Cultural dimension of biomedicine and pharmaceuticals DEEXOTISATION Medical
Cultural dimension of biomedicine and pharmaceuticals
DE-EXOTISATION • Medical anthropology at home (homecoming of anthropology; a logical result of studying the Other) • Studying familiar things abroad (churches, hospitals, schools, etc. ) • Example: African ethnographies.
Why were biomedical institutions, medicines and activities not studied? • Deceptively familiar • Not “cultural” (but science) • Not accessible
Anthropology in medicine • Not studying biomedical culture • But how culture presented obstacles to biomedicine (vaccination, health seeking, self-care, etc)
Example of pharmaceuticals: My ‘discovery’ in Ghana • Modern pharmaceuticals were the most frequently used treatment in Ghana • Example of “contraceptive” Alophen • Familiar medicines proved “exotic” after all • And I become exotic to myself as well.
Anthropology of pharmaceuticals • looking at medicines as social and cultural phenomena • social, cultural, emotional (etc) efficacies team up with medical efficacy
MEDICINES HAVE: • Chemical efficacy • Psychological efficacy • Symbolic efficacy (concreteness, ‘good to think with’) • Social efficacy • Emotional efficacy • NB. All contribute to medical efficacy
‘SOCIAL LIVES OF MEDICINES’ • II. The Consumers • 2. Mothers and children: • 3. Villagers and local remedies: • 4. Women in distress: • 5. Sceptical consumers: • • • III. The Providers 6. Drug vendors and their market: 7. ‘Pharmacists’ as ‘doctors’: 8. Injectionists: 9. Prescribing doctors:
continued • IV. The Strategists • 10. Manufacturers: scientific claims, commercial aims • 11. Health planners: making and contesting drug policy
Mothers giving medicines to their sick children • Medicines: · Have therapeutic efficacy · Confirm that mother cares · Send that message to child · To husband others · Which reinforces therapeutic effect
Women in distress relying on benzodiazepines • Medicines enable them to stay in control of their lives, socially, psychologically…. • But the dependence on the medicines also produces feelings of disempowerment. • Nett effect could be discomfort and distress at a deeper level.
Prescribing doctors · Prescribing is a way of dealing with uncertainty. · Prescribing is a token of concern. · Prescribing asserts doctor’s professional authority. · Prescription becomes itself a medicine. · Prescribing is a symbolic act to terminate a consult in a positive mood.
Manufacturers: scientific claims and commercial aims • Medicines are commodities that should produce profit. • The efficacy is scientifically proved. • Manufacturers believe in the efficacy of their products.
Policymakers: • Medicines are words that should be used convincingly in documents produced for political authorities. • Medicines are items, which, if managed well, legitimise political authority; if not managed well, they diminish credibility of politicians. • Medicines are essential ingredients in health care which are however difficult to control due to their commercial and other values.
Why difficult to control? They are commodities • • • Industry (reps) Prescribers Pharmacists Vendors consumers
Why difficult to control? They are culturally reinterpreted • Hot-cold • Colour • ‘Hiyang’
Essential medicines also escape control of health care providers • Commoditization • Cultural reinterpretation
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