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An Introduction to

Medical
Anthropology
Nur Azid Mahardinata
Center for Bioethics and Medical Humanities,
Faculty of Medicine, Universitas Gadjah Mada

Learning Objectives
At the end of this lecture, students should:
Gained an insight into the main concept of
cultural anthropology
Understand the general objectives and
approaches of medical anthropology
Be able to explain the differences of
anthropological approach and natural science
approach
Discuss the implementation of medical
anthropology in health research

Perkembangan Ilmu
Antropologi
Fase I (<1800an)
Ethnography (deskripsi bangsa-bangsa) nonEropa
Munculnya gagasan-gagasan mengenai
bangsa-bangsa non-Eropa (Afrika, Asia,
Oceania, dan Indian):
Bangsa lain adalah manusia liar keturunan iblis (savage,
primitif)
Bangsa lain adalah bangsa yang murni atau contoh
masyarakat yang belum mengenal kejahatan
Keanehan bangsa-bangsa lain tersebut adalah sebagai
objek museum

Perkembangan Ilmu
Antropologi
Fase II (Medio abad 19)
Penggolongan bangsa-bangsa di dunia dari
masyarakat dan budaya yang paling tinggi
(eropa barat) hingga yang paling rendah
Muncul karangan-2 atau tulisan ilmiah yang
mengklasifikasikan bahan-bahan mengenai
berbagai kebudayaan di dunia dalam berbagai
tingkat evolusi (lahirlah istilah antropologi)
Lebih bersifat akademis
Mempelajari masyarakat dan kebudayaan
primitif dengan maksud mendapatkan
pengertian mengenai tingkatan-tingkatan

Perkembangan Ilmu
Antropologi
Fase III (awal abad 20)
Berkembang sebagai ilmu praktis, untuk
mempelajari masyarakat dan
kebudayaan suku-suku bangsa di luar Eropa
guna kepentingan pemerintah kolonial dan
guna mendapat pengertian tentang
masyarakat modern yang bersifat kompleks

Fase IV (>1930an)
Antropologi gaya baru, dengan 2 tujuan:
Akademis: mencapai pengertian makhluk manusia
pada umumnya dengan mempelajari berbagai
bentuk fisiknya, masyarakatnya, maupun
kebudayaannya

Masalah-masalah Penelitian
dalam Antropologi
1. Masalah sejarah asal dan perkembangan manusia
(atau evolusinya) dipandang dari segi biologi
2. Masalah sejarah terjadinya berbagai ragam manusia,
dipandang dari ciri-ciri tubuhnya
3. Masalah sejarah asal, perkembangan, serta
penyebaran berbagai macam bahasa diseluruh dunia
4. Masalah perkembangan, penyebaran, dan terjadinya
beragam kebudayaan di dunia
5. Masalah mengenai asas-asas kebudayaan manusia
dalam kehidupan masyarakat-2 suku bangsa di dunia

Ilmu-ilmu Bagian
Antropologi
Antropologi biologi/fisik
Paleoantropologi
Antropologi fisik

Antropologi budaya/sosial
Prehistorik
Etnolinguistik
Etnologi
Etnopsikologi
Antropologi spesialisasi (ekonomi, politik, kesehatan,
kependudukan, pendidikan, perkotaan, hukum, dll)
Antropologi terapan

What is culture?
Known definitions of culture:
System of meaning belief, knowledge
and action by which people organize
their lives
That complex whole; which includes
knowledge, belief, art, morals, law,
custom, and any other capabilities and
habits acquired by man as a member of
society
The man-made of the environment

What is culture? (contd)


Culture comprise systems of ideas,
concepts, rules, and meanings that
underlie and are expressed in the ways
that human live
Anthropologists are not only interested in
ideas, beliefs, and meanings, but also in
what people do, as actual practices often
reflect beliefs

Medical
Anthropolog
y

By Deffinition:
The study of medical phenomena as culture (Hardon,
1995)
Medical systems emerge from human attempts to

survive disease and surmount death, and


from social responses to illness and the sick
role. Medical anthropology is the descriptions and

analysis of this process within the variety of the world


cultures (Ross, Moerman, and Tancredi, 1991)
Systematic inquiries by anthropologist into health
practices and explanations of disease across culture
Medical anthropology belongs to the domain of cultural
anthropology and has distinctly research approach from
biomedical sciences

Types of medical
anthropology
Anthropology in medicine the work of anthropologists
carried out in close collaboration with medical
professionals, making their data available to doctors in
order to improve the quality of medical services
Explaining the ideas of illness of patients to doctors
contribute to better communication between doctors
and patients
Anthropology of medicine take a distance from
medical practice and study it as a social and cultural
phenomena
Criticism of the term compliance for being doctor
centered

Approaches
in Medical
Anthropolog
y

Contextualization
Study subjects within context object of
research is broadened by the inclusion of
its relevant context to understand the
meaning of people ideas and practices
This is different with other sciences (i.e.
natural science) that explain their
object by reducing it to some basic
principles
Biology study the quality of water by taking
one drop and placing it under microscope,
looking for microbes
Anthropology studies how people use water
in everyday life, who collects and uses it, for

Emic and Etic Approaches


On understanding and studying culture in
context, anthropological research focusing
on the two approach:
The Emic approach how people view their
own situation and how they solve their problems
The Etic approach based on ideas of what
outsiders, policy makers, and health workers
have about a particular group

As an example: beliefs about the causes of


diarrhea (people ignorance vs. indigenous
knowledge)

Cultural relativism
Cultural relativism: cultures -- and so of ideas and
practices, are diverse and unique, they can only
be understood in terms of their own standards
and values
It is clear that one cannot speak in universal
terms, or using his/her own cultural background
to view other people and ways of life
(ethnocentrism)
A trained doctor may think that consult an
oracle to find out who caused a disease is
useless and senseless, while his patient may
be puzzled why the doctor is not paying
attention to the deeper and underlying causes
of the disease

Theoretical
Perspectives

Structural Functionalism
Social and cultural phenomena are seen as
functionally interconnected and basic to the
structural maintenance of society
The task of anthropologist is to show how the
different elements interact to make society into
what it is (its structural maintenance, harmony,
equilibrium)
Illness is a dysfunction of the body and health
care is contribute to the maintenance of society
as a whole by repairing the sick individual

Ecological perspectives
Culture is human adaptation to
environment because cultural phenomena
are seen as human solutions to problems
posed by the natural environment
Health is regarded as the result of
successful adaptations to
environmental challenge and disease
is the outcome of the failure to adapt
The spread of malaria clearing the forest
and agricultural way of life

Marxist political economy


Culture is mainly the outcome of political
and economic circumstances
Health or the lack of it, and the quality
of health are determined by social
competition between groups of people
and the unequal distribution of scarce
resources
The sale of pharmaceuticals in developing
countries primary objective is the
accumulation of capital, not disease
prevention or alleviation. Profit motive

Cognitive and symbolic


approach
Seeing the cognitive and symbolic
aspects of culture (emic approach)
how do people see illness
how do they choose various curative
alternatives
How do they communicate with health
practitioners

Related Concept
and research
Method in medical
anthropology

Related concepts in MedAnthro.


Analytical distinction between disease,
illness, and sickness
disease is the definition of health problem by
medical expert,
illness refers to the experience of the
problems by the patient, and
sickness is the social role attached to a health
problems by society at large

Medicalization the label of socially


unacceptable behavior as disease

Related concepts (contd)


Explanatory models explanations for the
origins of a condition and its treatment, by
patients and practitioners
Classification of theories of illness
causation:
Personalistic systems: illness is due to the
purposeful intervention of an agent, either
supernatural or human
Naturalistic systems: illness is explained in
impersonal, systematic terms can be caused
by natural forces or imbalance within individuals

Research Methods in
Anthropology
Qualitative approach in nature

Participant observation: observing the


practices and experiences of the people by
living for an extended period among the
group being studied, share experiences,
participate in daily events in order to be able
to describe customs and beliefs from
within
In-depth interview: involves day-to-day
conversation that allows longer questions
and probing (interviewer can go back and
review points that are not clear, informant is
more spontaneous in her or his responses)

Suggested Readings
Available at Center for Bioethics
Edel and Edel, 2000. Anthropology and
Ethics: the Quest for Moral
Understanding. New Jersey: Transaction
Publishers.
Johnson and Sargent, 1990. Medical
Anthropology: Contemporary Theory and
Method.
Gingrich and Fox, 2002. Anthropology, By
Comparison. London: Routledge

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