Medical Anthropology Quarterly: Vol. 17, No. 2 (june 2003)
articles
Female Genital Cutting: A Harmless Practice?
Gerry Mackie
A recent article in Medical Anthropology Quarterly (Obermeyer 1999) argues that the “facts” about the “harmful effects” of female genital cutting (FGC) are “not sufficiently supported by the evidence” (p. 79). The article suggests three further hypotheses, among others: (1) FGC may be of minimal harm because the more educated continue the practice just as much as the less educated; (2) FGC may be of minimal harm because it is so widespread and persistent; (3) FGC may be of minimal harm because the supposed link between the clitoris and female sexual pleasure is a social construction rather than a physiological reality. I challenge these hypotheses. I say that by appropriate standards of evaluation, FGC is harmful. Finally, I submit that most FHC is a proper matter of concern because it is the irreversible reduction of a human capacity in the absence of a meaningful consent. [female genital cutting, harm evaluation, critical epidemiology, harmful traditional practices]
The Story Catches You and You Fall Down: Tragedy, Ethnography, and 'Cultural Competence'
Janelle Taylor
Anne Fadiman’s The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Noonday Press, 1997) is widely used in “cultural competence” efforts within U.S. medical school curricula. This article addresses the relationship between theory, narrative form, and teaching through a close critical reading of that book that is informed by theories of tragedy and ethnographies of medicine. I argue that The Spirit Catches You is so influential as ethnography because it is so moving as a story; it is so moving as a story because it works so well as tragedy; and it works so well as tragedy precisely because of the static, reified, essentialist understanding of “culture” from which it proceeds. If professional anthropologists wish our own best work to speak to “apparitions of culture” within medicine and other “cultures of no culture,” I suggest that we must find compelling new narrative forms in which to convey more complex understandings of “culture.” [medical education, cultural competence, tragedy, ethnography, theories of culture]
Trading Nutrition for Education: Nutritional Status and the Sale of Snack Foods in an Eastern Kentucky School
Deborah L. Crooks
Overweight and poor nutrition of children in the United States are becoming issues of increasing concern for public health. Dietary patterns of U.S. children indicate that they are consuming too few fruits and vegetables and too many foods high in fat and sugar. Contributing to this pattern of food consumption is snacking, which is reported to be on the increase among adults and children alike. One place where snacking is under increased scrutiny and where it is being increasingly criticized, is in U.S. schools, where snack foods are often sold to supplement inadequate budgets. This article takes a biocultural approach to understanding the nutritional status of elementary school children in a rural community in eastern Kentucky. It pays particular attention to the ways in which the school’s nutrition environment shapes overweight and nutritional status for many of the children, focusing on the sale of snack foods and the reasons behind the principal’s decision to sell snack foods in the school. [nutritional anthropology, overweight, snack foods, Appalachia]
Death, Taxes, Public Opinion, and the Midas Touch of Mary Tyler Moore: Accounting for Promises by Politicians to Help Avert and Control Diabetes
Melanie Rock
Anthropologists have begun to publish ethnographic accounts of policy-making, but few have studied medical or health matters, despite broad acceptance in anthropology that “biopower” permeates contemporary societies. This article presents some findings from an ethnographic study of how diabetes gained recognition as a pressing public health problem in Canada. It underlines the importance of statistics for constituting power within and across nation states. Statistics imbricate people and things distributed across vast distances, but they still need to be generated and invoked by individuals to engender effects – as illustrated in this article by the contributions of researchers, aboriginal leaders, and an American actress, Mary Tyler Moore – in this case, the development of Canadian government policies justified in the name of averting and controlling diabetes. To make sense of these findings, subtle differences between two concepts coined by Michel Foucault, “biopower” and “governmentality” seem significant. [diabetes mellitus, public policy, population health, aboriginal health, Canada]
The Work of Andrew Weil and Depak Chopra -- Two Holistic Health/New Age Gurus: A Critique of the Holistic Health/New Age Movements
Hans A. Baer
Despite the popular roots of the holistic health/ New Age movements, a growing number of biomedical physicians have become proponents of holistic health as well as New Age healing. Over the past two decades, Andrew Weil and Deepak Chopra, two biomedically trained physicians, have merged as the visible and financially successful spokespersons of the movement. This article provides brief biographical sketches of Weil and Chopra and compare and contrasts their respective views on health, illness, healing, and health care. It also considers the response of various biomedical parties of these holistic health/New Age gurus who have attempted to integrate biomedicine and various alternative healing and metaphysical systems. Finally, this article argues that Weil and Chopra both epitomize the limitations of the holistic health/New Age movements, albeit in different ways. [holistic health/New Age movements, Andrew Weil, Deepak Chopra]
Risk and Danger among Women-Who-Prostitute in Areas where Farmworkers Predominate
Keith V. Bletzer
Based on ethnographic research in three agricultural settings in Florida, this article examines one aspect of risk and danger for female sex workers, that of interpersonal violence, while considering women’s responses to a shifting sex trade in areas where farmworkers live and work. Sex work in agricultural areas varies from urban sex work. Women eschew pimps, ask for back-up from local men entrenched in street settings, and canvass a wide spatial area rather than remained fixed in space. Oscillating between periods of capital-deficiency (non-season) and capital-intensification (harvest), women respond to increasing risk and danger by building a clientele of regular customers, refusing risky transactions and referrals, and creating a local infrastructure of sanctuary. Some women also construct schemes to relieve men of their money. These men typically are farmworkers, whose vulnerability and image of low risk for HIV expands the potential for risk and danger found in these settings. [commercial sex work, migrant and seasonal farmworkers, violence against women, southeastern United States (Florida)]
book reviews
The Social Fabric of Health: An Introduction to Medical Anthropology (John M. Janzen)
Reviewed by Beth A. Conklin
Migration, Mujercitas and Medicine Men: Living in Urban Mexico (Valentina Napolitano)
Reviewed by Ronalde Loewe
A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in Nineteenth-Century America (Michael Sappo)
Reviewed by Lynn Morgan
Cultural Perspectives on Reproductive Health. (Carla Makhlouf Obermeyer, ed.)
Reviewed by Paul Valentine