Medical Anthropology Quarterly: vol. 15 no. 2 (june 2001)
articles
Going
Like Gangbusters: Transnational Tobacco Companies “Making a
Killing” in South America
Kenyon Rainier Stebbins
This article reports on the recent growth of transnational tobacco companies (TTCs) in South America. Although some scholarly attention has been directed toward such growth in Asia and Eastern Europe, South America has also been targeted by the TTCs' aggressive expansionist practices in recent years. Fighting Big Tobacco is entirely different from combating most public health problems. Unlike cigarettes, most infectious diseases and maternal and child health problems never provide profits to transnational corporations and governments. Also, most public health problems (with alcohol being another notable exception) are not exacerbated by extensive advertising campaigns that promote the cause of the health problems. Supported by data gathered during three months of fieldwork in Ecuador, Peru, Chile, and Argentina in 1997, this article suggests that the TTCs' marketing strategies override cultural differences in the choices people make regarding smoking and health. Combining critical medical anthropology and public health, the article concludes that unless dramatic actions are taken, an avoidable outbreak of tobacco-related diseases will eventually reach epidemic proportions on the South American continent. It is also a "call to arms" for more medical anthropologists to investigate tobacco-related matters around the world. [cigarette transnationals, tobacco control, public health, political economy, South America]
Gendering Local Knowledge: Medicinal Plant Use
and Primary Health Care in the Amazon
Coral Wayland
Local knowledge is becoming increasingly important in primary health care projects. However, these projects often incorporate local knowledge in an uncritical manner. One area where this is apparent is in the lack of attention paid to the gendered nature of local knowledge. I use one example, women’s knowledge and use of medicinal plants in a low-income community in the Brazilian Amazon, to illustrate the links among authority, knowledge, and gender. In this article I argue that policy makers must pay attention to the relationships among authority, gender, and local knowledge and examine how the use of local knowledge in development strategies can affect existing (gendered) power relationships. Women’s roles as managers of household health (which includes medicinal plant use) are a source of authority for them. Because of that, the way in which local knowledge is incorporated into primary health care programs can have a significant impact on women’s authority. [medicinal plants, local knowledge, women, Brazil, primary health care]
How Japanese Women Talk about Hot Flushes: Implications
for Menopause Research
Jan Morgan Zeserson
An unanticipated onomatopoeic expression emerged during ethnographic interviews with Japanese women about menopausal symptoms. At the same time, a newly coined term for hot flush, derived from English, started appearing in Japanese media. These two independent linguistic phenomena led me to speculate on what linguistic expression of physical sensations may reveal about social forces in a given society. This report examines the complexities involved in studying physiological symptoms. The multiple and intertwined variables--including economics, politics, social organization, and language--involved in translating physiological symptoms cross-culturally have been well recognized. But how to study these variables remains a challenge. This article offers a case study of what careful attention to verbal expression may tell us. My argument underscores the social fact that the expressions people choose to use vary according to their reasons for communicating and that their motivations for verbalizing symptoms (hot flush, in this case) depend on the priorities and sanctions of the society in which they live. These factors must be given due consideration when assessing any symptoms of the individual body. [menopause, language, ethnography, hot flush, Japan]
The Children of Yemen: Bodies, Medicalization,
and Nation-Building
Meira Weiss
Yemenite Jews were among the many immigrants from Arab countries who were flown to Israel after its establishment in 1948. Following many complaints regarding the disappearance of Yemenite children from hospitals and schools in the transit camps where the new immigrants were kept in the 1950s, a governmental investigation committee was established in 1995. This article provides a preliminary description, from an anthropological perspective, of what is called in Israel "the Yemenite children affair." My analysis focuses on interviews with Yemenite Jews, describing how the bodies of new immigrants were medicalized and commodified and how immigrants and their families have come to resist these processes. I then focus on the role of the Israeli medical profession in promoting national goals and maintaining collective identity. [Israel, Yemenite children, medicine, nationalism, body, commodification, medicalization]
“You Ate All That!?”: Caretaker-Child
Interaction during Children’s Assisted
Dietary Recall Interviews
Elisa J. Sobo and Cheryl Rock
Young children’s dietary recalls generally are conducted with a guardian present, but how this contributes to data accuracy is unclear. Furthermore, some assumptions underlying the preference for guardian presence may be unfounded. To investigate the range of guardian-child interactions within the diet recall setting, we examined transcriptions of guardian-assisted recalls conducted with 34 children aged 7-11 whose households were enrolled with the San Diego site of the Olestra Post-Marketing Surveillance Study (OPMSS). While guardians did add to the breadth of data collected, children were quite knowledgeable about their diets. Moreover, they sometimes rejected guardian suggestions, and guardians generally could not provide assistance when children requested it. Guardian-child negotiations reflected cultural understandings regarding children, caretaking, and guardian-child power structures as well as food, and sometimes interviewers had to make very subjective data classification decisions. Suggestions for improving dietary recall methods are provided. Findings are relevant for other research methods involving children. [children; food; diet assessment; nutrition; interviewing; research methods]
“They Don’t Have to Suffer for Me”:
Why Dialysis Patients Refuse Offers of Living
Donor Kidneys
Elisa J. Gordon
In the present climate of organ shortage, high demand for kidney transplants, and better clinical outcomes from living donors, health care professionals expect and encourage patients to accept offers of living related donor (LRD) kidneys. When patients decide not to adhere to this course of treatment, scholars and policy makers may question why, given that it delays their chances of receiving a transplant. This article reports on patients’ decisions to refuse LRD kidney offers. An 18-month study was conducted of treatment decisions by hemodialysis patients (n=79). Fewer than half of those offered an LRD kidney (n=64) were willing to accept it, suggesting that sociocultural factors inform decisions. Patients expressed concerns about the potential donors’ well-being over their own and about compromising their relationship with the donor. This article concludes that social relations, emotions, and ethnomedical beliefs play an important role in patients’ treatment decisions and thus contributes to the anthropology of decision making. [decision making, living donors, bioethics, ESRD, transplantation]