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Chronic Conditions, Fluid States

Chronicity and the Anthropology of Illness

Edited and with an introduction by Lenore Manderson and Carolyn Smith-Morris

Publication Year: 2010

Chronic Conditions, Fluid States explores the uneven impact of chronic illness and disability on individuals, families, and communities in diverse local and global settings. To date, much of the social as well as biomedical research has treated the experience of illness and the challenges of disease control and management as segmented and episodic. Breaking new ground in medical anthropology by challenging the chronic/acute divide in illness and disease, the editors, along with a group of rising scholars and some of the most influential minds in the field, address the concept of chronicity, an idea used to explain individual and local life-worlds, question public health discourse, and consider the relationship between health and the globalizing forces that shape it.

Published by: Rutgers University Press

Title Page, Copyright

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pp. v-vi

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Preface and Acknowledgements

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pp. vii-xii

Gay Becker’s work on asthma and infertility highlights the ongoing nature of chronic health conditions—underlying persistent states that in their everyday presentation, and in their lived experience, are always variable. Our book is a critical inquiry into this variability and fluidity, and into the value of chronicity...

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pp. 1-18

In the past century, the world has witnessed dramatic epidemiological change. For reasons that we explore in this volume, the relative weight of infectious disease and injury on mortality and morbidity has declined, and instead, in the poorest and the wealthiest of nations, extended, often lifelong medical conditions predominate. These conditions neither develop nor continue in a vacuum...

Part One: The Idea of Chronicity

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Chapter 1: The Chronicity of Life, the Acuteness of Diagnosis

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pp. 21-37

The biotechnological marketplace shapes much of the discourse on the chronic–acute dichotomy, and ultimately has a significant effect on the foci of medical anthropologists. By distinguishing a condition that is curable and therefore acute (as in broken bones and many bacterial infections) from disease that is incurable and therefore chronic (as in heart disease and diabetes), we leave in place biomedicine’s self-referential system of disease classification...

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Chapter 2: Globalizing the Chronicities of Modernity: Diabetes and the Metabolic Syndrome

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pp. 38-53

For most of human history as hunters, gatherers, and agriculturalists, humans maintained an active physical lifestyle that varied with seasonal resources and promoted cardiovascular and metabolic fitness. But for the past five hundred years, since early European imperialism, there have been major changes in everyday life and, in consequence, in health. Early industrialization and globalization diffused commodities and labor-saving technologies for work and home...

Chapter 3: Is “Chronicity” Inevitable for Psychotic Illness?: Studying Heterogeneity in the Course of Schizophrenia in Yogyakarta, Indonesia

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pp. 54-74

Part Two: Gender and the Experience of Illness

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Chapter 4: Male Infertility, Chronicity, and the Plight of Palestinian Men in Israel and Lebanon

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pp. 77-95

Male infertility is a neglected reproductive health problem, yet it contributes to at least half of all cases of subfertility worldwide (P. Chan 2007; Kim 2001). Male infertility is often idiopathic, or of unknown cause; hence, it is recalcitrant to prevention and is among the most diffi cult forms of infertility to treat (Carrell et al. 2006; Devroey et al. 1998; Irvine 1998; Kamischke and Nieschlag 1998)...

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Chapter 5: “Half a Woman”: Embodied Disruptions and Ideas of Gender among Australian Women

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pp. 96-112

Scholarly attention and public health priorities related to women’s health have typically focused on pregnancy, childbirth, and other aspects of women’s reproductive health, and by extension, risks to the lives of women and their children. The chronic conditions that affect women uniquely or primarily—conditions that are not fatal, infectious, or exotic, nor with significant population impact— conventionally hover in the peripheral vision of most researchers; they rarely...

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Chapter 6: Ecuadorian Women’s Narratives of Lupus, Suffering, and Vulnerability

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pp. 113-130

An unhappy consequence of growing urbanization and increased life expectancy in the developing world is the appearance of more “fi rst world” health problems, especially “chronic disease” (Yach et al. 2004). In Latin America in particular, chronic illness, once associated with the wealthy and privileged, is increasingly found among a wide cross section of the population (Pan American...

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Chapter 7: Why Women Don’t Die in Childbirth: Maternal Survivorship in Badakhshan, Tajikistan

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pp. 131-154

conventional way to explain maternal mortality is to link maternal health with women’s access to lifesaving obstetric care. When maternal complications arise there is little doubt that obstetric medicine including caesarean sections, vacuum and forceps-assisted deliveries, save women’s lives. This line of thinking governs the assumption that comprehensive emergency obstetric care (EOC) is...

Part Three: The Clinical Interface

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Chapter 8: Chronic Illness and the Assemblages of Time in Multisited Encounters

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pp. 157-174

Time and timing are significant features of illness and medicine. Traditional Chinese Medicine (TCM) recognizes the importance of the circadian rhythms of illness. Body organs, the human body itself, and its life systems are treated with therapy that is organized into time periods known as chronotherapy (Samuels 2000). In the fourth century BC in Alexandria, Herophilos the anatomist...

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Chapter 9: Chronicity and AIDS in Three South African Communities

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pp. 175-194

In their history of HIV, Elizabeth Fee and Daniel Fox describe the international AIDS meeting in Montreal, Quebec, in 1989, and how Samuel Broder, then head of the National Cancer Institute, declared that AIDS was a “chronic disease and cancer the appropriate model of therapy” (Fee and Fox 1992). The speech was an intentional effort to normalize AIDS and to demonstrate the potential cascade...

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Chapter 10: Disability and Dysappearance: Negotiating Physical and Social Risk with Cystic Fibrosis

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pp. 195-211

Notions of progress are embedded in culture, where ideas of activity, achievement, and future orientation inform a view of life seen as a trajectory, a narrative where the individual has the responsibility for creating continuity and permanence. Of course there is a great deal of slippage with this trajectory since the unpredictability of actual lives serves as an ongoing counterpoint to the archetypal social narrative focused on the linear, orderly...

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Chapter 11: Caring for Children with Special Healthcare Needs: “Once We Got There, It Was Fine”

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pp. 212-229

With no stable map and no single point of entry, how do the parents or guardians of children newly living with chronic or disabling conditions gain access to and navigate through the various components of the healthcare system? How do they master what is generally, for them, a strange new world?
In asking and seeking to answer these questions, my focus has been on the experiences of U.S. parents of very young children (aged up to five years) who...

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Chapter 12: Chronic Conditions, Health, and Well-Being in Global Contexts: Occupational Therapy in Conversation with Critical Medical Anthropology

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pp. 230-246

Medical anthropologists know that our perspectives on chronic disease and illness provide much-needed critiques of the hegemony of biomedicine and insights into clinical applications. But can we make our voices heard and infl uence action in places where it makes a difference? For several decades a crisis in academic jobs for social scientists has meant that interdisciplinary and interprofessional initiatives may define some of the most important opportunities in...

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Afterword: Chronicity—Time, Space, and Culture

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pp. 247-252

key health issue facing humanity today is the increasing burden of chronic conditions. The year 2000 was the first in history in which people over sixty worldwide outnumbered children under five. The future is one in which chronic illnesses and end-of-life conditions faced by aging populations will play an ever-greater role in health care. Chronic illness is embedded in the local flow of moral experience, in the struggles of individuals to craft a moral life, and in the...


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pp. 253-308


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pp. 309-314


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pp. 315-320

E-ISBN-13: 9780813549736
E-ISBN-10: 0813549736
Print-ISBN-13: 9780813547466

Page Count: 336
Illustrations: 1
Publication Year: 2010