"[There is a ]
need to beware of that country’s model of health care as a template for other
nations, but also the great importance of heeding Illich’s warning to guard
against the social and cultural iatrogenesis that would result in ‘the
paralysis of healthy responses to suffering, impairment and death’ and lead to
a disabling dependence on ‘health care’ (Illich 1976)."
- Global Health Watch
"It is not
inequality which is the real misfortune, it is dependence."
― Voltaire
Often when thinking
about a way to fix a problem it is much simpler to provide a temporary solution
rather than find the origin of said problem and eliminating it. Frequently
temporary solutions come in a form of aid that does more harm than good. As a
position of power the global north tends to focus time and energy finding “solutions”
to the health problems prevalent in the global south. While it may seem
instinctual and nurturing, the care that world powers provide for 3rd
world countries initiates a cycle of dependence that is not only harmful but will
lead to an imminent demise.
The three pieces that I chose were a quote from Illich which was included in the text of Global Health Watch, an image produced from a Google search, and a quote from Voltaire.
The three pieces that I chose were a quote from Illich which was included in the text of Global Health Watch, an image produced from a Google search, and a quote from Voltaire.
The first
quote from Illich makes the claim that it is not possible to use the healthcare
systems of countries in the global north as templates for creating systems for
the global south. This provocative statement challenges the global north in
multiple ways. First, this quote is implying that there is some flaw within the
healthcare systems themselves that make it impossible to apply to a 3rd world
nation. Second, he asserts that this donation of a healthcare infrastructure
would be a “disabling dependence” instead of a solution. Both of these
implications, while accurate, are not how the global north thinks. With a
capitalistic agenda and demeanor, world powers dominate because of their notion
of having the best solution to all problems of the world.
The image
above is a depiction of a string of hands that are controlling the movement of
each person in front of it. If the image is viewed from left to right it ends
with the largest hand. It is easy to apply the concept of dependence to this picture
by noticing that without the hand behind the person, their 'legs' would not be
there. It is possible to both literally and figuratively rip the feet out from
underneath another nation if they are completely reliant on the aid of another
country.
The final
quote comes from Voltaire, who makes the statement declaring dependence as the
ultimate misfortune above all else. There is one desire that transcends all
international boundaries, it is known as independence. I think that Voltaire is
explaining that if a nation-state is provided a resource in which their entire
populace is dependent on, then there will be more problems than before that
donation was given; and ultimately their independence will be gone.
These three
pieces illustrate that being dependent on another nation in a medical, social,
political, or economical way could lead to monopolization and manipulation of
the indigenous populace and resources. If dominant countries and powers want to
invest in global health then there needs to be collaboration, education, and
self-sufficiency. I believe those three pieces to be the most important part of
assisting 3rd world countries. Without collaboration the local problems are
likely to be different then the problems that an outside source sees. Without
education problems that have been fixed will become problems again. And without
self-sufficiency independence will be gone, and an outside source will always
be needed.
The
problem of dependence within global health is analogous to a failing heart; a
Band-Aid will not replace a heart, and the 3rd world’s dependence on the
global north will not solve their lack of healthcare. Similar to the Chinese
Proverb stating “Give a man a fish you feed him for a day. Teach a man to fish
feed him for a lifetime”, global health should not be seen as the practice of
solving 3rd world medical problems; rather a force united for the
cause of equality within prevention and treatment of the global populace.
-Brittany Peters-
Sources
In Class: World Health Watch- An Alternative World Health Report
Image: Google
Outside Class: http://www.goodreads.com/quotes/tag/inequality?auto_login_attempted=true
I agree with the points made in this blog. First, that dependence can be deadly and that education and collaboration must be paramount for healthcare systems to remain sustainable. The Illich quote echoes a sentiment of Paul Farmer’s that he expresses in the Tracy Kidder book, Mountains Beyond Mountains; that you cannot impose the Global North’s healthcare systems on the Global South. Farmer see’s this as an economic problem, many third world countries lack the infrastructure and the funds to support the kind of healthcare systems that many countries of the Global North have. “One time he got in an argument about Cuba with some friends of his, fellow Harvard professors, who said that the Scandinavian countries offered the best examples of how to provide both excellent public health and political freedom. Farmer said they were talking about managing wealth. He was talking about managing poverty. Haiti was a bad example of how to do that. Cuba was a good one.”
ReplyDelete(Kidder 2003) So, if we look at a poor country like Cuba and their healthcare, which works quite well, how can we take what works there and apply that to other poor nations?
Collaboration and education must be paramount and really collaboration must come first. What do the nations that the NGO’s and PPP propose to help, think they need help with? Rather than marching in and forcing a local population to adhere to certain aspects of a plan, why not ask? We only have to look to the disaster of the Play Pump to see the results of doing without asking. This idea of collaboration is taken a step further in the Borofsky book, “Why a Public Anthropology?” in which the author poses the question, is it enough for anthropologists to just “do no harm”? Why a public anthropology? Rather than just report on what might be good from the scientist’s perspective we should be asking of the community, what they think would be good, what changes they want to see and what help they want. Education, I think is key to independence. If people in the country cannot sustain the results produced by initial outside help, then the chain of dependence continues. This form of education must fit with a plan of community based (horizontal) healthcare. People who live in the country and understand the ongoing changes in politics, economy and culture, will know best how to carry and evolve the system for the changing needs of the community. Educating those within the community as leaders of healthcare may help from a ethnophysiological standpoint as well, for persons who are already aware of the local practices would better understand how to educate the general population. Although as we read in Nichter chapter four; some local health practitioners such as doctors in India gave into cultural pressure from their patients to secure their private practice. Giving patients certain drugs only because patients insisted on them, even if that drug course was not considered best practice. Because other doctors were using this practice and this puts pressure on doctors who see a certain class of patients to provide that same course.
As usual, we can see that when the problems of Global health are examined they are big, and messy as we learned in the first week of the course, and there are no east answers.
-Crystal V.
Sources:
Kidder, Tracy (2003-09-09). Mountains Beyond Mountains (p. 194). Random House, Inc.. Kindle Edition.
(Kindle Locations 735-737). Center for a Public Anthropology. Kindle Edition.
This post touches on a very critical aspect of not only global health matters, but also global issues as a whole. Too often, being from the “global north” and a global superpower, we view issues very ethnocentrically. It seems like mindsets are “if it works here, then it will work there,” but in reality that is not true at all.
ReplyDeleteI want to expand on the dependency points. Brittany sums up the argument up by saying, “And without self-sufficiency independence will be gone, and an outside source will always be needed.” I agree with her critique and it made me think about a situation with the Hmong people during the Vietnam War. In a class I took last year, Anthropology of Southeast Asia, we read a book by Sucheng Chan called Hmong Means Free. It discussed the life of a Hmong refugee in America and the class talked about the implications of the United State’s actions on the Hmong people. We, the United States, recruited the Hmong people and in turn for their aid, we provided them food. Since they did not have to farm for food, rather help in the war, they did not carry on their tradition of farming. After the war, many Hmong people came over to the United States, as refugees, and spread throughout Southeast Asia. Wherever they went, they were deprived of their traditions because of our aid. The US helped the Hmong while they fought with us, but after the war was over we stopped giving. The Hmong are still facing many challenges with acclimating to life in the United States and wherever their refugee country is. We did this to them. We made them completely dependent on our aid and then stopped giving all together. It is a sad consequence that, arguably, good intentions created.
In regards to medical anthropology, I think this is a vital feature anthropologists must acknowledge. Essentially one is supposed to leave no mark of outsiders in a culture they have worked with. When an anthropologist is asked to intervene, however, they must weigh ways to improve issues without taking away their culture or traditions. This, I think is the most difficult, because sometimes the traditions are what is causing the problems. For example, kuru is a disease that affects the nervous system. This disease is rare, but it is deadly and it has been seen to be prevalent in Papua New Guinea tribes who practice cannibalism. Cannibalism is a tradition sacred to their culture, yet it is causing this fatal disease. It is a cycle because once someone dies of Kuru, they are ingested by their tribe, and then they get sick as well, and then there is a newly infected person who is going to be eaten next. Though this is hazardous to health, it is against anthropology, and some morals, to stop another cultures tradition. In our culture looking into theirs, it is wrong, but who is to say that we are right?
Ethnocentrism is imperative to avoid in anthropology. I think it is pretty much impossible to have a totally neutral view on an issue or a culture, but nothing should be labeled as “correct” or “better.” I think Brittany brought up a great point of dependence and it is well illustrated in the picture. There is no one, no culture, on this planet that has the right to be that first hand, the one ruling all.