Biomedicine, Healing and Modernity in Rural Bangladesh

Shah, Md. Faruk

doi:10.1007/978-981-32-9143-0

Cited by 4 publications

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“…Commercial and market interests have been identified as significant drivers of medicalisation in contemporary Western societies (Conrad, 2005). These may also feature in postcolonial non-Western settings, as Shah (2020) demonstrates in Bangladesh. He notes that the pharmaceutical industry directly contributes to the popularising of biomedicine among rural people.…”

Section: Traditional Medicines and Biomedicinementioning

confidence: 99%

“…Regardless of their dubious qualifications, representatives of pharmaceutical companies associate closely with these practitioners, just as they do with (qualified) doctors, in order to promote their products. In addition, over-prescription of drugs to treatment seekers appears to be a regular trend in medical consultations, which could at least partially be linked to the incentives that practitioners receive from pharmaceutical companies for increasing their sales (Shah, 2020). While the commercial interest-driven pharmaceutical industry may power the growth of the biomedical sector, the low commercial investment in the case of many traditional medicines may, conversely, be considered as having stunted their development and expansion.…”

Section: Traditional Medicines and Biomedicinementioning

confidence: 99%

“…Offering a bribe in order to receive faster/better service or the need to seek a pharmacy where the drugs will not be adulterated are among the regular concerns in the (localised) treatment seeking process. Further, as gender and class-based discrimination is rampant in the healthcare bureaucracies, the existing social inequalities become reinforced and even exacerbated through the healthcare landscape (Shah, 2020).…”

Section: Access To Therapeuticsmentioning

confidence: 99%

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Therapeutic practices in everyday life: Illness and health seeking in a rural community in Sri Lanka

Liyanagunawardena¹

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Therapeutic practices are enacted by people, around the world, as a means of improving or restoring health. While the ubiquity of therapeutic practices is well documented, there is surprisingly little research into the concrete practicalities of their enactment in everyday life. Further, the contemporary social scientific literature on medication use and care practices is largely concentrated on Western societies and/or the Global North, with a pronounced lack of contemporary studies into small rural communities which straddle the old/new worlds of biomedical and traditional therapeutics. The present study was designed as a focused/ short-term ethnography on a rural resource-poor community in Sri Lanka. It was shaped around questions on people’s understanding(s) of diverse therapeutic practices, their enaction in participant homes, the flow of medications to and from the homes, and therapeutic practices as implicated in the everyday life of the households and the community. I, a Sri Lankan researcher, carried out the fieldwork in one village over a period of nearly three months. The principal method of data generation was household interviews: 20 interviews which included 47 participants (15 men, 25 women and seven children). To gain greater insights into therapeutic practices in the households, photography (of medications) and participant observation (of treatment seeking activities) were used. Additionally, four popular local healers were interviewed in order to better understand the practices involving traditional therapeutics. Prior to analysis, the household interviews (carried out in Sinhala language) were transcribed and translated to English. Interview data, photographs and fieldnotes were thematically analysed through an iterative analytical process of coding, identifying themes, and drawing out key concepts. The conceptual framework was built primarily on the theoretical work of Veena Das and Annemarie Mol, to explore therapeutic practices as situated and arising within ordinary life. The findings of the study point to the complexities of a diversified postcolonial therapeutic landscape as played out in resource-poor households. On the whole, household therapeutic practices were identifiable in relation to one or more of the following therapeutic modalities: ‘English medicine’ (biomedicine), ‘Sinhala medicine’ (traditional herbal medicine), supernatural therapeutics, and Buddhism-inspired religious healing. As such, therapeutic practices appeared as hybrid practices that seep into and merge different therapeutic modalities; however, the therapeutic potential of these enactions remains situated and relational. Further, medications are entangled in relations of risk, responsibility and trust, as implied through their spatiality in the homes. They are also variously implicated in time, such as in terms of temporal organisations of treatment and generational transmission of therapeutics. In addition, it was found that people access a range of healthcare providers, from public hospitals providing fully subsidised healthcare (which, however, often involve other costs) to fee-levying biomedical/traditional practitioners and community pharmacies. Cost-effectiveness of treatment is often prioritised, given the overriding economic concerns of households. Once treatment is received, it is variously adapted, modified or even discontinued within the home. Be it in navigating healthcare settings where they get marginalised as poor and less educated, or in adapting therapeutics to suit their needs and circumstances, what becomes clear is the ingenuity, perseverance and care with which people engage in health seeking and therapeutic practices. I draw on Annemarie Mol and colleagues’ notion of ‘tinkering’ in care practices, and propose a complementary metaphor of ‘wrangling’ to capture the complexities and contingencies of health seeking in a resource-poor community. As such, the present study aims to contribute new empirical knowledge on therapeutic realities in a postcolonial/non-Western setting, as well as useful insights to inform public health and policy development in the country. In terms of theoretical contribution, the study seeks to problematise the productivity of Western theoretical notions when adapted to make sense of lived experiences elsewhere. The potential of a situated ethnography in furthering a decolonial research approach towards postcolonial/indigenous/non-Western societies is also examined.

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Section: Traditional Medicines and Biomedicinementioning

confidence: 99%

Section: Traditional Medicines and Biomedicinementioning

confidence: 99%

Section: Access To Therapeuticsmentioning

confidence: 99%

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Therapeutic practices in everyday life: Illness and health seeking in a rural community in Sri Lanka

Liyanagunawardena¹

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Biotechnologies of Care

Fitzgerald¹,

Park²

2022

A Companion to Medical Anthropology

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Engrained with modernity: commodification, medicalisation, and cross-border medical travel for health care in Nepal

Dahal

2022

Humanit Soc Sci Commun

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Biomedicine was introduced in Nepal by Christian Missionaries en route to Tibet and China. When Nepal entered the democratic era in the early 60s, a considerable influx of biomedicine was brought into Nepal by the modernizing state as part of the promise of national development. After the 60s, biomedicine expanded in Nepal mainly through private sector involvement. This had consequences in the health-care domain in Nepal including the commodification of health-care services and increasing medicalization. The practice and expansion of biomedicine is also closely associated with its social and cultural mediation. This article focuses to examine how the macro process of health development shaped the medical practices, especially the healing trajectories and cross-border medical travel of Maithili Brahmin women from Nepal’s Tarai. This article shows that the three prominent avenues of health-care services, namely, medicalization, commodification, and cross-border medical travel predominant in the study area, are thriving and intertwined in such a way that they are reciprocally strengthening each other. This article is based on primary ethnographic data generated from field research conducted in a social cluster among the women from Nepal’s Tarai.

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Biomedicine, Healing and Modernity in Rural Bangladesh

Cited by 4 publications

References 0 publications

Therapeutic practices in everyday life: Illness and health seeking in a rural community in Sri Lanka

Therapeutic practices in everyday life: Illness and health seeking in a rural community in Sri Lanka

Biotechnologies of Care

Engrained with modernity: commodification, medicalisation, and cross-border medical travel for health care in Nepal

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