George M. Foster

Medical anthropology and international health planning

Abstract International health planners have been slow to recognize that barriers slowing down the acceptance of modern medicine in traditional societies are just as much inherent in bureaucratic premises and operations as in the sociocultural forms of the recipient peoples. Beginning a generation ago anthropologists suggested an “adversary model” that posited a contest between modern and traditional medicine based largely on cultural dissonance, to explain resistances to change. Today it appears that quality, cost, and convenience of modern medicine rather than cultural incompatibility are the primary determinants of its acceptance. Medical role perceptions and the social costs of changes and reorganizations in health organizations are noted as problems in designing the most appropriate health services for developing countries. Possible roles for traditional healers in helping provide primary health care are discussed. Except for the use of indegenous midwives and perhaps mental illness specialists, it is argued, this approach will enjoy little success. In addition to doubts stemming from differing ideas of traditional and modern curers about etiologies and treatment, the proposal is based on an erroneous premise: that traditional healers will continue to be produced at the same rate as in the past. Contemporary evidence suggests their numbers will drop to a point where they will not constitute an adequate manpower reservoir, even should they be deemed accaptable on other grounds.

South seas cruise: a case study of a short-lived society.

Abstract In spite of its importance to the tourism industry, vacation cruising has been little researched. This paper describes an atypical cruise on a small ship in the South Pacific. It advances the concepts of “short-lived societies,” “cruise culture,” and the ship as “environment” to explain the behavior of passengers, and the ways in which they relate to each other. Passengers are described as an aging, upper middle class group, still physically active, flexible in relating to members of their class, yet cautious in developing social intimacies. Self-improvement is seen to be the moral rationale of many passengers in justifying a relatively expensive trip. Passenger expectations and behavior on small cruise ships, it is suggested, are quite distinct from what is found on large ships.

Life expectancy of utilitarian pottery in Tzintzuntzan, Michoacan, Mexico

Pottery life-expectancy has important archaeological implications for such problems as population sizes and duration of occupancy of sites. Specific data are here given from four contemporary Mexican village households on durability of several kinds of ware. The most important factors determining life-expectancy appear to be basic strength of the ware, functions of different types of vessels, handling practices, relative costs, and kinds of breakage. It may be inferred that similar factors determine life-expectancy in many contemporary and archaeological communities.

World Health Organization behavioral science research: Problems and prospects

The stated goals of World Health Organization-supported behavioral research are applied: to contribute to planning and policy decision-making, and to improve health care delivery methods. The evidence suggests the organization is getting less for its behavioral research dollar than it ought to: much research has been of poor quality, and researchers often appear more concerned with research design elegance than with practical application of results. Professional and structural factors explain this picture. Physician-dominated research committees that evaluate research applications assume that quantitative hypothesis-testing investigation is the only acceptable research model. Hence, in their grant applications behavioral scientists conform to the expectations of research committees, stressing quantitative methods and slighting the qualitative approaches that often are more productive in providing operational information. Research committee members also often fail to understand the scope of behavioral research possibilities: hoped-for results are limited to information on how to change community behavior more nearly to conform to the needs of health care delivery programs. Research on organization policies and programs is viewed as irrelevant and perhaps even threatening. To improve the quality and utility of WHO-sponsored behavioral research, the author suggests a workshop of organization personnel and short-term consultants and temporary advisors with prior experience, to evaluate past research, to identify its strengths and weaknesses, and to recommend modified research support procedures to produce higher quality, operationally-useful results.

Community development and primary health care: Their conceptual similarities 1

In an effort to meet the material and social needs of developing countries following the 2nd world war 2 types of programs developed. Community development (CD) the 1st to appear is a rural across-the-board developmental approach stressing agriculture health education and communication. The other is primary health care (PHC) which is designed to cope with the basic health needs of developing countries and set in the context of integrated socioeconomic development. CD and PHC are examined with the purpose of showing that PHC could profit from the experience of the older CD movement. CD and PHC are similar in concept philosophy and goals and it would be expected that PHC planners would be interested in the CD experience. This however is not often the case. The CD experience has not been an unqualified success due to misconceptions characterized in many CD programs and bureaucratic difficulties. Yet PHC should utilize both the positive and negative experience of CD in planning and operation of PHC programs.

Food safety and the behavioural sciences

International health programmes have been a major stimulus to the development of several specialties collectively known as medical behavioural science. Each new programme of the international and national agencies has led to an expansion of the areas of behavioural scientists in health research. This may also be expected from WHOs Food Safety Programme; its activities, and the findings contained in the report of a recently held meeting of a Joint FAO/WHO Expert Committee on Food Safety, are bringing to light the need for, and the opportunities in, behavioural science research on food safety. Although significant behavioural research has been done in nutrition and the treatment of diarrhoeal diseases, almost no attention has been paid to the ways in which food is rendered unsafe for human consumption or to the ways in which food safety can be increased. Suggestions are made as to the kinds of research needed, the data that must be gathered, and the ways in which, especially through health education, this information can be made operational.

A Second Look at Limited Good

Because of the controversy which has arisen since the original article on Limited Good was published in 1965, the author questions here whether or not it is a plausible model to explain peasant behavior and if he has made himself clear in describing it The nature of peasant behavior is not in dispute. Further clarification stresses that the model is not exclusive to peasant societies; that it is a model inferred from behavior; that it explains classic, not modernizing, peasant society; that peasant society is not a closed system; and that exceptions to the rule of Limited Good include religious prestige and intense emotional experiences. The author maintains that the cognitive orientation of Limited Good goes farther than any other model yet advanced to explain peasant behavior.

Godparents and Social Networks in Tzintzuntzan

Quantitative baptismal data (N=944) are used to explore the strategy of building social networks via compadrazgo ties. Godparents of a couples children most frequently are of the same social status as the parents (75%), friends rather than relatives (67%), village neighbors rather than outsiders (87%). Choice of friends versus relatives as godparents varies with birth order of children within families: early children are more likely than later children to have family friends rather than relatives as godparents. This pattern is explained by a family developmental cycle hypothesis, which postulates that new couples, especially if still living with the parents of husband or wife, wish to expand their social networks rapidly beyond family boundaries, but that when optimum network size is approached, double loading of kinship ties with new compadrazgo ties reduces expenses and obligations by slowing network expansion.

Medical anthropology: Some contrasts with medical sociology☆

Abstract In spite of many similarities, the fields of medical anthropology and medical sociology differ significantly in origins, in research methodologies, and in emphases. Medical anthropology has developed from three sources; (1) the traditional ethnographic interest in primitive medicine, (2) the culture and personality movement of the 1940s and (3) the international public health movement following World War II. A holistic, systems approach to research appears to characterize medical anthropology more than medical sociology. Anthropologists traditionally have studied the underdogs, the worlds primitive and peasant peoples. They reflect this orientation in their tendency to identify with patients and health workers near the bottom of the medical hierarchy, rather than with physicians and other high status professionals. In the final analysis the medical anthropologist sees problems in a cultural context, while the medical sociologist sees them in a social context.

Cultural responses to expressions of envy in Tzintzuntzan

ENVY AND JEALOUSY are emotions found in every society. Since they imply hostility and may result in overt aggression, they threaten the stability of group life unless they can be successfully controlled. The ways in which envy and jealousy are expressed in a society and the steps that are taken to neutralize their dangers can be described, analyzed, and classified by placing them along a continuum, the two poles of which represent respectively conscious (or overt) and subconscious (or covert) levels of awareness. Envious or jealous behavior falling near the conscious pole of the continuum can be described by informants and directly observed by anthropologists. The aggression that may follow because of these sentiments and the protective measures invoked because of this hostility are similarly apparent. Envious and jealous behavior falling near the subconscious pole of the continuum, and the techniques utilized to neutralize the consequent danger, must to a considerable extent be inferred from overt behavior. For, as the subconscious pole is approached, institutionalized and highly stylized behavior increasingly disguises expressions of envy and jealousy, and the true meaning of such behavior may be obscured both to the people whom it characterizes and to the anthropologist. To express admiration or to pay a compliment appear to be the most characteristic institutionalized-stylized forms of exhibiting envy and jealousy. Per-