Instructor: Sharon Abramowitz

Professor office hours: in Grinter Hall 494, Wednesdays 12:00-2:00, or by appointment.

TA: Nicole Striepe, nstriepe@ufl.edu

TA office hours: Turlington Hall B128, by appointment

Email: sabramowitz@ufl.edu, work: (352) 273-4763, cell (617) 599-0191

 

Synopsis

In our understanding of global health, the problem of culture is always an underlying issue. In this course, we examine the ways in which diverse societies construct illness and health experiences, balance healing traditions with multiple forms of medical practice, and integrate the human experiences of illness, recovery, and death with the technical world of biomedicine. Simultaneously, we engage with global health and biomedicine as cultural forms that have their own distinctive features. Looking at the global health interventions world-ide, we study how biomedicine - from epidemics, to infant mortality, to disaster relief, to DNA research – exists as a set of cultural constructs that transform human experiences of health and disease. Building upon the work of scientists, anthropologists, and scholars of the medical humanities, we explore new ways of thinking about global health and culture as global health institutions and forces are changing in the 21^st century.

 

Course Description

What is health? Is health a human right? How is the experience of being sick shaped by one’s culture? Does biomedicine stand apart from “culture” and “tradition” in our understanding of health and disease? Are biomedicine and international global health also “cultural,” or is “culture” just the exotic? Moreover, where is global health?

 

Using the work of scientists, anthropologists, and scholars of the medical humanities, this course explores new ways of thinking about global health and culture in the context of changing global health, medical, research, and security institutions in the 21^st century. This course uses ethnographic writings from around the world – including the United States, China, South Africa, France, and the former Soviet Union to explore health experience, health discourses, traditional and biomedical practices, and health governance in a global perspective. Our readings and conversations will serve as the springboard for a semester-long discussion about the meanings of health, sickness, and health justice, with an eye towards interrogating the emerging international principle of “health as a human right.” Through this discussion, we will be challenged to reconsider some of our own taken-for-granted assumptions about the infections and inequalities, global hierarchies of power, local health cultures and experiences, transnational health movements, and global arrangements of development and underdevelopment health – and bodies -- as problems of human security.

 

Course Objectives

• By the end of the semester, you will have been introduced to a diversity of cultural approaches to health and illness. You will have received instruction in the values, attitudes, and norms that constitute health-related aspects of culture in countries outside the U.S., and you will also have gained an understanding in the values, attitudes, and norms of western biomedicine.
• You will have been trained to distinguish between “traditional healing” and biomedical knowledge and practices, and you will have been trained to think critically about health in transcultural perspective.
• You will have studied biomedical knowledge as a cultural domain.
• You will have acquired a fluency in the core concepts of medical anthropology and global health, and been exposed to a broad range of theories and methodologies in medical anthropology.
• You will have learned to identify, describe, and explain the social institutions, structures, and processes that shape global health processes and outcomes at both the local level of practice, and the global level of transnational intervention. Specific issues addressed in the regard include: pandemic diseases, global forms of health intervention, the creation of international health standards, and the provision of NGO and state-sponsored health resources.
• You will have been exposed to critical theories regarding health, justice, and human rights. By the end of this semester, you will have considered multiple perspectives on the meanings of health justice in comparative perspective. You will be able to consider the principles of “health justice” and “health as a human right,” and formulated a distinct and individual position on the matter.

 

Requirements

Class Participation (10%)

Quiz 1 (20%)

Quiz 2 (20%)

Team Assignment (20%)

Final Exam (30%)

 

Attendance Policy and Class Participation

Class participation is mandatory, and class participation will be based in part on attendance. Attendance is mandatory, and foundational concepts and definitions that cannot be found in the readings will be introduced during lecture at every course meeting. During our course meetings, every student will be expected to participate in class discussion in a way that provokes thoughtful engagement with classmates.

 

Quizzes

Three take-home quizzes will be administered electronically over the course of the semester, through the Canvas system. Each quiz will include three open-ended questions covering the readings, social science methods and theories, and the broader themes of the course. For the first two quizzes, each answer should come to no more nor less than 300-350 words, with each quiz totaling approximately 750-1500 words. The final quiz will have customized instructions.

 

Quizzes will be administered on the following dates: September 23^rd-24^th, October 28 ^th-30^th, and during the final exam period.  Quizzes will open at 8:00AM on the first day, and they will close at midnight on the second day. During this time, students may engage in an open-book review of the materials. You may consult with your peers while working on take-home quizzes, but all work needs to be submitted individually, and it must be original. No group work will be accepted. Final quiz answers must be submitted electronically. Any references cited in the quizzes must be presented in appropriate citation format. All references require parenthetical citations and bibliographic references. The bibliographic material must be submitted in formal APA, Chicago Style, or American Anthropological Association citation conventions. If you are aware of a pending conflict with the quizzes, please let the instructor know immediately so that alternative accommodations can be made.

 

Team Assignments

The instructor will be assigning a teams-based global health cultures practice assignment. Students will have three in-class days to work on the assignment with their teammates, during a week for research and documentation. More details will be provided prior to the start of the team assignment period, but anticipate critical engagement, real-world examples, and multi-media usage. Team assignment grades will be based on two criteria (1) peer-review of participation and group contributions logged into Canvas, and (2) the evaluation of the submitted assignment. Assignment will be due on November 25^th. Students must receive confirmation from the TA that the TA has received their assignment as submitted in full.  There will be no late submissions accepted!

 

Grades

Grades for this course will be assigned according to UF’s grading policy. For further information, please review the UF policy here:  https://catalog.ufl.edu/ugrad/current/regulations/info/grades.aspx#grades.

 

Course Readings and Materials (Recommended, not Required)

• A Reader in Medical Anthropology: Theoretical Trajectories, Emergent Realities. Eds: Byron Good, Michael MJ Fischer, Sarah Willen, Mary-Jo DelVecchio Good. Wiley Blackwell Publishers.
• Global Pharmaceuticals: Ethics, Markets, Practices. Adriana Petryna, Andrew Lakoff, Arthur Kleinman.
• The Spirit Catches You and You Fall Down. Ann Fadiman.
• An Anthropology of Biomedicine. Nguyen and Lock

 

All readings will be posted in the resources folder of the course website as .pdfs. It is recommended that students purchase books in electronic version (aka Kindle), or previously owned, via the Internet.  All media material will be available free, via the Internet.

 

Policy on Late Assignments

You are required to complete all assignments by the stated due dates. Late assignments will lose one half-letter grade for each day past the deadline. There are no make-up opportunities for any assignment, as you will have ample time to complete each requirement. I will not assign grades of “incomplete” except under extreme circumstances (and only if you have completed 50% of the coursework). You must provide documentation of such circumstances from an appropriate authority.

 

“Requirements for class attendance and make-up exams, assignments, and other work in this course are consistent with university policies that can be found in the online catalogue at http://catalog.ufl.edu/ugrad/current/regulations/info/attendance/aspx.

 

Policy on Letters of Recommendation

The instructor is happy to write a letter of recommendation for you if you earn a grade of A- in the course or better, or distinguish yourself academically, as a leader among your peers, or through your research and service. The instructor will only write letters of recommendation with four weeks notice, and will require explicit instructions for submitting letters of recommendation, as well as a full statement of purpose, your resume, and an explanation of your intent in applying to the position or program. Please note – if you do not distinguish yourself through service, coursework, or research, I will not be able to give you an excellent recommendation.

 

Academic Honor Code

UF students are bound by The Honor Pledge, which states, “We, the members of the University of Florida Community, pledge to hold ourselves and our peers to the highest standards of honor and integrity by abiding by the honor code. On all work submitted for credit by students at the University of Florida, the following pledge is either required or implied: “On my honor, I have neither given nor received unauthorized aid in doing this assignment.” The Honor Code (http://www.dso.ufl.edu/sccr/process/student-conduct-honor-code/) specifies a number of behaviors that are in violation of this code and the possible sanctions. Furthermore, you are obligated to report any condition that facilitates academic misconduct to appropriate personnel.

 

Americans with Disabilities Act

Students requesting classroom accommodation must first register with the Dean of Students Office. The Dean of Students Office will provide documentation to the student who must then provide this documentation to the Instructor when requesting accommodation. For more information, contact:

Dean of Students Office Disability Resource Center

202 Peabody Hall or 0020 Reid Hall

Phone: (352) 392-1261 Phone: (352) 392-8570

 

University of Florida Counseling Services

Resources are available on-campus for students that feel like they are struggling in their personal or academic life. These resources include:

• University Counseling Center, 301 Peabody Hall, 392-1575, personal and career counseling
  • http://www.counseling.ufl.edu/cwc/Default.aspx
• Student Mental Health, Student Health Care Center, 392-1171, personal counseling
• Sexual Assault Recovery Services (SARS), Student Health Care Center, 392-1161, sexual counseling
• Career Resource Center, Reitz Union, 392-1601, career development assistance and counseling
• University Police Department, 392-1111, or 9-1-1 for emergencies

 

Online Course Evaluations

Students are expected to provide feedback on the quality of instruction in this course based on 10 criteria. These evaluations are conducted online at http://evaluations.ufl.edu. Evaluations are typically open during the last two or three weeks of the semester, but students will be given specific times when they are open. Summary results of these assessments are available to students at http://evaluations.ufl.edu/results.

 

 

Course Schedule

 

 

Date	Topic	Reading Assignment
8/24	What is Health?	Nancy Scheper-Hughes and Margaret Lock, “The Mindful Body” Hans Rosling, “The Best Stats You’ve Ever Seen” (Video) Recommended: Frankfurter “The Danger of Losing Sight of Ebola Victim’s Humanity”
8/26	Critical Medical Anthropology	Brown, Barrett, and Padilla, “Medical Anthropology: An Introduction to the Fields” Merrill Singer, “Beyond the Ivory Tower: Critical Praxis in Medical Anthropology”
Section 1: Health Cultures
8/28	Illness vs. Disease	Arthur Kleinman, “The Meaning of Symptoms and Disorders” Arthur Kleinman, “The Personal and Social Meanings of Illness”
8/31	Illness Experience	Bob and Lee Woodruff Interview on American Public Media’s Word for Word (audio) Robert Desjarlais, “Struggling Along: The Possibilities for Experience among the Homeless Mentally Ill”
9/2	Cultural Validity	Barbara Ehrenrich, “Smile or Die: Breast Cancer”
9/14	Medicine, Rationality, and Risk	Evans-Pritchard, “The Notion of Witchcraft Explains Unfortunate Events” Jared Diamond, “That Daily Shower Can Be a Killer”
9/16	Medical Epistemologies	Charles Leslie, “Introduction to Asian Medical Systems” Kuriyama, “The Expressiveness of the Body”
9/18	Structural Violence/ Sickness and Justice	Farmer, Paul. “On Suffering and Structural Violence: A View from Below” Rudolph Virchow, “The Charity Physician” Tracy Kidder, Mountains Beyond Mountains Parts I & II
9/21	Idioms of Distress and Culture-Bound Syndromes	Choose 2: Nancy Sheper-Highes, “Nervoso: Medicine, Sickness, and Human Needs,” Guarnaccia, Peter J. "Ataques de nervios in Puerto Rico: Culture‐bound syndrome or popular illness?." Medical Anthropology 15, no. 2 (1993): 157-170. Lee, Sing. "Reconsidering the status of anorexia nervosa as a Western culture-bound syndrome." Social Science & Medicine 42, no. 1 (1996): 21-34. Quinlan, M. B. (2010). Ethnomedicine and ethnobotany of fright, a Caribbean culture-bound psychiatric syndrome. J Ethnobiol Ethnomed, 6(9). Hegeman, E. (2013). Ethnic syndromes as disguise for protest against colonialism: Three ethnographic examples. Journal of Trauma & Dissociation, 14(2), 138-146.
9/23	QUIZ 1: ONLINE: NO CLASS
Section 2: The Culture of Biomedicine
9/30	What’s a Disease?	Brigid Schulte, “The Morgellons Mystery”
10/2	Medicalization	Lock and Nguyen, “Anthropologies of Medicine”
10/5	Histories of Disease	Aronowitz, “Addicted to Mammograms,” Peggy Orenstein, “Our Feel-Good War on Breast Cancer”
10/7	Biomedicine & Cultural Sensitivity: The Patient’s Perspective	The Spirit Catches You and You Fall Down Ch. 1-10 (be prepared for class participation)
10/9	Medical Training	Evans-Pritchard, “Training of a Novice in the Art of a Witch Doctor,” Byron Good, “How Medicine Constructs Its Object”
10/12	Healing Rituals & Therapeutic Emplotment	Victor Turner, “Muchona, The Hornet” Cheryl Mattingly, “The Concept of Therapeutic Emplotment”
10/14	Critiques of Biomedicine	The Debate over Autism and Vaccines
10/16	What’s Normal?	Lock and Nguyen, “The Normal Body”
10/19	Medical Mistakes	Atul Gawande, “Complications” p.11-74. 88-108
10/21	Race and Medicine GUEST SPEAKER: DR. LANCE GRAVLEE	Clarence Gravlee, “How Race Becomes Biology: Embodiment of Social Inequality” Hannah Landecker, “Immortality, In Vitro: A History of the HeLa Cell Line”
10/23	Critiques of Psychiatry	Interview with Dr. Allen Frances on Diane Rehm Show : The Validity of DSM-V
10/26	Medical Ethics: Research and Practice	Brandt, Allan. “Racism and Research: The Case of the Tuskegee Syphilis Study” Adriana Petryna, “Globalizing Human Subjects Research”
10/28	Biomedical Technologies Genetics (no class, read at home)	Lock and Nguyen, “Biomedical Technologies in Practice” Lock and Nguyen, “Genes as Embodied Risk” Angelina Jolie, “My Medical Choice” NYT
10/30	QUIZ 2: ONLINE: NO CLASS
Section 3: Global Health
11/2	EPIDEMICS AT HOME: EVENING VIEWING OF THE FILM AND THE BAND PLAYED ON FOLLOWED BY DISCUSSION (NOTE: NO CLASS DURING THE DAY. NIGHT CLASS FILM VIEWING)
11/4	Ebola Vaccines and Clinical Trials: Prof. Abramowitz Skypes in from International Conference in Geneva on Ebola and Clinical Trials
11/6	No Class: Homecoming
11/9	The Charitable Impulse	Berry, N. S. (2014). Did we do good? NGOs, conflicts of interest and the evaluation of short-term medical missions in Sololá, Guatemala. Social Science & Medicine.
11/11	No Class: Veteran’s Day
11/13	The Global Health Marketplace	Lock and Nguyen, “Who Owns the Body?” Ecks and Harper, “Public-Private Mixes: The Market for Anti-Tuberculosis Drugs in India”
11/16	Local Biologies	Lock and Nguyen, “Local Biologies and Human Difference”
11/18	Global Health Cultures in Practice: Team-based Learning Days “Ebola Games” Readings: Emergency Ebola Anthropology Network Advisory Brief “Culture and Clinical Trials,” ERAP’s “Anthropology and Clinical Trials,” Limn Issue #5: Ebola’s Ecologies; http://limn.it/issue/05/ or on canvas as PDF, Paul Farmer, “Diary,” London Review of Books http://www.lrb.co.uk/v36/n20/paul-farmer/diary
11/20
11/23
11/25	No Class: Global Health Cultures in Practice Assignment Due
11/27	No Class: Thanksgiving
11/30	Population Health	Lock and Nguyen, “The Right Population”
12/2	Global Health & Global Health Security	Laurie Garrett, “The Return of Infectious Disease,” “The Nightmare of Bioterrorism”
12/4	The Rights to Our Bodies?	Liptak, “Justices, 9-0, Bar Patenting Human Genes” Biehl, Joao and Adriana Petryna “Therapeutic Markets and the Judicialization of the Right to Health”
12/7	Global Pharmaceuticals	Andrew Lakoff, “High Contact: Gifts and Surveillance in Argentina” Han, Clara “The Work of Pharmaceuticals in Santiago, Chile”
12/9	Death and Life in Global Health Cultures	Kleinman, “Illness unto Death” Lee, Rebekah “Death on the Move: Funerals, Entrepreneurs, and the Rural-Urban Nexus in South Africa”
12/18	FINAL EXAMS DUE