Intro to Global Health Exam 1 Study Guide
Intro to Global Health Exam 1 Study Guide Anthro 3283
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This 11 page Study Guide was uploaded by Sophomore Notetaker on Saturday October 1, 2016. The Study Guide belongs to Anthro 3283 at Washington University in St. Louis taught by Peter Benson in Fall 2016. Since its upload, it has received 34 views. For similar materials see Intro to Global Health in Anthropology at Washington University in St. Louis.
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Date Created: 10/01/16
Intro to Global Health Exam 1 Study Guide Traditional healing ritual medicine that is effective because of placebo Biomedicine Hard branch of medicine that is globalized, dominant, highly effective and predictive, but narrowly framed (monotheistic one disease) Medicine Soft branch of medicine that implements external social factors and creates cultural syndromes. Healers may not be formally trained. Hard medicine specialties, neurology, oncology Soft medicine pediatrics, primary care, psychiatry (paid less, more women) Media and medicine medicine depicted as where health happens, doesn't portray "soft" roles, (House, Grey's). Doctors are preeminent members of society and knowledge. Thomas McKeown population growth and increased life expectancy not due to medical advancements, but improvements in the overall standard of living and social infrastructure Social medicine integrates hospitals and clinics with social undertakings. Understands that illness in not only biological but psychological The Anatomy Lesson of Dr. Nicolaes Tulp, 1632 (Painting) interior of the body becomes the domain of medicine, almost no exterior scenario; power scenario, doctor in charge (power move @perry) https://farm4.staticflickr.com/3216/3122401239_63a54b57df_m.jpg The Arthritis and Anesthesia Analogy; Social Medicine Anesthesiologist must look at the patient's full medical situation such as arthritis to give full treatment. Doctors cannot have tunnel vision Structural Violence (Paul Farmer) social structureseconomic, political, legal, religious, and cultural that stop individuals, groups, and societies from reaching their full potential Significance of Mpatso (RGH) falls ill with tuberculosis because of lack of infrastructure in society The New World of Global Health Jon Cohen global health: conglomeration of disciplines not just medicine What are some of the environmental and social causes of the current epidemic in West Africa? bushmeat trade, transportation, mining, deforestation (people moving closer to animals) History of sexuality (Book) Written by Foucault. Comes from Freud; sexuality is part of psychology. Biosocial When social aspects/factors are implemented into medicine Biopower When life is governed around health and medicine Michel Foucault's view on homosexuality throughout history Was medicalized in the 20th century (gave meds). Says that it's a label (means more than what you do in bed). Discipline & Punish The Birth of the Prison Michel Foucault; how crime is problematized. Criminals are punished rather than rehabilitated Medicalization/problematization of sexuality Sexuality as a psychiatric disorder What is the impulse to want to change someone? How do sexual behaviors become problems? Biopower vs. sovereign power contemporary power (gov't focus on health) vs. power of the king (lack of care for subjects) Panopticon an allseeing surveillance, gave the idea that they were always watched. People became their own watch guard out of fear. Problematized the act of taking a common part of life and making it into an issue that needs to be solved Leprosy stigma (leper clothing and colony), social death, religious leader role in diagnosis and care, social meaning of sickness. Plague of Justinian 500s killed 50 million in Roman Empire (1/3rd in 4 years) People thought it was caused by sin People thought the Jews did it, so towns were ravaged The impact of agriculture and demography rise of agriculture = rise in population density, humans living in closer proximity to animals and to one another Yersina Pesina Bubonic plague. Acquired from fleas and spread because of travel •bacteria commonly present in populations of fleas carried by ground rodents •infection of lymphatic system •chills, fever, cramps, seizure, bodily pain, gangrene, and "buboes" Epidemic Increase in visibility and occurence Phases of publichealth history 1. General health protection 2. Sanitary movement 3. Bacteriological revolution 4. Global Health Syphilis the "great pox" tremendous bloating in the world map b/c failure to get penicillin to people. Easily solved. Miasma A theory where people get sick from the air Dangerous social responses to plague whole Jewish populations massacred Problemitization of alchoholism in England Alcoholism reduced productivity so it was problemiticized to help the wealth class Why did Global Health develop at the time it did? It started in urban England where modern industry began. Greater Global Health means a better economy Variola major and Variola minor (smallpox) viral infection transmitted person to person, affects whole body and causes organ failure longterm blindness, scarring, stigma Edwin Chadwick Father of government's role in public health. Led sewer commission Public health developments in industrial England 1. Vital statistics: Birthdate, race, status of health, mortality rate 2. Social Science: Studying class, criminals, vice. Smallpox •only major infection disease to be eradicated worldwide (1979) due to coherent WHO efforts •the great victory of global health •persontoperson transmission in clinical stage •short latency period, immediately symptomatic 300500 million died in the 20th century Poor laws Political economy of welfare in England. People should have access to basic sustenance. If they are homeless, they are put to work. Country people came to the city. Problematization: The Queen problemitized poverty. What does it mean to be abled bodied? The Sanitary Idea Edwin Chadwick; rise of public health Unintended consequences of Cholera The miasma theory led people to dump waste into the Thames river, which led to more disease because it is water borne. Registration of Births and Deaths Act (1836) Demonstrates the rise of public health records Sanitary Movement social movement aimed at reforming living conditions in urban society linked to "filth" and "miasma" causing disease Malaria vs miasma Miasma led to dumping human waste Malaria: mosquitoes in lowlands, avoiding zones during hot weather How did miasma prevent deaths in Sardinia Corseco People avoided wetlands to get away from the bad air. But going to the highlands got them away from the wet lowlands with mosquitos and malaria. John Snow Proponent of waterborne cholera. Not well respected. Found the epidemic near his home because as a barefoot epidemiologist, he interacted with families to figure out the source. He saw that you can get infected by living in the same neighborhood but not by interacting with a dying person. Barefoot epidemiology Epidemic assessment not done in a exact scientific way. Done person to person, door to door. deaths congregating around broad street pump Theories of cholera 1. Miasma 2. Waterborne germ theory William Farr Founding figure in medical statistics. Pioneering research on cholera in 1840s and 1850s LondonBelieved miasma but John Snow changed his mind using data James Lind Wrote the treatise of scurvy (black death of the sea). Commissioned by the Royal Navy. Origin of epidemiology/Vitamin C deficiency. Was the policy for the sailors to eat limes. William Budd infectious diseases are contagious, studies of cholera and typhoid Louis Pasteur Employed by french beer/wine industry to study spoilage. Realized bacteria is in the air, but not miasma, leads to study of microbiology, pasteurization Jonathan Lister Hospitalism: Found out that people get sick in the hospital. Developed the antiseptic principle. Used alcohol and bandages to literally redress, (listerine) Koch postulates Organisms caused disease, not stench Significance of germ theory of disease shift away from abstract new focus on vectors & atrisk groups Von Pettenkofer miasmist, drank water Koch put feces in; suicide Colonial Medicine tropical medicine; rooted in fact that world was split up into empires a "civilizing" force ecological imperialism imperial ambitions aided by changing ecology of disease (ex: smallpox to help decimate populations) White Man's Burden American burden to colonize and missionize the Philippines in order to civilize them "White Man's Grave" refers to the tropics, white men susceptible to malaria, tyhpoid, or other infectious diseases Quinine chemical used to prevent and dampen malaria symptoms Neurasthenia a folk illness; has to do with nervous and mental weakness and fatigue (philippinitis), impairment to manhood Causes of Neurasthenia exposure to debilitating environments of the colonies and the tropics; proximity to natives, moist heat, unhygienic customs Racial lens of colonial medicine proximity to particular bodies that were considered dangerous; shows domination by miasma Benevolent assimilation justification for colonization of Philippines; role of public health as a missionizing force Pan American Health Organization (PAHO) strengthen national and local health systems through collaboration with ministries of health, NGOs, and other institutions Panama Canal 20,000 French workers on this project died from malaria and yellow fever Led to study by Carlos Finlay and Walter Reed that discovered and to creation of PAHO Example of US creating a better "public health" situation bc of wetland draining (biopower?!?!?) Tuskegee Syphilis Study (19321972) African American sharecroppers recruited for a study; "most infamous biomedical research study in US history" Missionary Medicine focus on illness, hygiene, and sin; clinical work fused with mission of converting natives to Christianity and modernity Carlos Finlay and Walter Reed research on yellow fever in Cuba; put in a room filled with people with yellow fever vs a room with mosquitoes with yellow fever leads to military medical discovery that malaria transferred by mosquitoes Rationales of Tuskegee Syphilis Study •better than "standard of care"/no existing care •natural laboratory •colonial overtones Aftermath of TSS •28 died of tertiary syphilis •100 died of related complications •74 subjects alive in 1972 •NY Times Expose Variola major =death Variola minor like chicken pox variola vaccinae cow pox. Most minor form. Variolation •"buying the smallpox" •dates back to 1400s China (nasal insufflation) 1720's English English prisoners Edward Jenner (17491823) •English country doctor •field studies with milkmaids and cowpox pustules •development of vaccination using cow tissue •envisioned eradication Eradication reduction of incidence to zero as a result of deliberate efforts Extinction disease pathogen goes extinct Elimination control to the point of very little/no growth Jonas Salk •developed polio vaccine (1953) Critique of vaccination •side effects •weakens natural immune responses •risk for diseases •dangerous chemicals used in vaccines •individual freedom Pertussis (whooping cough) •spike in cases of this illness when parents stopped vaccinating due to the low amount of cases World Health Organization •organization that is crisis oriented •cholera outbreak in Egypt in 1947 first international crisis Malaria Eradication Programme (1955) •top down approach focused on widespread DDT spraying (vector control) •failure of program due to lack of consideration of regional circumstances (agriculture, migration), and health infrastructures Vector control (malaria) •kill mosquitoes (DDT) •option chosen by Malaria Eradication Programme Parasite control •treat people with malaria Social reform •holistically improve hygiene and sanitation Global smallpox eradication WHO •mass publicity campaigns •communitylevel vaccine programs •surveillance and containment efforts •$300 million effort over 13 years The eradication of smallpox A triumph of management, not of medicine. Militaries forced vaccinations. Greatest health success of 19th century cholera Greatest health success of 20th century smallpox Scientific paper as a genre Literary genre that constructs the understanding of the world. Clinicians monitored every aspect of of colonists (blood cell count, complexion, hues, habits) Significance of St. Louis World's Fair Put Filipinos in cages. Example of imperialism. Informed consent Poor people getting money for studies. It is an ethical issue because they are incentivized to risk their life. Malaria Eradication courses of action Vector control Parasite control Social reform Result of widespread DDT spraying to defeat Malaria Topdown vector control didn't work to eradicate Malaria. Biosecurity There are strains of smallpox in the CDC headquarters. It is a security issue because a terrorist can release it. Global health •requires treaties and partnerships Robert N. Proctor Writer of, "Racial Hygiene, Medicine under the Nazis" example of the international reforms after Nazi medicine was exposed International Human Law Many different declarations of what is a basic human health. Different declarations reflected who was a major influence over the creation. Communist or Capitalist based. Geneva Convention •layed out rules of war •protection of noncombatants and civilians •protection of prisoners of war •no torture •limited means of war 18641949 International Committee of Red Cross •formed an organization that would care for the wounded 1859 American Red Cross Clara Barton 1891nursing, care for POWs, parcel service, monitoring of use of chemical weapons, monitoring of civilian populations UN Declaration (1948) health is a human right International covenant on Economic and Social committee 1966 Holistic vision on human rights. Highest attainable standard of physical/mental health. Primary healthcare movement •emphasis on building national healthcare and public health capacity •barefoot doctor World Health Organization •United Nations global health organization, 1948 •roots in PAHO, French Hygiene office, and League of nations •malaria eradication campaign •"hearts and minds" in the war against communism •US and Soviet collaboration in smallpox eradication campaign Yalta Conference formation of postwar Europe and prosecution of war crimes (leads to UN declaration) Almaata Conference on PHC Took place in a small city in Soviet Union Set the idea that global health goals should be ambitious. Critiqued medical elitism. Economies will grow if we give them primary healthcare (vaccinations) U.S. was weary because they believed in market based healthcare Everyone should have healthcare because of social justice Alma Ata set goals that were too grand Selective primary health care (SPHC) Response to AlmaAta failures Focus on basic (GOBI) for costeffectiveness GOBI Growth monitoring Oral rehydration Breastfeeding Immunizations World Bank Cost effective Focus on market system, not communist structure Vision of improving the economies it influenced UNICEFFFF •GOBI + FFF •$10 per child •family planning •female literacy •food supplementation • narrow focus on select health problems •no impact on infrastructure •cost effective, solely to keep people alive Barefoot doctor •Was a big effort in communist China to integrate the countryside into society. The image of barefoot doctor in ricepaddy was the new image of the doctor. Part of Rural Cooperative Medical Systems in China to provide basic healthcare (form of universal health care) Social Theory constructing society through definitions Social Construction of Knowledge and Reality Berger and Luckmann knowledge is not neutral, but a function of how some define Normal vs abnormal in psychiatry which is also linked to the medicalization of health care (pharmaceutical ads) The Woman in the Body Emily Martin •study of medical and scientific texts •language to describe female partsnegative •male "produces" or "penetrates," while eggs are passive receptacles (active and passive) Psychotropics and Gender •women prescribed twice as much as men •cymbalta •latuda PMS was medicalized because if affects women in the workplace Medicalization •making normal phases of life cycle •ex: PMS, childbirth, pregnancy, old age, hormonal changes medicalized DSM Constructs psychological disorders Rubric for psychological disorders Says is grief is 2 weeks (which fits into working society) Unanticipated consequences of social actions Robert Merton These consequences occur because Not enough knowledge Focus on immediate interests Mission creep goals keep on expanding Ex. American highways, bacteria resistance,etc Kevin Carter Distribution of resources Got pulitzer prize in photography for taking pictures of starving kid but didn't help the kid Committed suicide Got caught in a philosophical issue for taking a picture of a dying kid in order to save people bottom half of champagne glass distribution, while he lies in top Moral Models for Global Health The concept that we have constructed certain acceptable models that define our morals Ex. We use tax money in order to keep Benson's grandmother alive even if her old age burdens the system The Great Leap (19591961) famines in China due to massive redistribution of resources Utilitarianism John Stuart Mill and Jeremy Bentham •the greatest good for the greatest number •example of biopower Champagne glass distribution Richest 20% have 82.7% of the world's income John Rawls Veil of Ignorance If society was under a veil of ignorance, we would structure it differently Thomas Pogge Follower of Rawls. International order causes harm to poor Intellectual property rights raises drug prices Climate change doesn't matter in developed Peter Singer Thought that if we spend money on shoes, the money spent could have been used to save dying children. He equates this to not helping a drowning child. To not save the dying child is to actually kill the child. Amartya Sen •Nobel Prize 1988 •famines in colonial India are caused by problems with distribution of grain although there is actually an abundance •advocated for substantive freedom Substantive freedom •first one needs education and healthcare, and on that basis they can move forward (run a business, run a job) Marta Nussbaum •mature life •bodily integrity •bodily health •senses, imagination, thought •concept of the good •affiliation and respect •nature •material and political control over one's environment Liberation theology Poor people should be liberated from poverty •Paul Farmermoral and religiously imperative to help the poor Critiques of human rights declarations They are not easy to apply to people. They are symbolic. PEPFAR (President's Emergency Plan for AIDS Relief) Delivered HIV drugs to Africa Abstinence. They didn't give out condoms Medical Anthropology Explains how different cultures understand/treat illness Ethnography "the writing of difference" participant observation long term fieldwork mostly interviews (qualitative) "native's point of view" Culture Says how we view the world A set of guidelines/norms Misuses of culture Homogeneity Stereotyping Victim blaming ("that's part of their 'culture') Hellman Studied how cultural life, diet, family structure affect coronary heart disease among Japanese in Japan, Hawaii, California Also discussed how aging differs culture to culture Cervical Cancer in Guatemala High sexworker rates put women at risk Culture of Machismo: men don't like to use condoms Women don't like to go to clinics because they are treated like second class citizens (part of culture) Men don't like their wives getting checked out Kuru Shaking/laughing sickness in Papa New Guinea. Transmitted when women/children eat brains of dead relatives (culture influences disease) WHR Rivers •WWI and "shell shock" PTSD •medical anthropology becomes a sympathetic enterprise Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China •Arthur Kleinman says neurasthenia and depression came about socially Medical pluralism Getting treatment from various sources Religious Social groups Popular sector of medical pluralism nonprofessional informal 7090 percent of all healthcare selftreatment (pharmacy), friends, family Religious, help groups (AA) Folk sector of medical pluralism Healing specialist Focus on holism/balance Attention to social/supernatural causes of affliction Shamanism in Siberia Spiritual specialists outside domain of physicians Advantages/disadvantages of folk healing Holistic attention Treatment of illness, not just disease Often misdiagnosing, giving poor treatment potential exploitation Traditional Chinese Medicine yin/yang dualities vital energy (qi) circulates through meridians focus on anatomical structure, circulation of energies Ayurvedic medicine From India Second largest folk medicine Diagnoses focus on 5 senses and pulse Holistic: metabolism, digestion, excretion, exercise, yoga, meditation Alternative/complementary medicine acupuncturists, herbalist, massage, chiropractors Mashimon Saint Simon If you give him a cigarrette, you can pray to the idol It's another ethical issue of a poor person paying for quackery. Is it exploitation to charge entry? Walt Whitman on medical professionals There's an impression left on the medical professional after healing someone Pablo Picasso (Cabeza) Head of a medical student One eye open, one eye closed No Aging in India Lawrence Cohen; Western view of dementia (especially Alzheimer's) as a discrete and serious "brain disease" •Indian view of senility as result of the decline of traditional, supportive, extended family bc of urbanization, modernization, and Westernization What does cancer mean? •a war at all costs; battle, warfare, win/lose Language of pain in North Indian Culture •physical/emotional experience •experience and meaning of pain linked to: culture, cuisine, language, and tradition Illness as Metaphor Susan Sontag; words cancer, plague, or epidemic to refer to social problems, cancer as metaphor and meaning Sickness as defined in the Illness Narratives: Suffering, Healing, and the Human Condition Society's response to a disease, it's the meaning of affliction The Hospital a "small society" •main institutional structure •specialization, case differentiation •clothing, uniforms, social controls; signify rank and status Therapeutic Networks •need greater articulation/communication within therapeutic networks •integrate cultural bridge The Professional Sector •biomedicine as the "ethnomedicine" of Western society •able to govern terrain of what counts as proper medicine Quarentena Global effort to combat Black Plague Ships had to stay in port for 40 days Example of one of the first instances of biopower to protect citizens Shift from internat'l health to global health Health was no longer an issue between multiple governments but one that involved the world and NGO's Neoliberalism Focus on exports by International Monetary Fund (IMF) and World Bank Resulted in markets controlling health care Max Weber Discussed different authority types Traditional (patriarchy, feudalism) Charismatic (personality, religion) Rationallegal (state, courts) Modern life (dominance of bureaucracy and institutions) "iron cage" where we lost sentiment and religion to rationality
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