Medical Anthropology DPhil Research

Kitty Wheater, St Cross College, 2017
Supervisor: Elisabeth Hsu and Caroline Potter

Kitty’s DPhil thesis, Once More to the Body: an Ethnography of Mindfulness Practitioners in the United Kingdom (submitted, April 2017), is supervised by Prof. Elisabeth Hsu and Dr Caroline Potter. Drawing on fifteen months of ethnographic fieldwork, it explores techniques of self-cultivation among participants and practitioners of Mindfulness-based Cognitive Therapy. This psychotherapeutic intervention is derived from Buddhist meditation and cognitive therapy. Highlighting the paradoxes that occur as mindfulness emerges in evidence-based medicine and psychotherapy, her thesis asks what it means to be a mindfulness practitioner in this context. She concludes that tensions such as that between 'compliance' and 'compassion' in mindfulness-based approaches are irreducible, but productive of new and dynamic forms of ‘mindful’ subjectivity.

Information, self-management and common sense: anethnography among NHS community mental health teams and their patients

Neil Armstrong, Wolfson College, 2017
Supervisor: Elisabeth Hsu

NHS mental healthcare is changing in ways that reflect wider global trends. Increasingly, information and communication technologies are being introduced that help patients record both their symptoms and other data relevant to their health. My work focuses on one such technology, known as ‘True Colours.’ True Colours is being introduced to patients receiving secondary mental healthcare from the NHS in Oxfordshire and Buckinghamshire. I am embedded in the team that has developed True Colours and am now conducting ethnographic research as community mental health teams use the system as a part of standard care. The development and reception of True Colours casts light on a number of issues that are prominent in the anthropological and philosophy of science literature, such as: the changing role of diagnosis; the nature of biomedical knowledge; hidden assumptions in the biomedical concepts of ‘information’, ‘decision-making’ and ‘self-management’; the role of wider networks in the design and implementation of healthcare innovation (e.g. Lakoff 2005, Luhrmann 2000). True Colours represents patients in new ways, as quantified individuals with new freedoms and new responsibilities, and it produces new forms of data that have potentially profound bureaucratic implications for members of staff. 

Coordination in Crisis: An Ethnography of Nutritional Emergency

Darryl Stellmach, Wolfson College, 2016
Supervisor: Stanley Ulijaszek

My research examines disasters and complex emergencies as social phenomena, specifically the epistemology of disaster: how do we know an emergency when we see it? Disaster can be invisible. Geological hazards, environmental poisoning, epidemic or famine can unfold imperceptibly. In any complex crisis hard data is often flawed, absent or conflicting. Value systems, too, come into conflict. Participants must coordinate discordant opinions on causes, severity and methods. Intervention plans and action change constantly in response to new data and new developments. Social research on humanitarian response to nutritional crisis tends to focus on either the politics of malnutrition or the technical instruments used to detect it: rainfall, food prices, a child's arm circumference. I hope to complement these approaches with an organizational ethnography of how a single humanitarian aid institution combines these ways of seeing - technical, ethical and political-economic - to address uncertainty, identify large-scale nutritional crisis and develop a coherent response.

The Reception and Transformation of Homeopathy in Japan

Yuri Nonami, Green Templeton College, 2015
Supervisor: Elisabeth Hsu and Takehiko Kariya

This thesis examines from a medical anthropological viewpoint how the practice of the newly imported complementary and alternative medicine (CAM) has been transplanted, received and transformed in Japan. More specifically, I focus on homeopathy, which was introduced into Japan in the late 1990s. To address the research question, I focus on the practice of homeopathy from an anthropological viewpoint. The adoption of any new form of medicine is affected by the prevailing medical, social and cultural context. So, how and why was homeopathy introduced into Japan in the late 1990s? I explore this question by focusing on three aspects of the reception of homeopathy in Japan: (1) the institutionalisation of the homeopathy, including the formation of associations of practitioners and homeopathic colleges; (2) the translation of the theory and practice of homeopathy by the practitioners into a culturally acceptable form; (3) the utilisation and consumption of homeopathy by the patients, their families and self-prescribers. Over eighteen months of fieldwork in Japan led me to focus on these three elements of homeopathic practice.

Regarding the theoretical framework, this mainly explores medical pluralism and the health care system in Japan from an anthropological perspective, and the globalisation and transmission of medicine. I argue that the success of homeopathy in Japan was largely thanks to the transmission strategies set by the founders of the colleges for lay homeopaths. Mothers in particular, concerned by worries over family health care, were drawn to this approach. Furthermore, I argue that this group not only became consistent users of homeopathy but also propagated the therapy through "mothers’ self-help groups", thereby creating a strong tie with the lay homeopaths. I argue that mothers gained a sense of empowerment through homeopathy. Within the Japanese health care system it was the popular sector that received and developed homeopathy.

An ethnography of a ‘revolution’ in the Korean Medicine community

Seonsam Na, Green Templeton College, 2015
Supervisor: Roger Goodman

This thesis is about an event that occurred in 2012 among doctors practicing Korean Medicine in South Korea. These doctors are similar to Western medical doctors not just in status and public recognition but also in clinical reasoning except for the fact that the ‘therapeutic’ modalities they use are of traditional East Asian medical origin. Expressing strong dissent over two governmental policies, young doctors engaged in a series of collective actions that they called a ‘revolution’. Young doctors were first against the state's promotion of the developments of Korean Medicine formula-based pharmaceutical products. They also showed a determined stance against the state's decision to include Korean Medicine-based decoctions in the national health insurance for the treatments of the conditions affecting the elderly. Conducting brutal three month-long campaigns of discursive violence against the established members of their professional community whom they believe were working ‘with’ the state, the young doctors staged ruthlessly attacks on the conservative social structures governing their community. By exploring this inter-generational conflict, I attempt to highlight the dynamics of ‘pressure and resistance’ operating between the nascent welfare regime and the country’s private medical practitioners who provide the majority of health services to the public. The state, doubly burdened by the welfare finance and the fast aging population, applies relentless pressures on doctors in its attempt to control the rising healthcare cost and to capitalize on material and human resources of the medical communities, and it evokes collective resistance both from Western and Korean Medical practitioners. Through data gathered during the fieldwork in various national-level health policy scenes and in the Korean Medicine community, I argue that if the young doctors’ action to delegitimize those two governmental policies shown in the ‘revolution’ is their ‘conscious’ reaction to the pressures from the state, their unusually heightened anger seemingly directed against the seniors in their own community actually represents their resistance to the state’s pressures at the ‘unconscious’ level.

Seeking community in a neoliberal world: narrative analysis of eating management programs in the United States

Melanie Wenger, Wolfson College, 2015
Supervisor: Stanley Ulijaszek

There is increasing evidence that aspects of human eating may be addictive. Much of the existing literature examining this focuses on specific foods or individual pathologies of addiction. Qualitative research methods, in particular narrative analysis, offers a rich opportunity to better understand addictive aspects of human eating through the stories shared by those who have experienced compulsive eating. This research examines two different organizations that use storytelling as a tool for changing eating behaviours. Overeaters Anonymous (OA) and Weight Watchers (WW) began in the United States in the early 1960s as mutual support groups designed to help members with problems of compulsive overeating.  In comparing these two organizations, how each has changed over time, and the shifts in identity described by OA and WW members, this research identifies aspects of everyday living that members of both groups similarly highlight as important factors influencing compulsive eating. WW members describe changes in their consumer identities that are related to bodily appearance. In OA, members describe that they understand themselves as addicts, and recover from their addictions using the Twelve Steps. Based on these findings, I then assess to what extent a new framework for understanding addiction may be needed, and conclude by suggesting further areas of research that would be suitable for constructing this.

Risk, Childhood, Morality, and the Internet: An Anthropological Study of Internet Sexual Offending

Jonah Rimer, Green Templeton College, Hilary Term 2015
Supervisors: Caroline Potter, Jo Boyden

This thesis was based on 17 months of participant observation, semi-structured interviews, and focus groups in UK group programs for individuals who had downloaded illegal child abuse media.  Through engaging directly with offenders and those managing them, it provides an in-depth, qualitative understanding of how Internet use and perceptions of online space play a key role in Internet sexual offending, while also asking broader questions about online sociality and effects on normative behaviour.  It specifically explored why and how some people in the UK engage with illegal child abuse media.  Focus was placed on the potential factors associated with offending, participants’ relationships with the Internet, participants’ perceptions of childhood and children online and offline, and societal and institutional efforts to respond to the above.  The theoretical basis for analysis included Foucauldian theory, anthropology of the Internet, and the anthropology of childhood.  The primary research areas were social science of the Internet, childhood studies, human sexuality, group therapeutic processes, policy and the justice system, and research methodology and ethics.  For more information, please see here.

Made by artful practice: reproduction, health and the perinatal period among river Xié dwellers of northwestern Amazonia

Elizabeth Rahman, Linacre College, Trinity Term 2014
Supervisors: Elizabeth Ewart, Elisabeth Hsu

Contact: elizabeth.rahman@anthro.ox.ac.uk

This thesis is an ethnographic study of a little documented indigenous group, the Warekena people, who live on the Xié River in north-western Amazonia.  Examining the mythic histories of the animate riverscape, my work offers an overview of the emergence of riverside dwelling: beginning from a macro view of Xié river lifestyles, I explain how seasonal and distinguishing historic-mythic narratives tie in to wider idioms, and to experiences of social reproduction.  I focus on reproductive processes and the perinatal period, highlighting methods used by Xié dwellers to nurture healthy, quality-conscious lifestyles, and I examine Xié aetiologies and pathologies.  Mindfulness, or awareness, is viewed as a key component of good health. In this context, healthy childbirth is for the birthing mother an art form, a practice for which her total life experience has prepared her.  Childbirth is ranked with such other painful experiences as snakebite, and both childbirth and snakebite are opportunities for personal growth. Infant care is seen through the lens of specific, hands-on techniques that promote mindful states in both the carer and the cared for. Mindfulness emerges as a heuristic device that allows us to scrutinize the Amerindian soul and body, elucidating soul-loss in the ‘animist’ lived world. I argue that mindfulness is a core  characteristic of the  ‘cool’ hydrocentric and hierarchically conscious lifestyles of Xié river dwellers, and that it defines what it means to be a person, the Xié way.

Spaces of Uneventful Disaster: Tracking Emergenct Housing and Domestic Chemical Exposures from New Orleans to National Crises

Nick Shapiro, Green Templeton College, Hilary Term 2014
Surpervisors: Elisabeth Hsu, Javier Lezaun

Contact: shapiro.nick@gmail.com

In this thesis, I examine the politics, poetics, and logics of uneventful human harm in the United States by tracking the life and afterlife of a chemically contaminated emergency housing unit. In 2005, the Federal Emergency Management Agency (FEMA) deployed 120,000 trailers to the US Gulf Coast to house those displaced by Hurricanes Katrina and Rita. Testing, spurred by reports of inhabitant illness, revealed elevated levels of formaldehyde emanating from the plywood walls of the trailers. After being reclaimed by the federal government and beginning in 2010, the FEMA trailers were resold at auction to every corner of the country. Resold trailers gravitated to precarious populations at the poles of  rural capital accumulation—from oil patches in North Dakota to reservations in Washington state. These trailers serve as an exceptional substrate for an investigation into the anatomy of the uneventful as they once approached the apex of eventfulness as a national controversy and now reside in the shadows of the everyday.

The thesis apprehends and theorizes these dispersed and ordinary instruments of domestic harm across multiple registers: epistemological, material, spatial, and affective. I examine how failures of matter and meaning shaped and patterned the lives of those who inhabited the FEMA trailers as their lives became framed by chemical off-gassing, architectural insufficiency, material deterioration, and electrical short-circuiting. Crossing scales and venues, I explicate the modalities of scientific incomprehension that erode the perception, admittance, or substantiation of mass chemical exposure. These technical processes along with cultural horizons of eventfulness and the chronicity of disaster foreclosed avenues of toxic harm accountability. They bring ‘economies of abandonment’ into relief, and contemporary biopolitical priorities in which the FEMA trailer—an ostensible protection from harm that fosters illness—becomes possible.

Beyond the Social Skin: Healing Arts and Sacred Clays among the Mun (Mursi) of Southwest Ethiopia

Kate Nialla Fayers-Kerr, Green Templeton, Michaelmas Term 2013
Supervisors: Elisabeth Hsu, David Turton

Contact: kate.fayers-kerr@anthro.ox.ac.uk

This study of the agro-pastoralists ‘Mun’ or ‘Mursi’ of Southwest Ethiopia, attends to the preventive and curative substances and techniques of body painting.  Contrary to what we have come to expect from East African pastoralists, the Mursi are not only ontologically “cattle centred” but are also connoisseurs of earthy substances.  This knowledge of the earth rests at the heart of their medical culture and religious life.  While the anthropology of body art has long explored body painting as a means of person-making and socialisation, many communities around the world also claim that body painting can be medicinal.  I suggest that anthropologists rarely examine such local claims because of the theoretical prominence the social body and body politic in their approach, which downplays other ways in which corporality tunes into its own and wider life cycles.  Instead, we need an approach that simultaneously considers the biological and social body, acknowledging that ‘the person is the organism’ (Ingold 2000:3).  Through the daily and ritual application of earths and clays, people attune their bodily ecology to one another and to the local environment in order to reduce the impact and spread of afflictions.  Rubbing local earthy substances over all or parts of the body is locally appreciated as a way of adapting to or becoming consubstantial with the community and ecology.  Building on the decades of research David Turton has carried out among the Mursi, and inspired by environmental approaches to social life (Ingold 2000) and regional studies which connect religious experience with local ecology (Lienhardt 1961), I approach body painting with an awareness for the multiple ways in which contemporary body concepts and practices allude to a wide range of ecological experiences (Hsu, 1999, 2007, 2009).  I have thus produced an intimate study of the mundane and ritual life of this community, and I conclude that the local practice of body painting and other engagements with earthy substances are predicated upon an ecologically-sensitive bodily art of living.  To this extent, I attend to and uncover many of the practicalities of health as well as attending to the aesthetics of dwelling.

An ethnographic investigation of lifestyle change, living for the moment, and obesity emergence in Nauru    

Amy McLennan, St Edmund Hall, Michaelmas Term 2013
Supervisors: Stanley Ulijaszek, Elisabeth Hsu

The Republic of Nauru, a small Pacific island nation, has one of the highest obesity rates in the world. In the mid-1970s, the Nauruan population was one of the first in the world in which obesity, diabetes mellitus and cardiovascular disease – co-morbidities associated with obesity – were identified as significant public health concerns. Such ‘lifestyle diseases’ continue to have debilitating effects on the Nauruan community. In this thesis I draw on ethnographic fieldwork carried out in Nauru during 2010-11, involving participant observation, life history narratives and diverse historical materials to answer three questions. First, what characterises the Nauruan lifestyle? Second, in what ways did the Nauruan lifestyle change over the second half of the twentieth century, the time period during which obesity and diabetes rapidly escalated? Finally, how might these changes be linked to the emergence and persistence of ‘lifestyle diseases’ in Nauru? I focus on one characteristic that stood out prominently in many different aspects of Nauruan life: the suggestion that there is ‘No Action Unless Really Urgent’. In theorizing obesity, such living for the moment has been interpreted as laziness, pleasure-seeking or lack of self-control. However, it would appear that island time emerged gradually in the latter half of the twentieth century as Nauruans incorporated market-derived moral values – such as attaching importance to immediate commercial equivalence and getting more-for-less – into their everyday lives. Today, these values infuse not only economic and exchange practices, but also social relationships and nutritional habits. Living according to such values is important for social belonging; however, it can have negative implications for nutritional health.

Enacting molecular complexity: health and data in the metabolomics laboratory

Nadine Levin, Green Templeton College, Trinity Term 2013
Supervisors: Stanley Ulijaszek, Simon Cohn

In this thesis, I examine how biological data practices enable researchers to interact with and enact metabolism in statistical ways, and how this poses challenges to the "translation" of laboratory research into clinical practice. My research combines scholarship on the anthropology of science with science and technology studies, to show how data is intertwined with technologies, people, and values, and how it is used to make normative and naturalized claims about biology and disease.  It examines how data practices are changing concepts and understandings of biology, and consequently how this impacts notions of metabolic health and disease. In order to explore how data is negotiated in practice, I undertook fieldwork in “metabolomics”—the post-genomic study of the molecules and processes that make up metabolism—at the Computational and Systems Medicine Laboratory (CSM) at Imperial College London. I found that multivariate statistical practices are central to the historical identity and epistemic culture of metabolomics research at the BMM, and that they enable researchers to enact metabolism as an inherently complex entity. However, as metabolomics researchers mobilize these statistical practices towards clinical settings, the dynamic and complex nature of metabolism poses challenges to standardization and statisticalization. Consequently, as the translation of metabolomics knowledge into clinical practices places value on multivariate forms and large volumes of information, it faces challenges with the ability to "know" disease, the role of human interpretation and judgment, and the development of "personalized" approaches to medicine. 

Contextualizing food practices and change among Mexican migrants in West Queens, New York City

Marisa Macari, Green Templeton College, Trinity Term 2013
Supervisors: Stanley Ulijaszek, Mette Berg

This thesis is about food practices and change among Mexican migrants living in West Queens, New York City.  Public health research suggests that Mexican migration to the US has a negative impact on food practices, with diets being less nutritious over a migrant’s stay in the United States and obesity being more common among longer-term than more recently-arrived individuals. Through ethnography, I explore how migration shapes food practices and examine the nuanced process of nutritional change that is often obscured in large-scale epidemiological studies.  Food practices are important not just because they shape vulnerabilities to chronic diseases but also because they serve as prisms by which to examine migrants’ lives, pressures and aspirations. The three aims of this ethnography are to explore the food practices that Mexicans engage in after migration; to examine the social, temporal and political-economic contexts shaping food practices and change; and to describe how migrants themselves makes sense of nutritional change.  I explore these themes using the approach of structural vulnerability, which views health practices and outcomes as influenced by social structures, relationships and inequalities.  In so doing, I provide a critique of the public health literature’s use of the concept of acculturation to explain food practices, which largely obscures the role played by structural contexts and constraints. The thesis exposes a disconnect between the way in which the public health literature conceptualizes nutritional change and how it is lived ‘on the ground’.

The ecology of risk in an informal settlement: interpersonal conflict, social networks, and household food security

Adam Gilbertson, St Cross College, Trinity Term 2013
Supervisor: Stanley Ulijaszek

Contact: adam.gilbertson@anthro.co.uk

In Kenya, informal settlements are urban spaces characterised by poverty, high population densities, lack of infrastructure, tenuous land rights, increased rates of infectious diseases, and food insecurity. For many households, unemployment and illness are key contributors to an inability to purchase sufficient food on a daily basis. However, the causes of food insecurity are often complicated and not fully understood. Part of the problem is that few previous studies have privileged the role of interpersonal relationships within food security negotiations. Using data gathered over 15 months of fieldwork in the informal settlement of ‘Bangladesh’, Mombasa, Kenya, this thesis provides an ethnographic account of household food insecurity which focuses on the effects of intimate partner abuse on experiences of food security. Additionally, it addresses the dual role social networks play in food security experiences as well as the usefulness of concepts of ‘vulnerability’ to efforts made by researchers to account for risk at the intra-household scale.

Data provided through participant observation, questionnaires, ethnographic network analysis, and 109 in-depth interviews with 67 participants suggests that among impoverished households, causal interrelationships may exist between experiences of conjugal conflict and food insecurity. Whilst experiences of hunger often predispose households to experiences of conflict, abuse within intimate relationships in turn can cause families to experience further food insecurity. Furthermore, although friends, neighbours, and other social network members may assist in increasing household food security, they may also contribute to experiences of conflict, and therefore insecurity, within households. Finally, concepts of vulnerability tend to be less useful for analyses of risk within households, where members may be in conflict, than they are for studies which consider households to exist as ‘unitary’ entities. This is due to the inherent difficulty of dividing up lived experiences within multi-person households and distinguishing between what represents a hazard, as opposed to a ‘coping’ response, or an outcome with respect to food security. 

Manifestations of the Dead: Investigating ghost encounters among the Tsachila of western Ecuador

Daniel Dolley, Exeter College, Trinity Term 2013
Supervisors: Elisabeth Hsu, Elizabeth Ewart

Contact: daniel.dolley@gmail.com

Focussing on the Tsachila, Amerindians of western Ecuador, this thesis examines how competing “common knowledge” accounts of the afterlife (conventional Tsachi, Catholic, and Protestant) are related to experiences of encounters with ghosts. Inspired by conversation analysis it advocates the study of these encounters through close attention to how accounts of them are constructed in conversation, from which they emerge as inherently disruptive and resistant to any definitive interpretation. From this starting point a descriptive account is given of the ways in which these anomalous experiences form the background to everyday life among the Tsachila. Experiential associations are identified linking ghosts with the circadian patterns of sound, light and sociality. Next the thesis examines and compares a selection of myths depicting the dead and animals and it is shown that the boundaries between myth and everyday life and between the living and the dead are uncertain and subject to revision in the light of experience. They cannot be taken for granted but must be constantly reinforced. An example of such reinforcement is provided by the Tsachi celebration of the Catholic Day of the Dead, and it is shown how this intersects with and is inflected by Tsachi attitudes to the dead and their disposal. In the final chapter a selection of accounts of personal encounters with ghosts is examined to reveal ways in which the common knowledge previously discussed is both shaped, deployed and contested in the context of these accounts. It is suggested, in conclusion, that personal experience of this kind cannot be treated as simply a cultural expression, but that it exerts a motivating and disruptive force on thought and action.

Kidneys In-Between: An Anthropological Study of Live Kidney Transplantation in the Philippines

Yosuke Shimazono, St Cross College, Hilary Term 2013
Supervisor: Elisabeth Hsu

This thesis explores live kidney transplantation in the Philippines as a technologically constructed form of embodied social transactions. The medical and bioethical discourse on organ transplantation is often associated with dualism of the mind and the body, the person and the thing and the public policy is formulated in terms of the binary construct of the gift and the commodity. However, as is discussed in the first part of the thesis, a more careful examination of history of live kidney transplantation shows that this medical practice also continuously gave rise to phenomena that problematize the dualistic constructs.

Based on this historical understanding, the second part of the thesis explores the nature of kidney recipients’ bodily experiences. To undergo a transplant surgery is to undergo a transition from a regime of human embodiment to another: namely, from one in which their biological lives are sustained by the extra-corporeal kidney machine, to one in which their biological lives are sustained by a surgically installed ‘foreign’ living human kidney inside their body. As eighteen months fieldwork with Filipino kidney recipients reveals, an incorporation of a ‘foreign organ’ also engenders a set of novel bodily sensory experiences, which form a basis for recipients’ cultivation of a new body image and a post-transplant sense of self.

The final part of the thesis discusses kidney transplantation as a novel form of social transaction, involving a novel object of exchange. An examination of the intra-familial or inter-familial kidney transplantation reveals that a transfer of a vital body part often engenders the enduring reciprocal obligations on the part of the recipients. The ethnographic data collected from a fieldwork in urban slums in Metro Manila also reveals that, even in these cases of ‘commercial exchange’, commercial kidney donors resist the value of their vital body parts being seen as commensurable with the monetary ‘payment’ and insist on inalienability of the object transferred. This observation forms a basis for my critique of bioethical discourse on kidney trade. I argue that the commercial kidney donors’ voices that evade the dualism of the person and the thing, the gift and commodity, thereby disrupt an entire ‘field of opinions’, encompassing bioethical discourse both for and against organ market.  

Autonomy, cohesion and health. Perceptions of and responses to fever among urban Shipibo-Konibo in Mai Joshin

Doreen Montag, Linacre College, 2011
Supervisors: Elizabeth Ewart, Elisabeth Hsu, David Parkin, Laura Rival

Infectious diseases, such as dengue fever, are increasing in prevalence and have an immense impact on the daily life of Shipibo-Konibo people living in impoverished dwellings in the Peruvian rainforest. Consequently, fever as a central, common symptom becomes more important and visible in times of emerging and re-emerging infectious diseases. This thesis examines the hybrid constructions, perceptions of and responses to fever in Mai Joshin. The thesis explains the context in which fever experiences are embedded, emphasising the importance of socio- and political-historical dimensions such as the conquest and the concomitant introduction of new diseases. Based on twenty-five months of qualitative fieldwork in Mai Joshin, Peru, the thesis systematically identifies and examines the factors that influence and determine Shipibo-Konibo people’s perceptions of and responses to fever. I combine Bourdieu’s (1990) concept of habitus and Foucault’s (1978; 1994) biopolitics and governmentality approach to stress how complex historical, political-economic, and socio-cultural structures shape the daily reality of Shipibo-Konibo people, in which fever episodes are experienced. Two key classifications are identified: old fever and new fever. Old fever corresponds to a fever classification that is perceived to be embedded in pre-conquest Shipibo-Konibo structures and cosmology. New fever, which includes symptomatic fever and the fever spirit, is related to post-conquest events, following the first epidemic experiences of measles, smallpox and chickenpox. The phenomenological origin of the fever spirit is explored and the relationship between the fever spirit and other illness spirits, such as the denque spirit, are analysed. Pharmaceutical treatment as the main treatment of choice to expel the fever and other illness spirits is addressed in a politico-historical context. The structural influence of evangelical missionaries and biomedicine on the perception of treatment choice is explored in detail. Responses to fever cannot be understood without examining the Shipibo-Konibo people’s social relations under normal circumstances, in a fever case, and in an epidemic. The thesis concludes that Shipibo-Konibo people’s perceptions of and responses to fever are influenced and determined by ‘embodied history’ (Fassin, 2007a,b) and complex political-economic, social, and racial structures that require a carefully contextualised analysis.

Sickness, migration and social relations: therapeutic practices and medical subjectivities among Ghanaians in London

Kristine Krause, Linacre College, Michaelmas Term 2010
Supervisors: Steven Vertovec, Robert Parkin, Elisabeth Hsu

The existence of medical pluralism is well documented for Ghana as well as for other African countries. It is therefore of interest to ask to what extent multiple medical practices are used in the context of Ghanaian migration and how they are accessed. Based on fieldwork conducted intermittently from 2005 to 2009, the thesis explores how different therapeutic practices are used by first-generation migrants from Ghana in London in cases of sickness. How do specific situations people live in, the experiences they had, and the memories they embody, affect health practices and their positioning within British society. Findings are presented through the following four ethnographic fields: (1) the creation of transnational social spaces in London, (2) Pentecostal healing, (3) The impact of legal status on health practices and the political subjectivity of migrants. (4) The creation of therapy networks through fictive kinship relations. On a theoretical level, using my ethnography I will demonstrate that health-seeking behaviour can best be understood as a practical process involving improvisations that draw on past experiences, embodied routines, and advice from friends and experts in order to find an appropriate solution for a problem. Understood in this way, therapies can be approached as particular ways of consuming, experiencing, and relating, which are based neither on individual choice nor cultural determination, but on social contacts, second-hand knowledge, and ad hoc trial and error.

Convention, control and creativity: the case of Chinese medicine in Singapore

Arielle Rittersmith, Green Templeton College, 2010
Supervisor: Elisabeth Hsu

The Singaporean government promotes the city-state as the 'biopolis of Asia', with the intention of bolstering their reputation for the most advanced biomedical facilities and research in the region. This politically-crafted image explicitly has not included 'traditional' medicine. Yet, despite their general day-to-day compliance with laws and state agendas, Singaporeans from all walks of life continue to use and practice Chinese medicine, sustaining an adaptive practice that eventually demanded acknowledgement (of a sort) by the state. Beginning with the observation that differing social, political and economic conditions generate variable manifestations of Chinese medicine around the world, this thesis examines facets of medical use and practice in Singapore, focusing on power dynamics, embodied experience and negotiations of convention and creativity. Theoretically and methodologically developed within medical anthropology, this study includes a range of perspectives, including patients, caregivers, physicians, educators, legislators, shop owners, entrepreneurs, researchers and students. Exploring individual and group creativity vis-à-vis state agendas, and environmental aspects of embodied experience, this broad scope considers contemporary medical practice in relation to government policies favouring international investment, urban redevelopment, healthcare regulation, 'multiracial' nationalism and the management of history and heritage.

Can intergenerational volunteering enhance quality of life for persons with mild to moderate dementia? A mixed methods study

Daniel R. George, Hertford College. Trinity Term 2010
Supervisors: Stanley Ulijaszek and Harvey Whitehouse

Social engagement has been strongly associated with better health outcomes for persons in the late-life course. A small number of studies have signalled that one form of engagement – intergenerational volunteering – may be especially beneficial to older adults, but more research has been desirable.  This mixed methods study was designed to ethnographically assess the nature of intergenerational relationships and address the hypothesis that intergenerational volunteering would enhance quality of life (QOL) for persons with mild to moderate dementia. Research was carried out in an assisted living home in Cleveland, Ohio with persons affected by dementia who volunteered locally at an elementary school. Qualitative data were gathered through ten months of participant-observation ethnography at the assisted living home and school, as well as through narrative interviews, focus groups, and photographs. Data supported the hypothesis that QOL was enhanced by intergenerational volunteering through a variety of bio-psychosocial pathways, particularly through reduced stress. In addition to demonstrating the possible QOL benefits derived from intergenerational volunteering for persons with mild to moderate dementia, the study also confirmed that such persons can make significant contributions to their community.

Manufacturing Tibetan medicine. The creation of an industry and the moral economy of Tibetanness

Martin Saxer, Green Templeton College, 2010
Supervisors: Elisabeth Hsu and Charles Ramble

This thesis examines the recent creation of a Tibetan medicine industry in the People’s Republic of China. Within a mere decade hospital pharmacies throughout Tibet have been converted into pharmaceutical companies. Confronted with the logic of capital and profit, these companies now produce commodities for a nationwide market. While these developments are depicted as a big success by official China, they also meet with harsh criticism: medicine prices are on the rise and doctors complain that their quality is decreasing; the industry still relies extensively on wildcrafted herbs, which is seen as a threat to the survival of certain plant species; and the industrial application of traditional knowledge raises questions of intellectual property and cultural heritage. The quick and forced industrialisation touches upon much more than technical aspects of manufacturing Tibetan medicines. What is at stake is a fundamental (re-)manufacturing of Tibetan medicine as a system of knowledge and practice and its role in contemporary Tibet. The industry lies at the intersection of conflicting agendas and visions for Tibet. On the one hand, the industrial Tibetan medicine serves as an allegorical figure of Tibet’s rapid development and progress. The creation of an industry exemplifies the scope and speed of the Party State’s modernist schemes. On the other hand, Tibetan remedies are part of a booming “ethnicity industry”. They are marketed as products of ancient wisdom rather than science and modern technology. Industrial Tibetan medicine has emerged as a space in which Tibet as such is being discussed and shaped. My ethnography explores their tactics and strategies, their ethical reasoning and their engagement in the market not only for pills and remedies but also for Tibetanness – a market, I argue, that bears the characteristics of a moral economy at large, enmeshed in the global political spectacle that surrounds the “Tibet question” and China’s rise as a world power.

Cardamom, class and change in a Limbu village in east Nepal

Ian C. Fitzpatrick, Wolfson College, 2010
Supervisors: David Gellner and Laura Rival

This thesis investigates the history of economic differentiation in a Limbu village in east Nepal. By examining three historically overlapping productive processes – subsistence agriculture, cash crop cardamom cultivation, and international migration – this thesis shows how each productive process has contributed in different ways to the acceleration of economic differentiation. In particular this thesis focuses on cardamom cultivation which first provided a means to transform significantly the lives of a large section of Limbu society. Introduced into the village by a local inhabitant in 1968, and thereafter spread throughout the whole Kabeli river valley and beyond, the cardamom plant has given many households access to considerable cash. This has enabled some households to purchase property in the plains, send their children to English-medium private schools, and send sons abroad for work. Households with little or no cardamom however, have fallen into increasing indebtedness, losing access to land and becoming increasingly dependent on wage labour for survival. The thesis also discusses international labour migration, which has more recently become another important and lucrative productive process for a certain proportion of the village. This has resulted in the rapid growth of a dispersed village in Jhapa in the plains, which has become a hub for international migrants as well as a symbol of the hopes and aspirations of villagers. This has brought about yet further economic differentiation between households that have been able to finance visas for work abroad, and those that continue to struggle day to day. Despite the increased integration of the village with a national and global market, the continued existence of Limbu language and cultural practises emphasises the active role villagers have played in shaping their current condition.

Fat chances: a biocultural approach to overweight and obesity among British Bangladeshi adolescents in East London

Hayley Lofink, St Cross College, 2009
Supervisors: Stanley Ulijaszek and Bridget Anderson

The coexistence of underweight and overweight in the same communities and households is a phenomenon generally associated with some developing countries; however, this may be an emerging pattern in England. A survey of British Bangladeshi adolescents aged 11-14 years old in East London shows that 7%, 34% and 20% of boys and 3%, 29% and 14% of girls are underweight, overweight and obese, respectively. Research from the US and Canada reports higher levels of obesity in second and third generation immigrants compared to recently arrived immigrants or the general population. Given that the bulk of first-generation immigrants from Bangladesh arrived to England in the 1950s and 1960s, many individuals of Bangladeshi origin residing in England are second and third generation British. Therefore, it is uncertain why this population has maintained comparatively lower levels of obesity than other minority ethnic groups in England, and as compared to North American trends. This research aims to examine the cultural, social and economic production of underweight, overweight and obesity in low-income British Bangladeshi adolescents in East London. It is argued that qualitative research exploring the cultural, social and economic aspects of food preferences, preparation, allocation and consumption and an examination of activity patterns are necessary to understand these trends. 

Understanding anorexia nervosa through the phenemenological experiences of Israeli anorectics: a critical biocultural analysis

Karin Eli, 2009
Supervisor: Elisabeth Hsu

Anorexia nervosa is a complex disorder, and as such continues to challenge clinicians, biomedical researchers, and social theorists alike. While interpretations of anorexia nervosa abound, they are constructed as competing rather than complementary, and the exclusive relegation of anorexic meanings to demarcated domains– psychological, biomedical, or societal – precludes a full understanding of this disorder. The purpose of my doctoral research is to engender a holistic understanding of anorexia nervosa, incorporating the strengths of the psychological, biomedical, and feminist postmodernist perspectives, while eliminating the reductionism with which they are marred. I therefore intend to develop a critical biocultural analysis of anorexia nervosa, reconceptualizing this disorder as produced and maintained by the multifaceted interactions of the individual and the societal, and accounting for the effects of biology, psychology, history, and political economy. My analysis will rely upon anorexic women's own experiences and meanings, as conveyed through a phenomenological ethnography of anorexic embodiment. By conducting my research in Israel, uniquely situated at the edges of ‘the West', I will also endeavor to problematize the essentializing portrayal of the (stereo)typical anorectic as middle class, Western, Christian, and white – an image upon which most of the extant interpretations of anorexia nervosa are premised.

Morality and uncertainty living with HIV/AIDS in Zanzibar

Nadine Beckmann, St Anthony's College, 2008
Supervisor: David Parkin

This thesis explores the complex negotiations involved in Zanzibaris explanation and management of HIV/AIDS in the light of technical and wider global changes. Unique in its ethnographic focus, this is the first full-length ethnography investigating how a predominantly Muslim society deals with the growing threat of the HIV pandemic. The focus is on HIV positive peoples experiences of living with AIDS in this small island archipelago off the Tanzanian coast. Employing an actor-centred approach which emphasises the possibilities for agency in the context of structural limitations, illness and treatment are analysed as a varying and often unpredictable process. The collective backdrop to peoples responses to AIDS in Zanzibar is a pervasive sense of uncertainty, which, I argue, is better suited than the commonly employed concept of risk to understand the ways AIDS is made sense of in the islands. Discourses about AIDS in Zanzibar are fraught with uncertainty and contradiction, and the moral discourse has taken centre stage in the society's efforts to create meaning out of suffering. The thesis explores how different local and global views on life with the virus and competing approaches to illness and treatment are creatively fashioned, utilised, or dismissed by people living with HIV/AIDS in their efforts to normalise their condition. The recent introduction of free antiretroviral treatment has enormously aided this process and provided immense relief from the suffering they have endured. Highlighting the complex interdependencies between socio-cultural, political, economical, and biomedical factors this thesis contributes to the growing body of in-depth, contextual studies of HIV/AIDS that take into account both global interconnections and local disjunctures.

Time and longevity: concepts of the life-span among Tibetans in the Darjeeling Hills, India

Barbara Gerke, Green College, 2008
Supervisors: Charles Ramble and Geoffrey Samuel

This thesis explores Tibetan ideas of the life-span and the various life-forces that influence longevity. It presents ethnographic data from seventeen months of fieldwork among Tibetans in the Darjeeling Hills, West Bengal, India (2004 - 2006). Translations from two Tibetan medical texts (twelfth and seventeenth century CE) and a selection of astrological tables and divinatory texts that are currently used by the Tibetans in this region supplement the ethnographic material. From these materials emerges temporality as crucial to the study of longevity. While the concept of the life-span as such, in Tibetan known as tse (tshe), is not necessarily understood in durational terms and implies rather the idea of a reservoir, the various factors that exist to strengthen or "fill" this reservoir are intrinsically linked to temporal frameworks. For example, various systems of vitality and their reckoning (e.g. temporal ideas influence the ways people choose auspicious days for medical treatment, avoid the injury of vital points in the body that embed a vital essence, use almanacs to establish the status of annually-changing factors that determine their fortune, and interpret divination on the life-span in wider contexts of Buddhist ideologies). The thesis argues that it is through practices of temporalisation, in which Tibetan professionals and lay people mediate between temporal frameworks and the situation of individuals - or of social groups - that they strengthen their life-forces. In the pursuit of protecting and prolonging tse medical, astrological, divinatory, and ritual activities become mapped out. The thesis discusses practices of temporalisation in their wider contexts, involving ideas of karma, obstacles, auspiciousness, and of "blessing", by drawing from recent studies on the anthropology of time and by emphasizing situational agency.

Ethnic difference in perceived family burden and service use patterns in schizophrenia: a matched cohort study

Helen Mary Lloyd, Michaelmas Term 2007
Supervisors: Tom Burns, Elisabeth Hsu

This thesis investigated levels of parental burden in UK Punjabi Indian Sikh and White British parents with a son or daughter with schizophrenia. It explored clinical, family and service use variables that are associated with burden, and tested if burden predicted one-year outcome. It also included a chapter on qualitative anthropological inquiry exploring the local, social, and cultural factors that help shape perceptions of caregiving. Levels of burden and distress were generally low and barely showed differences between the groups studied. This may be due to several related factors: (1) generally low levels of patient symptoms and disability, and generally good levels of functioning, (2) generally low levels of psychiatric morbidity in parents, and (3) the presence of familial, social and religious support.  The qualitative anthropological study suggested that high quality relationships between two persons may also be important (e.g. mother and son), which the quantitative assessment of the burden may have failed to predict. Indian parents exhibited high expressed emotion (EE), characterised by over involvement more frequently  and Indian patients utilised mental health services less than White patients. The findings of the thesis suggest that parents of stabilised offspring generally do not perceive their role as burdensome. With appropriate support patients can live & work independently and maintain quality relationships. While local socio-environmental factors can shape human experience, and while Indian and White parents differ in some respects, the findings also suggest that there exist many characteristics of human culture that transcend group identities such as ethnicity, race or religion.

Heart distress on the Sino-Tibetan frontier: history, gender, ecology and ritual practice in Tibetan popular perceptions and experiences of heart distress (snying nad) and other illnesses in the Qinghai part of Amdo

Patrizia Bassini, St Cross College, Trinity Term 2007
Supervisors: Elisabeth Hsu and Charles Ramble

Stimulated by a marked tendency of medical anthropologists of Eastern medicines to explore “medical systems” in urban and institutional contexts, this thesis investigates health care from the home-base and the standpoint of ordinary people engaged in popular practices. This study attempts to answer questions such as: “What do we learn from the popular stance on health and illness?”, “What motivates the choice of health care?” and “Why is it important to consider popular perceptions and experiences of health and illness?” Through the analysis of the phenomenon of heart distress ( snying nad ) among other common illnesses such as gastric ( pho nad ) and gallbladder ( mkhris nad ) disorders, this thesis shows how people in rural areas in Amdo are creative agents of their own well-being. Patients explain heart distress as the outcome of shared and personal histories and the harmful influence of the sacred landscape they inhabit. The majority, however, are young brides who have to adjust to working hard in the household of often unsympathetic parents-in-law. Heart distress is not easy to overcome: habitual practices such as the hierarchy of food consumption in Tibetan households, for instance, constitute and express social and kin relations. These are embedded in a religious cosmology that constitutes an important determinant, together with the surrounding ecology, for the way people choose to treat other illnesses too. 

Learning to dance: sensory experience in British contemporary dance training

Caroline M. Parler Potter, The Queen's College, Hilary Term 2007
Supervisor: Elisabeth Hsu

This thesis addresses the social process of bodily learning and the cultural shaping of sensory experience. Based on heavily participatory fieldwork undertaken at a nationally recognized school for professional contemporary dance in London, it explores issues of social access, identity, bodily transformation, and institutionalized bodily control as they relate to the process of becoming a professional dancer in Britain. A central theoretical premise underpinning this investigation is that the heretofore unresolved division between concepts of ‘mind’ and ‘body’ (and its related dyad of ‘subject’ and ‘object’) is not merely a philosophical construct, but has its roots in actual bodily experience. I argue that a reshaping of dancers’ collective habitus (to use Bourdieu’s term) towards one that I describe as ‘experimental formality’ occurs through a bombardment of novel sensory experiences, which in turn become normalized through highly repetitive practice. I further argue that as a result of incorporating this reshaped habitus, dancers embody institutionally generated strategies for bodily scrutiny and control – a self-alienating struggle that I call ‘autopolitics’. This work concludes with a close description of seven key sensory modes experienced by dance students during training. In elucidating the multiple and overlapping relationships that exist between senses of kinaesthesia, heat, pain, taste, touch, sound and vision, I call for the recognition of a movement-framed sensorium as both an outcome of dance training and the medium through which bodily transformation occurs.

Perceptions of health, illness and healing in a Sichuan Village, China

Anna Lora-Wainwright, Green College, Michaelmas Term 2006
Supervisor: Elisabeth Hsu

This thesis explores attitudes to the body, illness and healing in contemporary rural China through the prism of Pierre Bourdieu's notion of habitus. It is divided in two parts. Part 1 shows that bodily dispositions articulate ways of engaging with one's surroundings and claims to authority and status. Hierarchies with regard to what constitutes a desirable body or a healthy diet are not stable but always disputed. Negotiations surrounding them are informative of wider social processes and serve to reproduce or challenge social relations and values. Part 2 examines bodily practices at times of illness through the case of oesophagus cancer. I highlight how family relationships are produced and contested through various practices of care, and that such relations engender particular bodily attitudes. Closer attention to practices during illness are therefore important for understanding how illness is experienced by all involved, but also how it intersects with family relations, attitudes to resources, strategies to secure them and invest them, and perceptions of the state and welfare provision. Employing habitus allows a closer grasp of the intricate processes through which family relations are formed, why families opt for particular forms of treatment and how the effectiveness of therapy is produced.

The art of the bank: nutrition policy and practice in India

Devi Sridhar, Wolfson College, Michaelmas Term 2006
Supervisors: Stanley Ulijaszek and David Gellner

This thesis is an ethnography of the World Bank. It critically examines the nutrition operations of the World Bank by way of the design and implementation of the Bank-funded Tamil Nadu Integrated Nutrition Project. It is an attempt to uncover the workings of power through a close look at the structures, discourses and agencies through which nutrition policy operates. Specifically I investigate how hunger and malnutrition have been defined and treated by the World Bank and with what consequences for the Bank's projects and the communities at which they are aimed. Hence this thesis looks both at the World Bank as an institution and at a Bank project in Tamil Nadu. I have attempted to untangle the ideology, politics and models that drive the Bank. I have also addressed why the Bank does what it does in nutrition.

A grammar of transformation: analysing anthropologically the construction of the psychotherapeutic practitioner

James Davies, St Cross College, Trinity Term 2006
Supervisor: David Parkin

In my paper I shall offer a general anatomy of a novice healer's transformation by analysing anthropologically how psychotherapeutic practitioners are constructed. I shall focus on the institutional devices employed by training academies to facilitate this transformation. Laying special emphasis on the construction of the person through personal therapy and supervision, I will treat the therapeutic encounter as a ritual encounter, which, through the manipulation of emotion, language, and symbol, alters the conceptual orientation of the therapist. As all such institutions are situated in a wider social context, this investigation must also be cognizant of this situated position influences the process of trainee re-socialisation. Thus attention will be given to how wider public perceptions influence the profession into which trainees are being initiated, and how these perceptions, negative or otherwise, influence the process of training itself. By perceiving the interrelations between self, curative, and social systems, and by further assessing how public perceptions of psychotherapy impact upon practitioner training and identity, I will show that the agenda of psychotherapeutic training institutes involves more than preparing practitioners to heal the patient but rather it is about sustaining a healing tradition, a tradition fighting for survival amid a sea of competing healing alternatives.

Journey from life to death: an anthropological study of cancer patients in Japan

Ikumi Okamoto, Pembroke College, Trinity term 2005
Supervisor: David Parkin

The kind of diseases affecting Japanese people and the causes of death in Japan have changed a great deal in the last several decades due to various factors, most notably the advancement of medical technology and changes in life style. The number of people who die from lifestyle diseases such as cancer, which are chronic and possibly need long-term hospitalization, increases every year. In the 1970s the hospice philosophy was introduced to Japan from the West. It encourages patients and their families to affirm life and to regard dying as a normal process, and offers a support system to help patients live as actively as possible and sustain a sense of selfhood, autonomy and dignity until they die. In practice, however, the dying process is still regarded as normal in contemporary Japan and many patients fail to die in the way proposed by the hospice philosophy. There is also disagreement between the patients and the medical professionals regarding their respective idea of good death. Hospices and PCUs, which were initially developed in order to provide humane care, have become places which provide a new form of institutionalized death, and consequently constrain the patients' dying patterns. In this thesis, I investigate the above issues from the perspectives of the anthropology and ethnography of Japan. I demonstrate how the framework of van Gennep's rites of passage and Turner's concept of liminality can be used to analyze the current situation in Japanese hospice settings. I also perform an ethnographic analysis of Japanese attitudes towards health, illness and death in order to illustrate the reasons why some Japanese patients fail to die a good health as proposed by hospice philosophy.

The grammar of healing: a study of eclecticism and historical continuity among the Chagga of Rombo District, Kilimanjaro Region, Tanzania

Knut Christian Myhre, St Antony's College, Trinity Term 2003
Supervisor: Wendy James

In this thesis I am investigating medical pluralism among the Chagga-speaking of Rombo District, Kilimanjaro Region , Tanzania . Against the background of Ludwig Wittgenstein's later philosophy, I am describing the concepts, practices and objects involved, in order to investigate how the use of different healing practices is meaningful to the people involved. The different healing practices are analysed against the background of a vernacular notion of ‘dwelling', which can be characterised as the orderly performance of production, reproduction and consumption. The activity of ‘dwelling' is constitutive of the homestead, affinal relationships, marriage and the person. It is demonstrated how the various vernacular illness conceptions can be understood as different forms of disruption of ‘dwelling', and the therapeutic alternatives are analysed according to the way they respond to, and deal with, these ‘disruptions'. It is then shown how an overlapping set of ‘family resemblance' concepts interrelate the different therapy alternatives, and make them part of the comprehensive grammar of healing. People's multilingual capabilities entail that this grammar extends geographically to create a horizon of meaning that transcends linguistic, ethnic and cultural boundaries. By means of early ethnographic sources, in particular those of the German missionaries Bruno Gutman and Johannes Raum, I argue that the concepts and practices of the present medically plural situation have a long history in the area, and cannot be accounted for solely in terms of recent social, economic and political changes.

Nurturing nature: men, steroids and anthropology

Adam Hamilton Russell, Magdalen College, Hilary Term 2003
Supervisors: Nick Allen, Elisabeth Hsu, Sarah Green

This thesis looks at several groups of men in southeast England who are engaged in the sale, traffic and use of certain pharmaceuticals to achieve a sense of “masculine performance enhancement” through chemically and nutritionally enhanced muscles and libidos, as well as biotechnological control over their physical and emotional selves. Through non-attribution interviews with these men, and analysis of larger media (print media, electronic media, and academic and scientific journals), this thesis seeks to place their behaviour within a social, political, historical and economic context. By focusing on the phenomenological aspects of bodybuilding, crime and masculinity, this thesis analyses why these men do what they do; what it is they feel they achieve from their behaviours; and how those behaviours can be best understood as a function of living in and through bodies that are being ‘denatured’ through advances in biology, technology, and the larger media. The disjunction between how these men are supposed to understand themselves according to Euro-American discourses of the self – as natural, circumscribed, and delineated citizens of England – and how they have experientially come to understand themselves – as local “big men” able to remake their bodies and personalities, as seen as explicable only through examining what it “feels” like to be in a body that is constantly manipulated, observed, and fussed over. these men are caught in the interstices among a post-modern imperative towards self-invention with (or submission to) biotechnology, the call of hegemonic masculinity, and the criminalisation of certain drugs that call into question the otherwise self-evident distinction between natural bodies and ‘enhanced’ machines. As a result, although they believe they are surpassing physical, moral and legal boundaries, in the process of “nurturing nature” they are reinscribing certain cultural forms and, ultimately, remain firmly situated within Euro-American social dynamics. This thesis is the first to examine performance enhancement and performance enhancing drugs from a phenomenological and anthropological purview. This thesis argues that there is a need to understand how the body interpellates social phenomena, and this can best be accomplished by analysing performance enhancement from a Maussian perspective of humans as psychological, social and physiological beings.

Traditional healers in a Christian nation: a study of Ng'anga in modern Zambia

Kaori Sugishita, Linacre College, Trinity Term 2002
Supervisor: David Parkin

In Zambian societies, discourses and practices concerning witchcraft and spirits constitute and indigenous system for dealing with affliction. This system has been historically changing as it interacts with modern/Western systems, particularly biomedicine and Christianity. A recent and significant development is that the Zambian government has recognized ng'anga , the specialists supporting the indigenous system, as the practitioners of a “traditional medicine” that could be introduced into the national health care system. For this reason, ng'anga are encouraged to reformulate their activities in accordance with biomedical standards. On the other hand, ng'anga attempt to incorporate such activities that cannot be rationalized from a biomedical perspective into Christianity, which has become the national religion of Zambia. Thus, the indigenous system for dealing with affliction is developing into either herbalism or a Christian healing system, owing to direct intervention by the state power. In many past and present African societies, we find various types of specialists who deal with human affliction through indigenous discourses and practices. Different English terms have been applied to them depending on ethnographic and analytical context; “witch doctors”, “medicine men”, “diviners”, “spirit mediums”, “traditional healers” etc. Ng'anga (sing. sing'anga), which means “doctors”, is a generic term for such specialists in many Bantu languages. In contemporary Zambian societies, ng'anga are still plentiful and relied upon by people in making sense of and solving their afflictions. Setting aside a concern with specialization, ng'anga are characterized for their employment of indigenous medicine, though their activities are not restricted to physical problems and are based on ideas about supernatural/unscientific causes of affliction, i.e. witchcraft and spirits. Ng'anga are regarded as being able to discern and affect these agents, for which they constitute an indispensable part of a social system dealing with affliction. This thesis investigates the interaction between such an indigenous system and its modern/Western counterparts, namely biological medicine and Christianity, which are all under the direct influence of state power.

Discourses on immigrant tuberculosis: a case study of New York City;s Chinese laborers

Ming-Jung Ho, Linacre Collegem Michaelmas Term 2001
Supervisor: David Parkin

This thesis addresses the issue of immigrant tuberculosis through a case study analyzing tuberculosis among Chinese immigrant labourers in New York City from five different perspectives — public health providers, private biomedical providers, traditional Chinese medical providers, and Chinese immigrant labourers, with and without tuberculosis disease. The first three chapters of the thesis examine the evidence presented in public health and biomedical doctors' discourses to support the importation hypothesis. I argue that the dominant biomedical explanation of immigrant tuberculosis as imported is partly a sociocultural construction, rather than a view that is completely based on unbiased scientific evidence. Furthermore, I discuss the underlying power relations shaping these discourses in a situation wherein Chinatown biomedical doctors are shown to be an important intermediary between the “dominant” public health authority and the “marginal” Chinese immigrant population. In the subsequent chapters, the more “marginal” discourses of traditional Chinese medical practitioners and Chinese immigrant labourers are discussed. An alternative, multi-factorial model emerges from the comparison between these dominant and marginal discourses. This model takes into account not only the conventional bacterial factor, but also three other levels of factors contributing to tuberculosis among New York City’s Chinese labourers: the ecological, the cultural, and the politico-economic.

From religion to therapy: an anthropological investigation of Naikan Therapy in Japan

Chikako Ozawa, St Antony's College, Hilary term 2001
Supervisor: David Parkin

This thesis is an anthropological investigation of Naikan, a Japanese practice based upon meditation-like bodily engagement and recalling one's past. Meaning ‘introspection', Naikan was founded by Ishin Yoshimoto, who adapted it from the Shin Buddhist cultivation practice of mishirabe , a sensory deprivation practice for achieving enlightenment. In Naikan clients sit separated from each other by paper screens for fifteen hours a day for seven days. They recall their past from birth to the present from the perspectives of significant others, periodically reporting their findings to the practitioner in confession-like style. It is a method for the reconstruction of the self through the recovery of memories and the rewriting of autobiography. Although scholars tend to treat Naikan as a therapy, I argue that this is only one dimension of Naikan and explore it from a broader perspective. This thesis proceeds on two levels: as an ethnographic analysis of Naikan, in which I describe my own experiences as a client and assistant practitioner as well as the experiences of others; and as a development of the theoretical issues of the social construction of memory, body practice and healing. I seek to explain how a relatively simple method can yield such transformative results, looking at the Naikan setting and its themes, the confessions of clients, the client practitioner relationship, Naikan's roots in Shin Buddhism, its social organization and comparisons and contrasts with Catholic confession, psychoanalysis, the New Age and new spirituality movements.

Theatre and therapy: the Tarantula's Dance in the Salento, Italy

Karen Lüdtke, Linacre College, Trinity Term 2000
Supervisor: David Parkin

This study aims to explore in what ways theatre - considered as a form of social interaction, encompassing dance, drama, music and ritual - and therapy can be seen to overlap on the level of experience. Both are viewed as inherently transformative processes. In order to research these issues, past and present uses of the music and dance of the Apulian tarantella, known as pizzica, are explored. For centuries, tarantism rituals were engaged with to heal those said-to-be-bitten by the tarantula spider through extensive dancing. Since the 1990s, the pizzica has returned to the limelight for entertainment and tourism, for political and commercial purposes, as well as therapeutic and spiritual reasons. This research examines how therapeutic efficacy, promoting and safe-guarding a sense of vitality or ‘presence, is furthered or hindered in the contexts of tarantism and so-called neo-tarantism in the Salento, the southernmost part of Apulia, by considering similarities and variations that mark these phenomena