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EN
Illness is a phenomenon that goes beyond its purely medical dimension; its social and cultural aspects are noted more and more often. The turn to medical anthropology discussed in the article as well as contextual approach to communication viewed through culture demonstrate that illness is a phenomenon that should be talked about openly. The research referred to by the author shows that thanatological themes should not be avoided also in conversation with children. Thanks to an analysis of therapeutic tales structured by Woźny’s cultural script it has been possible to demonstrate that conversations about death lose their dramatic quality, if they are based on metaphor. A vivid, well-ordered presentation of dying in the form of a metaphor from a tale is one of the ways of teaching children the truth about death. Presenting dying in the form of a ritual is thus a ready-made pattern, i.e. a cultural script.
EN
The text focuses on the theme of health care and amateur treatment in the extreme conditions of increased radiation after the explosion of the nuclear reactor at the Chernobyl power plant. It reconstructs the plight of the population from the accounts of residents living near the Chernobyl power plant, some of whom resettled in the Czech Republic, and analyses the relationship of the new state of affairs for folk healing. The text shows the logic of the adaptation mechanisms of the group of people to the new circumstances and their mobilization of the cognitive potential in the conditions in which professional aid and biomedicine, which they commonly used, failed. Besides the traditional practices of folk treatment, innovations based on scraps of information gathered from the mass media, reading, knowledge of a healthy lifestyle, the application of extreme medical cures devised by doctors through experimentation, assert themselves under extreme conditions. Other than the information on the application of specifi c methods and procedures, the text shows the process of how ‘human wisdom’ on health and disease is formed and adapts to a new, in this case extreme, situation. In an individualized, complex society, these ideas are distinctly private, fl exible and situational.
EN
The text focuses on the theme of health care and amateur treatment in the extreme conditions of increased radiation after the explosion of the nuclear reactor at the Chernobyl power plant. It reconstructs the plight of the population from the accounts of residents living near the Chernobyl power plant, some of whom resettled in the Czech Republic, and analyses the relationship of the new state of affairs for folk healing. The text shows the logic of the adaptation mechanisms of the group of people to the new circumstances and their mobilization of the cognitive potential in the conditions in which professional aid and biomedicine, which they commonly used, failed. Besides the traditional practices of folk treatment, innovations based on scraps of information gathered from the mass media, reading, knowledge of a healthy lifestyle, the application of extreme medical cures devised by doctors through experimentation, assert themselves under extreme conditions. Other than the information on the application of specifi c methods and procedures, the text shows the process of how ‘human wisdom’ on health and disease is formed and adapts to a new, in this case extreme, situation. In an individualized, complex society, these ideas are distinctly private, fl exible and situational.
Human Affairs
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2015
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vol. 25
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issue 3
276-287
EN
The paper offers a brief review of ethnological studies conducted in Slovakia in relation to the main theoretical directions in medical anthropology. This sub-discipline of social/cultural anthropology has not yet been established in Slovakia owing to local scientific traditions. The author covers ethnographic studies conducted in Slovakia that might be considered relevant to this field and places them in the context of developments in anthropology in central and eastern Europe. Ethnological work and empirical findings obtained in related social disciplines may motivate future inquiry. Recent ethnological studies have followed a new direction in research and suggest the beginnings of medical anthropology in Slovakia.
EN
This article is an ethnographic exploration of the responses of doctors to the 1997 healthcare reform in Poland. Based on research carried out among practitioners working in Podstawowa Opieka Zdrowotna (POZ, “Basic Healthcare”), which was established in 1997 and opened up to the market, I demonstrate the newly emerged self-identification of doctors, which can be expressed by the term, “the expanded doctor”. Following Elizabeth Dunn’s and Asta Vonderau’s ethnographies of post-socialist reconstructions, I examine how POZ practitioners became “expanded doctors”, and what particular elements constitute this novel and liberal self-definition. Based on Eliane Riska and Aurelija Novelskaite’s description of practitioners’ experiences of transforming from a planned economy to a world composed of “four logics”, I analyse the entrepreneurial face of the doctors’ self-identification, their attachment to private ownership, and the cult of liberal capitalism.
EN
The current frailties of the Romanian health care system are often explained by resorting to the previous regime’s institutional framework, rarely accepting that they are also the product of post-1990 reforms and the neoliberal means of system reconfiguration. This paper provides an ethnographic account of the ways in which two “products” of these reforms actively contribute to the augmentation of private medical services and to the diminishing access to quality care in the public system: the bureaucratization of primary medicine and the “dual medical practice”. More specifically, I use the concept of “informal exchanges” in order to explore the variety of transactions that occur between patients and the health care staff and to document the means through which its main social actors understand, reproduce, legitimize or blame the very existence of these practices. Then, I analyze how referrals to private medical units increasingly replace informal payments, simultaneously laying even harder obstacles in the access to health care for those in need.
EN
Since ancient times, cauterisation has been used in Africa as a treatment of wounds as well as other ailments. Arabs gained the knowledge of cauterisation from the work of Paul of Aegina and developed this method of treatment between the 9th and 10th century. Cauterisation was perfected by the Ottoman Empire. Currently, cauterisation is being used on almost the entire continent to treat ailments in people and cattle. As a result of skin burning, the body attempts to fight the results of tissue necrosis, initiating the process of healing of any inflammation in that area. This cruel method of pain treatment causes a number of complications, even death, and because of this there is pressure on therapists to give up this method of treatment.
EN
“Cancer. Anthropological study of practice and narration” by Hubert Wierciński is a work in the field of medical anthropology, a discipline gaining recent popularity in Poland. Author interviewed 44 people at selected medical facilities and among oncological patient’s organizations members. Using tools developed in so called “narrative paradigm” which has been founded in the 80’s of XX century, he describes world of people suffering from cancer. Wierciński challenges the idea that the life medicalization process is unambiguously harmful for the patients – a view developed by critical theory. According to authors notion, modern medicine helps patients organizing their experience and delivers useful language for its description. Gathering data supporting this view is certainly an important achievement. Other one is drawing attention on patient’s organizations importance for regaining psychological well-being process. The major drawback of Wierciński work is ambiguous metaphor according to which “narration is a medicine”. It can be understood in two ways: 1) having language which organizes experience of illness can improve chances for survival for cancer patients, 2) describing painful experiences can contribute in regaining psychological well-being. However, neither oncology nor psychology cannot support either of those theses. Description of the world of cancer patients focuses on aspects which are left unsaid, however analytical category of “tabu” wasn’t sufficiently conceptualized and operationalized. For this reason, part of work which focuses on poorly known aspects of illness, has purely descriptive value. Goals which were set by author were only partially achieved.
PL
This article has been based on the MA thesis “Suffering from Psoriasis and Atopic Dermatitis in the Context of Medical Anthropology”. I discuss typology of narrative about Arthur Frank’s illness. With its aid and a metaphor of illness as a journey he used, I describe the experience of suffering from two chronic illnesses – psoriasis and atopic dermatitis. In this way, I attempt to present complexity of the experience of suffering from both illnesses, their multi-level impact on life of the ill and the ways they work out to cope with them.
EN
This article aims at discussing experiences of parents whose child was diagnosed with Down syndrome. It is based on a two-year fieldwork research in large cities in Poland that included in-depth interviews with families and discourse analysis of Internet sources. Down syndrome is one of the most common genetic disorders, caused by the presence of a third copy of chromosome 21. Due to genetic nature of the disorder, there is no known cure for DS. Low muscle tone and mental impairment are one of the most common symptoms. In this article I examine the role of the physiotherapy in lives of DS children parents. Their children may never be fully functioning intellectually, but in most cases their physical development, however delayed, will be successful. I argue that the mother dedication in finding new methods of improving their children physical abilities may be seen as a way of regaining agency and acceptance.
EN
The article introduces contemporary medical anthropology. It describes the key concepts used by anthropologists to analyse practices related to health, sickness and healing. It examines the main approaches (interpretative approach, critical approach and cultural phenomenology) and follows the methodological trend of combining micro and macro levels in one analysis. The authors show both academic and applied aspects of the young subdiscipline. They examine contemporarily researched topics like: global health, medical tourism, medical trials or new medical technologies. They sketch a picture of an important and dynamically evolving area of anthropological research.
Lud
|
2021
|
vol. 105
114-142
EN
The article explores the cultural and economic dimensions in diagnosing depression in Polish psychiatric practice since the systemic transformation with a particular focus on strategies used by physicians. Based on ethnographic research in clinical settings, it discusses this issue in terms of realness and “realification” (urealnienie)– concepts referring to the relationship between categories of description and their objects. While the changes of diagnostic classifications since the 1990s had the explicit goal of tightening that relationship, in clinical practice it remains somewhat lose and unclear. What contributes to it is not just the specific ontology of mental disorders which is hard to reduce fully to objectively measurable symptoms, but several other factors: specific changes in the philosophy of diagnostic classifications and their complex nature as clinical, administrative and financial tools, as well as their referential nature, which connotes optimal, though unattainable, standards of care. It is also shaped by the pragmatics of clinical work and the patients’ limited resources, which render the diagnostics a tool of physicians’ “medical paternalism” – their informal, instrumental attempts to respond to the deficiencies of the system of care.
PL
Artykuł jest etnograficznym studium procesów diagnostycznych zaburzeń depresyjnych we współczesnej Polsce i ich zmian po transformacji ustrojowej, ze szczególnym uwzględnieniem strategii podejmowanych przez lekarzy. Opierając się na badaniach etnograficznych prowadzonych w kontekstach klinicznych, artykuł omawia problem relacji między kategoriami diagnostycznymi a ich przedmiotami, odwołując się do pojęć realności i urealnienia. O ile zmiany klasyfikacji diagnostycznej od lat 90. XX wieku miały na celu zacieśnienie tej relacji, o tyle w praktyce klinicznej pozostaje ona luźna i nieoczywista. Przyczyniają się do tego nie tylko specyficzna ontologia zaburzeń psychicznych, którą trudno w pełni sprowadzić do obiektywnie wymierzalnych objawów, ale także kilka innych czynników: specyficzne zmiany w filozofii klasyfikacji diagnostycznych, wielowymiarowość diagnoz jako narzędzi klinicznych, administracyjnych i finansowych, oraz ich referencyjna natura, konotująca optymalne, choć nieosiągalne standardy opieki. Wpływa na to także pragmatyka pracy klinicznej i ograniczone zasoby samych pacjentów, które czynią z diagnoz narzędzie nieformalnych, instrumentalnych działań i „paternalizmu medycznego” lekarzy w odpowiedzi na braki w systemie opieki.
Lud
|
2023
|
vol. 107
|
issue 1
10-41
EN
Developments in biotechnology and newborn screening allow for earlier detection and quicker diagnosis of diseases, even before symptoms are first displayed. This allows doctors to begin treatment of rare diseases in the early stages of life. Nevertheless, even with early diagnosis, the future for these patients is uncertain. In this article, I analyze the results of ethnographic research that was conducted among people with inborn errors of metabolism, their parents, and doctors in Poland. I examine newborn screening technology using the category of “anticipation” in its macro-social and experiential meanings (Adams et al. 2009; Jae 2018; Stephan and Flaherty 2019). Drawing from this concept, I attend to both the perspectives of doctors and what parents of children with inborn errors of metabolism experience. For these parents, the “diagnostic moment” (Jutel 2016) reveals a future that is characterized by anticipation. I argue that newborn screening engenders a therapeutically uncertain future for the patient, whose condition escapes both medical knowledge and expertise. In one of the inborn errors of metabolism discussed in this article, this future entails pathological bodily changes, such as retinopathy. Facing the chronic symptoms that this disease will have on their children, some parents actively seek ways to approach their child’s unknown future.
PL
Rozwój biotechnologii i badania przesiewowe noworodków umożliwiają wcześniejsze wykrycie i zdiagnozowanie choroby zanim pojawią się jej pierwsze objawy. Pozwalają tym samym na wprowadzenie leczenia niektórych chorób rzadkich na bardzo wczesnym etapie życia. Niemniej, w przypadku chorób rzadkich nawet prawidłowo i wcześnie postawiona diagnoza wyznacza niejednoznaczny horyzont czasowy i naraża na niepewną przyszłość. W niniejszym artykule analizuję wyniki badań etnograficznych prowadzonych wśród osób z wrodzonymi wadami metabolizmu, ich rodzicami i lekarzami w Polsce. Proponuję spojrzenie na technologię, jaką są badania przesiewowe przez pryzmat koncepcji „antycypacji” w jej wymiarze makrospołecznym i doświadczeniowym (Adams i in. 2009; Jae 2018; Stephan i Flaherty 2019). Wychodząc od tej koncepcji, w artykule przyglądam się zarówno perspektywie lekarzy, jak i doświadczeniom rodzin dzieci w wrodzonymi wadami metabolizmu, dla których „moment diagnostyczny” (Jutel 2016) naraża na przesiąkniętą antycypacją przyszłość. Argumentuję, że badania przesiewowe noworodków otwierają na niepewną terapeutycznie przyszłość, która wymyka się wiedzy i doświadczeniu eksperckiemu. Przyszłość ta wiąże się nieodłącznie ze zmianami patologicznymi w ciele, takimi jak retinopatia, która przynależy do obrazu choroby w jednej z wrodzonych wad metabolizmu. Przewlekłe skutki uboczne choroby sprawiają, że niektórzy rodzice aktywnie poszukują możliwości oddziaływania na niepewną przyszłość dzieci. 
PL
Artykuł przedstawia krótką historię lecznictwa za pomocą substancji naturalnych pozyskiwanych z roślin, praktykowanego w świecie od czasów najdawniejszych po erę dzisiejszych środków farmaceutycznych opartych na chemii. Ukazano w nim niezwykłe właściwości fitoterapii stosowanej od starożytności przez rozmaite społeczności kulturowo-cywilizacyjne. Opisano środki, jakimi dysponowali starożytni, a także jakich doświadczeń i odkryć dokonali uczeni późniejszych epok. Zwrócono uwagę na to, jakie obserwacje poczynione wieki temu okazały się ważne dla dalszego rozwoju medycyny, antropologii medycznej, etnobotaniki.
EN
The article presents a brief history of natural medicine based on substances derived from plants, practiced in the world from the earliest days up until the era of presentday chemistry-based pharmaceuticals. The unusual properties of phytotherapy applied from the ancient times in various cultural and civilizational communities have been shown. The author describes the means available to the ancients, as well as the experiments and discoveries made by scholars of later ages. Attention was paid to the observations important for the development of medicine, medical anthropology and ethnobotany.
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