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In response to the global call to upscale mental health services in low--income countries, mental health non-governmental organisations (MHNGOs) have sprung up in Kerala to address mental health needs by partnering with pre-existing locally grown, bottom-up, community-led pain and palliative clinics (PPCs) to increase access to mental health care through task-shifting. The MHNGOs mandate filtering only patients with 'severe mental disorders' from low socioeconomic backgrounds for their free services. This eligibility criterion mandated by the MHNGO is ruffling feathers within the palliative clinics that oppose such -classifications. They believe that suffering cuts across all divisions and should not be discriminated against based on economic background and severity of illnesses. When chronicity and suffering are held universal by the MHNGO and palliative care, respectively, it brings to the fore the enactment of two perspectives of care. Drawing on observations of clinical interactions between patients, MHNGO staff and mental health professionals and interviews with community volunteers of palliative care clinics in Kerala, this paper demonstrates how chronicity narrative promoted by MHNGOs based on biopsychiatric model gains hegemony, whereas the community care model loses traction progressively. The state, caught between these two narratives, frontstages development by submitting its health machinery to the MHNGOs flouting basic medical safety laws in its services to marginalised people like the tribal population. This paper argues that the rising dominance of chronicity narrative in community mental health clinics as well as in popular media discourses evolves out of power relations between the MHNGOs and the palliative clinics. [ABSTRACT FROM AUTHOR]

Existing literature demonstrates agro-chemicals result in physical toxicity and damages human health, flora and fauna. However, little is known about how such ‘toxicity’ relates to mental well-being and social suffering. This paper aims to demonstrate how local, national and international vectors are interlinked to shape social distress among cotton farmers in India. Ethnographic interviews and focus group discussions were conducted in a cotton-growing village of the Warangal district, Telangana state, India. The results advance the concept of counter therapeutic spaces and hypothesise that toxic landscapes emerge through a dynamic interaction between dispersed agencies that interact and reconfigure agricultural spaces into socially toxic places. The paper argues that the disciplines of public health and agriculture suffer from a failure of imagination to forge vital interdisciplinary links that could address farmer suffering. Unpacking local ecologies of farmer suffering offer innovative ways for enhancing mental health policy and interventions in India. [ABSTRACT FROM AUTHOR]

This paper examines the grid of sentiment that structures medical travel to India. In contrast to studies that render emotion as ancillary, the paper argues that affect is fundamental to medical travel's ability to ease the linked somatic, emotional, financial, and political injuries of being ill 'back home'. The ethnographic approach follows the scenes of medical travel within the Indian corporate hospital room, based on observations and interviews among foreign patients, caregivers, and hospital staff in Mumbai, New Delhi, Chennai, and Bangalore. Foreign patients conveyed diverse sentiments about their journey to India ranging from betrayal to gratitude, and their expressions of risk, healthcare costs, and cultural difference help sustain India's popularity as a medical travel destination. However, although the affective dimensions of medical travel promise a remedy for foreign patients, they also reveal the fault lines of market medicine in India. [ABSTRACT FROM AUTHOR]

In this study the author analyzes the relationship between the individual body and the body politic in a region of the north Indian state of Uttarakhand, in connection with social changes occurring at the local and trans-local level, which are impacting the status of the different healing systems. By investigating these issues, this paper aims to shed light on some of the complex ways in which practitioners and patients who take part in a local method of healing, in this case ritual healing through possession, respond to the expansion of biomedicine. [ABSTRACT FROM AUTHOR]

Drawing on data collected during a 16-month ethnographic investigation, this paper explores practices around Indians’ and Pakistanis’ use of herbal medications for diabetes control. The ethnographic study was conducted among Indian and Pakistani migrants in Edinburgh, Scotland and included extended participant observation, six group discussions and 21 semi-structured interviews. Respondents showed great resistance in adhering to medication prescriptions for diabetes control due to their various side effects, especially within the stomach. In order to avoid such side effects, respondents decreased medication dosage and turned to non-allopathic remedies that usually consisted of herbal medications that, according to Indians and Pakistanis, did not cause side effects as medications did and tackled the cause of the disease rather than its symptoms. Such remedies however, were not only combined with allopathic ones but also eventually replaced without the doctor's consultation. [ABSTRACT FROM PUBLISHER]

The co-existence of different types of medical systems (medical pluralism) is a typical feature of India's healthcare system. For conditions such as influenza-like illness (ILI), where non-specific disease signs/symptoms exist, clinical reasoning in the context of medical pluralism becomes crucial. Recognising this need, we undertook a qualitative study, which explored factors underpinning clinical decisions on diagnosis and management of ILI. The study involved semi-structured interviews including clinical vignettes with 20 healthcare practitioners (working within allopathy, homeopathy and Ayurveda) working in the private healthcare sector in Solapur city, India. An inquiry was conducted into criteria influencing the diagnosis, treatment, referral to specialist care and role of treatment guidelines for ILI. Thematic analysis was used to identify aspects relating to ILI diagnosis, treatment and referral. The diagnosis of influenza was based largely on clinical symptoms suggestive of influenza in the absence of other diagnoses. Referral for laboratory tests was only initiated if illness did not resolve, generally after 2–3 consultations. Antibiotics were often prescribed for persistent illness, with antivirals rarely considered. Some differences between practitioners from different medical systems were observed in relation to treatment and referral in case of persistent illness. A combination of analytical and intuitive clinical reasoning was used by the participants and clinical decisions were based on both social and clinical factors. Clinical decision-making was rarely a linear process and respondents felt that broad guidelines on influenza that allowed doctors to account for the sociocultural context within which they practised medicine would be helpful. [ABSTRACT FROM AUTHOR]

This paper examines the supernatural beliefs of najar (evil eye) and bhut (ghost) and their roles in illness causation in Gujarati families in Britain today. The data arose unexpectedly in an ethnography of child rearing patterns carried out in Harrow, North West London and a short period of observation in Ahmedabad, India. I used anthropological methods of participant observation and unstructured interviews, which were transcribed using pseudonyms. The study group involved 70 Hindu and Jain Gujarati households with children and the fieldwork was conducted over a period of four years. Many of the individuals studied had migrated from India to East Africa before coming to the UK in the 1970s, but maintain links with both countries through kinship ties, marriage and rituals. I set out to study the continuity of women's roles in the transmission of religious and moral values, the rituals of childhood, views about infant feeding, and parenting relationships within joint families. The beliefs of najar and bhut in poor, rural settings in India have been described, but these Gujarati beliefs in Britain have not been well documented. This study indicates that najar and bhut continue to be a concern of women in most Gujarati families in Britain today and across all socio-economic groups, not confined to those on the 'bread-line', as have been previously suggested. These beliefs align themselves with Hindu ideas of the soul and reincarnation: powerful forces residing outside the body. An understanding of these beliefs could be informative to health professionals working with Gujarati communities in the UK. [ABSTRACT FROM AUTHOR]

In the last decade, transnational surrogacy has attracted world-wide attention for making babies and pregnancies exchangeable with money. Involuntarily childless couples and individuals travel abroad and pay to have the desired child and to become parents. Acknowledging the importance of asking into the consequences of this monetization of reproduction, the author takes issue with universalistic assumptions about money and markets, and their presumed universal effects on social relations. Instead, it is argued that we need to explore how money works, and, by extension, how transnational surrogacy works out and becomes viable to people as a way to become parents. Putting together insights from economic sociology, and the assisted reproductive technology and parenting culture literature, the author employs the notion of accounting to grasp how people make sense of the money involved in making them parents. Based on a study involving 21 interviews with Norwegian gay and straight couples and single men and women seeking surrogacy abroad, the author explores how money is accounted for in three cases, set in three different countries; India, the United States and Canada. The analysis shows how money is accounted for in particular ways to confirm parenthood. These ways differ depending on the local context and transnational relations; ultimately making differentiated monetized parenthood. This is of significance when we try to conceptualize contemporary parenthood and how money seemingly sustains parenthood in ever more radical ways. [ABSTRACT FROM AUTHOR]

The state of Kerala, south India, has particularly high prevalence rates for cardiovascular disease (20%, Sugathan, Soman and Sankaranarayanan 2008) and Type II diabetes (16.3%, Kutty, Joseph, and Soman 1999). Although so-called 'lifestyle' diseases can be prevented and symptoms controlled by diet, exercise, and medicines, heart disease and diabetes have become the most common causes of suffering, disability and death. This article explores the social dynamics transforming consumer lifestyles as increased food consumption, reduced physical activity and social stress contribute to the burden of cardiovascular disease (CVD). It examines the centrality of food to ideas of the 'good life', to nurture social relationships and strengthen weak modern bodies, as the principle source of embodied pleasure and health. It explores the micro and macro politics of eating and feasting, limiting the extent to which 'individuals' (can) control food habits. Thus, despite widespread recognition of the relationship between diet, exercise and heart disease, the flow of food, the immediacy of pleasure, and associations between appetite and health override latent concerns about the negative impacts of dietary excesses on long-term health and chronic illness. Findings are discussed to highlight the inherent limitations of public health interventions focusing on education and individual choice. [ABSTRACT FROM AUTHOR]