Module Code and Title:         ATH102: Medical Anthropology

Programme:                          BA in Anthropology

Credit:                                   12

Module Tutor:                       Dolma Choden Roder

General objective: This module aims to provide an introduction to the central concepts and concerns of medical anthropology. Students will learn to think critically about the body, health, and medicine. In particular, they will look at the way in which ideas around these topics are historically, culturally and politically contingent. This module will take a cross-cultural approach to exploring a range of relevant topics.

Learning outcomes – On completion of this module, students will be able to:

1. Discuss the anthropological approach to issues around health, illness and the body.
2. Develop a cross-cultural understanding of health, illness and the body.
3. Examine medical beliefs and practices within particular cultural, historical and political contexts.
4. Summarize the history of biomedicine.
5. Evaluate the impact of medicalization on human culture and health.
6. Analyse individual experiences of illness and healing.
7. Evaluate health inequalities at both the local and global level.

Learning and Teaching Approach:

Assessment Approach:

A. Field trip report: Portion of Final Marks: 10%

Over the course of this module students will individually write a report on a field trip made to a relevant health-related site (logistics of the field trip will be organized by the tutor and could include a field trip to the indigenous hospital, the medical college, a BHU, or a particular unit within the hospital). These reports are expected to be both descriptive (for example, describing the site, the people at the site) and reflective (showing that students are attempting to make thoughtful and sincere observations) and must demonstrate the application of relevant key module concepts such as doctor-patient interactions, medicialization or medical pluralism. Students will be provided with a grading rubric that will help to guide the writing of the field report. Reports are expected to be 300-500 words in length.

2%       Description of the site/ summary of the visit (accuracy and completeness)

5%       Quality of analysis (includes well stated and original analysis, uses relevant module concepts and adequate support for all claims made)

1%       Organization

1%       Language       

1%       Referencing

B. Illness narrative: Portion of Final Marks: 10%

Students will interview someone who has either experienced an illness or a medical event. They will then produce an “illness narrative” based on the interview that recounts the experience as well as analyses its contents in relation to topics and ideas covered in the module. The narratives will be expected to be 300-500 words long.

2%       Draft of Illness Narrative (adherence to set criteria, quality of observations, uses relevant and adequate support for all claims made)

5%       Quality of Narrative (adherence to set criteria, quality of observations, uses relevant and adequate support for all claims made)

1%       Improvement of final product (in comparison to draft, with particular emphasis on consideration and incorporation of feedback provided)

1%       Organization

1%       Language and Referencing

C. Illness narrative presentation: Portion of Final Marks: 5%

Students will orally present their illness narratives to their classmates. The presentations will be between 7 and 10 minutes long. The presentation will be assessed on:

3%       Content (how well does the presentation address specified criteria, quality of overall narrative, all claims relevant and supported)

1%       Organization and Language use

1%       Delivery (volume, pace, efforts to engage audience) and time management

D. Class Test: Portion of Final Mark: 10%

Students will undertake a class test twice during the semester; once before mid-term and once after mid-term (5% each). The written test will be conducted within the class for duration of 40-50 min and cover 2-4 weeks of material. The tests are intended to help students better prepare for the exams as well as serve as an early indicator for tutors to gauge student’s level of understanding.

E. Class participation and preparedness: Portion of Final Mark: 10%

Students will be expected to participate substantially in class discussions, with contributions reflecting adequate preparation for topics under discussion. 5% of class participation and preparedness will be assessed before midterm, and the remaining 5% post midterm.

F. Midterm Examination: Portion of Final Mark: 15%

Students will take a written exam of 1.5 hr duration covering topics up to the mid-point of the semester.

Pre-requisites: AFD101: Introduction to Anthropology

Subject matter:

1. Unit I: Introduction to Medical Anthropology
   • History of medical anthropology: origin and influences
   • Definitions of key terms and concepts in medical anthropology
   • The importance of context to medical anthropology
   • Cross-cultural approaches to medicine and health: method, justification and strengths
2. Unit II: Anthropological Approaches to Health and Illness
   • The differences between health and illness
   • Definitions and scope of “normal”
   • Cross cultural understandings of well-being
   • Cross cultural understandings of illness
   • The sick role and illness narratives (Kleinman)
3. Unit III: An introduction to Biomedicine
   • Definition and implications of biomedicine (Good)
   • The history and spread of biomedicine
   • The medicalization of everyday life: implications, impacts and examples
   • The relationship of biomedicine to non-western cultures (Fadiman)
   • Biomedicine’s entanglements with political economy
   • Alternatives to biomedicine (e.g. Homeopathy, Ayurvedic, Chinese)
   • Systems of medical pluralism: definitions, implications and examples
4. Unit IV: Bodies and Selves
   • Anthropological theories of the body (Lock): definitions and key debates
   • The relationship between embodiment, identity and suffering (Martin): definitions and implications
   • The relationship between stigma and illness: definitions and examples
   • Medical anthropology approaches to mental health (Rosenhan)
   • The relationship between understandings of the body and the life course
     • Birth and reproduction: descriptions and examples
     • Dying and death: descriptions and examples

5. Unit V: Illness and Inequality
   • Human rights discourses and health: definitions and debates
   • Understanding and describing health care disparity: descriptions, implications and examples
   • Structural violence (Farmer): definition, description and implications
   • Critical medical anthropology
6. Unit VI: Culture and Health in Bhutan
   • Local understandings of health and illness: definitions and descriptions
   • Tibetan Buddhist discourses of health, illness and the body: definitions and implications
   • Traditional Bhutanese Medicine (Sowa Rigpa): descriptions and implications
   • Emergent health research in Bhutan: descriptions and debates
   • Medical pluralism in Bhutan: description and implications

Reading List:

1. Essential Reading
   • Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors and the collision of two cultures. New York: Farrar, Straus and Giroux.
   • Farmer, P. (2004). Pathologies of power: Health, human rights and the new war on the poor. Berkeley: University of California Press.
   • Lhamo, N. & Nebel, S. (2011). Perceptions and attitudes of Bhutanese people on Sowa Rigpa: Traditional Bhutanese medicine: A preliminary study from Thimphu. Journal of Ethnobiology and Ethnomedicine, 7(1).
   • Taylor, J. (2003). The story catches you and you fall down: Tragedy, ethnography and ‘cultural competence’. Medical Anthropology Quarterly, 17(2), 159-181.
   • Yangchen, S., Tobgay, T. & Melgaard, B. (2016). Bhutanese health and health care system: Past, present and future. The Druk Journal, 2(1).
2. Additional Reading
   • Adams, V. (1992). The production of self and body in Sherpa-Tibetan Society. In M. Nichter (Ed.), Anthropological approaches to the study of ethnomedicine (pp. 149-190). Tuscon, AZ: Gordon and Breach.
   • Adams, V. (2001). The sacred in the scientific: ambiguous practices of science in Tibetan Medicine. Cultural Anthropology, 16(4), 542–575.
   • Benedict, R. (1934). Anthropology and the Abnormal. In M. Mead (Ed.), An anthropologist at work: Writing of Ruth Benedict (pp. 262-283). New York: Avon Books.
   • Choden, K., Tobgay, S., & Ugyen. (2013). Healthy Gross National Happiness. Indo-Bhutan International Conference on Gross National Happiness, 2, 221-228.
   • Dorji, T. & Melgaard, B. (2012). Medical history of Bhutan: Chronicle of health and disease from Bon times to today. Thimphu: Centre for Research Initiatives.
   • Edmonds, A. (2007). Even the poor have a right to be beautiful: Cosmetic surgery in neoliberal Brazil. Journal of the Royal Anthropological Institution, 13(2), 363-381.
   • Good, B. (1994). How does Medicine Construct its Objects? In Medicine rationality and experience: An anthropological perspective (Lewis Henry Morgan Lectures) (65-87). Cambridge: Cambridge University Press.
   • Gyatso, J. (2004). The authority of empiricism and the empiricism of authority: Medicine and Buddhism in Tibet on the eve of modernity. Comparative Studies of South Asia, Africa and the Middle East, 24(2), 83-96.
   • Kleinman, A. (1988). Personal and Social Meaning of Illness. In The illness narratives: Suffering, healing and the human condition (pp. 31-55). New York: Basic Books
   • Lock, M. (1993). Cultivating the body: Anthropology and the epistemologies of bodily practice and knowledge. Annual Review of Anthropology, 22, 133-155.
   • Lorway, R., Dorji, G., Bradley, J., Ramesh, B.M., Shajy, I., & Blanchard, J. (2011). The Drayang Girls of Thimphu: Sexual network formation, transactional sex and emerging modernities in Bhutan. Culture, Health & Sexuality: An International Journal of Research, Intervention and Care, 13(sup2), S293-S308.
   • Martin, E. (2001). The women in the body: A cultural analysis of reproduction Boston: Beacon Press.
   • Rosenhan, D. L. (1973). On Being Sane in Insane Places. Science, 179(4070), 250-8.
   • Wangchuk, P., & Tobgay, T. (2015). Contributions of medicinal plants to the Gross National Happiness and Biodiscovery in Bhutan. Journal of Ethnobiology and Ethnomedicine, 11, 48.

Date: March 15, 2018