Medical Anthropology

Employee voice has largely been examined as a universal concept in unionized and non-unionized settings, with insufficient attention to diversity of workers (Rank, 2009). As invisible minorities, gay, lesbian, bisexual, and transgender employees provide a valuable focal point from which to examine employee voice mechanisms. Positing that gay, lesbian, bisexual, and transgender (GLBT) employees are often silenced by what is perceived as “normal” in work organizations, this paper considers some of the negative consequences of this silencing, and proposes ways in which voices of GLBT employees and other invisible minorities may be heard. With its relevance to policies and practices in other organizations, the “don’t ask, don’t tell” policy of the U.S. military is used as a lens through which to analyze voice, silence, and GLBT employees. Specific recommendations are provided for HR managers to facilitate the expression of voice for GLBT employees in today’s increasingly diverse organizations.

Within the field of psychology, the majority of research on artistic creativity focuses on the originating creator, i.e. the artist, while neglecting the art audience. A brief literature review considers the trajectory of thought that led to such neglect. Utilizing the definition of shaman constructed by Ruth Inge-Heinze (1997), a preliminary definition of the art audience as shamanic community is constructed. The study demonstrates how art can provide for the audience’s psychological, social, and spiritual needs; thus, illustrating the defining constructs of the art audience as shamanic community. The formation of a new subfield in creative studies, the psychology of the art audience, is recommended with specific recommendations for future studies.

Since 1999, a campus-community partnership experience, linking the school of Nursing of the Universidad Javeriana with people from a neighborhood in Bogotá, Colombia, has been in operation. Using a participatory approach, and with much very limited financial resources, the partnership has developed child and community health programs, health education, and research on health care practices, therapeutic itineraries in infant health care, and the history of the neighborhood. This experience demonstrates the advantages of participatory approaches in building partnership through mutual knowledge and trust. Health programs have been designed, integrating community’s social capitol based on a long history of participation and activism, community’s resources as well as nurses’ knowledge and skills as advisors. Advantages, obstacles, and limitations of the participatory approaches are discussed.

Resumen
Desde 1999 hemos venido desarrollando una experiencia comunidad-universidad entre personas del barrio El Paraíso en Bogotá y la facultad de Enfermería de la Universidad Javeriana. Utilizando un modelo participativo, y con recursos limitados, a través de nuestro trabajo conjunto logramos desarrollar, entre 1999 y 2001, programas comunitarios de atención en salud a la población infantil en escuelas y guarderías, programas de promoción de la salud con grupos de adultos, e investigaciones sobre conocimientos y prácticas en el cuidado de la salud y sobre itinerarios terapéuticos en el cuidado de la salud de los infantes. Esta experiencia muestra las ventajas de los enfoques participativos y el papel que juegan en la construcción de asociaciones basadas en el conocimiento mutuo y la confianza. Los programas de salud han sido diseñados integrando el capital social acumulado por las personas el barrio a través de su larga historia de participación comunitaria y activismo social, así como otros recursos e instituciones de la comunidad, y los conocimientos y capacidades de las enfermeras que actuamos como asesoras. Finalmente, se concluye con una discusión sobre las ventajas, obstáculos y limitaciones de los enfoques participativos.

Health and Culture: Elements for the study of diversity and disparities. In the public health field, culture, which is an inherent element of the health – disease phenomenon has been understood in different ways. This article explores the relationship between health and culture linking three main purposes: First, analyzing culture as a concept widening it towards understanding the role played by power on structuring the cultural diversity and the social subjects; second, analyzing the ideas about culture present on three of the current models of public health in Colombia and Latin America – the Natural History of Disease, Primary Health Care, and Heatlh Promotion; and third, going beyond understanding culture as risk factors and life styles through developing three types of actions: documenting and developing research about the diversity of the health systems, uncovering and analyzing health inequalities and practices of domination in the health field and developing participative intervention programs with the social actors.

Resumen
La cultura es un elemento constitutivo del fenómeno salud – enfermedad que ha sido entendida de diferentes maneras en el campo de la salud pública. Este artículo explora la relación salud – cultura articulando tres propósitos centrales: uno, revisar críticamente diversos conceptos de cultura y considerar al poder como un elemento que estructura y determina la diversidad cultural y de los sujetos sociales;  dos, analizar las concepciones de cultura presentes en tres de los modelos que actualmente se integran en la práctica de la salud pública en Colombia y otros países de América Latina – Historia Natural de la Enfermedad, Atención Primaria en Salud y Promoción de la Salud; y tres, enunciar la necesidad de ir más allá de la idea de cultura como factor de riesgo, factores protectores y estilos de vida a través de tres acciones: documentar y desarrollar investigación sobre la diversidad de los sistemas de salud; desenmascarar y analizar las inequidades y las prácticas de dominación en salud y desarrollando investigaciones y programas de intervención participativos con los diferentes actores sociales.

"I don´t like it, but it’s okay if I misbehave. Voices of girls and boys from a neighborhood of Bogotá about punishment.
I present a qualitative research study conducted from January through December 2006. Along with eight girls and five boys from a neighborhood located at the east hills of Bogotá, we conducted a qualitative, participatory ethnographic study about their ideas, feelings and attitudes about punishment. Participants narrated events of punishment at home and less frequently at school. Parents punish their children hitting them with objects, spanking, scolding them, forbidding whatever they like or keeping them at their bedrooms. As result of being punished, participants said they feel bad, bored, guilty, angry and confused. They suggest not being hit or humiliated, but rather be telling or explaining about their bad behaviors. However, many of them talked about ideas that justify corporal punishment as an effective mean for controlling children’s bad behaviors. Finally, I discuss results within the context of the literature about the effects of punishment and the policy about ending corporal punishment, and propose some actions with local and institutional actors.

Resumen
Presento los resultados de una investigación cualitativa, participativa con enfoque etnográfico, que realizamos de enero a diciembre de 2006 con ocho niñas y cinco niños de un barrio de los cerros orientales de Bogotá, sobre sus ideas, sentimientos y actitudes acerca del castigo . Los participantes narraron eventos de castigo en el hogar y con menor frecuencia eventos en el colegio. Los papás y las mamás castigan a los niños pegándoles con objetos, con la mano, regañándolos, prohibiéndoles gustos o dejándolos en el cuarto. Cuando los castigaban, los participantes manifestaron, entre otros, sentirse mal, aburridos, rabiosos, culpables y confusos. Proponen que, si se portan mal, no les peguen ni los humillen, sino que les hablen y les expliquen. Sin embargo, muchos de los participantes expresaron ideas que justifican el castigo corporal y humillante, como una medida necesaria para controlar las malas acciones de los niños. Finalmente, discuto los resultados en el contexto de la literatura sobre los efectos del castigo y la política de erradicación del castigo corporal y planteo algunas acciones con diferentes actores locales e institucionales.

Risk-medicine represents a form of medicalisation that is based on the calculation of health-related risks rather than on current medical statuses. While the study of risk-medicine has produced ample research, one aspect is critically understudied: its epistemological grounds, and the effects of its conception of knowledge on the social enactment of, and response to, its associated practices. Using prenatal screening and diagnosis as a focal point, this paper proposes a sustained look into a most particular epistemological feature of risk-medicine, i.e. its quest for knowledge of the uncertain and for control over the indeterminate. The author takes on the notions of uncertainty as advanced by quantum mechanics to point to the indeterminacy of  statistically evaluated but undiagnosed conditions, and the mechanisms of social control (‘governmentality’) associated with it: ‘indignation’ and blame allocation. The reading women’s resistance to definitions of ‘high risk’ as a sign of ‘bad motherhood’ reflects such governmental attention to a responsible personal management of risks. The analysis uses the story of a baby whose Downs Syndrome diagnosis was only ascertained days after his birth – as narrated by his mother. In a society where the presence/absence of congenital abnormalities stands as a major axis upon which a newborn’s identity is defined, this “high risk” baby remains in a liminal, between and betwixt state for which the mother is blamed, not so much for not having terminated the pregnancy, as for not having gone through diagnostic tests which would have settled this ambiguous state.

This article focuses on midwives who practice complementary and alternative medicine (CAM) in Israel. After qualifying as nurses in mainstream biomedical institutions, these midwives have, at some point in their careers, opted to study a variety of CAM skills and practice them in hospital delivery rooms in Israel. The authors explore the relationship of selected elements of feminist ideology to the epistemology of CAM midwives. Seven context-specific themes are viewed as central to their epistemological stance: rejection of the medicalization of birth; a strong belief in the "naturalness" of childbirth; rejection of the overuse of technology; empowerment of women; nostalgia and reverence for the past; centrality of intuition, feeling, and emotion; and active advocacy. In-depth, semistructured interviews were carried out during 2004 to 2005 with 13 midwives. These narratives provided empirical material for a qualitative analysis. Evidence is shown to demonstrate the unique feminist quality of the core beliefs of the CAM midwives.

The paper seeks to provide an insider's view into the implementation of goals set by the European Commission for socio-economic research. By analysing project coordinators' responses to questionnaires (n=88), several aspects of the emergence of a European social science research community are examined. Focus is placed on three 'European Added Values', defined within two subsequent calls for research proposals and funding opportunities: framework programmes 4 and 5 (1994-1998, and 1998-2002 accordingly). These 'Added Values' will set the expected features of European-funded research projects, and will include: (1) transnationality - the involvement of researchers from a variety of EU states; (2) applied research - the potential implementation of outcomes in socioeconomic policy; and (3) interdisciplinarity - the integration and collaboration of different disciplinary perspectives. These 'ideals' were tested against reports as to the reality of the research practices, and found to have a significant compatibility, as well as several discrepancies, with the objectives set out by the EU research committee. This paper allows for an understanding of the dynamics of European research consortia, and the factors involved in the success or failure in attaining the overarching goals of the EU Commission.

Objectives The determinants of the use of withdrawal in Turkey are examined using a multinomial logistic model.
Methods Data were drawn from a nation-wide population-based cross-sectional study, the Turkish Demographic Health Surveys that took place in 1998 and 2003. Detailed interviews
were conducted with 8576 women aged 15–49 and analysed using SPSS.
Results Contextual, cultural and demographic characteristics define women’s choice of withdrawal over modern methods. Socio-economic status, education, employment status, and past fertility behaviour are among key determinants. First-ever used contraception method has a very strong impact on later choices. Urban women, the more educated, those
with better socioeconomic status, and those living in less crowded households resort less to withdrawal. Experience and empowerment positively linked to modern contraceptive use among women in Turkey.
Conclusions The use of contraceptive methods in Turkey differs greatly. Empowerment of women in terms of better socioeconomic status, better education, modern and liberal
attitudes towards women and family planning seem to reduce withdrawal use as the main method of contraception. The results suggest the need for education (particularly targeting
young women and couples), information and provision of modern contraceptive services particularly for disadvantaged groups.

This paper presents the concept of 'risk-medicine' through the analysis of the rejection of prenatal screening among ultra Orthodox Jews in Israel. The foundations of this phenomenon are examined, defining 'risk' as a major socio-cultural feature of late modern Western society. The authors describe eight possible components of resistance to biomedicine, some being specifically applicable to risk-medicine: cultural discrepancy, lack of information, religious prohibitions, risk-aversion, incompatible health and illness cosmologies, fear and mistrust, governmental control, and irreconcilable epistemological differences. The analysis identifies two fundamental dimensions associated with risk-medicine: its epistemological basis, and the governmental surveillance that it involves. While the former stems from diverging conceptions on the values of different forms of 'gnosis' (probabilities vs. certainty) the latter draws upon the relationship between the state and risk-medicine, portraying ultra Orthodox women's rejection of prenatal screening as a form of resistance to nationalist, secular forces. The paper advances new concepts (namely 'risk-medicine' and 'gnosis' as related to 'pro-gnosis' and 'dia-gnosis') that may constitute a ground for further research on forms of medical epistemologies and practices and their related forms of resistance, namely in the context of religious and ideological incompatibilities.

"The study explores the process of boundary demarcation within
hospital settings by examining a new phenomenon in modern
medicine: collaboration between alternative and biomedical
practitioners (primarily physicians) working together in
biomedical settings. The study uses qualitative methods to
examine the nature of this collaboration by calling attention
to the ways in which the biomedical profession manages to
secure its boundaries and to protect its hard-core professional
knowledge. It identifies the processes of exclusion and
marginalization as the main mechanisms by which symbolic
boundaries are marked daily in the professional field. These
processes enable the biomedical profession to contain its
competitors and at the same time to avoid overt confrontations
and mitigate potential tensions between the two medical systems."

"This article presents a critical appraisal of the psychosocial empirical research on surrogate mothers, their motivations for entering into surrogacy agreements and the outcome of their participation. I apply a social constructionist approach toward analyzing the scholarship, arguing that the cultural assumption that “normal” women do not voluntarily become pregnant with the premeditated intention of relinquishing the child for money, together with the assumption that “normal” women “naturally” bond with the children they bear, frames much of this research. I argue that this scholarship reveals how Western assumptions about motherhood and family impact upon scientific research. In their attempt to research the anomalous phenomenon of surrogacy, these researchers respond to the cultural anxieties that the practice provokes by framing their research methodologies and questions in a manner that upholds essentialist gendered assumptions about the naturalness and normalness of motherhood and childbearing. This leads the researchers to overlook the intrinsic value of the women's personal experiences and has implications for social policy.

Keywords: Surrogate motherhood; Surrogacy; Infertility; Reproduction; Gestational carrier; Gender"

Birthing a Mother is the first ethnography to probe the intimate experience of gestational surrogate motherhood. In this beautifully written and insightful book, Elly Teman shows how surrogates and intended mothers carefully negotiate their cooperative endeavor. Drawing on anthropological fieldwork among Jewish Israeli women, interspersed with cross-cultural perspectives of surrogacy in the global context, Teman traces the processes by which surrogates relinquish any maternal claim to the baby even as intended mothers accomplish a complicated transition to motherhood. Teman's groundbreaking analysis reveals that as surrogates psychologically and emotionally disengage from the fetus they carry, they develop a profound and lasting bond with the intended mother.

"Title: ขอบฟ้าแห่งปรัชญา: ความรู้ ปรัชญา และสังคมไทย
Other Titles: Horizon of philosophy : knowledge, philosophy, and Thai society
Authors: โสรัจจ์ หงศ์ลดารมภ์
Author's Email: Soraj.H@Chula.ac.th
Subjects: ปรัชญา--ไทย
ไทย--ภาวะสังคม
Issue Date: 2541
Publisher: จุฬาลงกรณ์มหาวิทยาลัย
Description: วิชา ปรัชญาเป็นอย่างไร: สถานการณ์ของปรัชญาในโลกตะวันตก -- ความรู้ของมนุษย์: ประสบการณ์นิยมและเหตุผลนิยม -- ความรู้ของมนุษย์: ความล้มเหลวของทฤษฎีสหนัยนิยมส่วนใหญ่ -- ภาษากับความจริง ข้อเท็จจริงกับคุณค่า -- ธรรมชาติ ประโยชน์ และทิศทางของปรัชญา -- ปรัชญาในสังคมไทย
URI: http://hdl.handle.net/123456789/2733"

ภาษากับความหมายเป็นสิ่งสำคัญยิ่งของมนุษย์ ซึ่งหากปราศจากภาษากับความหมายแล้ว มนุษย์ก็นากที่จะดำรงความเป็นมนุษย์อยู่ได้ ปัญหาต่างๆ ของปรัชญาเองก็ถือได้ว่าสามารถทอนลงไปเป็นปัญหาเกี่ยวกับภาษาและความหมายได้ ทั้งสิ้น ตัวอย่างเช่น การถกเถียงเกี่ยวกับธรรมชาติที่แท้จริงของความเป็นจริงหรือความรู้ หรือความดีกับความงาม ก็เป็นไปได้ว่าเป็นการถกเถียงเกี่ยวกับความหมายที่แท้จริงของคำ เช่น “ความดี” หรือ “ความเป็นจริง” หรือ “ความรู้” หนังสือเล่มนี้เป็นหนังสือที่แนะนำการสนทนาและทฤษฎีสำคัญๆ ต่างๆ เกี่ยวกับปรัชญาภาษา จึงเหมาะแก่ผู้ที่เรียนวิชานี้ อย่างไรก็ตาม เนื้อหาของหนังสือเล่มนี้ก็เหมาะแก่ผู้ที่ศึกษาวิชาที่เกี่ยวข้องอื่นๆ ด้วย เช่น อรรถศาสตร์หรือภาษาศาสตร์ เนื่องจากทฤษฎีเกี่ยวกับภาษาและความหมายเป็นรากฐานของทฤษฎีต่างๆ ในวิชาการหลายแขนง ผู้ที่สนใจรากฐานของทฤษฎีก็ย่อมได้ประโยชน์จากหนังสือเล่มนี้โดยตรง

This article focuses on blood donation as a form of bloodletting in a context where donation is commonly seen to alleviate the symptoms of ‘thick blood’. It deals with the gendered aspects of blood donation, and the parallels drawn between donating blood and menstruating. Women are seen not to need to donate blood as much as men, who, in the absence of menstruation, are more prone to thick blood and  require a means to expunge the ensuing excess. While blood donation professionals strive to reconstruct donation as a selfless and ungendered act, counterposing the ‘facts’ of arterial blood circulation to local bloodlore and beliefs, lay understandings challenge this construction in the use they make of blood donation centres or by reiterating the personalistic and gendered dimensions of donation. The article explores cases of patients who use hormonal contraceptives which suppress menstruation and express concerns over the resulting accumulation of blood in the body. It considers how blood donation is adopted by some women as a means of dispelling both the perceived inconveniences of menstrual bleeding and its swelling effects. Such literalized engagements with medical technologies reveal a conception of the body as a permeable, malleable and recipient-like enclosure. These views are often characterized as ‘ignorance’ by medical practitioners, where ignorance is seen to derive not only from the absence of knowledge, but from the presence  of the wrong kind of knowledge.

"This book is a welcome rediscovery of the importance of emotions as key social and political facts. The perception that emotions are not after-effects but are themselves constitutive of practice is a timely reminder and insight.\
— Professor Paul Rabinow, University of California, Berkeley

"A powerful affirmation of the humanity of the field encounter in all its ambivalence, and a timely call for social scientists to harness the rich potential of a people-centered research enterprise."
— Professor João Biehl, Princeton University

“Emotions in the Field is an important, generative contribution to our understanding of the emotional and intellectual dimensions of ethnographic research and the anthropological enterprise more generally.... Narrations like this get to the ways in which fieldwork proceeds through labyrinths of decentering moments, hesitations, insights, doubts, anxieties, sensations, ritual formations, and oscillations of emotion and knowledge…. The volume as a whole speaks richly to these matters, in ways that are not pat or conventional, and furthers understanding of them in significant and timely ways. The book would work well in courses on ethnographic research methods. It should be required reading for budding ethnographers on the verge of essaying their first forays into “the field.”
- Ethos - Professor Robert Desjarlais.

"This book will provoke discussion of fieldwork from a new perspective, and hopefully spark new contributions to the literature. It will be of most use to those concerned with the linkages between ethnographic methodology and the analyses that anthropologists produce, as well as to those entering the field or newly returned. I have already recommended it to a number of graduate students as a significant resource in predicting, understanding and analysing fieldwork practice."
--- Anthropological Forum


"Emotions in the Field is an excellent contribution to discussions of fieldwork methodology in general, and the role of emotions in ethnographic research in particular....[it] provides an efficient anti-dote to most textbooks on ‘qualitative methods’ and their
implicit rationalist epistemologies and positivist orientations. Every fieldworker could get inspiration from reading it, and post-graduate courses in ethnographic methods could benefit from its
different contributions".
-- Ethnos -- Dr Jakob Krause-Jensen

"I welcome the way in which emotions are given center stage in
this volume, seen as not only worthwhile, but also as potentially important and useful in the creation of knowledge. Issues such as transference and countertransference are not usually taught in methods classes, leaving neophyte fieldworkers sometimes holding incomprehensible and possibly upsetting
and disturbing feelings. Thus, sociologists should take note of the book and its message"
--- Contemporary Sociology

“At last, anthropology is opening up and becoming more honest and frank about the experience of doing the job….. students may feel anxious in writing about their emotions in the field, as emotion (over reason) has long been associated with irrationality and a lack of objectivity. This volume goes a long way towards countering such stagnant prejudices”.
--- Journal of the Royal Anthropological Institute

"Thought-provoking, stimulating and at times moving, this volume will be a stimulating tonic for jaded researchers, while its personal insights into fieldwork’s daily realities render it a thoughtful volume for those about to embark on field research.
--- Qualitative Research

As emotion is often linked with irrationality, it’s no surprise researchers tend to under-report the emotions they experience in the field. However, denying emotion altogether doesn’t necessarily lead to better research. Methods cannot function independently from the personalities wielding them, and it’s time we question the tendency to underplay the scientific, personal, and political consequences of the emotional dimensions of fieldwork. This book explores the idea that emotion is not antithetical to thought or reason, but is instead an untapped source of insight that can complement more traditional methods of anthropological research.
With a new, re-humanized methodological framework, this book shows how certain reactions and experiences consistently evoked in fieldwork, when treated with the intellectual vigor empirical work demands, can be translated into meaningful data. Emotions in the Field brings to mainstream anthropological awareness not only the viability and necessity of this neglected realm of research, but also its fresh and thoughtful guiding principles."

This collection contains anthropological reflections on blood donation practices in different regional contexts including Brazil, China, India, the Navajo Nation, Papua New Guinea, Sri Lanka, the  United States and elsewhere, and provides new ethnographic and theoretical insights on connections between blood donation and nationalism, warfare, kinship, the politics of infection, menstruation, sexual minorities, technological innovation, and shifting economic regimes. An afterword is provided by Marilyn Strathern.

Table of contents:

1. Introduction: Blood Donation, Bioeconomy, Culture - Jacob Copeman

2. Solidarity and Distinction in Blood: Contamination, Morality and Variability - Jing Shao and Mary Scoggin

3. Glorious Deeds: Work Unit Blood Donation and Postsocialist Desires in Urban China - Kathleen Erwin, Vincanne Adams and Phuoc Le

4. Gathering Points: Blood Donation and the Scenography of 'National Integration' in India - Jacob Copeman

5. 'Please Give a Drop of Blood': Blood Donation, Conflict and the Haemato-Global Assemblage in Contemporary Sri Lanka - Bob Simpson

6. Alleviative Bleeding: Bloodletting, Menstruation and the Politics of Ignorance in a Brazilian Blood Donation Centre - Emilia Sanabria

7. Emplacement and Contamination: Mediation of Navajo Identity through Excorporated Blood - Maureen Schwarz

8. Vital Publics of Pure Blood - Thomas Strong

9. Failed Recipients: Biomedical and Relational Technologies of Blood Extraction in a Papua New Guinean Hospital - Alice Street

10. Afterword - Marilyn Strathern

This special issue of Body & Society explores critical issues arising from enactments of blood donation and transfusion in different parts of the world. With articles focusing on Brazil, China, India, the Navajo Nation, Papua New Guinea, Sri Lanka, the United States and elsewhere, description and analysis is presented of a modal and mobile constellation of practices and knowledges, transnational in distribution, but also situationally enacted in particular instances. What comes across is the scope of blood donation: its extraordinary emotive force, the complex methodologies it requires for the mobilization of populations, its ability to stimulate imaginative thought among diverse constituencies, its variations of transactional form, the ways in which it reproduces controversies globally. The scope of blood donation – the remarkable heterogeneity of its enactments and of the associations condensed therein – can perhaps only begin to be captured with the bringing together of such a wide-ranging set of ethnographic accounts as is presented in this special issue.

This article explores nationalist interpretations of blood donation activity, examining how some Indians read integrative messages into the practical procedures through which blood is donated and distrib- uted. The first post-Independence Prime Minister of India, Jawaharlal Nehru, proclaimed the need for ‘national integration’ as a bulwark against a myriad of linguistic, caste and ethnic agitations that threatened to disrupt the unity of the newly formed nation-state. This article shows that a striking manifestation of the Nehruvian ideology of national integration possesses a compelling presence in the Indian blood donation milieu. Scholars of India have long been preoccupied with documenting attempts by the Hindu right to redefine the nation in exclusively Hindu, anti-Nehruvian terms. Questioning the prevailing assumption that the only thing that counts politically in India today is the debunking or overriding of Nehruvian ideals of the secular inclusive nation, this article rehabilitates Nehruvianism as an important ethnographic subject. In so doing it demonstrates the roles of anonymity, enumeration and an array of technical and imaginative gathering points in the formation of the ‘difference-traversing gift’. The article also highlights ways in which technology may be employed for the imagining of social diversity.

Blood component therapy is a technology designed to enhance the efficiency of distribution and accuracy of prescription of donated blood. A centrifuge machine spins whole donated blood, thereby separating it according to the relative gravity of its constituent components. These are principally red cells, platelets and plasma. The divisions of blood component therapy are held by doctors and donors alike to multiply the substance because this permits the treatment of at least three people from one donated unit of blood. Component separation is held to produce both quantitative and qualitative benefits: more patients can be treated from a single donated unit; and not only that, blood division also allows patients to be treated for the specific ailment from which they are suffering – the transfusion of a whole unit of blood, now re-perceived as three components as opposed to a single unit, would not only represent the quantitative waste of two units, it would provide patients with components that are qualitatively unnecessary for their specific condition. The re-production of blood therefore introduces a new particularism into transfusion therapy. Developed in the United States in the 1950s, the technology had become widespread in developed countries by the late 1960s. The technology requires a linked set of three blood bags (called triple bags) for the components to subsequently be separated into. Indian blood banks, however, only began to move beyond crude glass bottles and introduce PVC collection bags in the early 1980s. It has been estimated that 25% of donated blood in the country is now separated into components. In Delhi the percentage is much higher. Blood banks that do not possess this technology invariably plan to acquire it just as soon as sufficient funds become available to them. Blood separation technology may be said to be a ‘default descriptor’ of modernity and sophistication in Indian blood banking circles. According to medico-marketing campaigns, those who persist in prescribing whole blood are abject and benighted. I once heard a proselytiser of ‘componentisation’ refer to a colleague who prescribes whole blood as a thief (chor in Hindi). The prescription of whole blood ‘steals’ use-value. Advertisements which inform the public that ‘One blood donation of yours can save three lives, not just one’ point to the inadequacy of the singular. Saving only one life is insufficient, derisory.

This article examines processes involved in blood donation and ‘blood management’ in an anthropological light. It claims that blood management is not restricted to the procedures that medical professionals employ on blood outside of bodies, but that ‘manage- ment’ practice is enforced by donors themselves onto their own internal bodily processes. It suggests that donation and transfusion centre on issues of time-management and production; concepts of temporal synchrony and investment are employed to explore the implications of this dimension of blood donation. By way of a comparison with gift- giving amongst Jains in India, this article argues for an ‘overlapping’ of – and dependency between – different economies within blood-banking processes. In examining the general processes involved in blood donation, it aims to provide the groundwork for future comparative analyses of blood-banking processes.

In Sub-Saharan Africa relations between the state and so-called tradition has in many contexts lately been reshaped. The Mozambican state, for example, recently formally ‘recognised’ its’ traditional authorities vesting these with the authority, among others, to apply traditional law to resolve conflicts. By some, this has been celebrated as bespeaking true ‘legal pluralism’. However, based on research in and around Chimoio, Mozambique, this paper will argue that legal pluralism as an analytical concept is an impasse as it overemphasises formal legal bodies/structures and simplifies the ambivalence and contested nature of the authority of both state and tradition and their interrelatedness. Using the case of the so-called recognition of traditional authorities and issues pertaining to justice, this paper will argue for the possibility of probing the relations between tradition and state in working towards reconstituting African political and legal anthropology. Further, the paper argues that in the Mozambican case it may be fruitful to speak of the formation and development of a number of sovereignties in the interstices between state and tradition. Based on empirical examples, the paper will attempt to show how the application of sovereignty analytically makes it apt to analyse the complexity of a politics of justice. Moreover, it will be argued that this focus may be one contribution towards a reformulation of political and legal anthropology sensitive to local contexts and an alternative to a universalizing systemic typologization on the one hand and, conversely, the individuating and monadic tendencies inherent to some approaches to postcolonial subjectivities.

Pre-abortion counselling has a role in promoting safe sex practices and in preventing repeated unplanned pregnancies and repeated abortions among abortion-seeking women. Such counselling is essential in Vietnam, especially given the common use of abortion. Arguably, in Ho Chi Minh City, Vietnam, the delivery of pre-abortion counselling is more urgent for young women, who have historically been ignored by State reproductive health initiatives and are increasingly exposed to transmission of sexually transmitted infections (STIs), unplanned pregnancies and abortion. This paper charts urban Vietnamese service providers’ discourses in pre-abortion counselling specific for reducing risks of additional unwanted pregnancies, repeat abortion and STI/HIV transmission among young Vietnamese women. Thirteen providers working in counselling delivery, management and programme-planning at the Reproductive Health Care Centre of Ho Chi Minh City participated in this study. Through qualitative interviews, this paper elicits a range of provider attitudes, considerations and approaches in pre-abortion counselling and presents these discourses using participant anecdotes. Demonstrated among participant responses were five key pre-abortion counselling phases for promoting effective family planning among young women. Topics covered in these counselling phases included abortion complications, post-abortion fertility return, contraception, behaviour change and STI/HIV prevention and sexual and reproductive health basics (SRH). The service provider discourses gleaned from this study are foundational for further research and development of best practice guidelines in pre-abortion counselling

African healing systems have always been pluralistic in form and structure, capable of absorbing new traditions and practices. The spread of Chinese medicine in Tanzania over the past decade is a testament to the flexibility of pluralistic healing systems, as well as evidence of south–south processes of globalisation that are often ignored by the literature on globalisation. This article suggests, through a study of a Chinese medical clinic in Dar es Salaam, that its popularity highlights the strengths of local cultures despite increasing globalising forces, and that any consideration of globalisation must include south–south (or East–south) dynamics as well as the customary focus on the north–south track. The article also suggests that whilst the absorption of new traditions of healing speaks to the strength of the local, it also functions as an indication of the failure of alternative healing systems to address key current medical needs, and as such represents a crisis in health, as much as strength, in the healing sector.

"Preimplantation tissue typing has been proposed as a method for creating a tissue matched child that can serve as a haematopoietic stem cell donor to save its sick sibling in need of a stem cell transplant. Despite recent promising results, many people have expressed their disapproval of this method. This paper addresses the main concerns of these critics: the risk of preimplantation genetic diagnosis (PGD) for the child to be born; the intention to have a donor child; the limits that should be placed on what may be done to the donor child, and whether the intended recipient can be someone other than a sibling. The author will show that these concerns do not constitute a sufficient ground to forbid people to use this technique to save
not only a sibling, but also any other loved one’s life. Finally, the author briefly deals with two alternative scenarios: the creation of a human leukocyte antigen (HLA) matched child as an insurance policy, and the banking of HLA matched embryos."

Gunther von Hagens' Body Worlds exhibition contextualises its display of plastinated bodies within the Renaissance tradition of écorché (or flayed body) art - surrounding its figures with screen-prints of early modern anatomical illustrations, labels bearing explanatory medical information, and quotations about the body and mortality from religious and philosophical sources. This paper argues that the early modern écorché figure informs not only the iconography, but also the kind of anatomical knowledge - the anatomised vision of the body - that Body Worlds reproduces. While images of early modern anatomical art serve to foreground the declared educational aim of the show, primarily by contextualising it within a long history of public anatomy, they also reveal that for von Hagens, as for the Renaissance anatomists before him, the anatomical significance of the body is to be found by removing its skin and exposing its interior. Such images do not simply reveal the inside of the body, this article demonstrates, but rather represent the invention of a specifically modern concept of bodily interiority, one intricately connected to a wider reconceptualisation of the body as individual and self-contained.

"Background: Reports that death notices in the Times-Picayune, the New Orleans daily newspaper, increased dramatically in 2006 prompted local health officials to determine whether death notice surveillance could serve as a valid alternative means to confirm suspicions of excess mortality requiring immediate preventive actions and intervention.

Methods: Monthly totals of death notices from the Times-Picayune were used to obtain frequency and proportion of deaths from January to June 2006. To validate this methodology the authors compared 2002 to 2003 monthly death frequency and proportions between death notices and top 10 causes of death from state vital statistics.

Results: A significant (47%) increase in proportion of deaths was seen compared with the known baseline population. From January to June 2006, there were on average 1317 deaths notices per month for a mortality rate of 91.37 deaths per 100,000 population, compared with a 2002–2004 average of 924 deaths per month for a mortality rate of 62.17 deaths per 100,000 population. Differences between 2002 and 2003 death notices and top 10 causes of death were insignificant and had high correlation.

Discussion: Death notices from local daily newspaper sources may serve as an alternative source of mortality information. Problems with delayed reporting, timely analysis, and interoperability between state and local health departments may be solved by the implementation of electronic death registration.


Key Words: excess mortality • natural disasters • hurricane Katrina • public health system • death notice surveillance • mortality data • health statistics"

"Reviews of The Making of Psychotherapists:

“An insightful study of the training of psychoanalytic psychotherapists from an anthropological perspective…[and] a valuable contribution to ethnographies of professional socialization.”
- Journal of the Royal Anthropological Institute.

“A remarkable anthropological study via participant observation of the world of psychoanalysis and psychoanalytic psychotherapy. Davies has produced a tour de force of critical yet compassionate engagement covering all aspects of our institutional life, including the institution of the clinic itself…. Anyone involved with training or other work of any kind in psychoanalytic organisations who cares about the degree of self-knowledge and social awareness they bring to their jobs should read this work.”
- Professor Andrew Samuels (Analytical Psychology), University of Essex


"According to James Davies's fascinating book, the medicalized mental health landscape in which English psychoanalytic institutes currently operate...further discourages analysts from critically assessing their institutional systems, theoretical assumptions, and professional practices....This thought-provoking book, which is suitable for teaching at both the graduate and undergraduate level, should make even the most unreflexive analyst question traditional institutional practices. If such questioning ultimately leads to better patient care, then we all stand to benefit"
- Medical Anthropology Quarterly

“James Davies has produced an unprecedented book that is stimulating, challenging and unequivocal in its claims.”
- The United Kingdom Association for Psychotherapy Integration.

“His careful and well-written examination of the training process and the insights that he brings from anthropology offer us a timely and valuable contribution to meeting the many challenges now threatening the vitality and even very existence of our profession…. This groundbreaking new book dissects the way that the profession is taught and asks whether its very vitality is at stake.”
- The Foundation for Psychotherapy

“A wise, thoughtful, careful examination of a world often shrouded in secrecy. Davies is both a trained psychotherapist and a trained anthropological observer. As a result, his observations have a quite different feel than most of the literature in either field. Not only psychotherapists, but their clients (not to mention anthropologists) can look to this book to understand how this profession learns to see and respond to human pain.”
- Professor Tanya Luhrmann, (Anthropology and Psychology),
Stanford University

“Combining narrative and analytical skills, Davies provides a gripping story of life among trainee and professional psychoanalytic therapists and their patients. The clinic is the participant anthropologist's village and the dramatis personae are the individuals he studies, whose ambitions and problems punctuate their learning and experiences of psychotherapy.... While laying bare the sometimes unpalatable essence of such training, Davies conveys warmth and empathy for his fellow participants. The value of the study goes beyond the particular instance of psychoanalysis and tells us how small groups meet all kinds of unanticipated consequences as they transmit the knowledge on which their profession depends”.
- Professor David Parkin (Social Anthropology),
University of Oxford.

“I highly recommend this book to anyone interested in the field of psychoanalysis, in
the culture of institutions, and in how institutions foster change in their constituent members.”
- Contemporary Psychology (American Psychological Association).

“James Davies’ ‘The Making of Psychotherapists: An Anthropological Analysis’ is a thorough and thought provoking anthropological study of the culture of psychoanalytic training…. On his impressive juxtaposition of mastery of both anthropological and psychoanalytic theory, Davies points out that in a parallel development psychoanalysis developed the notion of countertransference and anthropology that of self-reflexivity….Davies’ book is well written, thoroughly and academically resourced and describes with acute detail the striving for the establishment of the doctrine of psychoanalysis…. It is essential reading for anyone involved in the therapy world who is interested in the understanding of the philosophical, historical, social and political implications of the construction of psychoanalysis in the twentieth century.”
- The European Journal of Psychotherapy and Counselling."

Since the mid-1990s, Americans have been made more aware of chronic sleep deprivation and sleep disorders exacerbated by dominant temporal regimes of work, school and family life, primarily through increased medical and media attention; concomitantly, Americans have turned to medical treatments and pharmaceutical cocktails to achieve “normalcy” rather than attending to the social and cultural causes of sleep sickness. This turn toward pharmaceuticalization is aided in part by the proliferation of medical “disorders” and the pharmaceuticals marketed to treat them (e.g. “excessive daytime sleepiness” requires treatment once reserved for narcoleptics). These cocktails have explicit and implicit components: The former consist of pharmaceuticals, the latter of capital dependencies, including ties to medical insurance companies, stable employment, and familial networks. In this paper, I examine the proliferation of pharmaceutical cocktails through the concept of the pharmakon – something simultaneously remedy and cause – to illuminate the causes and effects of such pharmaceutical regimens in contemporary American society, specifically those relating to sleepiness. Specific cases of this struggle between chemical dependence and normalcy are offered from my ethnographic work with patients who suffer from sleep disorders.

Sleep, within allopathic medical and biological science, has only recently become an object of broad interest, having previously been understood as a relatively benign fact of nature. Along with this new interest in sleep, a host of sleep “disorders” have emerged, as well as a more nuanced knowledge of sleep and its biological and social effects. I n order to grow further as a sub-field, sleep physicians must make sleep mobile. This requires that sleep become abstract, that it become a more porous concept so as to allow its interconnection with diverse spheres of extant knowledge. This mobility depends on a two-fold process of representation: It begins with the rendering of patients’ bodies as “abstract bodies” and produced as data, from which they can be reconstituted as “cases;” and, with these cases in hand, sleep can be interpellated into diverse spheres of public life, from the family to the workplace and the school, and wherever else representations of cases can be made to resonate. Sleep provides an aperture through which to examine the mutually constituting roles and conceptions of the body, modernity and biopolitics as they are presently pursued in biomedical practice, of varying levels of awareness and explicitness.

"Bernstein has written an excellent book. It is full of insight, carefully researched, and casts a particular light on Taman culture."—Victor T. King, Borneo Research Bulletin

"Bernstein makes an important contribution to the ethnographic literature of what some may see as a disappearing world of traditional societies located in out-of-the-way places."—Steve Ferzacca, American Ethnologist

"Not only does it present an incisive analysis of a socio-cultural group of which we have little knowledge, [but] it is particularly rich in ethnographic detail ... providing valuable comparative material for Southeast Asian scholars."—Amanda Harris, RIMA

"Bernstein's important book is full of insight, is carefully researched and casts particular light on Taman culture. Bernstein's data are so admirably detailed that they permit us to recast our interpretations in slightly different terms.—ASEASUK News

"Rich in ethnographic detail, it additionally raises issues that transcend the Taman, making it of interest not only to Borneo and Indonesian specialists, but to all, including general readers, who are seriously concerned with shamanism and ritual healing."—Clifford Sather, Journal of Southeast Asian Studies

"Well-written and thought provoking. It will capture the attention of anyone interested in shamanism, comparative religion, and Indonesian anthropology."—David Hicks

"The author has carefully integrated ethnographic detail into a debate about cultural relativism and the advantages of accepting indigenous truth claims and beliefs in local context. The book is empirically strong, ethnographically rich, and written in clear prose. "—Gretchen G. Weix

DESCRIPTION
This fascinating case study focuses on shamanism and the healing practices of the Taman, a formerly tribal society indigenous to the interior of Borneo. The Taman typically associate illness with an encounter with spirits that both seduce and torment a person in dreams or waking life. Rather than use medicines to counter the effect of these discomforting visitors, the shamans—called baliens—use stones that are said to contain the convergence of wild spirits that have come into being during the initiation ceremony.

Jay Bernstein argues that shamanism continues to flourish not merely because of tradition, but because it meets real needs for therapy that are not otherwise satisfied. He stresses the exchange of objects in shamanic ceremonies and argues for the relevance of psychology and symbolic and social processes in explaining the identity of shamans. Finally, he situates Taman shamanism in the context of the pluralistic medical system of interior Borneo, which includes the traditions of the nearby Malay Muslims and Iban Dayaks.

Written in a style that will engage the interest of both scholars and beginning students, Spirits Captured in Stone is a valuable contribution to contemporary debates in cultural and medical anthropology; the anthropology of religion, as well as magic and ritual; folklore; and Southeast Asian ethnography.