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Neglected Tropical Diseases

Creating a New Disease Grouping

Samantha Vanderslott

Neglected tropical diseases show how a disease group can be formed to compete in the global health policy marketplace. The naming and branding of a new disease category is used to organize activities, direct attention and resources, and rationalize the governance of diseases. The politics of classification involves processes of negotiation and conceptual development by key actors. Here, discussions about central characteristics, naming, and inclusion and exclusion criteria are rarely settled. Contradictions are present in the “tropical” and “neglected” characterizations, as well as choices of universalist rather than particularist approaches. Interacting with these considerations is a continued progression in means of dealing with disease from health actors and changing attributes of diseases in populations.

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Health interregionalism in combating communicable diseases

EU cooperation with ASEAN and the African Union

Vincent Rollet

English abstract: This last decade, regional organizations progressively became unavoidable actors of regional health governance and have been supported by some global health actors to strengthen such a role. Among these actors, the European Union (EU) is the only regional organization that implements health initiatives in cooperation with its regional counterparts. This article focuses on such “health interregionalism” toward Southeast Asia and Africa and in the field of communicable diseases, with the main objective of assessing its nature and identifying its main functions. It concludes that although appreciated and needed, the EU’s health interregionalism should better reflect the EU’s experience in regional health governance in order to represent a unique instrument of development aid and an added value for regional organizations.

Spanish abstract: En el último decenio, las organizaciones regionales se han convertido progresivamente en actores inevitables de la gobernanza regional de la salud, recibiendo el apoyo de actores mundiales para fortalecer esa función. Entre éstos, la Unión Europea (UE) es la única organización regional que implementa iniciativas de salud en cooperación con sus contrapartes regionales. Este artículo se centra en este ““interregionalismo en salud”” hacia el sudeste asiático y África y en el ámbito de las enfermedades transmisibles, con el objetivo de evaluar su naturaleza e identificar sus principales funciones. Concluye que el interregionalismo en salud de la UE debería reflejar mejor su experiencia en materia de gobernanza regional de la salud, al representar un instrumento único de ayuda al desarrollo y un valor añadido para las organizaciones regionales.

French abstract: Au cours de la dernière décennie, les organisations régionales sont progressivement devenues des acteurs incontournables de la gouvernance régionale de la santé et ont été soutenues par certains acteurs mondiaux. Parmi ces acteurs, l’Union européenne (UE) est la seule organisation régionale qui mette en oeuvre des initiatives en matière de santé en coopération avec ses homologues régionaux. L’article se concentre sur cet «interrégionalisme en matière de santé» vers l’Asie du Sud-Est et l’Afrique dans le domaine des maladies transmissibles, afin d’évaluer sa nature et d’identifier ses principales fonctions. Il conclut que, bien qu’apprécié et nécessaire, l’interrégionalisme devrait mieux refléter l’expérience de l’UE en matière de gouvernance de santé régionale afin de représenter un instrument unique d’aide au développement et une valeur ajoutée pour les organisations régionales.

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Agnes G. Loeffler

This article offers an analysis of two medical case histories presented by an Iranian allopathic physician to illustrate the power of diet in the management of disease. Uncovering underlying cultural assumptions about health and health maintenance strategies leads to the following insights: (1) Galenic medical ideas have not been replaced by allopathic theories in the world view of Iranian physicians; (2) allopathic medical treatment options (pharmaceuticals) are applied to indigenous disease categories; (3) there is deep-seated scepticism about etiologic theories of allopathic medicine and its ability to treat certain conditions; (4) the authority of allopathic medicine is not unquestioned in Iran.

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Saudi Patients and Health Care Providers

Divergent Perceptions of Illnesses and Their Symptoms

Mohamed Harakati, Faissal Shaheen, Hani Tamim, Saadi Taher, Adel Al. Qublan and Abdulla Al Sayyari

This cross-sectional survey study analyses the degree of concordance between Saudi patients and their nurses and physicians in four areas: (1) perceived causation of diseases and drivers of cure, (2) symptom ranking and perception, (3) views on social habits and traditional medicine, and (4) assessment of health care providers' empathy. The doctors and nurses were asked to predict their patients' responses to the survey. Significant divergence was found between the patients' responses and the health care providers' predictions. Cultural and background differences between the two groups, as well as a large educational gap, might account for this disparity. Such discordance could conceivably lead to wrong diagnoses being made, due to the different levels of importance that patients and doctors accord to symptoms.

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From Villainous Letch and Sinful Outcast, to “Especially Beloved of God”

Complicating the Medieval Leper through Gender and Social Status

Christina Welch and Rohan Brown

This article explores the socio-religious construction of the medieval “ideal” leper; a male pedagogical symbol of social and moral status and a figure in a physical and spiritual state of liminality, where their physical decay was a sign of their moral corruption. It argues that within vernacular literature, and theology, the medieval male leper was typically perceived as an outcast experiencing social death before succumbing to the slow degeneration of the disease. Typically conceived, and represented as lusty and carnal, the “ideal” male leper wore his own sin as physical deformity as a result of the close theological interpretation of the body and the soul. However, once his spiritual and physical contagion was contained within a leprosaria (a leper hospital), he could be perceived as a semi-holy figure, living out his purgatorial punishment on earth. Living out his purgation and segregated from his former communities, the article contests that the once frightening and sinful medieval male leper could transform his social status, becoming “especially beloved by God.”

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Yagoub Yousif Al-Kandari

The rate of consanguineous marriage in Kuwait is considered to be high. Several research studies have shown that marriage among relatives is one of the major factors leading to health problems because it increases homozygosis. This article deals with both cultural and physical aspects by examining the health consequences of consanguineous marriages in Kuwait. Variables such as reproductive wastage, health problems in the offspring and infant mortality are included and measured in relation to other socio-cultural variables. Cultural variables such as the respondents' roots (Bedouin and non-Bedouin) and beliefs (Muslim Sunni and Muslim Shi'a) are also examined. The results show that there is no significant association between consanguineous and non-consanguineous marriages in the rate of abortion or the mortality of infants and children up to five years old. Finally, the data reveal significant differences between the genetic and genetic-environmental diseases in consanguineous couples' offspring and those of non-consanguineous couples. Since some of these findings contradict those of other studies, more research is needed.

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William Palmer

The English conquest of Ireland during the sixteenth century was accompanied by extreme violence. Historians remain divided on the motivations behind this violence. This article argues that the English violence in Ireland may be attributed to four main factors: the fear of foreign Catholic intervention through Ireland; the methods by which Irish rebels chose to fight; decisions made by English officials in London to not fund English forces in Ireland at a reasonable level while demanding that English officials in Ireland keep Ireland under control; and the creation of a system by which many of those who made the plans never had to see the suffering they inflicted. The troops who carried out the plans had to choose between their own survival and moral behaviors that placed their survival at risk.

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Enwinding Social Theory

Wind and Weather in Zulu Zionist Sensorial Experiences

Rune Flikke

This article discusses the theoretical potential of air, winds, and atmosphere as they place flux, transience, and motion at the center of the human predicament. Based on ethnographic fieldwork conducted among urban Zulu Zionists, it is argued that the winds blowing across the landscape of KwaZulu-Natal also blew through bodies and in the process restructured subjectivities. Through a general discussion of the phenomenal aspects of air, I argue that we need to approach our sensory relations to weather and atmosphere with a diachronic focus on changing local body-worlds. This is, I argue, a leap of the imagination that is needed in order to challenge the material and visual that implicitly underpin much social theory. Such a theoretical move is needed in order to properly approach weather-worlds.

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Esther Hertzog

This article elaborates on the connection between hygiene/cleanliness and the bureaucratic control of Ethiopian immigrants in Israel. It discusses the role of stigmatisation in constructing immigrants' perceived backwardness and weakness, which necessitate guidance. The analysis also demonstrates the patronisation of immigrant women through inspection of their tidiness as mothers and housewives. The case of the Ethiopian immigrants, who began arriving in Israel at the beginning of the 1980s and still immigrate, will be used to suggest that the bureaucratic regulation of immigrants, rather than racism or cultural differentials, is behind the integration process. Moreover, the similarities between the absorption practices applied towards immigrants from Ethiopia and those from Muslim countries in the 1950s will be discussed in terms of the bureaucratic patronage over immigrants in Israel.

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Humans, Animals, and Health

From Ecology to Entanglement

Alex M. Nading

Medical and environmental social scientists have recently become interested in how health brings human and nonhuman animals together. is article discusses historical approaches to this question. It then explores applied disease ecology, which examines how anthropogenic landscape change leads to “disease emergence.” The article goes on to review two critical approaches to the question. Critics of bio-security concern themselves with the ways in which animal and human lives are regulated in the context of “emerging diseases” such as avian influenza and foot and mouth disease. Scholarship on human-animal “entanglement” focuses on the ways in which disease, instead of alienating humans from other life forms, brings their intimate relationships into sharper relief. The article argues that health is one terrain for developing a critical environmental analysis of the production of life, where life is the ongoing, dynamic result of human and nonhuman interactions over time.