Marjorie A. Muecke

New paradigms for refugee health problems

Two paradigms that have shaped our understanding of refugee health are identified: the objectification of refugees as a political class of excess people, and the reduction of refugee health to disease or pathology. Alternative paradigms are recommended: one to take the polyvocality of refugees into account, and one to construe refugees as prototypes of resilience despite major losses and stressors. The article is organized into three sections, mirroring the life history of refugees from internal displacement in the country of origin to asylum in a second (usually neighboring) country, and for some, to permanent resettlement in a third country. In each of the three sections, the primary topics that are treated in the literature are identified, and key problems identified for discussion.

Health care systems as socializing agents: Childbearing the North Thai and Western ways

Abstract The purpose of this paper is to show how two diverse health care systems act as powerful socializing contexts that differentially influence social action related to the same biological phenomenon, child birth, in the same population unit. After a brief description of the alternate health care systems now active in urban North Thailand, the socializing messages that are communicated to maternity clients of the North Thai and Western systems are compared. That is, the aim is to identify the cultural propositions about social roles and action that underlie the operation of the two health care systems, demonstrating that health care systems (1) socialize their agents and clients toward specific attitudes, understandings, beliefs and values about society, health and fertility, and (2) act as instruments of social change and indirect education.

Born female: The development of nursing in Thailand

Nursing was the first education-based occupational field for women in Thailand. In the brief span of 90 years since its beginning in hospital bedside care, it has become a professional field that has one of the greatest concentrations of women with doctoral degrees in the nation (n = 23). The academic evolution of nursing was instigated by the decisive contributions of two rich and powerful interests, the monarchy and private U.S.A.-based foundations. A cadre of doctorally prepared nurses has emerged. They, like members of other professions in Thailand, are predominantly from the urban privileged sector of society. The majority of todays nurses have followed a different course starting from petty bourgeoisie origins in towns and moving laterally through provincial bureaucratic channels. To date, lack of basic education has denied the poor and minority ethnic groups from the hill areas access to nursing. We describe the development of the nursing profession in three phases: the beginning of nurse training, 1896-1926; the creation of a small elite of nurses, 1926-1956; and the development of academic nursing, 1956 to the present. The future depends upon how the current polarization between the minority elite of university-prepared nurses and the majority lower middle class nurses proceeds. Since each group is governed and educated by separate government Ministries, and since women do not have access to higher government positions, nursing may have little control over its own development unless its new leaders take new leadership. One strategy is to recruit men into university nursing.

From Women in White to Scholarship: The New Nurse Leaders in Thailand

The nature of nursing in Thailand has changed dramatically since World War II. The field is now led by a cadre of women who make nursing one of the largest occupational concentrations of women who hold doctoral degrees in the country. In this article reflections of these nurses on their profession, on their reasons for entering it, and on their contributions to its development are discussed. The findings are derived from a survey of 16 nurses with doctoral degrees and from participant observation. The women and their parents who guided their choice of a career were attracted to nursing by ideals of social service and family obligations. They were also attracted to nursing by its cultural definition as a female career and by the pragmatics of university entrance examinations. Most of the informants attributed their career success to hard work, family support, a strong sense of responsibility and commitment, self-sacrifice for the common good, and a calm demeanor. A minority of informants stressed new values of scholarship and management skills such as long-range planning and independent thinking. The emergence of these new values suggests that nursing in Thailand is on the verge of a new stage in its rapid evolution.

Guest Editorial: Shifting sexuality among lowland Thai women

The three papers on gender and sexuality among lowland Thai women in this issue of Culture Health & Sexuality represent the aim of a larger group of Thai researchers to contest stereotypes of female sexuality that dominate the English language literature on gender and sexuality in Thailand. With the support of The Ford Foundation the larger group was first convened in the year 2000 by the Chulalongkorn University Social Science Research Institute (CUSSRI) in Bangkok. Anthropologists Amara Pongsapich the Institute Director and I invited Thai researchers known to be studying gender and sexuality issues among lowland Thai women to participate in a series of authors’ workshops to review each other’s work and prepare it for submission for publication in English. The initial aims of the group were to contest the dominant international discourse (both in media and research) that addresses Thai women and sexuality solely in terms of sex work to address women’s sexuality in the complexity of its situatedness in different places of lowland Thai society and to bring voices of Thai researchers into the international discourses on Thai women and sexuality. (excerpt)