Medical Anthropology

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 bangsabangsa 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 dalam sejarah evolusi dan sejarah
penyebaran kebudayaan manusia di muka bumi
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
• Praktis: mempelajari manusia dalam beragam masyarakat suku
bangsa guna membangun masyarakat suku bangsa tersebut
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? (cont’d)
• 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
Anthropology
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
Anthropology
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 what purpose
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
explains why some essential drugs are extremely
scarce in particular society
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 Med-Anthro.
• 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 (cont’d)
• 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