UCONN anthropology professors Sarah Willen and Cesar Abadio-Barrero organized three panels at the 2016 Annual Meeting of the American Anthropological Association in Minneapolis on the intersection of anthropology, health, and human rights. For more information on these panels, including the panel abstracts please click here.
New volume edited by Merrill Singer entitled A Companion to the Anthropology of Environmental Health published by Wiley-Blackwell draws on theories from political ecology, ecobiosocial understanding, and ecosyndemic analysis. This volume brings together 23 chapters by anthropologists that examine how human health around the world is impacted by human interactions with the environment, including anthropogenic environmental restructuring that adversely impacts human wellbeing…
Incoming doctoral student competes in Charles “Rhio” O’Connor Memorial Scholarship Essay Contest
One of our first year doctoral candidates writes on Power Relations in Boston’s Botanicas in relation to the need for a more expansive approach to mainstream cancer treatment. The candidate’s reflection is inspired by an essay contest hosted by Cancer Monthly, Inc. The competition is in commemoration of the late Charles “Rhio” O’Connor, who was diagnosed with an “incurable” cancer (mesothelioma) and told he had but one year to live. “Instead of giving up he found his own path to health and outlived his prognosis by more than six years. This path to health included creating his own treatment protocol which consisted of vitamins, minerals, vegetables and fruits components, essential fatty acids, amino acids, enzymes, herbs, a healthy (primarily vegetarian) diet and mind-body medicine.”
Author: A. Rodriguez, Incoming Doctoral Candidate
Exploring Power Relations in Boston’s Botanicas:
A Timely and Expanded Approach to Mainstream Cancer Treatment
Cancer continues to be leading cause of death for North Americans 85 years and under, despite the fact that oncology research has become the most highly funded medical foci in this country since the 1970s. Indeed, the National Cancer Institute has doled out approximately $100 billion in its – hitherto fruitless – quest for a cancer cure. The publishing of this essay is particularly inspired by the thought-provoking and galvanizing story of James “Rhio” O’Connor, paradigm-shifter, victim of one of the most deadly cancers (mesothelioma) and poster child for the effectiveness of albeit non-FDA approved and controversial alternative treatments to cancer. O’Connor was told he would live no more than 12 months post-diagnosis of the “incurable” cancer. Through adoption of a regimen informed by an integrated mind-body medicine painstakingly similar to Gerson’s (1999) Cancer Therapy approach, O’Connor outlived this prognosis by over half a decade. Commensurate with Rhio’s unconventional remedial approach and “belief in something greater than himself” (“James ‘Rhio’ O’Connor Memorial Scholarship Fund”, 2016) are the healing modalities practiced by a host of Complementary and Alternative Medicine (CAM) practitioners in Botanicas nationwide. This essay is a brief presentation of my work in Boston Botanicas specifically, and historically-rooted power relations inhibiting the full impact of CAM in the treatment of a host of chronic diseases, namely “incurable” cancers.
It is widely understood that the traditional medical arena in the United States is fostering ever increasing interest in non-biomedical healing modalities, as evidenced in the raised awareness and practice of alternative and complementary healing systems (Sansgiry, Mhatre & Artani, 2013). Within the past 40 years, the medical landscape of the United States has radically changed. All major cities and many rural areas currently proffer services representative of the biomedical as well as culturally diverse and oftentimes religiously rooted modus operandi to healing. In Boston, for example, a number of CAM healers (e.g., Haitian mambos and oungans, Vietnemese monk shamans, Charismatic Catholic Priests, Episcopalian healing experts, and Pentecostal faith healers) are all within blocks of each other and of the teaching hospitals at Boston University Medical Center.
This particular spatial formation in Boston motivates a deeper understanding of power relations and knowledge production prerequisite to problematizing the catch-all term ‘ethnomedicine’. An ethnomedical system derives from a particular set of institutions, and cultural ideologies and practices. All healing practices represent highly specific cultural assumptions and norms in a given time and space. It is critical, therefore, to identify the frameworks or cultural parameters (e.g., cultural, traditional, and/or alternative practices) from which we can understand specific healing practices, such as healing rooted in Catholic doctrine, Cuban cultural practice, and Puerto Rican Spiritism, for instance.
The notion that a rich diversity of healing practices are aggregated into the reductionistic category of “ethnomedicine”, with biomedicine standing solo as the reference, is an important indication of the relations of power at stake in the health fields. Several CAM healing traditions, Cuban Santería, for instance, appear to offer a hardy health delivery system and referral network that enhances and works with the biomedical health care system, while occasionally replacing it altogether (Pasquali, 1986; Chavez & Gomez-Beloz, 2001). My primary scholarly interest during my graduate studies was to continue examining institutions, traditional and contemporary healing systems, and problems. My focus thus was to collect oral histories from CAM healers offering curative services in different cultural communities.
This report presents my expectations upon entering into the ethnographer’s role, followed by a brief comparative analysis examining my first set of field notes, the raw data collected by previous researchers, and my review of the relevant Botánica and CAM literature, all in the context of CAM’s relevance to cancer treatment in North America. As prefaced, central to this analysis is the overarching aim to unpack the problem of relational power in the fields of healing practices, with particular emphasis on biopower and intersubjectivity in the context of CAM in Botánicas and opportunity for refined approaches towards cancer treatment.
A Nascent Ethnographer’s Field Expectations
My fervor for identifying and examining intersubjectivity, and the effects of biopower in the context of CAM is evident in the questions percolating in my mind as a novice ethnographer. How do CAM healers construct their world and their practices intersubjectively? Do healers within and among healing traditions share best practices? If so, do healers refine their syncretic treatment modalities based on what other healers have adopted? And if not, do they see themselves in competition with either or both fellow community-based CAM healers and/or with practitioners subscribing to biomedical approaches? Do individual CAM healers see themselves as independent, not part of a system, and thus not influenced by Biopower? Michele Foucault coined the construct ‘biopower’, the critique that medicine and public health as emerging fields serve as productive disciplining fields to reproduce the labor force needed for a capitalist system; enter the expert’s examining or medical gaze and “the medically informed life” (1973; 1988, p. 100). Biopower, essentially the act of subjecting human well being to the politically charged impulses of a defectively informed populace, is the state’s power over one’s body, given its reverberating effect on every facet of life – from health to work to education. Biopower informs one of what one can and cannot, and what one should and should not do, and has the power to enforce these ideas via structural, direct, and or cultural violence. Given that fields of healing practices, such as community based CAM, operate from positions of relative disempowerment relative to biomedical enterprises, this last question provokes a number of very interesting sub-questions. Do healers of this practice see themselves as part of the biomedical biopower apparatus? Do they see themselves as subjects of the biopower ‘enterprise’ of disciplining? Is there a deliberate refutation of the biomedical gaze and ways of knowing that is part of a deeper project of refuting the base of legitimacy on which biomedicine is built and on which its power relies? Only when these questions are attended to can changes and improvements be made in our healthcare system and the way we treat cancer in North America.
Relatedly, my preliminary analyses point to a poignant theme, specifically the socially constructed function of community-based CAM healers, as understood through services offered to patrons, as well as healers’ perception of their role in relation to the biomedical community. Consistent with Koehler’s (2007) data was one practitioner’s adamant clarification that customers are immediately referred to western trained physicians for medical ailments, though they did not offer examples of such symptoms. Here, I noted CAM healers’, very much like naturopathic doctors’, perpetuation of the western medicine-CAM dichotomy, rather than a partnership, which would otherwise reveal an appreciation for the cancer-eradicating healing opportunities that transpire from marrying the two subfields of medicine. In the previously collected raw data, community-based CAM healers often make sure to differentiate their line of work from that of western medicine. In that same vein, it is interesting that this practitioners distinguished the work of Botánicas as distinct from the work of both Western trained physicians, given, in light of the latter, indisputable commonalities in the approach to ameliorating ailments, both specifically aiming towards more traditionally conceived, ‘natural’ solutions.
Launching into ethnographic research, I was particularly interested in learning if community based CAM healers perceive themselves as independent, not part of a system, and thus not influenced by biopower. One can argue that CAM healers do, in fact, perceive themselves as distinct from the mainstream health system, which as an aside inherently gives cancer patients and health practitioners license to explore a diversity of cancer treatments by their own volition, thereby preempting any potential legal liability on the part of conventional medical practitioners. Contrary to perceiving themselves as colluding in a common enterprise with the productive disciplining practices of biomedicine, their existence and continued practice of different forms of healing serve as a form of resistance or refutation of this system of power. This resistance is evidenced by their selection of healing techniques and practices originating from a slew of Afro-Caribbean healing modalities, deliberately distinct from biomedical techniques and doctrine, to generate a composite healing system, unique to the individual healer.
My empirical work on CAM is tremendously informative as it relates to the ever evolving domain of oncological research and the disproportionately powerful forces at play in the prevention of delivering a broad range of effective treatments to deadly cancers and the like. CAM engages cultural, religious, and historical systems of diagnosis, referral, treatment, and knowledge of health and wellbeing with potential to expand resources at one’s disposal in the face of the most unsavory and allegedly irremediable of conditions. Religious and cultural background, notwithstanding, the implications of continued research of this sort offers the possibility and hope of providing more extensive and effective cancer treatments and healthcare through intentional combination of CAM, naturopathic and/or biomedical approaches to disease prevention and eradication
UCONN Anthropology faculty Sarah S. Willen with a collective of authors just published a new article in Social Science and Medicine about migration as a social determinant of health.
Migration as a social determinant of health for irregular migrants: Israel as case study
Yonina Fleischman, Sarah S. Willen, Nadav Davidovitch, Zohar Mor
More than 150,000 irregular migrants reside in Israel, yet data regarding their utilization of and perceived barriers to health care services are limited. Drawing on semi-structured interviews conducted with 35 irregular migrant adults between January and September 2012, this article analyzes the role of migration as a social determinant of health for irregular migrants, and especially asylum seekers. We analyze two kinds of barriers faced by migrants when they attempt to access health care services: barriers resulting directly from their migration status, and barriers that are common among low-income communities but exacerbated by this status. Migration-related barriers included a lack of clear or consistent legislation; the threat of deportation; the inability to obtain work permits and resulting poverty and harsh living and working conditions; and discrimination. Barriers exacerbated by migrant status included prohibitive cost; poor and confusing organization of services; language barriers; perceived low quality of care; and social isolation. These findings support recent arguments that migrant status itself constitutes a social determinant of health that can intersect with other determinants to adversely affect health care access and health outcomes. Findings suggest that any meaningful effort to improve migrants’ health will depend on the willingness of clinicians, public health officials, and policymakers to address the complex array of upstream political and socio-economic factors that affect migrants’ health rather than focusing on narrower questions of access to health care.
You are warmly invited to the next World Health Organization Global Health Histories online webinar on ‘Climate Change & Health’ on THURSDAY 17 September 2015 (12:30 – 14:00pm CET). This month’s speakers are Professor Merrill Singer (University of Connecticut, USA) & Dr Diarmid Campbell-Lendrum (WHO). Further details and event poster are available here.
This seminar will be broadcast live over the internet. By signing up for this (registration is free and on a first come first served basis) participants can listen to the talks, view the speakers’ PowerPoint presentations and, if they wish, pose questions to the presenters and other discussants. To register please use this link.