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Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogenesis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to medical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis' immediate and lingering presences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics. [ABSTRACT FROM AUTHOR]

Reducing the maternal mortality rate (MMR) is an important part of Mexico's commitment to the Millennium Development Goals, and the country has made great strides towards achieving this goal. However, researchers have questioned to what extent the focus on improved MMR and other indices of maternal health has contributed to an emphasis on improved statistics rather than quality care, and the effect this has had on the quality of reporting. While public health officials and hospital administrators alike agree that improved obstetric reporting is necessary, there is little discussion regarding the accuracy of the data that are submitted and the institutional pressures that may contribute to the production of inaccurate data. Using ethnographic research collected in Tulum, Quintana Roo, this paper explores how biomedical childbirth functions as a source of legitimization for the state while simultaneously providing the means for the presentation of an ideal subjecthood, one that situates birthing women and healthcare personnel as properly attenuated to the norms and needs of the modern Mexican state. By highlighting the point of disjuncture between women's experiences and the formal ‘reality’ created through hospital texts, this paper explores the place of biomedical birth as a producer of and legitimization for Mexican public health policy. [ABSTRACT FROM PUBLISHER]

This paper focuses on the diversity in patients' experience of biomedicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations. [ABSTRACT FROM AUTHOR]

This paper describes the birth (or rebirth) of Italian medical anthropology around the middle of the 1950s, and its subsequent complex development up to the present. During this fairly long process, the author played a role that was probably of some importance, that of both a direct witness and active participant. Here these developments are briefly reviewed, in an attempt to single out some of the stimuli and the most significant occasions that have happened, their theoretical and methodological reference points, the main lines of research that have been tackled along the way, as well as the ‘social demand’ and the ‘social use’ that have integrated and oriented the practice of the new discipline within the horizon of some of the more general problems of Italian society. In outlining here the profile of and the various events in Italian medical anthropology, this paper takes into account the fact that, although a medical anthropology with that name and the disciplinary set-up that are now internationally attributed to it began in Italy only in the mid-1950s, important lines of research to which we would today attach that name had been undertaken long ago. [ABSTRACT FROM PUBLISHER]

The aim of this paper is to convey the relevance of a Gramscian perspective in medical anthropology, stressing his anti-essentialist way of reasoning about ‘nature’. The author claims that Gramsci's understandings of the bodily life of the state can deconstruct naturalized realities in ways that are helpful for the ethnographer engaged in the political anthropology of embodiment and the management of health, persons, and life itself. The paper is presented in three parts. An attempt is made, first, to frame the relevance of Gramsci for Italian medical anthropology and second, to explore the components of the Gramscian concept of ‘second nature’ within the perspective that he himself calls ‘an anthropology’. Third, an example is given of how the proposed Gramscian insights could inform an ethnography on the biopolitical aspects for the early detection of Alzheimer's disease, which is currently being carried out in Perugia. [ABSTRACT FROM PUBLISHER]

This paper explores the potentials of applying Michel Foucault's notion of 'self-care' to issues in medical anthropology. While Foucault's writings on regimes of power/knowledge have had an enormous influence on medical anthropologists, his late works on the ethics of the self have not yet received much attention. This paper discusses Foucault's notion of self-care in relation to Ayurvedic interpretations of digestion in Kolkata (formerly Calcutta, India). In Kolkata, it is a widely held belief that attentive care of the self, and especially for the stomach, can set a person free from dependencies. Yet at the same time, 'modern' people are seen as unable to live up to the ethics of self-care. The parallel between bodily sovereignty and cultural/political sovereignty produces a discourse on 'lack of self-control' as one of the main reasons for continuing dependency in all spheres of life. [ABSTRACT FROM AUTHOR]

This paper proposes a way of framing the study of ‘noncommunicable diseases’ within the more general area of chronic conditions. Focusing on Africa, it takes as points of departure the situation in Uganda, and the approach to health issues developed by a group of European and African colleagues over the years. It suggests a pragmatic analysis that places people's perceptions and practices within a field of possibilities shaped by policy, health care systems, and life conditions. In this field, the dimensions of chronicity and control are the distinctive analytical issues. They lead on to consideration of patterns of sociality related to chronic conditions and their treatment. [ABSTRACT FROM PUBLISHER]

In exchanges between health professionals and consultants in the West African context, the word malaria is often replaced by its equivalent in the local dialect. In the Nouna health district of Burkina Faso the term malaria is regularly translated as sumaya. Acknowledging that there may be important epistemological differences between malaria, a term issued from the biomedical epistemology, and sumaya, which is borrowed from traditional medicine epistemology, the possible mismatches between these two terms have been assessed to anticipate problems that may result from their translation by different health stakeholders. By consulting various traditional healers and other members of the communities about the local meaning of the term sumaya, it has been possible to compare the conceptualisation of sumaya to the biomedical conceptualisation of malaria and assess the gap between them. An investigation based on a sample of 13 traditional healers and over 450 individuals from Nouna's health district was conducted to document the meaning of the term sumaya. This paper demonstrates that the generally accepted translation of the word malaria as sumaya is a mistake when one looks at the different systems of belief and representations given to each of these two terms. [ABSTRACT FROM AUTHOR]

The Type 2 diabetes epidemic in India poses challenges to the health system. Yet little is known about how urban Indians view treatment and self-care. Such views are important within the pluralistic healthcare landscape of India, bringing together allopathic and non-allopathic (or traditional) paradigms and practices. We used in-depth qualitative interviews to examine how people living with diabetes in India selectively engage with allopathic and non-allopathic Indian care paradigms. We propose a ‘discourse marketplace’ model that demonstrates competing ways in which people frame diabetes care-seeking in India's medical pluralism, which includes allopathic and traditional systems of care. Four major domains emerged from grounded theory analysis: (1) normalization of diabetes in social interactions; (2) stigma; (3) stress; and (4) decision-making with regard to diabetes treatment. We found that participants selectively engaged with aspects of allopathic and non-allopathic Indian illness paradigms to build personalized illness meanings and care plans that served psychological, physical, and social needs. Participants constructed illness narratives that emphasized the social-communal experience of diabetes and, as a result, reported less stigma and stress due to diabetes. These data suggest that the pro-social construction of diabetes in India is both helpful and harmful for patients – it provides psychological comfort, but also lessens the impetus for prevention and self-care. Clarifying the social constructions of diabetes and chronic disease in India and other medically pluralistic contexts is a crucial first step to designing locally situated treatment schemes. [ABSTRACT FROM PUBLISHER]

Departing from what has in medical anthropology been termed the individual body, the social body and body politics, actor-networks in medical pluralism are investigated on the basis of a study of complementary and alternative forms of medicine (CAM) in Denmark, including participant-observation in 12 clinics of reflexology, biopathy and kinesiology, as well as interviews and informal conversations with more than 40 alternative practitioners and 300 patients of CAM clinics. In this study, several actor-networks that connect metaphorical models of the body, clinical technology, social relations and political structures of the Danish society are revealed: a technocrat network, a social-democratic consultancy network and a neo-liberal network. The co-existence of several actor-networks has phenomenological as well as structural implications. The implications for patients using several forms of therapy is important insofar as the patients' move between different actor-networks of healing implies switches between different experiences of body and self. Each of the actor-networks at the same time implies different positions in relation to the public healthcare system, and some actor-networks appear to be more compatible than others with the generalized and technical properties of public healthcare. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare perceptions and practices in relation to human and livestock illness among the Luo in Western Kenya. Qualitative methods of data collection such as key informant interviews, open-ended, in-depth interviews, focus group discussions, narratives, and participant- and direct observations were applied. The study showed that there were significant parallels between human and livestock illnesses regarding terminology, perceptions of pathogenesis and treatment seeking practices. Even practitioners and their medications were often the same. The rationale behind pathogenesis in both cases was usually that illnesses resulted from some form of inhibition of flow through blockage or clogging of the various ‘channels’ in the body. Treatment aimed at decongesting or unblocking these channels so as to create openness that would guarantee normal flows and restore health. The study concludes that the domain of animal illness be taken more into account in human medical anthropological studies and vice versa. It further argues the case for considering these similarities when planning and implementing health care services. [ABSTRACT FROM AUTHOR]

The article provides information on the medical course, which is the Master of Science in Medical Social Anthropology, offered at the University of Keele in Great Britain. The aim of the course is to explore the cultural performance of sickness and healing in a social structural framework with due reference to the provision of health care in diverse cultural and national settings.