Ant 3478: 1A77 Global Health Cultures

ANT 3478: 1A77 Global Health Cultures

Fall 2013

Meeting Times and Locations: M, W, F 3^rd Period: McCarty Hall G186

Instructor: Sharon Abramowitz

Office Hours: Mondays 11:00-12:00, or by appointment.

Office #: Grinter Hall #494, [phone]

Email: [e-mail], cell [phone]

Synopsis

In our understanding of global health, the problem of culture is always an underlying issue. In this course, we examine the ways in which diverse societies construct illness and health experiences, balance healing traditions with multiple forms of medical practice, and integrate the human experiences of illness, recovery, and death with the technical world of biomedicine. Simultaneously, we engage with global health and biomedicine as cultural forms that have their own distinctive features. Looking at the global health interventions world-ide, we study how biomedicine - from epidemics, to infant mortality, to disaster relief, to DNA research – exists as a set of cultural constructs that transform human experiences of health and disease. Building upon the work of scientists, anthropologists, and scholars of the medical humanities, we explore new ways of thinking about global health and culture as global health institutions and forces are changing in the 21^st century.
Course Description

What is health? Is health a human right? How is the experience of being sick shaped by one’s culture? Does biomedicine stand apart from “culture” and “tradition” in our understanding of health and disease? Are biomedicine and international global health also “cultural,” or is “culture” just the exotic? Moreover, where is global health?

Using the work of scientists, anthropologists, and scholars of the medical humanities, this course explores new ways of thinking about global health and culture in the context of changing global health, medical, research, and security institutions in the 21^st century. This course uses ethnographic writings from around the world – including the United States, China, South Africa, France, and the former Soviet Union to explore health experience, health discourses, traditional and biomedical practices, and health governance in a global perspective. Our readings and conversations will serve as the springboard for a semester-long discussion about the meanings of health, sickness, and health justice, with an eye towards interrogating the emerging international principle of “health as a human right.” Through this discussion, we will be challenged to reconsider some of our own taken-for-granted assumptions about the infections and inequalities, global hierarchies of power, local health cultures and experiences, transnational health movements, and global arrangements of development and underdevelopment health – and bodies -- as problems of human security.
Course Objectives

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  By the end of the semester, you will have been introduced to a diversity of cultural approaches to health and illness. You will have received instruction in the values, attitudes, and norms that constitute health-related aspects of culture in countries outside the U.S., and you will also have gained an understanding in the values, attitudes, and norms of western biomedicine.
  
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  You will have been trained to distinguish between “traditional healing” and biomedical knowledge and practices, and you will have been trained to think critically about health in transcultural perspective.
  
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  You will have studied biomedical knowledge as a cultural domain.
  
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  You will have acquired a fluency in the core concepts of medical anthropology and global health, and been exposed to a broad range of theories and methodologies in medical anthropology.
  
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  You will have learned to identify, describe, and explain the social institutions, structures, and processes that shape global health processes and outcomes at both the local level of practice, and the global level of transnational intervention. Specific issues addressed in the regard include: pandemic diseases, global forms of health intervention, the creation of international health standards, and the provision of NGO and state-sponsored health resources.
  
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  You will have been exposed to critical theories regarding health, justice, and human rights. By the end of this semester, you will have considered multiple perspectives on the meanings of health justice in comparative perspective. You will be able to consider the principles of “health justice” and “health as a human right,” and formulated a distinct and individual position on the matter.
  

Requirements

Class Participation (25%)

2 Quizzes (40%)

Final Quiz (35%)

Class Participation

Class participation is mandatory, and class participation will be based on attendance. Attendance is mandatory, and foundational concepts and definitions that cannot be found in the readings will be introduced during lecture at every course meeting. During our course meetings, every student will be expected to participate in class discussion in a way that provokes thoughtful engagement with classmates.

Quizzes

Three take-home quizzes will be administered electronically over the course of the semester, through the Sakai system. Each quiz will include three open-ended questions covering the readings, social science methods and theories, and the broader themes of the course. For the first two quizzes, each answer should range from 250-500 words, with each quiz totalling approximately 750-1500 words. The final quiz will have customized instructions.

Quizzes will be administered on the following dates: September 22^rd-23^rd, October 27^th-28^th, and November 21^rd-26^th. Quizzes will open at 8:00AM on the first day, and they will close at midnight on the second day. During this time, students may engage in an open-book review of the materials. You may consult with your peers while working on take-home quizzes, but all work needs to be submitted individually, and it must be original. No group work will be accepted. Final quiz answers must be submitted electronically. Any references cited in the quizzes must be presented in appropriate citation format. All references require parenthetical citations and bibliographic references. The bibliographic material must be submitted in formal APA, Chicago Style, or American Anthropological Association citation conventions. If you are aware of a pending conflict with the quizzes, please let the instructor know immediately so that alternative accommodations can be made.
Grades

Grades for this course will be assigned according to UF’s grading policy. For further information, please review the UF policy here: https://catalog.ufl.edu/ugrad/current/regulations/info/grades.aspx#grades.

Course Readings and Materials (Recommended, not Required)

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  A Reader in Medical Anthropology: Theoretical Trajectories, Emergent Realities. Eds: Byron Good, Michael MJ Fischer, Sarah Willen, Mary-Jo DelVecchio Good. Wiley Blackwell Publishers.
  
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  Death Without Weeping. Nancy Scheper-Hughes.
  
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  Global Pharmaceuticals: Ethics, Markets, Practices. Adriana Petryna, Andrew Lakoff, Arthur Kleinman.
  
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  The Spirit Catches You and You Fall Down. Ann Fadiman.
  
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  An Anthropology of Biomedicine. Nguyen and Lock
  

All readings will be posted in the resources folder of the course website as .pdfs. It is recommended that students purchase books in electronic version (aka Kindle), or previously owned, via the Internet. All media material will be available free, via the Internet.

Attendance Policy and Policy on Late Assignments

You are required to complete all assignments by the stated due dates. Late assignments will lose one half-letter grade for each day past the deadline. There are no make-up opportunities for any assignment, as you will have ample time to complete each requirement. I will not assign grades of “incomplete” except under extreme circumstances (and only if you have completed 50% of the coursework). You must provide documentation of such circumstances from an appropriate authority.

“Requirements for class attendance and make-up exams, assignments, and other work in this course are consistent with university policies that can be found in the online catalogue at http://catalog.ufl.edu/ugrad/current/regulations/info/attendance/aspx.
Academic Honor Code

UF students are bound by The Honor Pledge, which states, “We, the members of the University of Florida Community, pledge to hold ourselves and our peers to the highest standards of honor and integrity by abiding by the honor code. On all work submitted for credit by students at the University of Florida, the following pledge is either required or implied: “On my honor, I have neither given nor received unauthorized aid in doing this assignment.” The Honor Code (http://www.dso.ufl.edu/sccr/process/student-conduct-honor-code/) specifies a number of behaviors that are in violation of this code and the possible sanctions. Furthermore, you are obligated to report any condition that facilitates academic misconduct to appropriate personnel.

Americans with Disabilities Act

Students requesting classroom accommodation must first register with the Dean of Students Office. The Dean of Students Office will provide documentation to the student who must then provide this documentation to the Instructor when requesting accommodation. For more information, contact:

Dean of Students Office Disability Resource Center

202 Peabody Hall or 0020 Reid Hall

Phone: [phone] Phone: [phone]
University of Florida Counseling Services

Resources are available on-campus for students that feel like they are struggling in their personal or academic life. These resources include:

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  University Counseling Center, 301 Peabody Hall, 392-1575, personal and career counseling
  
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    http://www.counseling.ufl.edu/cwc/Default.aspx
    
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  Student Mental Health, Student Health Care Center, 392-1171, personal counseling
  
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  Sexual Assault Recovery Services (SARS), Student Health Care Center, 392-1161, sexual counseling
  
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  Career Resource Center, Reitz Union, 392-1601, career development assistance and counseling
  
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  University Police Department, 392-1111, or 9-1-1 for emergencies
  

Online Course Evaluations

Students are expected to provide feedback on the quality of instruction in this course based on 10 criteria. These evaluations are conducted online at http://evaluations.ufl.edu. Evaluations are typically open during the last two or three weeks of the semester, but students will be given specific times when they are open. Summary results of these assessments are available to students at http://evaluations.ufl.edu/results.

Course Schedule

Date		Topic	Reading Assignment
8/21		What is Health?	Nancy Scheper-Hughes and Margaret Lock, “The Mindful Body” Hans Rosling, “The Best Stats You’ve Ever Seen” (Video)
8/23		Critical Medical Anthropology	Brown, Barrett, and Padilla, “Medical Anthropology: An Introduction to the Fields” Merrill Singer, “Beyond the Ivory Tower: Critical Praxis in Medical Anthropology”
Health Cultures
8/26		Illness vs. Disease	Arthur Kleinman, “The Meaning of Symptoms and Disorders” Arthur Kleinman, “The Personal and Social Meanings of Illness”
8/28		Illness Experience	Bob and Lee Woodroff Interview on American Public Media’s Word for Word (audio) Robert Desjarlais, “Struggling Along: The Possibilities for Experience among the Homeless Mentally Ill”
8/30		Local Knowledge & Cultural Validity	Cheryl Mattingly, “The Concept of Therapeutic Emplotment”
9/2	No Class: Labor Day
9/4		Sickness and Justice	Rudolph Virchow, “The Charity Physician” Tracy Kidder, Mountains Beyond Mountains Parts I & II
9/6	No Class
9/9		Medicine, Rationality, and Risk	Evans-Pritchard, “The Notion of Witchcraft Explains Unfortunate Events” Jared Diamond, “That Daily Shower Can Be a Killer”
9/11		Medical Epistemologies	Charles Leslie, “Introduction to Asian Medical Systems” Kuriyama, “The Expressiveness of the Body”
9/13	No Class
9/16		Structural Violence	Nancy Sheper-Highes, “Reciprocity and Dependency,” “Delirio de Fome”
9/18		Idioms of Distress, Bodies of Insecurity	Nancy Sheper-Highes, “Nervoso: Medicine, Sickness, and Human Needs,” “Everyday Violence: Bodies, Death, and Silence”
9/20		The Problem of Interpretation	Marilyn Nations and L.A. Rebhun “Angels with Wet Wings Won’t Fly”: Maternal Sentiment in Brazil and the Image of Neglect” Nancy Sheper-Highes, “(M)other Love: Culture, Scarcity, and Maternal Thinking”
The Culture of Biomedicine
9/23		What’s a Disease?	Brigid Schulte, “The Morgellons Mystery”
9/25		Medicalization	Lock and Nguyen, “Anthropologies of Medicine”
9/27	Class Cancelled
9/30		Do Diseases Have Histories?	Aronowitz, “Addicted to Mammograms,” Peggy Orenstein, “Our Feel-Good War on Breast Cancer”
10/2		Biomedicine & Cultural Sensitivity	The Spirit Catches You and You Fall Down Ch. 1-10
10/4
10/7		Medical Training		Evans-Pritchard, “Training of a Novice in the Art of a Witch Doctor”
10/9		Medical Rituals	Byron Good, “How Medicine Constructs Its Object” Victor Turner, “Muchona, The Hornet”
10/11		What’s Normal?	Lock and Nguyen, “The Normal Body”
10/14		Medical Mistakes	Atul Gawande, “Complications” p.11-74. 88-108
10/16		Race and Medicine	Clarence Gravlee, “How Race Becomes Biology: Embodiment of Social Inequality” Hannah Landecker, “Immortality, In Vitro: A History of the HeLa Cell Line”
10/18		Critiques of Biomedicine	The Debate over Autism and Vaccines
10/21		Critiques of Psychiatry	Interview with Dr. Allen Frances on Diane Rehm Show : The Validity of DSM-V
Global Health
10/23		Facticity in Global Health	Paul Farmer, “Immodest Claims of Causality: Social Scientists and the “New” Tuberculosis
10/25		Truth vs. Facts in Global Health	Paul Farmer, TBA
10/28		Local Biologies	Lock and Nguyen, “Local Biologies and Human Difference”
11/1		Population Health	Lock and Nguyen, “The Right Population”
11/4		Global Health & Global Security	Laurie Garrett, “The Return of Infectious Disease,” “The Nightmare of Bioterrorism” (Film: And the Band Played On)
11/6		Global Pharmaceuticals	Andrew Lakoff, “High Contact: Gifts and Surveillance in Argentina”
The Biotechnological Embrace
11/8 & 11/11: Homecoming and Holiday, No Class (Reading TBA)
11/8		Medical Ethics: Research and Practice	Adriana Petryna, “Globalizing Human Subjects Research” Susan Reynolds Whyte, Michael Whyte, Lotte Meinert, Betty Kyaddondo “Treating AIDS: Dilemmas of Unequal Access in Uganda”
11/11		Biomedical Technologies	Lock and Nguyen, “Biomedical Technologies in Practice”
11/13		Genetics	Lock and Nguyen, “Genes as Embodied Risk” Angelina Jolie, “My Medical Choice” NYT
11/15		The Future of the Body	Lock and Nguyen, “Genomics, Epigenomics, and Uncertain Futures”
11/18		Who Owns the Body?	Lock and Nguyen, “Who Owns the Body?” Liptak, “Justices, 9-0, Bar Patenting Human Genes”
11/20		Chemical Engineering	Anne Lovell, “The Case of High-Dose Buprenorphine in France”
11/23	Final Quiz