Medical Anthropology: The Ecology of Health and Disease

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Medical AnthropologyThe Ecology of Health and
Disease

• Social Facts, Cultural Prescriptions and
  Ethno-Psychiatry

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Outline of Presentation

• Definition of Medical Ecology
• Relation of Medical Ecology in the study of
  culture of healing
• Cases of Medical Ecology
• The Mindful Body
• Body as a social construct
• Body and mind continuum

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Medical Ecology described (McElroy and Townsend)

• Medical anthropology studies human health in a
  variety of environmental and cultural concerns
  from isolated tribal peoples to urban
  communities. A subfield called MEDICAL ECOLOGY
  views health and disease as reflections of
  relationships within a population

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Medical Ecology described (McElroy and Townsend)

• Medical Ecology considers health to be a measure
  of how well a group of people has adapted to the
  environment
• Medical Ecology looks at health and its
  implication to the modification of the
  environment.
• Thus, medical ecology utilizes multidisciplinary
  approach to consider a wide range of human
  solutions to environmental problems and the
  health repercussions of those solutions.

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Medical Ecology Model
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CASES IN MEDICAL ECOLOGY

1. Subanun Tribe, Zamboanga del Norte (Western
   Mindanao), Philippines
2. Yonomano Tribe, Brazil
3. Inuit (Eskimos) in Alaska, Greenland and
   Northwest Canadian Territories

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Disease Diagnosis of Subanuns

• ECOLOGICAL FACTORS

• ANTHROPOLOGICAL FACTORS

• Most of the population practice swidden farming
  in the mountainous interiors
• Subanuns are full time farmers
• Subanuns are naturalists they believe that
  their existence is close to nature

• Communal relationships
• No much social hierarchy
• Special statuses are few in number
• No gender segregation men and women do farming
  and rearing of children

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Disease Diagnosis of Subanuns

• Medical anthropological factors

• All Subanuns are herbalists (memulun)
• In the sphere of making decisions about disease,
  differences in individual skill and knowledge
  receive recognition but there is no formal status
  of diagnostician or even, by Subanun conception,
  of curer

• There are 186 disease names
• There are religious specialists or mediums
  (belian) whose job is to maintain communications
  with the very important supernatural constituents
  of the Subanun universe.
• Mediums hold curing ceremonies and are channels
  for the divine healing

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The Subanuns of Zamboanga
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The Yanomamo

• Brazil, South America

Disease is greedy, it wants to eat people, it is
a glutton. It is too string for the shaman there
are not in this world, shamans strong enough to
stand up to it. - Davi Kopenawa, a YanomamI
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The Yanomamo

• Ecological factors

• Yanomami villages are set up in small bands or
  tribes of 40 to 350 people.
• Yanomami daily life revolves around gardening,
  collecting wild foods, collecting firewood,
  making crafts, fetching water, and gossiping and
  visiting with each other.

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The Yanomamo

• Anthropological factors

• The Yanomami are horticulturalists.
  Approximatley 80-90 of the Yanomami diet is
  cultivated from gardens the remaining percentage
  is from hunting
• Yanomami technology is basic, such as a pole and
  vine bridge. Their tools are devised from
  materials that can be made immediately available
  from their environment.

• Each village has the necessary technology to
  sustain itself without outside influence. The
  introduction of these time-saving elements have
  an effect on each segment of their cultural
  fabric - from marriage, political alliance, to
  warfare.
• Yanomami social process is predominantly
  concerned with the formation of groups and the
  regulation of intergroup relations through
  alliance and warfare.

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The Yanomamo

• MEDICAL ANTHROPOLOGICAL FACTORS
• The Shaman are masters that enter the realm
  between the human, spirit and animal worlds with
  the use of a powerful hallucinegic drug called
  ebene.
• In Yanomami culture, only men become Shamans and
  are called shabori or hekuri.
• Men separate into different groups and blow the
  brownish-green powder into each others nostrils
  using a hollow three-foot tube. This
  hallucinogenic drug is very important in telling
  of myths that surround religious beliefs.

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The Yanomamo

• Religious beliefs that encompass the Yanomami
  culture are extremely complex. According to
  their belief, there are four levels of reality.
  The Yanomami believe things tend to fall downward
  to a lower layer. The duku ka misi, or top
  layer, is thought to be most pristine and tender.
  The Yanomami believe that many things originated
  in this layer. It is only considered as having a
  vague function in everyday life. The next layer
  down, called the hedu ka misi, is known as the
  sky layer. It has trees, gardens, villages,
  animals, plants, and most importantly, the souls
  of the deceased. Everything that exists on earth
  is said to have a counterpart on the third layer.
  The bottom surface of the layer is said to be
  what the Yanomami on earth actually see the
  visible sky. Stars and planets are attached to
  the bottom surface and move across it on their
  individual trails.

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The Yanomamo

• The Yanomami attribute most deaths, besides those
  caused by another human or animal, to hekura.
• Any village member who is ill is sent away with
  the children because the smoke can contaminate
  them.
• If many people die of an epidemic, the bodies are
  taken to the forest and hung in the trees to
  decompose. A few weeks later, the remaining
  flesh is scraped from the bones and the bones are
  burned and the ashes stored for drinking later.
• Many myths in the Yanomami culture describe how
  the animals and spirits are transformed into
  humans. When these original people died, they
  turned into spirits or "hekura."In this context
  no badabo means "those who were in the beginning
  of time."

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The Inuit or Eskimos

• ECOLOGICAL FACTORS
• Daily life for the Inuit included peril and
  hardship. With ferocious animals, hostile storms,
  deceptive ice, frigid waters, frequent hunting
  accidents, and endless bitter temperatures, the
  Inuit had much to endure and much to be weary of.
  
• The typical, historical Inuit would be lucky to
  live past 60.
• The Inuit were traditionally hunters and
  fishermen, living off the Arctic animal life.
  They hunted, and still hunt, whales, walruses,
  caribou, seals, polar bears, musk oxen, birds,
  and in lean years any other less commonly eaten
  animals such as foxes.
• The Arctic has very little edible vegetation
  resulting in a carnivorous diet, although some
  Inuit did supplement their diet with seaweed and
  other plants.

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The Inuit or Eskimos

• ANTHROPOLOGICAL FACTORS
• The division of labor in traditional society had
  a strong gender component. The men were
  traditionally hunters and fishermen. The women
  took care of the children, cleaned huts, sewed
  and cooked. However, there are numerous examples
  of women who learned to hunt out of necessity and
  more recently as a personal choice.
• The marital customs among the Inuit were not
  strictly monogamous, many Inuit relationships
  were implicitly or explicitly sexually open, and
  polygamy, divorce and remarriage were fairly
  common.
• Marriages were often arranged, sometimes in
  infancy, and occasionally forced on the couple by
  the community. Marriage was expected for a man as
  soon as he could hunt for himself, and for women
  at puberty.
• Family structure was flexiblea household might
  consist of a man and his wife or wives and
  children it might include his parents or his
  wife's parents as well as adopted children or it
  might be a larger formation of several siblings
  with their parents, wives and children or even
  more than one family sharing dwellings and
  resources. Every household had a head of
  householdan elder or a particularly respected
  man.

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The Inuit or Eskimos

• MEDICAL ANTHROPOLOGICAL FACTORS
• The Inuit traditionally practiced a form of
  shamanism based basically on animist principles.
• They believed that all things had a form of
  spirit, just like humans, and that to some extent
  these spirits could be influenced by a pantheon
  of supernatural entities that could be appeased
  when one required some animal or inanimate thing
  to act in a certain way.
• The shaman (Inuktitut angakuq, sometimes spelled
  angakok) of a community of Inuit was not the
  leader, but rather a sort of healer and
  psychotherapist, who tended wounds and offered
  advice, as well as invoking the spirits to assist
  people in their lives. His or her role was to
  see, interpret and exhort the subtle and unseen.
  Shamans were not trained, they were held to be
  born with the ability.

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The Inuit or Eskimos

• Inuit religion was closely tied to a system of
  rituals that were integrated into the daily life
  of the people.
• These rituals were not terribly complicated, but
  they were held to be absolutely necessary.
• According to a customary Inuit saying, "The great
  peril of our existence lies in the fact that our
  diet consists entirely of souls."
• By believing that all thingsincluding
  animalshave souls like those of humans, any hunt
  that failed to show appropriate respect and
  customary supplication would only give the
  liberated spirits cause to avenge themselves.

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THE MINDFUL BODY(Scheper-Hughes and Lock)

• MEDICAL ANTHROPOLOGY