Annotation Annotation
The conceptual and practical work done by social medicine and global health have often overlapped. In this paper, we argue that new efforts to apprehend 'the social' in social medicine offer important insights to global health along five lines of critical analysis: (1) reconfigurations of the state and new forms of political activism, (2) philanthrocapitalism and the economisation of life, (3) The economy of attention, (4) anthropogenic climate change, and (5) the geopolitics of North and South.;
Social theorists have explored the ways in which quantification serves as an instrument of governance in the modern state, whether tied to concerns of population size and quality or to problems of social behavior. Biopolitics are as visible in the modern socialist states as they are in free-market democratic states, and they are perhaps nowhere more visible today than in the new global standards of "evidence-based medicine," wherein it is assumed that only quantifiable evidence can serve to establish policy, procedure, and outcome. When it comes to creating ways to "civilize" and organize their target citizenry through health development, Socialist China as relied on such technologies as much as have health development funding agencies from donor countries. In this article, I look at quantitative methods in relation to assumptions that morality can be severed from truth and that numbers are potentially morally neutral. This idea is tied not only to forms of modern subjectivity but also to the distinct ways in which certain linguistic and theoretical practices relate to provisional notions of "lying," "truth-telling," and ways of "believing." An exploration of the effects of attempts to quantify maternal behavior, morbidity, and morality in rural Tibet highlights the problem of morality within an environment in which numbers are never free-standing but, rather, are always presumed to carry moral messages, and in which domains that cannot be quantified serve as a primary basis for knowing truth. Through an exploration of rural Tibetan encounters with health development programs for safe motherhood, I provide a critique of quantification and return to questions about "belief" as a rubric that interrupts modern dichotomies of lies versus truths.
The Sherpa are a Tibetan-speaking people who moved into the valleys of eastern Nepal in the middle of the sixteenth century. They survived as traders transporting goods by Yak across the Himalayas, linking the markets of China to Nepal and India. This collection of 19 documents about the Sherpa covers a period from the 1950s to 1990s. The Sherpa environment, religion, and social change have received the most attention by these authors.
Tibetan refugees and Western activists note that if universal human rights standards were enforced in China, Tibetans would suffer less and come closer to political independence. This article explores potential problems of universalism and individualism in human rights discourse by examining understandings of the body and suffering among Lhasa Tibetan women. Data are taken from accounts of political prisoners and women patients at Lhasa's traditional Tibetan medical hospital. The data suggest a collective subjectivity, based on ideas about karma and congruencies of body, mind, and society that contrast with those found in international human rights discourse. Tibetans are forced to adopt universalist and individualist positions to make their claims for human rights heard while ironically articulating ideas about suffering that would contest such universalist positions. The article proposes a need for alternative conceptualizations of human rights taken from Tibetan epistemologies of suffering, and illustrates the utility of medical anthropological inquiries about embodiment and subjectivity for addressing larger political debates about human rights. [Traditional Tibetan Medicine, Human Rights, Epistemology, Bodily Suffering]
Purpose This report from the field details the ways that one small maternal child health NGO, which began its work in Tibet and now works in the mountain communities of Nepal, has established a model for integrated healthcare delivery and support it calls the 'network of safety.' Description It discusses some of the challenges faced both by the NGO and by the rural mountain communities with whom it partners, as well as with the government of Nepal. Conclusion This report describes and analyzes successful efforts to reduce maternal and infant mortality in a culturally astute, durable, and integrated way, as well as examples of innovation and success experienced by enacting the network of safety model.
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