Negotiating “The Social” and Managing Tuberculosis in Georgia
Tóm tắt
In this paper I utilize anthropological insights to illuminate how health professionals and patients navigate and negotiate what for them is social about tuberculosis in order to improve treatment outcomes and support patients as human beings. I draw on ethnographic research about the implementation of the DOTS (Directly Observed Therapy, Short Course) approach in Georgia’s National Tuberculosis Program in the wake of the Soviet healthcare system. Georgia is a particularly unique context for exploring these issues given the country’s rich history of medical professionalism and the insistence that the practice of medicine is a moral commitment to society. I argue for critical attention to the ways in which treatment recipients and providers navigate what, for them, is “social” about therapeutic practices and their significance for avoiding biological and social reductionism.
Tài liệu tham khảo
Abdullaev, N. 2000. Tuberculosis rages in the Caucasus. Prism 6(10). http://www.jamestown.org/single/?tx_ttnews%5Btt_news%5D=27962&no_cache=1#.VnglWYT8-_s. Accessed June 19, 2003.
Aerts, A., M. Habouzit, L. Mschiladze, N. Malakmadze, et al. 2000. Pulmonary tuberculosis in prisons of the ex-USSR state Georgia: Results of a nation-wide prevalence survey among sentenced inmates. International Journal of Tuberculosis and Lung Disease 4(12): 1104–1110.
Bazylevych, M. 2011. Vaccination campaigns in postsocialist Ukraine: Health care providers navigating uncertainty. Medical Anthropology Quarterly 25(4): 235–256.
Bonnet, M., V. Sizaire, Y. Kebede, et al. 2005. Does one size fit all? Drug resistance and standard treatments: Results of six tuberculosis programs in former Soviet countries. International Journal of Tuberculosis and Lung Disease 9(10): 1147–1154.
Cohen, L. 2000. No aging in India: Alzheimer’s, the bad family, and other modern things. Berkeley: University of California Press.
Dubos, R., and J. Dubos. 1992. The white plague: Tuberculosis, man and society. New Brunswick, NJ: Rutgers University Press.
Ecks, S., and I. Harper. 2013. Public–private mixes: The market for antituberculosis drugs in India. In When people come first: Critical studies in global health, edited by J. Biehl and A. Petryna, 252–275. Princeton: Princeton University Press.
Farmer, P.E. 1999. Infections and inequalities: The modern plagues. Berkeley: University of California Press.
Farmer, P.E. 2003. Pathologies of power: Health, human rights, and the new war on the poor. Berkeley: University of California Press.
Garner, P., and J. Volmink. 2003. Directly observed treatment for tuberculosis: Less faith, more science would be helpful. British Medical Journal 327(7419): 823–824.
Gelmanova, I.Y.D.V., S.P. Taran, A.A. Mishustin, A.V. Solovyova Golubkov, and S. Keshavjee. 2011. “Sputnik”: A programmatic approach to improve tuberculosis treatment adherence and outcome among defaulters. International Journal of Tuberculosis and Lung Disease 15(10): 1373–1379.
Harper, I. 2006. Anthropology, DOTS, and understanding tuberculosis control in Nepal. Journal of Biosocial Science 38(1): 56–67.
Harper, I. 2010. Extreme condition, extreme measures? Compliance, drug resistance, and the control of tuberculosis Anthropology and Medicine 17(2): 201–214.
Harper, I. 2014. Development and public health in the Himalaya. London: Routledge.
Isaakidis, P., S. Smith, S. Majumdar, J. Furin, and T. Reid. 2014. Calling tuberculosis a social disease—an excuse for complacency? The Lancet 384(9948): 1095.
Kleinman, A., V. Das, and M.M. Lock (eds.). 1997. Social suffering. Berkeley: University of California Press.
Koch, E. 2006. Beyond suspicion: Evidence, (un)certainty, and tuberculosis in Georgian prisons. American Ethnologist 33(1): 50–62.
Koch, E. 2013. Free market tuberculosis: Managing epidemics in post-Soviet Georgia. Nashville: Vanderbilt University Press.
Koch, E. 2015. Protracted displacement in Georgia: Structural vulnerability and “existing not living.” Human Organization 74(2): 135–143.
Lakoff, A. 2010. Two regimes of global health. Humanity: An International Journal of Human Rights, Humanitarianism, and Development 1(1): 59–79.
Latour, B. 2007. Reassembling the social: An introduction to actor-network-theory. Oxford, UK: Oxford University Press.
Lessem, E. 2014. Tuberculosis drug development hobbles forward. In 2014 pipeline report, edited by A. Benzacar, 19–21. New York: i-Base/Treatment Action Group.
Lessem, E., H. Cox, H. Daniels, et al. 2015. Access to new medications for the treatment of drug-resistant tuberculosis: Patient, provider and community perspectives. International Journal of Infectious Diseases 32(March): 56–60.
Lindenbaum, S. 1978. Kuru sorcery: Disease and danger in the New Guinea Highlands. Mountain View, CA: Mayfield Publishing Company.
Lock, M. 1993. Encounters with aging: Mythologies of menopause in Japan and North America. Berkeley: University of California Press.
Lock, M. 2001. The tempering of medical anthropology: Troubling natural categories. Medical Anthropology Quarterly 15(4): 478–492.
Lomtadze, N., R. Aspindzelashvili, M. Janjgava, et al. 2009. Prevalence and risk factors for multidrug-resistant tuberculosis in the Republic of Georgia: A population-based study. International Journal of Tuberculosis and Lung Disease 13(1): 68–73.
Martin, E. 1987. The woman in the body: A cultural analysis of reproduction. Boston: Beacon Press.
McMillen, C.W. 2015. Discovering tuberculosis: A global history, 1900 to the present. New Haven, CT: Yale University Press.
Mdivani, N., E. Zangaladze, N. Volkova, et al. 2008. High prevalence of multidrug-resistant tuberculosis in Georgia. International Journal of Infectious Disease 12(6): 635–644.
Moshin, A. 2014. Treating tuberculosis as a social disease. The Lancet 383(9936): 2125.
Packard, R.M. 1989. White plague, black labor: Tuberculosis and the political economy of health and disease in South Africa. Berkeley: University of California Press.
Peuch, J. 2002 Georgia: Official says TB epidemics contained, but warns against too much optimism. Radio Free Europe/Radio Liberty (RFE/RL), October 29. http://www.rferl.org/content/article/1101224.html. Accessed March 13, 2005.
Porter, J., K. Lee, and J. Ogden. 2002. The globalization of DOTS: Tuberculosis as a global emergency. In Health policy in a globalizing world, edited by K. Lee, K. Buse, and S. Fustukian, 181–194. Cambridge, UK: Cambridge University Press.
Quesada, J., L.K. Hart, and P. Bourgois. 2011. Structural vulnerability and health: Latino migrant laborers in the United States. Medical Anthropology 30(4): 339–362.
Rasanathan, K., A. Sivasankara Kurup, E. Jaramillo, and K. Lönnroth. 2011. The social determinants of health: Key to global tuberculosis control. International Journal of Tuberculosis and Lung Disease 15(6): S30–S36.
Shin, S., J. Furina, J. Bayonab, K. Matec, J. Yong Kim, and P. Farmer. 2004. Community-based treatment of multidrug-resistant tuberculosis in Lima, Peru: 7 years of experience. Social Science and Medicine 59(7): 1529–1539.
Seeberg, J. 2013. The death of Shankar: Tuberculosis and social exclusion in a poor neighbourhood in Bhubaneswar, Odisha. In Navigating social exclusion and inclusion in contemporary India and beyond, edited by K.B. Nielsen, M. Fibger Qvortrup, and U. Sudoka, 207–226. London: Anthem.
Seeberg, J. 2014. The event of DOTS and the transformation of the tuberculosis syndemic in India. Cambridge Anthropology 32(1): 95–113.
Street, A. 2014. Biomedicine in an unstable place: Infrastructure and personhood in a Papua New Guinean hospital. Durham, NC: Duke University Press.
Trostle, J. 2005. Epidemiology and culture. Cambridge, UK: Cambridge University Press.
Virchow, R. 1958. Disease, life, and man. Translated by I.J. Rather. Stanford, CA: Stanford University Press.
World Health Organization. 2015. Global tuberculosis report. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf?ua=1. Accessed November 30, 2015.
Zachariah, R., A.D. Harries, S. Srinath, et al. 2012. Language in tuberculosis services: Can we change to patient-centered terminology and stop the paradigm of blaming the patients? International Journal of Tuberculosis and Lung Disease 16(6): 714–717.