Animating biomedicine's moral order: The crisis of practice in Malawian medical training

Current Anthropology

Volumn 53, Issue 6, 2012, Pages 755-788

  Wendland, Claire ^a  

^a UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84870565332     PISSN: 00113204     EISSN: None     Source Type: Journal    
DOI: 10.1086/668467     Document Type: Article

References (146)

1. Adams, V. 1998. Doctors for democracy: health professionals in the Nepal revolution. Cambridge: Cambridge University Press.
2. Alubo, S. O. 1994. The medical profession and health policy in Nigeria. In Physicians and health care in the Third World. A. Ugalde and S. O. Alubo, eds. Pp. 3-17. Williamsburg, VA: Department of Anthropology, College of William and Mary.
3. Andersen, H. M. 2004. "Villagers": differential treatment in a Ghanaian hospital. Social Science and Medicine 59:2003-2012. [SvdG]
4. Anderson, Warwick. 2009. From subjugated knowledge to conjugated subjects: science and globalisation, or postcolonial studies of science? Postcolonial Studies 12(4):389-400.
5. Auslander, M. 1993. "Open the wombs!": the symbolic politics of modern Ngoni witchfinding. In Modernity and its malcontents: ritual and power in postcolonial Africa. J. Comaroff and J. L. Comaroff, eds. Pp. 167-192. Chicago: University of Chicago Press.
6. Baer, H. A., M. Singer, and I. Susser. 1997. Medical anthropology and the world system: a critical perspective. Westport, CT: Bergin & Garvey.
7. Bassett, M. T., L. A. Bijlmakers, and D. M. Sanders. 2000. Experiencing structural adjustment in urban and rural households of Zimbabwe. In African women's health. M. Turshen, ed. Pp. 167-192. Trenton, NJ: Africa World Press.
8. Baszanger, I. 1985. Professional socialization and social control: from medical students to general practitioners. Social Science and Medicine 20(2):133-143. [IB]
9. Beagan, B. L. 2000. Neutralizing differences: producing neutral doctors for (almost) neutral patients. Social Science and Medicine 51(8):1253-1265.
10. Becker, H. S., B. Geer, E. C. Hughes, and A. L. Strauss. 1961. Boys in white: student culture in medical school. Chicago: University of Chicago Press.
11. Bharadwaj, A. 2006. Sacred conceptions: clinical theodicies, uncertain science, and technologies of procreation in India. Culture, Medicine and Psychiatry 30(4):451-465.
12. Bharadwaj, A., and P. Glasner. 2009. Local cells, global science: the rise of embryonic stem cell research in India. London: Routledge. [AB]
13. Biehl, João, and Peter Locke. 2010. Deleuze and the anthropology of becoming. Current Anthropology 51(3):317-352.
14. Burke, T. 2003. Eyes wide shut: Africanists and the moral problematics of postcolonial societies. African Studies Quarterly 7(2/3). http://web.africa.ufl.edu/asq/v7/v7i2a12.htm.
15. Butt, Leslie. 2002. The suffering stranger: medical anthropology and international morality. Medical Anthropology 21(1):1-24.
16. Candea, Matei. 2011. "Our division of the universe": making a space for the non-political in the anthropology of politics. Current Anthropology 52(3): 309-334. [LM]
17. Cassell, J. 1998. The woman in the surgeon's body. Cambridge, MA: Harvard University Press.
18. Chinsinga, B. 2002. The politics of poverty alleviation in Malawi: a critical review. In A democracy of chameleons: politics and culture in the new Malawi. H. Englund, ed. Pp. 25-42. Uppsala, Sweden: Nordiska Afrikainstitutet (Nordic Africa Institute).
19. Chokani, A. C. V. 1998. Local medicines audit: reasons for going to the sing'anga first. MBBS Year IV Project, on file with the Department of Community Health, College of Medicine, University of Malawi.
20. Clarke, A. E., L. Mamo, J. R. Fishman, J. K. Shim, and J. R. Fosket. 2003. Biomedicalization: technoscientific transformations of health, illness, and U.S. biomedicine. American Sociological Review 68:161-194.
21. Comaroff, J. 1982. Medicine: symbol and ideology. In The problem of medical knowledge: examining the social construction of medicine. P. Wright and A. Treacher, eds. Pp. 49-68. Edinburgh: Edinburgh University Press.
22. Comaroff, J. 1993. The diseased heart of Africa: medicine, colonialism, and the black body. In Knowledge, power and practice: the anthropology of medicine and everyday life. S. Lindenbaum and M. Lock, eds. Pp. 305-329. Berkeley: University of California Press.
23. Cunningham, A., and B. Andrews. 1997. Introduction: Western medicine as contested knowledge. In Western medicine as contested knowledge. A. Cunningham and B. Andrews, eds. Pp. 1-23. Manchester: Manchester University Press.
24. Dahlenburg, G. W. 1993. Letter from Malawi: the first year of the College of Medicine of the University of Malawi. Tropical Doctor 23:4-6.
25. Daston, L. 1995. The moral economy of science. Osiris 10:3-26.
26. Davenport, Beverly Ann. 2000. Witnessing and the medical gaze: how medical students learn to see at a free clinic for the homeless. Medical Anthropology Quarterly 14(3):310-327.
27. De Craemer, W., and R. C. Fox. 1968. The emerging physician. Stanford, CA: Hoover Institution on War, Revolution and Peace.
28. Dumit, J., and R. Davis-Floyd. 1998. Introduction: cyborg babies-children of the third millennium. In Cyborg babies: from techno-sex to techno-tots. R. Davis-Floyd and J. Dumit, eds. Pp. 1-18. New York: Routledge.
29. Etkin, N. L., P. J. Ross, and I. Muazzamu. 1999. The rational basis of "irrational" drug use: pharmaceuticals in the context of development. In Anthropology in public health: bridging differences in culture and society. R. A. Hahn, ed. Pp. 165-181. New York: Oxford University Press.
30. Farmer, P. 1999. Infections and inequalities: the modern plagues. Berkeley: University of California Press.
31. Farmer, P. 2004. An anthropology of structural violence: Sidney W. Mintz lecture for 2001. Current Anthropology 45(3):305-325.
32. Fassin, Didier. 2009. Another politics of life is possible. Theory, Culture and Society 26(5):44-60.
33. Feierman, S. 1985. Struggles for control: the social roots of health and healing in modern Africa. African Studies Review 28(2/3):73-147.
34. Feierman, S. 2000. Explaining uncertainty in the medical world of Ghaambo. Bulletin of the History of Medicine 74:317-344.
35. Feierman, Steven, and Julie Livingston. 2012. Caring for African health care: reading clinical case studies for systemic insights. In Institute for Advanced Study Yearbook 2010-2011. Luca Giuliani, ed. Pp. 308-317. Berlin: Wissenschaftskolleg zu Berlin. [DK]
36. Feudtner, C., D. A. Christakis, and N. Christakis. 1994. Do clinical clerks suffer ethical erosion? students' perceptions of their ethical environment and personal development. Academic Medicine 69:670-679.
37. Flint, K. 2006. Indian-African encounters: polyculturalism and African therapeutics in Natal, South Africa, 1886-1950s. Journal of Southern African Studies 32(2):367-385.
38. Forgacs, D. 1988. The Antonio Gramsci reader: selected writings 1916-1935. New York: New York University Press.
39. Fox, R. C. 1979. Essays in medical sociology: journeys into the field. New York: Wiley.
40. Freidson, E. 1970. Profession of medicine: a study of the sociology of applied knowledge. New York: Harper & Row. [IB]
41. Freidson, E. 1976. Doctoring together: a study of professional social control. New York: Elsevier. [IB]
42. Gibson, D. 2004. The gaps in the gaze in South African hospitals. Social Science and Medicine 59:2013-2024. [DG]
43. Good, B. 1994. Medicine, rationality and experience: an anthropological perspective. Cambridge: Cambridge University Press.
44. Good, B., and M.-J. D. Good. 1993. "Learning medicine": the constructing of medical knowledge at Harvard Medical School. In Knowledge, power and practice: the anthropology of medicine and everyday life. S. Lindenbaum and M. Lock, eds. Pp. 81-107. Berkeley: University of California Press.
45. Good, M.-J. D. 1995. American medicine: the quest for competence. Berkeley: University of California Press.
46. Hafferty, F. W. 1991. Into the valley: death and the socialization of medical students. New Haven, CT: Yale University Press.
47. Hafferty, F. W. 2006. Professionalism: the next wave. New England Journal of Medicine 355(20):2051-2052.
48. Hamdy, S. F. 2008. When the state and your kidneys fail: political etiologies in an Egyptian dialysis ward. American Ethnologist 35(4):553-559.
49. Harvey, D. 2005. A brief history of neoliberalism. Oxford: Oxford University Press.
50. Hojat, M., M. J. Vergare, K. Maxwell, G. Brainard, S. K. Herrine, G. A. Isenberg, J. Veloski, and J. S. Gonnella. 2009. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine 84(9):1182-1191.
51. Huish, R. 2009. How Cuba's Latin American School of Medicine challenges the ethics of physician migration. Social Science and Medicine 69(3):301-304.
52. Hunt, Nancy Rose. 1999. A colonial lexicon of birth ritual, medicalization and mobility in the Congo. Durham, NC: Duke University Press.
53. IHME (Institute for Health Metrics and Evaluation). 2010. Financing global health 2010: development assistance and country spending in economic uncertainty. Seattle: IHME. [JP]
54. Iliffe, J. 1998. East African doctors: a history of the modern profession. Cambridge: Cambridge University Press.
55. Inhorn, M. C. 2003. Local babies, global science: gender, religion, and in vitro fertilization in Egypt. New York: Routledge. [AB]
56. Janzen, J. 1982. Lemba, 1650-1930: a drum of affliction in Africa and the New World. New York: Garland.
57. Jewkes, R., N. Abrahams, and Z. C. Mvo. 1998. Why do nurses abuse patients? reflections from South African obstetric services. Social Science and Medicine 47(11):1781-1795. [SvdG]
58. Kamat, V. R. 2008. Reconsidering the allure of the culturally distant in therapy seeking: a case study from coastal Tanzania. Medical Anthropology 27(2): 106-135.
59. Kamat, V. R. 2009. The anthropology of childhood malaria in Tanzania. In Anthropology and public health: bridging differences in culture and society. R. A. Hahn and M. C. Inhorn, eds. Pp. 35-64. Oxford: Oxford University Press.
60. Kaspin, D. 1996. A Chewa cosmology of the body. American Ethnologist 23(3): 561-578.
61. Katz, P. 2001. The scalpel's edge: the culture of surgeons. Boston: Allyn & Bacon.
62. Kim, J. Y., J. V. Millen, A. Irwin, and J. Gershman, eds. 2000. Dying for growth: global inequality and the health of the poor. Monroe, ME: Common Courage.
63. Kitching, G. 2000. Why I gave up African studies. African Studies Review and Newsletter 22(1):21-26.
64. Kleinman, A. 1993. What is specific to Western medicine? In Companion encyclopedia of the history of medicine. W. F. Bynum and R. Porter, eds. Pp. 15-23. London: Routledge.
65. Kleinman, A., and P. Benson. 2006. Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Medicine 3(10):e294, doi: 10.1371/journal.pmed.0030294. [DG]
66. Kohler, R. E. 1999. Moral economy, material culture, and community in Drosophila genetics. In The science studies reader. M. Biagioli, ed. Pp. 243-257. New York: Routledge.
67. Konner, M. 1987. Becoming a doctor: a journey of initiation in medical school. New York: Viking.
68. Kressin, N. R. 1996. The effect of medical socialization on medical students' need for power. Personality and Social Psychology Bulletin 22(1):91-98.
69. Lachenal, Guillaume. 2012. Experimental hubris and medical powerlessness: notes from a colonial utopia, Cameroon, 1939-1949. In Rethinking biomedicine and governance in Africa. Paul Wenzel Geissler, Richard Rottenburg, and Julia Zenker, eds. Pp. 119-140. Bielefeld: Transcript. [PWG]
70. Langwick, Stacey. 2008. Articulate(d) bodies: traditional medicine in a Tanzanian hospital. American Ethnologist 35(3):428-439.
71. Langwick, Stacey. 2010. From non-aligned medicines to market-based herbals: China's relationship to the shifting politics of traditional medicine in Tanzania. Medical Anthropology 29(1):15-43.
72. Langwick, Stacey. 2011. Bodies, politics, and African healing: the matter of maladies in Tanzania. Bloomington: Indiana University Press. [PWG, SL]
73. Latour, Bruno. 2004. Why has critique run out of steam? from matters of fact to matters of concern. Critical Inquiry 30:225-247. [SL]
74. Lewis, B. 2007. The new global health movement: Rx for the world? New Literary History 38(3):459-477.
75. Livingston, Julie. 2005. Debility and the moral imagination in Botswana. Bloomington: Indiana University Press.
76. Livingston, Julie. 2012. Improvising medicine in an African oncology ward. Durham, NC: Duke University Press. [PWG]
77. Lock, M. 2001. The tempering of medical anthropology: troubling natural categories. Medical Anthropology Quarterly 15(4):478-492.
78. Lock, M., and D. R. Gordon. 1988. Biomedicine examined. Dordrecht: Kluwer Academic.
79. Lock, M., and V.-K. Nguyen. 2010. An anthropology of biomedicine. Malden, MA: Wiley-Blackwell.
80. Löyttyniemi, V. 2001. Doctors drifting: autonomy and career uncertainty in young physicians' stories. Social Science and Medicine 52:227-237.
81. Luedke, T. J. 2006. Presidents, bishops, and mothers: the construction of authority in Mozambican healing. In Borders and healers: brokering therapeutic resources in southeast Africa. T. J. Luedke and H. G. West, eds. Pp. 43-64. Bloomington: Indiana University Press.
82. Luke, H. 2003. Medical education and sociology of medical habitus: "it's not about the stethoscope!" Dordrecht: Kluwer Academic.
83. Lwanda, J. 2005. Politics, culture and medicine in Malawi: historical continuities and ruptures with special reference to HIV/AIDS. Zomba, Malawi: Kachere.
84. Lyons, M. 1992. The colonial disease: a social history of sleeping sickness in northern Zaire, 1900-1940. Cambridge: Cambridge University Press.
85. Maier, B. 1988. Gesundheit für Alle und Kolonisierung für Wenige: das Dilemma der traditionellen Medizin? Curare 11(4):196-206.
86. Marks, S. 1994. Divided sisterhood: race, class and gender in the South African nursing profession. New York: St. Martins.
87. Marsland, R. 2007. The modern traditional healer: locating "hybridity" in modern traditional medicine, southern Tanzania. Journal of Southern African Studies 33(4):751-765.
88. Martin, H. M. 2009. Nursing contradictions: ideals and improvisation in Uganda. Diemen, The Netherlands: AMB. [SvdG]
89. Meinert, L., H. O. Mogensen, and J. Twebaze. 2009. Tests for life chances: CD4 miracles and obstacles in Uganda. Anthropology and Medicine 16(2): 195-209.
90. Meinert, Lotte. 2009. Hopes in friction: schooling, health and everyday life in Uganda. Greenwich, CT: Information Age.[DK]
91. Merton, R. K., G. G. Reader, and P. L. Kendall, eds. 1957. The student-physician: introductory studies in the sociology of medical education. Cambridge, MA: Harvard University Press.
92. Minn, Pierre. 2011. Where they need me: the moral economy of international medical aid in Haiti. PhD dissertation, McGill University. [PR]
93. Mizrahi, T. 1986. Getting rid of patients: contradictions in the socialization of physicians. New Brunswick, NJ: Rutgers University Press.
94. Mkandawire, T., and C. Soludo. 1996. Our continent our future: African perspectives on structural adjustment. Dakar: CODESRIA.
95. Mol, Annemarie. 2003. The body multiple: ontology in medical practice. Durham, NC: Duke University Press. [SL]
96. Morsy, S. A. 1988. Islamic clinics in Egypt: the cultural elaboration of biomedical hegemony. Medical Anthropology Quarterly 2(4):355-369.
97. Mulemi, B. A. 2010. Coping with cancer and adversity: hospital ethnography in Kenya. In African studies collection, vol. 22. Leiden: African Studies Center. [DG]
98. Munthali, A. C. 2003. Change and continuity: perceptions about childhood diseases among the Tumbuka of northern Malawi. PhD dissertation, Rhodes University, Grahamstown, South Africa.
99. Muula, A. S., and R. L. Broadhead. 2001. The first decade of the Malawi College of Medicine: a critical appraisal. Tropical Medicine and International Health 6(2):155-159.
100. National Statistical Office [Malawi] and ORC Macro. 2001. Malawi Demographic and Health Survey 2000. Zomba, Malawi, and Calverton, MD: National Statistical Office and ORC Macro.
101. Nguyen, Vinh-Kim. 2002. Sida, ONG et la politique du témoignage en Afrique de l'Ouest. Anthropologie et Sociétés 26(1):69-87.
102. Nguyen, Vinh-Kim. 2010. The republic of therapy: triage and sovereignty in West Africa's time of AIDS. Durham, NC: Duke University Press.
103. Nisula, T. 1999. Everyday spirits and medical interventions: ethnographic and historical notes on therapeutic conventions in Zanzibar town. Helsinki: Suomen Antropologinen Seura.
104. Okeke, Iruka. 2011. Divining without seeds: the case of strengthening laboratory medicine in Africa. Ithaca, NY: Cornell University Press. [DK]
105. Paley, J. 2001. Marketing democracy: power and social movements in post-dictatorship Chile. Berkeley: University of California Press.
106. Parsons, G. N., S. B. Kinsman, C. L. Bosk, P. Sankar, and P. A. Ubel. 2001. Between two worlds: medical student perceptions of humor and slang in the hospital setting. Journal of General Internal Medicine 16(8):544-549.
107. Petryna, Adriana. 2009. When experiments travel: clinical trials and the global search for human subjects. Princeton, NJ: Princeton University Press.
108. Pfeiffer, James. 2003. International NGOs and primary health care in Mozambique: the need for a new model of collaboration. Social Science and Medicine 56:725-738.
109. Prince, Ruth J. 2012a. The moral economy of HIV in an east African city. Medical Anthropology Quarterly 26:4 (December), forthcoming. [PWG]
110. Prince, Ruth J. 2012b. The politics and anti-politics of HIV interventions in Kenya. In Biomedicine and governance in Africa. R. Rottenburg and J. Zenker, eds. Bielefeld: Transcript. [PWG]
111. Probst, P. 1999. Mchape '95, or, the sudden fame of Billy Goodson Chisupe: healing, social memory and the enigma of the public sphere in post-Banda Malawi. Africa 69(1):108-138.
112. Ranger, T. 1992. Plagues of beasts and men: prophetic responses to epidemic in eastern and southern Africa. In Epidemics and ideas: essays on the historical perception of pestilence. T. Ranger and P. Slack, eds. Pp. 241-268. Cambridge: Cambridge University Press.
113. Redfield, Peter. 2006. A less modest witness: collective advocacy and motivated truth in a medical humanitarian movement. American Ethnologist 33(1):3-26.
114. Rekdal, O. B. 1999. Cross-cultural healing in East African ethnography. Medical Anthropology Quarterly 13(4):458-482.
115. Rowden, R. 2009. The deadly ideas of neoliberalism: how the IMF has undermined public health and the fight against AIDS. London: Zed. [JP]
116. Rwangabo, P. C. 1993. La médicine traditionnelle au Rwanda. Paris: Éditions Karthala.
117. Scheper-Hughes, N. 1992. Death without weeping: the violence of everyday life in Brazil. Berkeley: University of California Press.
118. Schoepf, B. G., C. Schoepf, and J. V. Millen. 2000. Theoretical therapies, remote remedies: SAPs and the political ecology of poverty and health in Africa. In Dying for growth: global inequality and the health of the poor. J. Y. Kim, J. V. Millen, A. Irwin, and J. Gershman, eds. Pp. 90-126. Monroe, ME: Common Courage.
119. Scott, J. C. 1976. The moral economy of the peasant: rebellion and subsistence in Southeast Asia. New Haven, CT: Yale University Press.
120. Scott, J. C. 1985. Weapons of the weak. Everyday forms of peasant resistance. New Haven, CT: Yale University Press. [SvdG]
121. Senah, K. A. 2002. "Doctor-talk" and "patient-talk": power and ethnocentrism in Ghana. In Ethnocentrism: reflections on medical anthropology. S. van der Geest and R. Reis, eds. Pp. 43-66. Amsterdam: Aksant. [SvdG]
122. Shapiro, M. 1987. Getting doctored: critical reflections on becoming a physician. Santa Cruz, CA: New Society.
123. Sherr, K., A. Mussa, B. Chilundo, S. Gimbel, J. Pfeiffer, A. Hagopian, and S. Gloyd. Forthcoming. Donor-induced brain drain and health workforce distortions in Mozambique: a cross-sectional study. Health Affairs. [JP]
124. Sinclair, S. 1997. Making doctors: an institutional apprenticeship. Oxford: Berg.
125. Smith, R. 2001. Why are doctors so unhappy? there are probably many causes, some of them deep. BMJ: The British Medical Journal 322:1073-1074.
126. Sunder Rajan, K. 2006. Biocapital: the constitution of postgenomic life. Durham, NC: Duke University Press.
127. Taylor, J. S. 2003. Confronting "culture" in medicine's "culture of no culture." Academic Medicine 78(6):555-559.
128. Thompson, C. 2005. Making parents: the ontological choreography of reproductive technologies. Cambridge, MA: MIT Press. [AB]
129. th century. Past and Present 50:76-136.
130. Tousignant, Noemi. Forthcoming. Thésards in the city: making knowledge and money with pharmacy in Dakar, Senegal. [PWG]
131. Turner, V. W. 1968. The drums of affliction: a study of religious processes among the Ndembu of Zambia. Oxford: Clarendon and the International African Institute.
132. Turshen, M. 1999. Privatizing health services in Africa. Piscataway, NJ: Rutgers University Press.
133. Ugalde, A., and S. O. Alubo. 1994. Introduction. In Physicians and health care in the ThirdWorld. A. Ugalde and S. O. Alubo, eds. Pp. 8-9. Williamsburg, VA: Department of Anthropology, College of William and Mary.
134. UNDP (United Nations Development Program). 2000. Human development report 2000. Human rights and human development. New York: Oxford University Press for the United Nations Development Program.
135. van Der Geest, S., and K. Finkler. 2004. Hospital ethnography: introduction. Social Science and Medicine 59:1995-2001. [SvdG]
136. Vaughan, M. 1991. Curing their ills: colonial power and African illness. Oxford: Polity.
137. Wear, D., J. M. Aultman, J. D. Varley, and J. Zarconi. 2006. Making fun of patients: medical students' perceptions and use of derogatory and cynical humor in clinical settings. Academic Medicine 81(5):454-462.
138. Wendland, Claire L. 2010. A heart for the work: journeys through an African medical school. Chicago: University of Chicago Press.
139. Wendland, Claire L. 2012. Moral maps and medical imaginaries: clinical tourism at Malawi's college of medicine. American Anthropologist 114(1):108-122.
140. West, H. G., and T. J. Luedke. 2006. Introduction: healing divides: therapeutic border work in southeast Africa. In Borders and healers: brokering therapeutic resources in southeast Africa. T. J. Luedke and H. G. West, eds. Pp. 1-20. Bloomington: Indiana University Press.
141. Whyte, Susan R., Michael A. Whyte, and D. Kyaddondo. 2010. Health workers entangled: confidentiality and certification. In Anthropologies of AIDS: the morality of illness, treatment and death in contemporary Africa. Ute Luig and Hansjoerg Dilger, eds. Pp. 80-101. Oxford: Berghahn. [DK]
142. World Bank. 1982. Accelerated development in sub-Saharan Africa: an agenda for action. Washington, DC: World Bank.
143. World Health Organization. 2010. World health statistics 2010. Geneva: WHO.
144. Wright, P., and A. Treacher, eds. 1982. The problem of medical knowledge: examining the social construction of medicine. Edinburgh: Edinburgh University Press.
145. Zaman, S. 2004. Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh. Social Science and Medicine 59(10):2025-2036. [SvdG]
146. Zaman, S. 2005. Broken limbs, broken lives: ethnography of a hospital ward in Bangladesh. Amsterdam: Aksant. [SvdG]