Über die Autorin bzw. den Autor

Marcia C. Inhorn is the William K. Lanman, Jr. Professor of Anthropology and International Affairs at Yale University. She is past president of the Society for Medical Anthropology and the author, most recently, of The New Arab Man: Emergent Masculinities, Technologies, and Islam in the Middle East.

Emily A. Wentzell is Assistant Professor of Anthropology at the University of Iowa.

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Medical Anthropology at the Intersections

DUKE UNIVERSITY PRESS

Contents

Acknowledgments..............................................................................................................................................................viiMARCIA C. INHORN AND EMILY A. WENTZELL Introduction: Medical Anthropology at the Intersections...............................................................................1ONE | EMILY MARTIN Grafting Together Medical Anthropology, Feminism, and Technoscience.......................................................................................23TWO | LYNN M. MORGAN Getting at Anthropology through Medical History: Notes on the Consumption of Chinese Embryos and Fetuses in the Western Imagination.....................41THREE | LAWRENCE COHEN Making Peasants Protestant and Other Projects: Medical Anthropology and Its Global Condition..........................................................65FOUR | DIDIER FASSIN That Obscure Object of Global Health....................................................................................................................95FIVE | ARTHUR KLEINMAN Medical Anthropology and Mental Health: Five Questions for the Next Fifty Years.......................................................................116SIX | MARGARET LOCK From Genetics to Postgenomics and the Discovery of the New Social Body...................................................................................129SEVEN | RAYNA RAPP AND FAYE GINSBURG Anthropology and the Study of Disability Worlds.........................................................................................163EIGHT | MERRILL SINGER Medical Anthropology and Public Policy: Using Research to Change the World from What It Is to What We Believe It Should Be............................183NINE | RICHARD PARKER Critical Intersections and Engagements: Gender, Sexuality, Health, and Rights in Medical Anthropology..................................................206Notes........................................................................................................................................................................239References...................................................................................................................................................................251Contributors.................................................................................................................................................................307Index........................................................................................................................................................................313

Chapter One

Grafting Together Medical Anthropology, Feminism, and Technoscience

Within the groves of anthropology, the many grafts between medical anthropology, feminism, and science and technology studies (STS) have borne a rich harvest. In this chapter I trace how some of these grafts came about through a historical framing of the ways my work added to and benefited from them, moving through a variety of field sites and problems, from reproduction, through HIV/AIDS, and into mental health. The topics addressed by medical anthropology were so central to the constitution of twentieth- and twenty-first-century society and culture that scholars working in feminist studies and STS were eager to address them—topics such as diverse ways of defining health, stratified access to medicine and clinics, and centralized knowledge about the health and mortality of populations, to name just a few. Medical anthropology offered scholars specialized knowledge of how to understand institutions and practices that lay at the heart of contemporary forms of power and subjectivity. In return, feminism and STS offered complementary ways to understand the topics that medical anthropologists were addressing. In particular, feminism offered a robust way of seeing how medical institutions and practices were embedded in race and gender differences rooted in the larger political economy; STS offered ways of examining the assumptions lying in the background of medical practices: such things as the experimental method, the ideal of objectivity, or the paths by which scientific knowledge is produced and changed.

The metaphor of "intersections" inspired the event behind this book because it captures some aspects of the comings and goings between medical anthropology, feminism, and technoscience. An "intersection," like a section of a road shared by two highways or a group of elements common to two sets, captures some of the developments I will sketch: it captures the sense of shared problems and shared goals among the disciplines. But I am also guided by the metaphor of a "graft" because, in the plant kingdom, a graft can lead to a new organism with higher yields and better quality. The rich contributions these three fields have made to each other have laid the groundwork for exciting "grafts" still to come. I gesture toward some of them in my conclusion.

Many of us who were trained in anthropology in the late 1960s and early 1970s were primed to engage with questions at the heart of medical anthropology, whether we knew it or not. Many of my peers' research projects dealt with questions of health and sickness, life and death, or technology and gender, inspired by the now classic writings of Edmund Leach (1964), Raymond Firth (1963), Meyer Fortes (1949), Mary Douglas (1991), Victor Turner (1967), Clifford Geertz (1973), or Claude Lévi-Strauss (1963)—even though only a minority of us would have said we were "medical anthropologists." We might not have worked in medical institutions or with trained specialists, but we often studied cosmological notions about life and death and ritual practices during birth, illness, and death wherever we did fieldwork.

For some of us, a path into a more specialized concern with the topics of medical anthropology became available during the 1970s. Despite my own lack of training, it seemed unexceptional to me that Navel Medical Research Unit No. 2 (NAMRU-2), which had moved to Taiwan years before in 1955, offered me a summer job to investigate hepatitis and other endemic diseases at the village level in Taiwan. Despite my own dismay over the war in Vietnam, NAMRU seemed like a neutral research enterprise devoted to public health measures that would reduce disease. Their explicit goal—to study infectious diseases of military significance in Asia—sounds much more ominous now. However, NAMRU support was invaluable to medical anthropology as a field, as evidenced by their support of Arthur Kleinman's early work in Taiwan.

I could not shed any light on the causes of Taiwan's hepatitis epidemic, but I did figure out why villagers would not accept measles vaccines, then available for no cost at every rural health clinic. Measles, it turned out, was regarded as a phase in the life cycle that served the beneficial purpose of letting out the polluting matter that everyone could not help having inside their bodies from passing through the "dirty" female birth canal. If you did not get rid of this pollution through the oozing pustules of measles, you would break out with it on your deathbed and be marked by dirty sores forever after in the next world. What should I do with this knowledge? If I suggested that the vaccine could have an adjuvant added to it so that it would produce a local pustule that people might accept as a...