Blackness and pushes for a reconsideration of the relationship between form and function, appropriate claim-making, article writing, and engagement with scholarship.
Med Anthropol Q
· 2023 Dec · PMID 37459454
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Evidence-based obstetrics can employ statistical models to justify greater use of cesareans, sometimes excluding experiential elements from informed decision making. Over the past decade, prenatal providers adopted a vag...Evidence-based obstetrics can employ statistical models to justify greater use of cesareans, sometimes excluding experiential elements from informed decision making. Over the past decade, prenatal providers adopted a vaginal birth after cesarean (VBAC) calculator designed to support patients in making informed decisions about their births by estimating their probability for a VBAC. Among other factors, the calculator used race and ethnicity to make its estimate, assigning lower probabilities for a successful VBAC to Black and Hispanic patients. I analyze how a diverse group of women and their providers engaged with the VBAC calculator. Some providers used low calculator scores to remove a shared decision-making model by prescriptively counseling Black and Hispanic women who desired a VBAC into undergoing repeat cesareans. Consequently, women racialized by the calculator as Black or Hispanic used experiential knowledge to challenge the calculator's assessment of their supposed lesser ability to give birth vaginally.
Med Anthropol Q
· 2023 Dec · PMID 37354543
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Drawing from ethnographic research with Latin American migrant mothers seeking prenatal care at a safety net clinic in southern Connecticut, I describe the racial dynamics of a medical hierarchy that situates White provi...Drawing from ethnographic research with Latin American migrant mothers seeking prenatal care at a safety net clinic in southern Connecticut, I describe the racial dynamics of a medical hierarchy that situates White providers and nurses above Black and Brown medical assistants and patients, terming this the prenatal care color line. I characterize three segments of the prenatal care color line: through (1) onerous enrollment in prenatal care support that strips rights from migrant mothers; (2) differences in racialized embodiment that harden essentialist and stereotyped notions surrounding Latinx reproduction, making the experience of pregnancy and birth a process of race-making; and (3) obstetric racism manifest through both denying or delaying critical medical care to Latinx pregnant patients while also overmedicalizing their uncomplicated births. I argue that the presence of the prenatal care color line-in my study clinic as in other safety net clinics-permits the harsher racialization of Latinx birthers.
Med Anthropol Q
· 2023 Dec · PMID 37354542
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This article examines the making of clinical care by tracing how music therapists integrate their work within North American hospitals. Situated on the margins of the clinic, music therapists are in pursuit of clinical r...This article examines the making of clinical care by tracing how music therapists integrate their work within North American hospitals. Situated on the margins of the clinic, music therapists are in pursuit of clinical recognition-to be perceived and understood as valuable to biomedicine. The pursuit of clinical recognition illustrates how the configuration of care is an aesthetic concern, negotiated not only through processes of reasoning and rationalization but also through sensory-affective experiences. Music therapists cultivate a clinical aesthetic to their care by demonstrating clinical efficacy to their medical colleagues and self-fashioning clinical subjectivities through participation in medical rounds and charting. While clinical recognition creates conditions of possibility for music therapists to provide care in biomedical institutions, recognition is perpetually elusive for hospital music therapists. By cultivating sonic atmospheres and connections, music therapists disrupt and exceed a normative clinical aesthetic, illustrating ways of caring in the clinic beyond biomedical scripts.
Aggarwal NK, Chen D, Lewis-Fernández R
… +1 more, Guarnaccia P
Med Anthropol Q
· 2023 Sep · PMID 37335932
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Anthropologists have critiqued cultural competence programs in medical settings while introducing mental health clinicians to social theories on culture for practice. We explore how patients articulated narratives about...Anthropologists have critiqued cultural competence programs in medical settings while introducing mental health clinicians to social theories on culture for practice. We explore how patients articulated narratives about themselves and how clinicians responded to such narratives through an intervention known as the Cultural Formulation Interview that anthropologists have helped develop. We conducted over 500 hours of fieldwork from 2014 to 2019 at an outpatient clinic in New York, analyzing multiple data (participant observation, medical records, patient-clinician sessions, and individual debriefing interviews) in a trial joining clinical and ethnographic methods. Our study enrolled 45 patients and six clinicians, yielding 117 patient-clinician appointments and 98 debriefing interviews. Most patients differed in how they presented their identities through demographic forms and discussed them in sessions with their clinicians. Two-thirds of the patients drew connections between their personal identities and experiences of mental illness. These results reveal why cultural identities should not be taken for granted in clinical settings.
Med Anthropol Q
· 2024 Dec · PMID 37335921
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Joining in virtual conversation, Ashanté M. Reese and Sheyda M. Aboii explore their engagements with Black feminist praxis and theory in their ethnographic fieldwork and emergent projects. Marking the start of the inaugu...Joining in virtual conversation, Ashanté M. Reese and Sheyda M. Aboii explore their engagements with Black feminist praxis and theory in their ethnographic fieldwork and emergent projects. Marking the start of the inaugural Black Feminist Health Science Studies (BFHSS) Collaboratory in May 2021, this edited interview between a professor and graduate student addresses perspectives on what it might mean to work alongside others and attend to methods of Black life and Black livingness. Together, Reese and Aboii consider refusal as a careful balance between documentation and redaction in their work. They also discuss fieldwork with the dead through altar making, practiced memorialization, and strategic remembrance. Their exchange concludes with a return to Black feminist guides for storytelling, witnessing, and living. Among other thematics, this exchange highlights the creative potential of generous collaboration in BFHSS and the attendant vulnerabilities that create the "something that feels shared" vital to medical anthropological inquiry.
Mental health has become an exceptionally important social and public health issue in Australia. The government has invested billions of dollars in new services, while ubiquitous ad campaigns call on ordinary people to t...Mental health has become an exceptionally important social and public health issue in Australia. The government has invested billions of dollars in new services, while ubiquitous ad campaigns call on ordinary people to tend to their psychological well-being. This national valorization of mental health is striking, given the well-documented psychiatric harm suffered by refugees under Australia's offshore detention regime. This article draws on ethnographic work with a group of volunteer therapists who provide crisis counseling to these detained refugees over WhatsApp, allowing them to intervene in scenarios where therapy is inaccessible but badly needed. Highlighting the predictable challenges and surprising affordances of delivering care in this restrictive and high-stakes context, I show how my informants forge a genuine therapeutic connection with their clients. While this intervention is meaningful, I argue that the volunteers are aware that it is no substitute for winning political freedom.
Regulations governing assisted reproduction control the degree to which gamete donation is legal and how people providing genetic material are selected and compensated. The United States and Spain are both global leaders...Regulations governing assisted reproduction control the degree to which gamete donation is legal and how people providing genetic material are selected and compensated. The United States and Spain are both global leaders in fertility treatment with donor oocytes. Yet both countries take different approaches to how egg donation is regulated. The US model reveals a hierarchically organized form of gendered eugenics. In Spain, the eugenic aspects of donor selection are more subtle. Drawing upon fieldwork in the United States and Spain, this article examines (1) how compensated egg donation operates under two regulatory settings, (2) the implications for egg donors as providers of bioproducts, and (3) how advances in oocyte vitrification enhances the commodity quality of human eggs. By comparing these two reproductive bioeconomies we gain insight into how different cultural, medical, and ethical frameworks intersect with egg donor embodied experiences.
In this article, we examine the citational practices of US medical anthropology and seek to decenter Western-centric theory to minimize its theoretical dominance in the field. We call for a robust engagement with a broad...In this article, we examine the citational practices of US medical anthropology and seek to decenter Western-centric theory to minimize its theoretical dominance in the field. We call for a robust engagement with a broader variety of texts, genres of evidence, methodologies, and interdisciplinary forms of expertise and epistemology in response to the unbearable whiteness of the citational practices we critique. The practices are unbearable in that they do not support or scaffold the work we need to do as anthropologists. We hope this article invites readers to move in different citational directions to build foundations and epistemologies that support and enrich the capacity for anthropological analysis.
Med Anthropol Q
· 2024 Dec · PMID 37172286
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This autoethnographic visual essay narrates a Black feminist praxis of ancestral collage-making within my curation of #blackgirlquarantine: an exhibition of blackwomxnhealing in the wake of 2020 (BGQ). I detail my spirit...This autoethnographic visual essay narrates a Black feminist praxis of ancestral collage-making within my curation of #blackgirlquarantine: an exhibition of blackwomxnhealing in the wake of 2020 (BGQ). I detail my spiritual, affective, and embodied journey of stretching collage art to make room for memorializing the lives of Black womxn and girls who are no longer here to tell their stories. I write at the intersection of healing, memory, and mourning, and merge a Methodology for the Black Feminist Sacred with visual anthropology and digital humanities to read creative rituals of digital altar work as text.
This article examines the citational politics of teaching, learning, and doing ethnographic projects that study up in medical anthropology by examining the references that are often cited, the ones that exist but are not...This article examines the citational politics of teaching, learning, and doing ethnographic projects that study up in medical anthropology by examining the references that are often cited, the ones that exist but are not widely circulated, and the gaps in between. I take a reflexive approach to understanding how my positionality shaped my path toward studying up. In so doing, I reveal the complex tensions of implementing ethnographic methods in spaces that are (intentionally) challenging to access while simultaneously being embedded within academic and social environments that are plagued by hierarchical power relations. My approach critically examines the liberal, feminist, and Marxist legacies in anthropology that have shaped traditional forms of studying up and highlights the Black, Indigenous, postcolonial, and feminist methods that are vital for understanding how to study power from the margins.
Med Anthropol Q
· 2023 Jun · PMID 37161842
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Vaccine skepticism, and the related practices of selective- or non-vaccination, has steadily grown in the twenty-first century, especially among US mothers. The phenomenon has been especially pronounced in Oregon, which...Vaccine skepticism, and the related practices of selective- or non-vaccination, has steadily grown in the twenty-first century, especially among US mothers. The phenomenon has been especially pronounced in Oregon, which ranked first nationally for the number of kindergarteners with nonmedical exemptions in 2018. Based on 12 months of digital research in Oregon in the context of the COVID-19 pandemic, my findings suggest that mothers' vaccine skepticism emerges from experiences of iatrogenesis from childhood through childbirth. While existing literature analyzes medical distrust among BIPOC communities as related to historical and ongoing iatrogenesis, scholars often portray vaccine skepticism among white US mothers as related to "neoliberal parenting" and "intensive mothering." By analyzing mothers' vaccine skepticism as an outgrowth of iatrogenesis, this article underscores the long-term ramifications of systematic medical harm against women in the US. This finding is particularly relevant amid public health crises, when mitigation depends upon vaccine utilization. [vaccines, medical distrust, US mothers, iatrogenesis, autonomy].