Newsletter: May 2001
Ann Miles and Fred Bloom Co-Contributing Editors
Is African Indigenous Therapy Equivalent to Biomedical Therapy?
By Edward C. Green (Independent anthropologist)
Carl Kendall's review of my book Indigenous Theories of Contagious Disease (Medical Anthropology Quarterly 14(4):628-30) contains some inaccuracies and mischaracterizations which need to be cleared up. The basic thesis of the book is that indigenous understandings of the contagious disease process in Africa and elsewhere in the developing world tends not to be magico-religious in character, but naturalistic and related to empirical observation. And these naturalistic etiologic notions tend to relate to behaviors that limit rather than spread contagious disease. The hope expressed in the book is that international health programs will recognize this and thereafter be less inclined to dismiss African health beliefs as dysfunctional and dangerous, prior to empirical investigation.
The most egregious mischaracterization on the part of Kendall is:
Among the false syllogisms here is the idea that if indigenous contagion theory is equivalent to germ theory, then indigenous therapy is equivalent to biomedical therapy. I don’t think I buy that, nor do most Africans (p.630)
Well, neither do I. The trouble is, I did not write nor imply what this reviewer attributes to me. I only suggest that indigenous contagion theory (that is, the belief system) shares a number of fundamental similarities with biomedical contagion theory, broadly speaking, although not necessarily with germ theory per se. For example, both are naturalistic and related to empirical observation. But I never say or imply that "indigenous therapy is equivalent to biomedical therapy." This attribution of course makes me look like an extremist, or perhaps a New Age romantic.
The closest thing I can think of that Kendall could have found in my book to make the statement quoted above is my caution that we need far more research on all aspects of indigenous medicine before we have a right to dismiss or reject it (Green 1999:268). True, I give the example of some herbs that have purgative effects (raising the danger of dehydration) yet have been recently shown to be effective pharmacologically against a range of diarrhea-causing pathogens. This of course is not saying that "indigenous therapy is equivalent to biomedical therapy," that we should banish antibiotics, surgeons and hospitals from Africa, and any other such nonsense. In fact, I write that among the aims of African-biomedical collaboration should be "discouraging use of unclean (unsterilized) razors for any type of treatment" by traditional healers, and promoting "referrals to hospitals and clinics when biomedical treatment is proven superior to indigenous therapy" (Green 1999:267).
In another misrepresentation, Kendall starts with the following attribution:
He is arguing that since most causes are not supernatural, they must be natural, and thus (1) they predict appropriate health care behavior (and there is no consequent health problem)… (Kendall 2001:630)
To deal with the first assertion first, I never say that all non-supernatural etiologic beliefs are natural, in fact I take pains to present as balanced a viewpoint as I can, e.g.:
This is not to say that all African health beliefs and practices are naturalistic, rational, or health-promotive. Some are not by objective, scientific standards, and these are discussed in some detail in chapter 8. (Green 1999:14)
Regarding the component of indigenous contagion theory to which I devote most space, namely pollution beliefs, I say outright that they are not fully naturalistic, they are "quasi-naturalistic" (Green 1999:14). I say that pollution beliefs occupy:
...a somewhat ambiguous position in relation to the "natural/non-natural" or natural/supernatural dichotomy, which is central to Bantu thought and to which anthropologists have attributed much importance. Pollution may appear to straddle both sides of the dichotomy (Green:1999:52)
Kendall ignores numerous, important qualifying statements in the book, and represents my argument as one-sided, monolithic, in fact crude and extremist. But distortion becomes outright misrepresentation when he continues with his follow-on assertion (from his comment just quoted) by saying of naturalist health beliefs, "thus (1) they predict appropriate health care behavior (and there is no consequent health problem)…"
Again, I do not say this. What I do say is that indigenous contagion beliefs tend to be--more often than not--naturalistic in character (but of course not always so) and to lead to rational behavior (defined as those behaviors that tend to limit rather than increase contagion), at least more than personalistic or “supernatural” beliefs, which are more likely to lead to other types of health behavior.
If an MAQ reader only reads Kendall’s review and not my book, she or he will of course agree more with balanced views expressed by the reviewer than with the fanatical sounding viewpoint attributed to the book's author. I myself would agree with the reviewer. He is simply setting up a straw man.
Regarding the role of Western biomedicine in Africa, my position is the same as the late King Sobhuza II of Swaziland (a voracious reader of anthropology journals), who argued that Africa needs a system which combines the best of both Western and African medical traditions.
2001 Basker Prize Competition
The Eileen Basker Memorial Prize was established by the Society for Medical Anthropology to promote excellence in research on gender and health. The Basker Prize is made annually to scholars from any discipline or nation, for a specific book, article, film, or exceptional Ph.D. thesis produced within the preceding three years. The Prize is publicly announced during the Society for Medical Anthropology Business Meeting, held during the annual American Anthropological Association Meeting. Winners receive a cash award.
The Basker Prize is awarded to the work judged to be the most courageous, significant, and potentially influential contribution to scholarship in the area of gender and health. The 2000 Prize was awarded to Gelya Frank for her book entitled "Venus on Wheels: Two Decades of Dialogue on Disability, Biography, and Being Female in America". Two 1999 prizes were awarded to Adele Clarke for "Disciplining Reproduction: Modernity, American Life Sciences, and the Problems of Sex," and to Rayna Rapp for "Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America." Other examples of past winners include: Nancy Scheper-Hughes for "Death Without Weeping;" Barbara Duden for "The Woman Beneath the Skin;" Margaret Lock for "Encounters with Aging;" Marcia Inhorn for "The Quest for Conception;" and Paul Farmer, Margaret Connors, Janie Simmons, and others (Partners in Health) for "Women, Poverty and AIDS: Sex, Drugs, and Structural Violence."
The Basker Prize committee very strongly encourages all interested persons to submit a nomination for the 2001 Competition. Individuals are nominated by one or more person(s) who must write a letter of nomination verifying the impact of the particular work on the field. Self-nomination is not permitted, and works submitted without an accompanying letter of nomination cannot be considered. To submit a nomination, contact – by Thursday 28 June 2001 - the chair of the Basker Prize Committee: Catherine Panter-Brick, Department of Anthropology, University of Durham, 43 Old Elvet, Durham DH1 3HN; tel (44) 191 374 2840/41; fax (44) 191 374 7527; email Catherine.Panter-Brick@durham.ac.uk
Rivers and Hughes Student Prizes-Call for Submissions
To recognize and reward scholarly achievement in medical anthropology, the Society for Medical Anthropology has created the WHR Rivers Undergraduate Student Paper Prize and the Charles Hughes Graduate Student Paper Prize. The Rivers Prize will be given for the outstanding paper in medical anthropology written by an undergraduate student; the Hughes Prize will be awarded for the best paper written by a graduate student. Both prizes carry a $250 cash award, and the journal Medical Anthropology Quarterly will have the right of first refusal on winning manuscripts. Prizes are awarded during the Business Meeting of the Society for Medical Anthropology.
Entries for the Rivers and Hughes prizes must be postmarked by June 15,2001. Entries should not exceed 20 double-spaced pages, not including bibliography. Submissions for the Rivers and Hughes Prizes should follow the authors' guidelines for the Medical Anthropology Quarterly or the American Anthropologist. Further details can be found on the SMA website at:http://www.cudenver.edu/public/sma. Submit 5 copies along with a brief biographical sketch and social security number to the SMA Prize Committee Chair: James Trostle, Anthropology Program, Trinity College, 300 Summit St., Hartford, CT 06106-3100 phone 860/297-2564; fax 297-5358 james.trostle@trincoll.edu.
To submit to this column, contact Ann Miles at miles@wmich.edu.