4 - Medicalization and illness experience: two case-studies

Summary

Medical ideology in Jeanty

The diffusion of biomedicine in Jeanty has created not only new routes to material advance, but also new ways to think about the body and new treatments for disease. The everyday talk about illness is filled with references to microbes and infections, X-rays and injections. When people discuss cases of AIDS (sida) or tuberculosis (tibèkiloz), they do not regard these biomedical terms as puzzling foreign concepts which demand a cultural translation. No one questions a family's decision to spend enormous sums at local mission hospitals or to consult private physicians in Les Cayes and Port-au-Prince. However, the easy acceptance of biomedicine – illustrated in detail by the case-studies in this chapter – raises some troubling questions. Has the adoption of biomedical disease categories subverted the moral meanings of suffering? Has it deflected the possibility of political critique inherent in bodily disorder? Has biomedicine diminished the power and legitimacy of other healing forms? In other words, has biomedicine “medicalized” the concepts of affliction and healing practices in Jeanty?

The recent explosion of anthropological interest in medicalization grows from the basic constructionist insight that medical realities are social products and social accomplishments (see Conrad and Schneider 1992). While claiming simply to reflect objective facts of biology, biomedical discourses are in fact culturally constructed and historically contingent. Through the powerful philosophical doctrines of naturalism and individualism, biomedicine successfully hides its cultural scaffolding and political interests (Gordon 1988). However, medicalization is more than just an intellectual project.