Medical Anthropology Quarterly最新文献

This article examines how Eritrea's realization of Millennium Development Goal 5 (the reduction of maternal mortality) reveals the complex workings of medical sovereignty in sub-Saharan Africa. Through the case study of Eritrea, I demonstrate how postcolonial African countries might approach structuring their healthcare systems to navigate—and challenge—the neoliberal contours of global health humanitarianism. By analyzing both Eritrea's colonial history and the liberation-era history of medicine alongside contemporary healthcare policymaking, I trace how racial and gender dynamics shape the reduction of maternal mortality and the pursuit of medical sovereignty more broadly. To engage in this pursuit, African states must negotiate the tensions between autonomous healthcare development and the political constraints of global health humanitarianism.

This article explores how acuteness is experienced by people with endometriosis in Finland. Drawing on in-depth interviews as well as anonymous written endometriosis stories, we trace instances when the sense of chronicity and cyclicality of endometriosis is disrupted by a possibility of risk to life. These instances include when endometriosis tissue grows in unanticipated and aggressive ways, when medical interventions lead to unexpected complications or medications raise concerns about a gradually developing risk, and when endometriosis diagnosis becomes a catch-all category that could mask the onset of a life-threatening condition. Our analysis of illness experiences suggests that, while risk to life is an unlikely outcome in chronic conditions such as endometriosis, concerns about risk shape how the chronicity and cyclicality of endometriosis are felt and managed in everyday life.

Based on 28 months of ethnographic research in Deanuleahki-a river valley in Sápmi, the transborder Indigenous Sámi homeland-this article traces my interlocutors' striving to reclaim and repair ecological and kin relations through the everyday praxis of care. I trace this striving through the unmaking and remaking of local relations of care amidst encroachment by post-Second World War Nordic welfare states and regimes of environmental stewardship. I propose a dual conceptualization of ecosocial injury and resurgent care to account for, on the one hand, care's alienation from its social and ecological contexts; and, on the other, the intimate everyday labor of revivifying relations of kinship and belonging, and conditions of material livability, within local ecologies. This defiant and desirous politics of care carves out an opening to attend ethnographically and theoretically to both dislocation and repair in spaces of Indigenous resurgence. In conceptualizing such a politics of care, the article brings into conversation key literatures in medical anthropology and in the interdisciplinary scholarship on care and Indigenous resurgence.

In this article, we examine the clinical encounters of people diagnosed with a severe mental illness (SMI). Drawing on more than 1-year of ethnographic research and interviews in Indonesia, we show that instances of moral self-reflection occurring in the process of acquiring and appropriating clinical insight emerge at the intersection of heterogeneous discursive regimes. When biomedical notions of health and illness dominate these discourses, they reimagine pre-existing notions about spirituality and religion. Furthermore, consenting to psychiatric notions of health and illness can create common ground and a sense of shared experience, leading to grassroots movements for the empowerment of the mentally ill, self-help groups, and other support structures. At the same time, these processes can increase uncertainty and be generative of a culture of blame, as individuals are caught in overlapping and at times contradictory moral systems that each have the potential to strip patients of their moral status.

Achieving a target of zero-zero disease, zero disability, and zero discrimination-has become the dominant focus of campaigns to control or eliminate diseases, from HIV/AIDS to malaria to leprosy. Given the historical failure of most eradication programs over the last century, such teleological imaginings of disease-free futures might seem overly utopian. But even if it were possible to eradicate such diseases in their entirety, would this be universally welcomed, even by those most affected by them? In this article, I compare the narratives of national and international bodies concerned with eliminating leprosy, in particular, with the more ambivalent narratives of those affected by the disease in India, the country where the disease is most prevalent. For the latter, the promise of elimination not only seems unrealistic, but represents a potential loss of identity. Imagining disease trajectories in less linear terms, I argue, might also nuance understanding of them.

In Turkey's occupational health system, doctors must use the International Labor Organization's (ILO) standards to classify the chest radiographs of workers at risk of lung diseases caused by dust exposure. Yet these standards do not provide a uniformity of care within the tripartite structure of the occupational health system, which divides disease surveillance, disease diagnosis, and worker compensation into distinct silos. This division often produces ambiguity and unpredictable outcomes for occupational disease claims. The traffic of diagnostic decisions among workplaces and medico-legal institutions-what I refer to as diagnostic ecologies-shapes medical knowledge. The tripartite organization of the occupational health system in Turkey makes the evaluation of chest radiographs a space where professional expertise and professional ethics are constantly negotiated. A focus on diagnostic ecologies illustrates how disease ontology is distributed across the occupational health system's components.

Selective abortion of female fetuses is a widespread, illegal, and profoundly consequential form of family planning in contemporary India. In Gujarat state, public health campaigns against the practice rely on narratives exhibiting the hallmarks of melodrama: good-evil binaries, stock characters, emotional provocations, simplistic diagnoses, and inevitable triumphs. As biopolitical truths, such narratives resonate ethically and emotionally for people. By individualizing blame, obscuring structure, circumscribing discourse, and legitimizing authority, such narratives also exert many classic biopolitical effects. But they do not necessarily transform subjectivity or behavior, as biopower is often assumed to. Anti-sex selection messaging illustrates how moralistic, sentimentalized interventions against potentially harmful practices can provoke strong responses without changing actions. In highlighting resonance as a relevant biopolitical limit, the not-quite-paradoxes of Gujarati public health narratives-encapsulation without accuracy, regulation without discipline, authority without efficacy, participation without transformation-suggest one approach for analyzing the governance of life without falling into determinism.

Since the 1990s, preimplantation tests within in vitro fertilization have promised to enhance the selection of embryos for uterine implantation. However, alongside ethical controversies, these diagnostic techniques often identify a high rate of mosaic embryos—those containing a mix of cells deemed normal and abnormal—creating one of the largest technical challenges related to the testing. These cases raise dilemmas for professionals in assisted reproduction and, more intensely, create challenges for individuals whose embryos are identified as mosaic. This article examines the experiences of a woman who decides to implant a mosaic embryo, focusing on her strategies for managing technical uncertainties and evaluating the embryo's potential. It highlights the essential role that online forums play in this process and examines how users utilize these platforms to gain insights and navigate the complex decisions involved with new biomedical technologies.