Wednesday, January 22, 2014
Thoughts
I would start with something more recent to test the
waters. For example, in the aftermath of
WWI, I would endeavor to establish the Universal declaration of Human rights,
namely, “Everyone has the right to a standard of living adequate for the health
and well-being of himself and his family, including food, clothing, housing,
and medical care, and necessary social services,” rather than Mussolini’s
“corporatism,” where Big Business, Big Government, and Big Finance combine to
exploit the people with monopolized prices and corrupted dollars. Throughout history there has been some form
of subjection: be it religious, culture, race, or gender. The dominant form of subjection of our time
is this economic subjection, which is played out by our businesses, by our
governments, and by our banks. I would
probably try to encourage a profit cap which would distribute profit to those
that built the company productivity.
Under this system, business creation would not be for a selfish reason,
but rather a social one. As the social
aspects of society are more awarded and expanded into genius from strict
capital gain, so would productivity.
Many of the social diseases that are created by this accumulation
competitiveness would reduce and even be eradicated, ultimately leading to the
improvement and progression of the society, rather than the harnessing of the
poor for greater capital gain. In the
words of Muhammad Yunus, “Poverty can be eradicated in our lifetime. We only need the political will.” Then, if successful, I would explore deeper
into time…
Sunday, August 7, 2011
Over a Half Can of Pepsi
"Hi Grandpa, how was your day?" All 6'4" of the cowboy who had once laid railroad and conquered the west is now saddled in a brown rocking chair. One arthritic hand covered with leathered age spots rubs a head rimmed in only the thinnest silver. Regardless of being a tomboy, I kiss him on the shiny spot and pull up a chair next to him. But, before I can sit, he points to a small blue cup on Grandma's old basin sink.
"Not too bad," he says while clinking his teeth back into place. I detour to the fridge and he smiles. He doesn't bother getting up because it's long since been an easy task, but patiently waits for me to pour him half a can of Pepsi.
I don't know precisely when it became a family institution, but I'm sure it started with the man in the chair. He never drank a full can, only half. And if there wasn't someone to share it with, the can was covered and placed back in the fridge. It made a limp refreshment later on, but nothing was ever wasted at Grandma's and Grandpa's house; and it was best that all understood that early on.
"Is Grandma out in the garden?" I ask.
Grandpa sips his Pepsi like a shot of something strong from an old saloon, although to my knowledge he was never a drinking man. "No, she's over at the Beiling's trying to swap some apples for cherries."
"Is she going to can them or make some jelly?"
He shakes his head no, "With the late frost this year I don't imagine there will be enough for either."
Rubbing my hands together like a mischievous kid, my face splits into a grin, "Then it's either a pie or fresh nibbling."
Grandpa grins back at me, then sips his soda. Suddenly, he gets a faraway look and says, "You never know how good a cherry pie is unless..."
This is what I was waiting for, "Unless, Grandpa?"
Full blue eyes come back to me and he says, "How about a ride?"
I leap up, "I'll go get the truck!" Abandoning my half can of Pepsi, I run out of the room.
Grandpa's truck is white with a red cab interior. The letters on the tailgate have long since faded and become unreadable; but, anyone knows a Ford when they see one. Climbing inside, I'm struck by the smell of dust and hot vinyl. A smell that would for years to come bring immediate nostalgia. I pump the gas and turn the ignition. With a deep grumble, the trusted Ford comes to life and, with all the experience of two full months with a driver's license, I back down the dirt driveway, narrowly avoiding one of Grandma's prize rosebushes.
On the porch Grandpa waits with his cane and burnt Stetson hat. Very slowly he ambles his way around to the driver's side door, while I slide over to make room. As he moves I'm reminded of what they say about old drivers. Perhaps, it is not entirely safe letting Grandpa drive, but no one ever recommends otherwise. "Creak!" the door opens and he hands me his cane while gently sitting down and shutting the door with a firm hand. Holding the wheel like soft leather reins, he maneuvers us back into the semi-circular drive and then forward onto the road.
One can sometimes guess where Grandpa is taking them by whether he turns left or right. The mystery is revealed a bit at that moment. Today he's turning left - we're heading to the reservoir.
The reservoir is located up the mountain on a dangerously curvy road. It was one of the main wonders that turned this little piece of desert into a habitable place. The other was the mountain itself that wrapped cool arms around three sides of the town, protecting it from a quarter of the day's heat. After passing the dam, the trees start to fill in the occasional bush making it an honest oasis. Memories fill my mind of countless fishing trips, learning to swim, touching a deer, ... so many memories over sixteen years of summers.
Now, one might expect Grandpa to share some story about how the Wild West was won as the truck rambled along kicking up dust - along with some sage advice that would give one's life meaning in the end. But that is not how my Grandpa works and it took me awhile to understand that. Grandpa is not a man of much conversation. He came from a world where men of "action" were not supper hyped up men full of adrenaline and speed, like the ones in movies with an eloquent last line; but rather, those who communicated by their actions and their choices in life. For example, I knew Grandpa loved me because he made the effort to spend time with me. And now, with the cowboy being so much slower, each of his individual actions have become much more valuable because each one held the weight of many unsaid words.
Pulling off the road and down a slight embankment, Grandpa parks the Ford under a tree by the water. Enthused, I jump out and make my way bounding over to the fallen log only to stop short. There, wiggling under the back end of the log, is a wild skunk. Having heard my haphazard approach, he gives one more frantic pull and frees himself from his latest hiding place. Immediately, he hisses at me - stumbles a bit sideways - then closer towards me. Although he seemed injured, his movement wasn't impaired enough to stop his impending attack.
Long ago Grandpa went over what I was to do when encountering a wild animal. It was unbelievably hard calming my racing heart in order to stand perfectly still while preparing for flight at the same time. However, the problem at the moment was that I couldn't breath deeply enough to calm my adrenaline infused heart. I couldn't get enough air into my lungs to call for help either. So, I stand there watching the little black eyes focus on me with accusation for all his pain. I know instantly that he was going to attack me with those incredible teeth and claws - and that I couldn't do anything about it.
Some people say that a lot of thoughts run through one's mind in an impending crisis or that their mind goes blank. As for me, I just looked for Grandpa.
Looking over my shoulder, I see him just in time as he pulls up his rifle one last inch and fires. Smoke comes off the gun, and with Grandpa's hat lowered over his eyes, I can see for a moment back into time at the man that he once was.
Only the smallest sound comes from the skunk. The shot is clean and the animal is no longer in pain. As for me, I'm a speechless statue. Grandpa sits me down and takes care of the skunk. When he comes back we don't say much as we watch fish touch the top of the water sending circles repeating across the reservoir. Holding my young, clear, new hand in his old, well-used one, I think on what it means to be old, young, and a ripple off of Grandpa. I ponder what my own actions communicate to others about me; and I think on how long it will take for me to drive as well as Grandpa.
After twilight, we drive up to the porch. Very slowly Grandpa climbs out and makes his way into the house with a shuffling step. Much slower than him, I park the truck under his work shed's carport. I don't even make it to the back screen door before the smell of fresh baked cherry pie reaches out to me. My stomach responds with a fresh growl of hunger, while I pick up the pace and cut towards the kitchen.
"You left your drink on the table, Heather." I come to a halt by the doorway.
"Yes, Grandma. I'm sorry." Hoping this wasn't a prelude to missing out on the pie, I jump in with, "I'll wash the dishes."
My tiny five-foot tall Grandma gives me the Eye of scrutiny and consideration only to break it off when Grandpa points to his empty blue cup. She smiles at him and relents. "It's in the fridge. Don't do it again. Now, how about some whipped-cream on your pie?"
"Yes, please." At the fridge I down my limp soda with a smack and pull out a fresh can. Taking Grandpa's blue cup and Grandma's pink cup off the basin, I split the can between them.
The pie melts the whip-cream, making white drizzles down the sides. Mmmmmmmm. Grandpa's right. You never know how good a piece of cherry pie is - almost as good as a half can of Pepsi.
"Not too bad," he says while clinking his teeth back into place. I detour to the fridge and he smiles. He doesn't bother getting up because it's long since been an easy task, but patiently waits for me to pour him half a can of Pepsi.
I don't know precisely when it became a family institution, but I'm sure it started with the man in the chair. He never drank a full can, only half. And if there wasn't someone to share it with, the can was covered and placed back in the fridge. It made a limp refreshment later on, but nothing was ever wasted at Grandma's and Grandpa's house; and it was best that all understood that early on.
"Is Grandma out in the garden?" I ask.
Grandpa sips his Pepsi like a shot of something strong from an old saloon, although to my knowledge he was never a drinking man. "No, she's over at the Beiling's trying to swap some apples for cherries."
"Is she going to can them or make some jelly?"
He shakes his head no, "With the late frost this year I don't imagine there will be enough for either."
Rubbing my hands together like a mischievous kid, my face splits into a grin, "Then it's either a pie or fresh nibbling."
Grandpa grins back at me, then sips his soda. Suddenly, he gets a faraway look and says, "You never know how good a cherry pie is unless..."
This is what I was waiting for, "Unless, Grandpa?"
Full blue eyes come back to me and he says, "How about a ride?"
I leap up, "I'll go get the truck!" Abandoning my half can of Pepsi, I run out of the room.
Grandpa's truck is white with a red cab interior. The letters on the tailgate have long since faded and become unreadable; but, anyone knows a Ford when they see one. Climbing inside, I'm struck by the smell of dust and hot vinyl. A smell that would for years to come bring immediate nostalgia. I pump the gas and turn the ignition. With a deep grumble, the trusted Ford comes to life and, with all the experience of two full months with a driver's license, I back down the dirt driveway, narrowly avoiding one of Grandma's prize rosebushes.
On the porch Grandpa waits with his cane and burnt Stetson hat. Very slowly he ambles his way around to the driver's side door, while I slide over to make room. As he moves I'm reminded of what they say about old drivers. Perhaps, it is not entirely safe letting Grandpa drive, but no one ever recommends otherwise. "Creak!" the door opens and he hands me his cane while gently sitting down and shutting the door with a firm hand. Holding the wheel like soft leather reins, he maneuvers us back into the semi-circular drive and then forward onto the road.
One can sometimes guess where Grandpa is taking them by whether he turns left or right. The mystery is revealed a bit at that moment. Today he's turning left - we're heading to the reservoir.
The reservoir is located up the mountain on a dangerously curvy road. It was one of the main wonders that turned this little piece of desert into a habitable place. The other was the mountain itself that wrapped cool arms around three sides of the town, protecting it from a quarter of the day's heat. After passing the dam, the trees start to fill in the occasional bush making it an honest oasis. Memories fill my mind of countless fishing trips, learning to swim, touching a deer, ... so many memories over sixteen years of summers.
Now, one might expect Grandpa to share some story about how the Wild West was won as the truck rambled along kicking up dust - along with some sage advice that would give one's life meaning in the end. But that is not how my Grandpa works and it took me awhile to understand that. Grandpa is not a man of much conversation. He came from a world where men of "action" were not supper hyped up men full of adrenaline and speed, like the ones in movies with an eloquent last line; but rather, those who communicated by their actions and their choices in life. For example, I knew Grandpa loved me because he made the effort to spend time with me. And now, with the cowboy being so much slower, each of his individual actions have become much more valuable because each one held the weight of many unsaid words.
Pulling off the road and down a slight embankment, Grandpa parks the Ford under a tree by the water. Enthused, I jump out and make my way bounding over to the fallen log only to stop short. There, wiggling under the back end of the log, is a wild skunk. Having heard my haphazard approach, he gives one more frantic pull and frees himself from his latest hiding place. Immediately, he hisses at me - stumbles a bit sideways - then closer towards me. Although he seemed injured, his movement wasn't impaired enough to stop his impending attack.
Long ago Grandpa went over what I was to do when encountering a wild animal. It was unbelievably hard calming my racing heart in order to stand perfectly still while preparing for flight at the same time. However, the problem at the moment was that I couldn't breath deeply enough to calm my adrenaline infused heart. I couldn't get enough air into my lungs to call for help either. So, I stand there watching the little black eyes focus on me with accusation for all his pain. I know instantly that he was going to attack me with those incredible teeth and claws - and that I couldn't do anything about it.
Some people say that a lot of thoughts run through one's mind in an impending crisis or that their mind goes blank. As for me, I just looked for Grandpa.
Looking over my shoulder, I see him just in time as he pulls up his rifle one last inch and fires. Smoke comes off the gun, and with Grandpa's hat lowered over his eyes, I can see for a moment back into time at the man that he once was.
Only the smallest sound comes from the skunk. The shot is clean and the animal is no longer in pain. As for me, I'm a speechless statue. Grandpa sits me down and takes care of the skunk. When he comes back we don't say much as we watch fish touch the top of the water sending circles repeating across the reservoir. Holding my young, clear, new hand in his old, well-used one, I think on what it means to be old, young, and a ripple off of Grandpa. I ponder what my own actions communicate to others about me; and I think on how long it will take for me to drive as well as Grandpa.
After twilight, we drive up to the porch. Very slowly Grandpa climbs out and makes his way into the house with a shuffling step. Much slower than him, I park the truck under his work shed's carport. I don't even make it to the back screen door before the smell of fresh baked cherry pie reaches out to me. My stomach responds with a fresh growl of hunger, while I pick up the pace and cut towards the kitchen.
"You left your drink on the table, Heather." I come to a halt by the doorway.
"Yes, Grandma. I'm sorry." Hoping this wasn't a prelude to missing out on the pie, I jump in with, "I'll wash the dishes."
My tiny five-foot tall Grandma gives me the Eye of scrutiny and consideration only to break it off when Grandpa points to his empty blue cup. She smiles at him and relents. "It's in the fridge. Don't do it again. Now, how about some whipped-cream on your pie?"
"Yes, please." At the fridge I down my limp soda with a smack and pull out a fresh can. Taking Grandpa's blue cup and Grandma's pink cup off the basin, I split the can between them.
The pie melts the whip-cream, making white drizzles down the sides. Mmmmmmmm. Grandpa's right. You never know how good a piece of cherry pie is - almost as good as a half can of Pepsi.
Grandma Was Right
(About sex and other things)
“Don’t have sex before marriage,” was Grandma’s advice over the birds and the bees. In a society that no longer relied on horses to commute, that among the many “outdated” items or pieces of advice were considered expired. However, the study of physiology has made me reflect back on what was considered wise for thousands of years before. I’m not going to go to focus on why modern societies do what they do; but rather on why Grandma was right.
In nature, flora and fauna alike have chemical reactions associated with the preservation of their species. You could even say that the reproduction and/or survival are the reason for ALL physiological responses to their environment. Hormones released during sex are more than just a “feel good”. They model “love” and “infatuation” in the brain and are linked to the visual and physical person associated with the release of those sex hormones. In species where the offspring are helpless for long periods of time, both the male and female are chemically induced so that they will be connected to each other for the task of raising/preserving the offspring. The human child is helpless much longer than most species and requires a greater demand on its parents. As such, the hormones released during sex are to connect/commit both parents to the potential long term development of the young.
This may seem general but on a personal level I noticed this. During a stressful time of my life I started having a sexual relationship with someone I wasn’t interested on the premise that it was “healthy” and would help relieve some of the pressure I was feeling. However, immediately afterwards I started having more “affectionate” thoughts and feelings for the man - which lead to more sex - which lead to my believing that I was in love with him. Remember, this was someone that beforehand I considered not suitable for me on many levels and I had no feelings for him whatsoever. Basically, I had drugged myself through sex hormones into believing I was in love; and because of that, I was willing to ignore the multiple problems in our relationship. Unfortunately, I’m not alone on this either. After conducting a poll which questioned if others had the experience of feeling “love” and “infatuation” after sex, 100% of the individuals said, “yes.” Now I believe there are exceptions to this and other contributing factors, but it is safe to say that physiology and sex hormones are a contributor to the “love” feeling.
This hormone drugged feeling is not exclusive to couples either. Imagine that someone is having sex with themselves while watching pornography or looking at pictures. They are still having the chemical response to connect them for the preservation of potential offspring, yet there is no other person or offspring. Basically, they are drugging themselves into “loving” pornography. An obvious problem to this physiological response is that the other person is not actually there; therefore, there is no complimentary response to the relationship. Often this has lead to frustration and/or dissatisfaction. However, the individual is now chemically drugged and will not want to stop, so an alternative is needed. One alternative is an increase in their visual stimulation through another strong chemical reaction in the body that is associated with preservation; namely, pain. It is no small wonder that pornography has branched into what is painful, harmful, or unnatural; and those who masturbate to that imagery are chemically drugging themselves into “loving” those things as well. This generates a sadistic attitude towards partners and/or people in general.
Part of what makes us who we are is our genetics – another part of what makes us who we are is our actions. It is possible that someone could have no genetical disposition to sadism and yet become one. With violence and cruelty on the rise, any contributing factors can be too much. During a “gang” member interview in a nice suburban neighborhood, I was told about the pressure a teen gets to join one affiliation or another. However, in order to join most gangs, a boy had to either kill or rape someone. He concluded that most of them chose rape. It goes without saying how damaging this drugged “love” will be for them and their environments.
At this point I reflect on why there are so many single parents in the world today when the body has such a strong physiological response to sex. The answer is simply another hormone driven reaction associated with preservation. The self preservation chemicals are more intense, have a faster response, and are more utilized. Statistically nearly half of the low income and homeless people in the United States are single parents. The financial demand on individuals and families has increased dramatically in the past fifty years. It once was possible for one employed individual to support a family. As the national production demand on their human resource increased, so did the number of jobs within the general household. In response to capitalistic inflation, a household provider may need to get a second job or the spouse may start working and sometimes the children too. For example, in Seattle it takes four minimum wage earners to cover the rent on a two bedroom apartment. Home of the Java capital, individuals have turned to stimulants in order to do more. Recently, 5-hour, which is a liquid stimulant for focus, had a commercial on TV in the which a woman states how she needed her 5-hour shot every day in order to get through her second job. The body responds in various manners to increased stress, one of which is a “flight” mechanism for self preservation. It is no wonder really that under such financial and physical stresses that one of the adults would take “flight” from the domestic home in search of something better for themselves; even if it’s not better for those left behind.
With such powerful physiological responses to sex and preservation, how can we stop the unintentional destructive force that society has created and suffers under? Maybe we could listen to Grandma and wait to have sex. If indeed having 10 billion nerve cells in our brains has given us superior intellect as a species, then perhaps we should use that in decisions on who we are with and when; build relationships versus sex drugged "love". Also, some of the other "old" traditions could be dusted off and looked at again for their merit, for example, balance in the home and workplace. However, since capitalism only escalates productivity, it would take a unified stand against productivity's consumption of human and natural resources in order to find a new balance between demand and labor. Activism is the key on three levels. Individually, how we live matters. Community, how we care for each other matters. Nationally, how we govern matters. If all else fails, listen to Grandma - she was right.
Friday, May 27, 2011
Longitudinal Analysis of Deciduous Tooth Emergence (V): Effects of Nutrition in Bangladeshi Children
byHeather Rose & Dr. Darryl Holman
Aim
* To better understand the variability of tooth emergence.
* Analyze the effects of nutrition, sanitation, and income covariates for children whose anthroprometrics were measured at two months of age.
* Analyze the effects of famine on tooth emergence on children born shortly before, during, and after the famine.
* Submit/Publish findings in the American Journal of Physical Anthropology.
The Bangladesh Famine: 1974-1975
* Natural disaster
* War
* Administrative and economic mismanagement
* Inflation
* Inequalities in socioeconomic relations
* Exhausted international bailout aid
* Shortages in the global food supply
* Government downplayed the severity of the crisis
* Culminated into one of the worst famines in history
* Estimated 1 to 1.5 million died
Data Collector
The International Center for Diarrhoeal Research, Bangladesh (ICDDR, B)
* Mission, "Knowledge for global life saving solutions."
* Training including: biostatistics, family planning, demographic survelance, and child survival strategies.
* Research priorities: child health, infectious diseases, vacine sciences, reproductive health, nutrition, population, HIV/AIDS, and safe water.
* http://www.icddrb.org/
Sample - Meheran, Bangladesh
* Dental records were analyzed for 397 children.
* Children were examined monthly for one year and quarterly thereafter.
* Many children were recruited at birth.
* All children were less than one year of age at recruitment.
Method of Analysis
* Analysis was by proportional hazards regression models with a lognormal distribution of tooth emergence for ten teeth.
* Observations are interval-censored or right-censored.
* Two seperate analyses were undertaken:
* Analysis 1: Effects of covariates on tooth eruption in 252 children.
* Analysis 2: Timing of tooth eruption for 397 children born before (Prefamine) during
(Perifamine) and after the famine (Control).
Results
Strong evidence that deciduous tooth emergence is affected by child's health and nutritional environment.
* Overall, famine, sanitation, income, and anthropometric measures at age two months, affected tooth emergence in a way consistent with the idea that poor health and nutrition delays the emergence of deciduous teeth.
* Tooth emergence may be affected by sanitation infrastructure through differences in the cumulative burden of disease (especially diarrheal disease) that a child might experience as teeth develop and migrate through the bone before emergence.
* Income may be acting through energy availability, so that children in poor households experience delays in emergence of their dentition.
* For six of the ten deciduous teeth, larger values of one or more anthropometric measures resulted in younger ages at emergence. The anthropometric measures serve as a proxy for a child’s health, so that these results contradict the idea that tooth emergence is not affected by health.
* Children born just before the famine showed delayed emergence, whereas children born during the famine showed no consistent effects. A plausible interpretation is that fetuses were relatively buffered in utero from the nutritional stresses experienced by their mother during the famine.
Special Thanks
Dr. Darryl Holman, ICDDR,B, and UW Anthropology Honor's Panel
Aim
* To better understand the variability of tooth emergence.
* Analyze the effects of nutrition, sanitation, and income covariates for children whose anthroprometrics were measured at two months of age.
* Analyze the effects of famine on tooth emergence on children born shortly before, during, and after the famine.
* Submit/Publish findings in the American Journal of Physical Anthropology.
Sample - Locati
on
onThe Bangladesh Famine: 1974-1975
* Natural disaster
* War
* Administrative and economic mismanagement
* Inflation
* Inequalities in socioeconomic relations
* Exhausted international bailout aid
* Shortages in the global food supply
* Government downplayed the severity of the crisis
* Culminated into one of the worst famines in history
* Estimated 1 to 1.5 million died
Data Collector
The International Center for Diarrhoeal Research, Bangladesh (ICDDR, B)
* Mission, "Knowledge for global life saving solutions."
* Training including: biostatistics, family planning, demographic survelance, and child survival strategies.
* Research priorities: child health, infectious diseases, vacine sciences, reproductive health, nutrition, population, HIV/AIDS, and safe water.
* http://www.icddrb.org/
Sample - Meheran, Bangladesh
* Dental records were analyzed for 397 children.
* Children were examined monthly for one year and quarterly thereafter.
* Many children were recruited at birth.
* All children were less than one year of age at recruitment.
Method of Analysis* Analysis was by proportional hazards regression models with a lognormal distribution of tooth emergence for ten teeth.
* Observations are interval-censored or right-censored.
* Two seperate analyses were undertaken:
* Analysis 1: Effects of covariates on tooth eruption in 252 children.
* Analysis 2: Timing of tooth eruption for 397 children born before (Prefamine) during
(Perifamine) and after the famine (Control).
Results
Strong evidence that deciduous tooth emergence is affected by child's health and nutritional environment.
* Overall, famine, sanitation, income, and anthropometric measures at age two months, affected tooth emergence in a way consistent with the idea that poor health and nutrition delays the emergence of deciduous teeth.
* Tooth emergence may be affected by sanitation infrastructure through differences in the cumulative burden of disease (especially diarrheal disease) that a child might experience as teeth develop and migrate through the bone before emergence.
* Income may be acting through energy availability, so that children in poor households experience delays in emergence of their dentition.
* For six of the ten deciduous teeth, larger values of one or more anthropometric measures resulted in younger ages at emergence. The anthropometric measures serve as a proxy for a child’s health, so that these results contradict the idea that tooth emergence is not affected by health.
* Children born just before the famine showed delayed emergence, whereas children born during the famine showed no consistent effects. A plausible interpretation is that fetuses were relatively buffered in utero from the nutritional stresses experienced by their mother during the famine.
Special Thanks
Dr. Darryl Holman, ICDDR,B, and UW Anthropology Honor's Panel
Wednesday, December 30, 2009
The Beasts of the World
mornings thoughts....
Can we be more than animals?
The more I look into human populations and societal ills - the more I see inequality generating anger, illness, helplessness, sorrow, frustration, prisoners or slaves, and death. I see how accumulation sickness has struck on every landmass of the world. That regardless of the development of altruism and technology, humanity is still being savaged by those in power. That even rebellion and revolutions for equality ultimately end with new players in those positions ready to become the next beasts of the world.
With all that evolution and God has given humanity, why cannot we see our way to equality and peace? With the brilliance of our advanced minds, why cannot we be enlightened on how to share and preserve?
There are two possible outcomes for homo sapiens. They may destroy our world and all within ... or ... they may become the guardians of life.
... it is possible for us to be more than beasts.
Can we be more than animals?
The more I look into human populations and societal ills - the more I see inequality generating anger, illness, helplessness, sorrow, frustration, prisoners or slaves, and death. I see how accumulation sickness has struck on every landmass of the world. That regardless of the development of altruism and technology, humanity is still being savaged by those in power. That even rebellion and revolutions for equality ultimately end with new players in those positions ready to become the next beasts of the world.
With all that evolution and God has given humanity, why cannot we see our way to equality and peace? With the brilliance of our advanced minds, why cannot we be enlightened on how to share and preserve?
There are two possible outcomes for homo sapiens. They may destroy our world and all within ... or ... they may become the guardians of life.
... it is possible for us to be more than beasts.
Tuesday, November 24, 2009
Medicine: More Than Just a Body
Long ago my mother, Utahna, was dying from a brain tumor. There was no way for us, her children, to prevent her death irreplaceably damaging all of our young lives. Her body and its ability to fight such an anomaly was failing; and we were powerless to stop it. Fortunately, there are those that endeavor to enter the war against such entities, illnesses, and diseases in order to save the lives of those entangled within. They practice more than just the art of medicine, but also the craft of power. “Led by medicine, the ‘human sciences,’ through their production of knowledge, developed increasingly refined ‘technologies of power’” (Davenport, pg 312). It goes without saying that in order to control the internal physiological environment doctors have to have power over it. However, such interplay is not without its social consequences. In this paper I’m going to look at some of the ways power works in and through medicine. Namely: the objectification of the body; how impoverished displaced sugar cane cutters in Alto de Cruzeiro suffer “nervosa” as a consequence to the political, social, and medical play of power; and finally, how Angel Bay medical students try to bridge the objectification and social politics in order to truly help their patients.
When my mother woke up paralyzed one morning, the emergency personnel were quick to itemize her condition into blood pressure, temperature, heart rate, what limbs she couldn’t move, where there was pain, and so on. She no longer was Utahna, a poet and mother six, but rather a puzzle that they needed to break down into smaller and smaller pieces in order to find out why her body wasn’t working. In a sense, my mother stopped being a person and became an object. This “objectifying” is when doctors, “transform them into problematic body parts rather than view them as whole human beings in fully contextualized psychological and social environments” (Davenport, pg 311). As the body is broken down into systems then subsystems, the microscopic way the doctor’s view their patients has been coined as the “medical gaze” by Michel Foucalt. The technical discourse that follows only supports the distancing of the patient from the “condition”. One might wonder why there’s a critique against this objective perspective when it seems inevitable or even professional. However, the critique is not about what it takes into account, but rather what it lacks. If the cause or the solution lies outside the physical body, will even the greatest microscope or “medical gaze” be able to find it? An example of this is sorely seen in the impoverished cane cutters of Alto de Cruzeiro.
After a quarter of a century of repressive military rule, the political climate in Alto de Cruzeiro is uneasy. Here the, “dominant exercised their power both directly through the state and indirectly through a merging with civil society… that hegemony operates as a hybrid of coercion and consensus” (Hughes, pg 171). In “Nervoso: Medicine, Sickness, and Human Needs,” Nancy Scheper Hughes indicates that it’s, “into this potentially explosive situation, doctors, nurses, pharmacists, and the first few timid psychologist to appear on the landscape are recruited in an effort to domesticate and pacify an angry-hungry population” (Hughes, pg 211). In Alto de Cruzeiro the power to address the physical ailments of its starving people lies not only on the doctor, but also on the political and social climate. With so many engaged, it raises some questions as to why their physical needs are not being met. Beyond that is why the doctors are treating their patients for “nervoso" and not hunger. “How have these people come to see themselves primarily as nervous and only secondarily as hungry?” (Hughes, pg 177) Two examples of these mortally tired cane cutters are Severino Francisco and Seu Tomas’.
Starting as an eight year old child, Severino cut the cane until he became sick. He like many others had to work the cane on empty stomachs (Hughes, pg 176). They would eat when they could and, when they couldn’t; they would try to sleep till the next day (Hughes, pg 182). Severino continued until the “illness” that spread through his legs and body got too bad for him to work in the fields. After searching for a “cure” he took up the barber profession to provide for his family. “I barely make enough to feed my wife and children. The cacula [last born] cries for milk all the time, but I have to deny her because out of the little besteira that I earn I have to put something aside every week for my medicines.” In addition, it falls to the doctors to sign his disability papers and, therefore, it is in his best interest to turn to them to for help. However, “they just kept sending me home with remedios for my heart, for my blood, for my liver, for my nerves. Believe me, so vivo de remedios [I live on medications]” (Hughes, pg 181). Seu Tomas’ was also prescribed many medications for his “illness” although, in Seu Tomas’ case, he stopped taking certain ones because they “began to offend” his empty stomach (Hughes, pg 183). When asked why they are treating his nerves and not his hunger, he laughed and said, “Who ever heard … of a treatment for hunger? Food is the only cure for that.” He goes on to say that, “It’s easier to get help with remedior. You can show up at the prefeitura with a prescription… but you can’t go to the mayor and beg for food!”(Hughes, pg 184) In both of these examples they were treated at the doctor’s for “nervoso” which is a folk term that manifests like hunger in their physical bodies as headaches, tremors, weakness, tiredness, irritability, angry weeping, among others. How are the doctors of Alto de Cruzeiro going to fight their war on illness if they cannot see their patients in their “fully contextualized psychological and social environments?” And, since they don’t, the consequences to objectifying their patients has become a population that is slowly dying of hunger, yet sees themselves as “ill” or nervous. Nancy Hughes sums up their unfortunate conclusion.
“There are power and domination to be had from defining a population as ‘sick’ or ‘nervous’ and in need of the ‘doctoring’ hands of a political administration that swathes itself in medical symbols. To acknowledge hunger, which is not a disease but a social illness, would be tantamount to political suicide for leaders whose power has come from the same plantation economy that has produced the hunger in the first place. And because the poor have come to invest drugs with such magical efficacy, it is all too easy for their faith to be subverted and used against them. If hunger cannot be satisfied, it can at least be tranquilized, so that medicine, even more than religion, comes to actualize the Marxist platitude on the drugging of the masses” (Hughes, pg 202-203).
As the cane workers are, “paralyzed within a stagnant semifeudal plantation economy that treats them as superfluous and dependent,” they are left with two choices (Hughes, pg 182). They can recognize their political, social, and physical suffering and protest; which may offer them lethal consequences. Or, they can turn to medicine to “cure” their physical crisis. In the hospital, or clinic, the doctors have two choices as well. The first is to take the pain on under the, “technical domain of medicine, where they will be transformed into a ‘disease’ to be treated with an injection, a nerve pill, a soporific” (Hughes, pg 214). While the second is to, “provide a space where new ways of addressing and responding to human misery,” is worked out (Hughes, pg 215). By practicing more than just the art of medicine and the craft of power, one way a doctor can balance the act of “gazing” is by “witnessing”. This is seen throughout the city of Angel Bay where local university medical students learn and practice in homeless clinics.
The ideology of “witnessing” is directly in opposition to how medicine constructs its patients as “objects” (Davenport, pg 316). What Beverly Ann Davenport calls “witnessing” is where the doctor consciously works to “see” the whole patient, “not simply the medical aspects of the patient’s complaint, but also his or her social and psychological environment” (Davenport, pg 318). As Beverly reports on their “quality, not quantity” motto through five micro-practices, the conflict between “gazing” and “witnessing” becomes more apparent. It starts with a gentle, thorough probing of the patient’s history. For example, when a first year student asks how long he should let the patient “ramble on” before he jumped “to the important medical stuff,” the second year student points out that allowing the patient to “ramble on” was a powerful interview technique. She asserts basically that, “what is ‘medically important’ would be revealed in the ‘witnessing’ process” (Davenport, pg 318-9). Otherwise, treatment might end up like it did for the drug user that moved to Angel Bay City from the East Coast. In that case, “the ultimate irony … is that a heroin-user is advised to quit smoking in order to take birth control pills to relieve the symptom of irregular periods, which is caused by her heroin addiction in the first place” (Davenport, pg 320).
Another aspect of “witnessing” is thinking of the patients as subjects; where the doctor sees both the disease and the person who is suffering from it. One doctor tackles this by not referring to his patient in third person singular, but rather by name. It’s not, “a 46-year-old white man who comes in with a history of …” but rather, “So I met Bill. And Bill was disheveled…” (Davenport, pg 321-2) When charting or meeting with other doctors they tend to depersonalize their patients and the discourse becomes more of “gazing” and less about the human around it. For my mother, her extreme poverty and physical beatings from her father when she was young never came into her discourse. Every time she would seek help with her headaches the doctors wrote her off a prescription or indicated that her pain was imagined and did nothing. For decades, no tests were run because they never looked beyond her body for a cause and, therefore, they never felt expensive tests were warranted. Like for my 40 year old mother, “gazing” rather than “witnessing” costs and destroys lives.
Objectification of the body may simplify medical learning, but it complicates patient care. As seen in the cane cutters of Alto de Cruzeiro, the medical removal of humanity from the people makes them political and social power tools. Unless new ways of responding to human misery are generated, and the objectification of the patient is challenged, then the loss and destruction of lives will continue. The students of Angel Bay have begun this process with the “witnessing” of their patients. Fortunately, there are those that endeavor to enter the war against illnesses, and diseases in order to save the lives of those entangled within. “Seeing” their patient may be their next great step.
Bibliography
Davenport, Beverly Ann. 2000. "ARTICLES - Witnessing and the Medical Gaze: How Medical Students Learn to See at a Clinic for the Homeless". Medical Anthropology Quarterly. 14 (3): 310.
Scheper-Hughes, Nancy. 1992. Death without weeping: the violence of everyday life in Brazil. Berkeley: University of California Press.
When my mother woke up paralyzed one morning, the emergency personnel were quick to itemize her condition into blood pressure, temperature, heart rate, what limbs she couldn’t move, where there was pain, and so on. She no longer was Utahna, a poet and mother six, but rather a puzzle that they needed to break down into smaller and smaller pieces in order to find out why her body wasn’t working. In a sense, my mother stopped being a person and became an object. This “objectifying” is when doctors, “transform them into problematic body parts rather than view them as whole human beings in fully contextualized psychological and social environments” (Davenport, pg 311). As the body is broken down into systems then subsystems, the microscopic way the doctor’s view their patients has been coined as the “medical gaze” by Michel Foucalt. The technical discourse that follows only supports the distancing of the patient from the “condition”. One might wonder why there’s a critique against this objective perspective when it seems inevitable or even professional. However, the critique is not about what it takes into account, but rather what it lacks. If the cause or the solution lies outside the physical body, will even the greatest microscope or “medical gaze” be able to find it? An example of this is sorely seen in the impoverished cane cutters of Alto de Cruzeiro.
After a quarter of a century of repressive military rule, the political climate in Alto de Cruzeiro is uneasy. Here the, “dominant exercised their power both directly through the state and indirectly through a merging with civil society… that hegemony operates as a hybrid of coercion and consensus” (Hughes, pg 171). In “Nervoso: Medicine, Sickness, and Human Needs,” Nancy Scheper Hughes indicates that it’s, “into this potentially explosive situation, doctors, nurses, pharmacists, and the first few timid psychologist to appear on the landscape are recruited in an effort to domesticate and pacify an angry-hungry population” (Hughes, pg 211). In Alto de Cruzeiro the power to address the physical ailments of its starving people lies not only on the doctor, but also on the political and social climate. With so many engaged, it raises some questions as to why their physical needs are not being met. Beyond that is why the doctors are treating their patients for “nervoso" and not hunger. “How have these people come to see themselves primarily as nervous and only secondarily as hungry?” (Hughes, pg 177) Two examples of these mortally tired cane cutters are Severino Francisco and Seu Tomas’.
Starting as an eight year old child, Severino cut the cane until he became sick. He like many others had to work the cane on empty stomachs (Hughes, pg 176). They would eat when they could and, when they couldn’t; they would try to sleep till the next day (Hughes, pg 182). Severino continued until the “illness” that spread through his legs and body got too bad for him to work in the fields. After searching for a “cure” he took up the barber profession to provide for his family. “I barely make enough to feed my wife and children. The cacula [last born] cries for milk all the time, but I have to deny her because out of the little besteira that I earn I have to put something aside every week for my medicines.” In addition, it falls to the doctors to sign his disability papers and, therefore, it is in his best interest to turn to them to for help. However, “they just kept sending me home with remedios for my heart, for my blood, for my liver, for my nerves. Believe me, so vivo de remedios [I live on medications]” (Hughes, pg 181). Seu Tomas’ was also prescribed many medications for his “illness” although, in Seu Tomas’ case, he stopped taking certain ones because they “began to offend” his empty stomach (Hughes, pg 183). When asked why they are treating his nerves and not his hunger, he laughed and said, “Who ever heard … of a treatment for hunger? Food is the only cure for that.” He goes on to say that, “It’s easier to get help with remedior. You can show up at the prefeitura with a prescription… but you can’t go to the mayor and beg for food!”(Hughes, pg 184) In both of these examples they were treated at the doctor’s for “nervoso” which is a folk term that manifests like hunger in their physical bodies as headaches, tremors, weakness, tiredness, irritability, angry weeping, among others. How are the doctors of Alto de Cruzeiro going to fight their war on illness if they cannot see their patients in their “fully contextualized psychological and social environments?” And, since they don’t, the consequences to objectifying their patients has become a population that is slowly dying of hunger, yet sees themselves as “ill” or nervous. Nancy Hughes sums up their unfortunate conclusion.
“There are power and domination to be had from defining a population as ‘sick’ or ‘nervous’ and in need of the ‘doctoring’ hands of a political administration that swathes itself in medical symbols. To acknowledge hunger, which is not a disease but a social illness, would be tantamount to political suicide for leaders whose power has come from the same plantation economy that has produced the hunger in the first place. And because the poor have come to invest drugs with such magical efficacy, it is all too easy for their faith to be subverted and used against them. If hunger cannot be satisfied, it can at least be tranquilized, so that medicine, even more than religion, comes to actualize the Marxist platitude on the drugging of the masses” (Hughes, pg 202-203).
As the cane workers are, “paralyzed within a stagnant semifeudal plantation economy that treats them as superfluous and dependent,” they are left with two choices (Hughes, pg 182). They can recognize their political, social, and physical suffering and protest; which may offer them lethal consequences. Or, they can turn to medicine to “cure” their physical crisis. In the hospital, or clinic, the doctors have two choices as well. The first is to take the pain on under the, “technical domain of medicine, where they will be transformed into a ‘disease’ to be treated with an injection, a nerve pill, a soporific” (Hughes, pg 214). While the second is to, “provide a space where new ways of addressing and responding to human misery,” is worked out (Hughes, pg 215). By practicing more than just the art of medicine and the craft of power, one way a doctor can balance the act of “gazing” is by “witnessing”. This is seen throughout the city of Angel Bay where local university medical students learn and practice in homeless clinics.
The ideology of “witnessing” is directly in opposition to how medicine constructs its patients as “objects” (Davenport, pg 316). What Beverly Ann Davenport calls “witnessing” is where the doctor consciously works to “see” the whole patient, “not simply the medical aspects of the patient’s complaint, but also his or her social and psychological environment” (Davenport, pg 318). As Beverly reports on their “quality, not quantity” motto through five micro-practices, the conflict between “gazing” and “witnessing” becomes more apparent. It starts with a gentle, thorough probing of the patient’s history. For example, when a first year student asks how long he should let the patient “ramble on” before he jumped “to the important medical stuff,” the second year student points out that allowing the patient to “ramble on” was a powerful interview technique. She asserts basically that, “what is ‘medically important’ would be revealed in the ‘witnessing’ process” (Davenport, pg 318-9). Otherwise, treatment might end up like it did for the drug user that moved to Angel Bay City from the East Coast. In that case, “the ultimate irony … is that a heroin-user is advised to quit smoking in order to take birth control pills to relieve the symptom of irregular periods, which is caused by her heroin addiction in the first place” (Davenport, pg 320).
Another aspect of “witnessing” is thinking of the patients as subjects; where the doctor sees both the disease and the person who is suffering from it. One doctor tackles this by not referring to his patient in third person singular, but rather by name. It’s not, “a 46-year-old white man who comes in with a history of …” but rather, “So I met Bill. And Bill was disheveled…” (Davenport, pg 321-2) When charting or meeting with other doctors they tend to depersonalize their patients and the discourse becomes more of “gazing” and less about the human around it. For my mother, her extreme poverty and physical beatings from her father when she was young never came into her discourse. Every time she would seek help with her headaches the doctors wrote her off a prescription or indicated that her pain was imagined and did nothing. For decades, no tests were run because they never looked beyond her body for a cause and, therefore, they never felt expensive tests were warranted. Like for my 40 year old mother, “gazing” rather than “witnessing” costs and destroys lives.
Objectification of the body may simplify medical learning, but it complicates patient care. As seen in the cane cutters of Alto de Cruzeiro, the medical removal of humanity from the people makes them political and social power tools. Unless new ways of responding to human misery are generated, and the objectification of the patient is challenged, then the loss and destruction of lives will continue. The students of Angel Bay have begun this process with the “witnessing” of their patients. Fortunately, there are those that endeavor to enter the war against illnesses, and diseases in order to save the lives of those entangled within. “Seeing” their patient may be their next great step.
Bibliography
Davenport, Beverly Ann. 2000. "ARTICLES - Witnessing and the Medical Gaze: How Medical Students Learn to See at a Clinic for the Homeless". Medical Anthropology Quarterly. 14 (3): 310.
Scheper-Hughes, Nancy. 1992. Death without weeping: the violence of everyday life in Brazil. Berkeley: University of California Press.
Sunday, November 8, 2009
An Aid of Meaning
Assumptions about the ailing are as common as doctors hypothesize on what’s wrong with their patients. In the work’s of John Aggergaard Larsen “Finding Meaning in First Episode Psychosis,” and Rachel R. Chapman “Endangering safe motherhood in Mozambique,” these assumptions are challenged by a broader understanding of the how and the why. Namely, by the context of the patient, and the meaning that they take in their experiences, will model how they are treated or diagnosed; the effectiveness of the treatment; and what other avenues they will take to understand their illness in order to get better.
As people go throughout their daily lives they attach meaning, symbols, and images to not only their communication, but also in their understanding of life and the world around them. In a very real aspect they are living a metaphor. These life metaphors find their voice in the narratives that often are passed over or missed entirely. When missed they present themselves in puzzles like, “why women are not going to a free maternity clinic until the end of their pregnancy, regardless of the high infant and child mortality rate?” (Chapman, 355) Or seen in the initiation of an early intervention program, OPUS, to study and understand why the mentally ill suffer as they do. (Larsen, 451) There are those that would be tempted to claim, like in the Gondola data, “high-risk women in developing countries as unmotivated and/or non-compliant victims.” (Chapman, 371) This in essence blames the women for the death of their children. Or that the mentally ill are just crazy and their ailment causes their suffering. (Larson, 451) But to accept these arguments would be to completely abandon conceptual clarity.
Conceptual clarity, or a system of explanation, emerges from many aspects. These are found in the biomedical aspect of an illness, the spiritual or religious, the financial, the cultural, and the individual narratives. In “Finding Meaning in First Episode Psychosis,” John Larson calls it Bricolage when, “they tried to connect and supplement various systems of explanation in innovative theory-building work.” (Larson, 461) That even the delusions themselves are a patients attempts, “to master a frightening and bewildering subjective state by imposing meaning or forcing an explanation upon experiences which would otherwise be meaningless or inexplicable.” (Larson, 460) In essence they are taking pieces of what makes sense and building an understanding of what they are experiencing. And for many, “they found resonance in a wider cultural repertoire, that is, the myths, traditions, and institutional bases of authority in the wider society.” (Larson, 462) It is through all the pieces or layers of understanding that the OPUS intervention program could find success.
Another parallel reference to a patients layering of treatments to find the cure is in Rachel Chapman’s “Endangering Safe Motherhood in Mozambique.” In Chapman’s chart on page 363 we see the veritable bricolage in the form of treatments the women pursue. Namely: Pharmaceutical, herbal, district health center, church, curandeiro, prophet, prayer, mission clinic, traveling “nurse”, and maternity clinic. For example, in Raquel’s story the layering of her treatment was related to finance, culture, religion, and biomedicine. After paying for first diagnosis, she was given a prescription that she could not afford. The pharmacy gave her half her treatment for the money which did not help her at all. The next month a curandeiro accepted the same amount of money for three months of an infusion of roots. This helped but did not cure the patient but gave her an understanding that it cleaned inside her for the baby. Then finally a traveling “nurse” charged three times the amount for the pills and infusion to inject Raquel and her husband over the next three weeks. She believes that the injections attacked the site where her illness was fixed. Although this overcame her symptoms, Raquel also went to her prophet who gave her a blessing and sacred water to drink and bathe in. This was to cleanse her body and to not have anymore bad luck. According to Raquel it was the multiple layers that was her cure under the umbrella of her belief that the three treatments were symbolic of the “Father, Son, and Holy Spirit.” (Chapman, 364)
With more of an Ethnographic research style that took into account attention to the Bricolage or fluidity of treatment, both authors’ uncovered important aspects in how to help and understand their patients better. This starts with understanding that the patients are very active in finding meaning in their ailment in order to help them. For example, Chapman noted that, “under conditions of frequent reproductive morbidity and loss, little access to cash, immense domestic and agricultural work burdens, and limited routes to female social and economic self-determination” the women still, “demonstrate significant initiative in mobilizing the resources they deem necessary to influence their own reproductive labor and decrease the odds of poor pregnancy outcomes.” (Chapman, 371) While Larsen argued that; “individuals take an active role when applying understandings and meanings to their situations and experiences,” that, “plural healing systems can exist within an overarching cultural tradition,” and that, “culture as a ‘tool kit’ of symbols, stories rituals, and world-views” will be used “in varying configurations to solve different kinds of problems.” (Larsen, 457) Due to these discoveries solutions could be addressed.
For the women in Mozambique, social conflict and economic tension are reproductive threats. Those, due to migration of women from large patrilocal and polygynous households into smaller nuclear residence, many women suffer under an economic vulnerability due to lack of wage paying jobs for women. (Chapman, 369) The women without cash capital cannot compete and must be directly or indirectly dependent on male cash resources. As these women compete for resources many keep their pregnancies secret as a protective measure. That once it is known they are preyed upon by mal espirito kin and midwives seeking assistant gifts. Basically, safe motherhood in Mozambique, “lies beyond the scope of medical or even public health solutions alone.” (Chapman, 372) However, some changes can be made. Merging the maternity clinic with the District Health Center will provide patient privacy and may draw more women in for early maternity care. Also, better service that lowers the wait time will draw the women who can’t be away from home or the farm long.
For those that are mentally ill, teaching them a psychoeducation, “provided highly influential concepts and theories.” Through this education many “found explanations by drawing on systems of explanation available from the cultural repertoire of the wider society.” (Larsen, 465) As meaning comes, many are relieved of their tormented feelings and to an extent their helplessness. Indeed, it is a goal as different explanations are, “rejected, accepted, appropriated, and reevaluated in a continuous process.” (Larsen, 465) By providing an institution or mental health community to provide education and various contexts, the patient can become part of the solution.
In both of these articles the Anthropologist’s looked for the narrative of those that were ailing. This required that they put aside assumptions or conclusions that they and others jumped to early on. By doing this a broader understanding of the how and why emerged in a format that could assist not only in effective treatment, but also in ways for the ailing to find meaning in their experiences. As noted above, understanding does not fix all problems. But it did offer incite into small changes that can make a difference. Perhaps, with more seeking meaning within a culture the larger socioeconomic changes can be made. In fact, I would submit that it is the only way those changes ever came to be.
Bibliography
Larsen JA. 2004. "Finding meaning in first episode psychosis: experience, agency, and the cultural repertoire". Medical Anthropology Quarterly. 18 (4): 447-71.
Chapman RR. 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk". Social Science & Medicine (1982). 57 (2): 355-74.
As people go throughout their daily lives they attach meaning, symbols, and images to not only their communication, but also in their understanding of life and the world around them. In a very real aspect they are living a metaphor. These life metaphors find their voice in the narratives that often are passed over or missed entirely. When missed they present themselves in puzzles like, “why women are not going to a free maternity clinic until the end of their pregnancy, regardless of the high infant and child mortality rate?” (Chapman, 355) Or seen in the initiation of an early intervention program, OPUS, to study and understand why the mentally ill suffer as they do. (Larsen, 451) There are those that would be tempted to claim, like in the Gondola data, “high-risk women in developing countries as unmotivated and/or non-compliant victims.” (Chapman, 371) This in essence blames the women for the death of their children. Or that the mentally ill are just crazy and their ailment causes their suffering. (Larson, 451) But to accept these arguments would be to completely abandon conceptual clarity.
Conceptual clarity, or a system of explanation, emerges from many aspects. These are found in the biomedical aspect of an illness, the spiritual or religious, the financial, the cultural, and the individual narratives. In “Finding Meaning in First Episode Psychosis,” John Larson calls it Bricolage when, “they tried to connect and supplement various systems of explanation in innovative theory-building work.” (Larson, 461) That even the delusions themselves are a patients attempts, “to master a frightening and bewildering subjective state by imposing meaning or forcing an explanation upon experiences which would otherwise be meaningless or inexplicable.” (Larson, 460) In essence they are taking pieces of what makes sense and building an understanding of what they are experiencing. And for many, “they found resonance in a wider cultural repertoire, that is, the myths, traditions, and institutional bases of authority in the wider society.” (Larson, 462) It is through all the pieces or layers of understanding that the OPUS intervention program could find success.
Another parallel reference to a patients layering of treatments to find the cure is in Rachel Chapman’s “Endangering Safe Motherhood in Mozambique.” In Chapman’s chart on page 363 we see the veritable bricolage in the form of treatments the women pursue. Namely: Pharmaceutical, herbal, district health center, church, curandeiro, prophet, prayer, mission clinic, traveling “nurse”, and maternity clinic. For example, in Raquel’s story the layering of her treatment was related to finance, culture, religion, and biomedicine. After paying for first diagnosis, she was given a prescription that she could not afford. The pharmacy gave her half her treatment for the money which did not help her at all. The next month a curandeiro accepted the same amount of money for three months of an infusion of roots. This helped but did not cure the patient but gave her an understanding that it cleaned inside her for the baby. Then finally a traveling “nurse” charged three times the amount for the pills and infusion to inject Raquel and her husband over the next three weeks. She believes that the injections attacked the site where her illness was fixed. Although this overcame her symptoms, Raquel also went to her prophet who gave her a blessing and sacred water to drink and bathe in. This was to cleanse her body and to not have anymore bad luck. According to Raquel it was the multiple layers that was her cure under the umbrella of her belief that the three treatments were symbolic of the “Father, Son, and Holy Spirit.” (Chapman, 364)
With more of an Ethnographic research style that took into account attention to the Bricolage or fluidity of treatment, both authors’ uncovered important aspects in how to help and understand their patients better. This starts with understanding that the patients are very active in finding meaning in their ailment in order to help them. For example, Chapman noted that, “under conditions of frequent reproductive morbidity and loss, little access to cash, immense domestic and agricultural work burdens, and limited routes to female social and economic self-determination” the women still, “demonstrate significant initiative in mobilizing the resources they deem necessary to influence their own reproductive labor and decrease the odds of poor pregnancy outcomes.” (Chapman, 371) While Larsen argued that; “individuals take an active role when applying understandings and meanings to their situations and experiences,” that, “plural healing systems can exist within an overarching cultural tradition,” and that, “culture as a ‘tool kit’ of symbols, stories rituals, and world-views” will be used “in varying configurations to solve different kinds of problems.” (Larsen, 457) Due to these discoveries solutions could be addressed.
For the women in Mozambique, social conflict and economic tension are reproductive threats. Those, due to migration of women from large patrilocal and polygynous households into smaller nuclear residence, many women suffer under an economic vulnerability due to lack of wage paying jobs for women. (Chapman, 369) The women without cash capital cannot compete and must be directly or indirectly dependent on male cash resources. As these women compete for resources many keep their pregnancies secret as a protective measure. That once it is known they are preyed upon by mal espirito kin and midwives seeking assistant gifts. Basically, safe motherhood in Mozambique, “lies beyond the scope of medical or even public health solutions alone.” (Chapman, 372) However, some changes can be made. Merging the maternity clinic with the District Health Center will provide patient privacy and may draw more women in for early maternity care. Also, better service that lowers the wait time will draw the women who can’t be away from home or the farm long.
For those that are mentally ill, teaching them a psychoeducation, “provided highly influential concepts and theories.” Through this education many “found explanations by drawing on systems of explanation available from the cultural repertoire of the wider society.” (Larsen, 465) As meaning comes, many are relieved of their tormented feelings and to an extent their helplessness. Indeed, it is a goal as different explanations are, “rejected, accepted, appropriated, and reevaluated in a continuous process.” (Larsen, 465) By providing an institution or mental health community to provide education and various contexts, the patient can become part of the solution.
In both of these articles the Anthropologist’s looked for the narrative of those that were ailing. This required that they put aside assumptions or conclusions that they and others jumped to early on. By doing this a broader understanding of the how and why emerged in a format that could assist not only in effective treatment, but also in ways for the ailing to find meaning in their experiences. As noted above, understanding does not fix all problems. But it did offer incite into small changes that can make a difference. Perhaps, with more seeking meaning within a culture the larger socioeconomic changes can be made. In fact, I would submit that it is the only way those changes ever came to be.
Bibliography
Larsen JA. 2004. "Finding meaning in first episode psychosis: experience, agency, and the cultural repertoire". Medical Anthropology Quarterly. 18 (4): 447-71.
Chapman RR. 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk". Social Science & Medicine (1982). 57 (2): 355-74.
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