In lieu of an abstract, here is a brief excerpt of the content:

VVVVVVVVVVV 230 12 Chronic Conditions, Health, and Well-Being in Global Contexts Occupational Therapy in Conversation with Critical Medical Anthropology GELYA FR ANK, CAROLYN BAUM, AND MARY LAW 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 influence 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 medical anthropology for years to come (Inhorn 2007c). Despite its phenomenal growth and success relative to anthropology overall, the subfield of medical anthropology has not been immune from these challenging conditions. Medical anthropology has strong partnerships with public health, bioethics, and nursing . In this chapter, we sketch some foundations for a more concerted interface of medical anthropology with occupational therapy in scholarship, practice, and, importantly, professional developments. Occupational therapy is a practice profession founded in the United States in 1917. Its practitioners address health promotion, wellness and quality of life, rehabilitation, and function. The profession’s practice base in the United States has been mainly in medical and school settings, and a vibrant community practice has been emerging internationally, in tandem with World Health Organization (WHO) initiatives in human rights, disability studies, and progressive revisions in the International Classification of Function. Occupational therapy’s core approach is the use of everyday activities with people to improve or regain their capacity to participate in a meaningful and satisfying life. Historically, its scope of practice has been primarily with people who have chronic illnesses and disabilities—physical, cognitive, developmental, and psychiatric. The term occupation, in the context of the development of this field of practice, refers to engagement in life activities. It goes far beyond what some might think of as CHRONIC CONDITIONS, HEALTH, AND WELL-BEING 231 work; it includes the activities necessary to care for self and others, productive activities related to paid or volunteer employment, school- and literacy-related activities, and social engagement in family and community life. Medical anthropologist Elisa Sobo (2004), writing on the interface between pediatric medical practice and children with special needs, has reflected that anthropologists generally see ”health” as a broad construct, consisting of physical , psychological, and social well-being, including role functionality. Occupational therapy’s definition is remarkably congruent. Based on the belief that all people need to engage in occupation in relation to survival, health, well-being, and life satisfaction, occupational therapy is a “profession whose focus is on enabling a person (i.e., individual client) or a group of persons (i.e., group, community, or an organization client) to access and participate in activities that are meaningful, purposeful, and relevant to their lives, roles, and sense of wellbeing ” (American Occupational Therapy Association 2000: 3). In this chapter, we bring together medical anthropology (Frank) and occupational therapy (Baum and Law) and suggest how closer alignment can benefit the two professions. As argued elsewhere, medical anthropology and occupational therapy together with disability studies can produce and circulate more powerful discourses and practices to mitigate disempowering effects of chronic conditions on everyday life (Frank and Zemke 2008). People with disabilities and chronic conditions comprise perhaps 10 or 12 percent of the world’s population. Disability is linked disproportionately with poverty and social exclusion, a situation that is particularly acute in industrializing countries and struggling economies. Medical anthropologists have demonstrated how biomedical, political– economic, and demographic trends create specific configurations of dependency and needs for chronic care. Leaders in the profession of occupational therapy are acutely aware of the challenges of defining and providing services to enhance opportunities for people and families with chronic conditions to live meaningful, purposeful lives. Both professions focus on access to the range of opportunities and activities that people may expect to enjoy in their society . Medical anthropology typically takes a critical view of power differentials and cultural framings that produce structural inequalities, while occupational therapy typically intervenes at the level of individuals and their families. What would a profession look like if it were equipped with both approaches? What Medical Anthropologists Need to Know about Occupational Therapy and Its Transformations: A Cultural History in North America Occupational therapy describes itself as working at the interface of the person and environment, to widen and enrich the dynamic space of meaningful...

Share