Week 2

Question 1

Medical pluralism
Popular sector

Answer 1

This is the lay, non-professional, non-specialist domain of society,
where ill health is first recognized and defined and health-care
activities are initiated. It includes all the therapeutic options that
people use, without any payment and without consulting either folk
healers or medical” - Self-treatment, self- medication, advice from
relatives, friends, colleagues, neighbors… (Page 82)

Question 2

Folk Sector:

Answer 2

• “… certain individuals specialize in forms of healing that are either
  sacred or secular, or a mixture of the two. These healers are not
  part of the official medical system and occupy an intermediate
  position between the popular and professional sectors.” (Page 84)
• Examples sometimes of these are midwives, herbalists, found in Nepal, faith healers, shamans which are
  sangomas, inyangas, etc.

Question 3

Professional sector

Answer 3

“This comprises the organized, legally sanctioned healing
professions, such as modern Western scientific medicine, also
known as allopathy or biomedicine. It includes not only physicians of
various types and specialties, but also the recognized paramedical
professions such as nurses, midwives and physiotherapists.” pg94

Question 4

Popular Sector:

Answer 4

• Hierarchy of resort
• Lay understandings of the body and how it works
• Feminisation of care
• Sharing of medication
• Making of remedies
• Food as healing
• Facebook groups
• Beliefs about prevention
• Shared beliefs about prevention, illness and * Experience as the best teacher
• Undermined by biomedical practitioners

Question 5

Folk Sector:

Answer 5

• Shared cultural values and worldview
• Holistic care
• Beyond the body, relationships, environment, etc.
• Involvement of famity in treatment and care
• Unregulated
• No ‘formal’ training but apprenticeship
• Undermined by biomedical practitioners (scammers, threat to proper treatment, danger, etc)
• Attempts at formalization

Question 6

Professional Sector:

Answer 6

• Dominant system of health care
• Organised, upheld by law, accepted
• Higher social status
• Western origins
• Not always accessible * Male dominated
• Isolated/isolating
• In crisis

Question 7

Medical Pluralism & Half Stories:

Answer 7

• Insufficient biomedical healthcare access
• Lack of economic resources
• Support of Indigenous/traditional medicine by governments
• Use of alternative medical traditions by biomedicine practitioners:
  mistrust
  -Medical - Regional
• Historical considerations
• Etiology

Question 8

Biomedicine

Answer 8

• Often informed but a mind-body separation
• No allowance for chance/ misfortune
• Treats the body as a natural universal scientific entity-reductionist
• Internalizing discourse - ..Focused primarily named entities such as viruses, genes, biomarkers, or other signs Internal to the body, pg60

vs

Other Medical Traditions
Does not assume a universal body
Externalising discourse - “locate the origins of disease largely
outside of the human body and include references to human social
relationships, the environment, and the spiritual or cosmic order* pg 60

Question 9

Takeaway from Lecture 1: WEEK 2.

Answer 9

• There are many medical traditions.
• The three sectors are not ‘gospel.
• Need to understand medical cultural-economic context.
  decisions within a socio-political,
• Disconnect between how people understand they need and the biomedical understanding their of bodies and what
  the body.
• Medical decisions are not divorced from experiences of gender, race,
  and place - they are made in context.

Question 10

R1: The Context

Answer 10

set in “the Park”

Question 11

R1: TB burden:

Answer 11

Highest global rates of TB and MDRTB

Question 12

R1: Environment-related illness:

Answer 12

Inadequate housing
Insufficient water
Lack of sanitation

Question 13

R1: Work-related illness:

Answer 13

Accidents
Pesticide poisoning - farm workers

Question 14

R1: Poverty-related illness:

Answer 14

sickness Malnutrition
induced by poverty.
Anxiety (Lots of stress in the environment)
High Blood Pressure (High Blood)
Diabetes (suiker)
Alcohol abuse and dependence (legacy of the dop system - farmers
were payed with alcohol and not money)
Violence

Question 15

R1: Fiona Ross draws from Hellmans concept of: Time Poor & Time Rich

Answer 15

“Between 2001 and 2003, more than thirty of the eight hundred people living
in The Village died,3 mainly of diseases related to poverty, including TB, and
diseases compounded by HIV seropositivity, and of violence. Very few have
lived long enough to die a death not associated with illness or violence - to
die ‘of old age’ (ouderdom) as it was locally known. In dry, sociological terms,
the number of dead accounted for almost four percent of the population over 2 years

Question 16

R1: Were born sick. Newborns come into this world sick and stay that way

Answer 16

example- baby shower they bring medicine as gift
People that live in the Park understand the context that they live in. Ilness is a social disease. There are very clear health disparities that health settles

Question 17

R1:Understanding the Body & Medical Pluralism:

Answer 17

The Body is Vulnerable to external and internal agents in The Park:
Internal (germs, working conditions, etc)
External (excess heat, jelousy, passion, emotions)
Sometimes both
- Medications/solutions
The solutions are different to this illness because the context in which
they live in the Park is different.
Biomedical
Social (Rastafari as calming influences and mediators in society - they are people that can bring peace
Sometimes both

Question 18

R1: Local Models of the Body and Illness:

Answer 18

• Alcohol is used as anti-stress - Smoking zol whilst in the ARV medication
  trial - Rastafari belives in zol
  Hypertensive = impending death
• Lack of adherence
• Sharing of prescription drugs
• No access to fruits
• Questions and beliefs about contagion and efficacy od mediactions “vet TB (fat TB) “maer Tb” “mooi tb” “lelik tb” “vinnig or gallop tb” and “touched by tb”
  Example made: The visitor who fell - random lady , they thought she was mad, possessed or had epilepsy when she fell.

Question 19

R1: Insights from Medical Anthropology in The Park:

Answer 19

NB- This example is interesting because it shoes the overlap of all the
different models and beliefs of the body and health of people who all
live in the same context.
* Must be able to see how ill health affect’s people differently and it
looks different to everyone. The way disease settles is different in
different contexts bc of inequality and poverty.
* The forms as out sociality made illness possible:
* Friendships are built around illness, taking h medication together,
lifts to the clicking together for TB treatment. It builds relationship.
* Denies friends too - nobody wants to hang out with someone in
the ugly stage of TB
* Inequality and poverty = Chronic disease and premature death
* Forms of sociality that illness makes possible or denies
* Impact of illness on individual and their relationships
* Local discourses on health
* Biomedical model as authoritative knowledge
* Biomedicine is localized
* Diagnosis as a social process

“Unlike the standard analytic model that, as I described earlier, sets
‘local’ knowledge in opposition to a universalistic biomedical
knowledge, biomedicine is but one of a range of possible ‘local’
ways of understanding and interpreting affliction. What
distinguishes biomedicine from other regimes is that the implicated in the provision of care.”

Question 20

Reading 4

Answer 20

Summary of: ‘Sincedisa – we I
can help!’ A Literature Review
of Current Practice Involving Traditional African Healers in Biomedical
HIV/AIDS Interventions in South Africa. - Wreford, J.

Question 21

reading 4 overview

Answer 21

This literature review explores how traditional African healers—who hold
longstanding cultural authority in many South African communities—are
being included (or excluded) in HIV/AIDS interventions alongside the
biomedical system. It’s a rich study in medical pluralism, colonial legacies,
and power relations in health care.

Question 22

R4: Key Anthropological Themes

Answer 22

1. Medical Pluralism
   & Cultural Authority
   In South Africa, many people consult both biomedical professionals and
   traditional healers (known as sangomas, inyangas, etc.).
   Traditional healers aren’t just “alternative” practitioners—they are spiritual
   guides, community therapists, and cultural custodians.
   They often serve as the first point of contact for health issues, including HIV/AIDS
2. Epistemological Conflicts
   Biomedical institutions often dismiss traditional healing as unscientific or even dangerous, especially in the context of HIV/AIDS.
   This reflects a deeper epistemological divide: biomedicine privileges
   empirical, testable knowledge, while traditional healing is embedded in
   spiritual, ancestral, and communal knowledge systems.
3. Colonial & Postcolonial Legacies
   Under colonial and apartheid rule, criminalized.
   traditional healers were marginalized and
   Although post-apartheid policies now officially recognize them, real inclusion
   in public health strategies remains limited.
   The legacy of colonial medicine as the dominant knowledge system
   continues to shape these dynamics.
4. HIV/AIDS & Collaboration Models
   biomedically
   The review finds that collaborations do exist, but they’re often driven and hierarchical.
   Healers are sometimes trained to recognize symptoms and refer patients to
   clinics—but aren’t treated as equal partners.
   In some cases, they are co-opted into the biomedical system rather respected for their own knowledge base.
   Successful models involve mutual respect, dialogue, and acknowledgemnt of healers’ cultural legitimacy.
5. Healers’ Perspectives
   Many healers want to collaborate, not to replace biomedicine but to work alongside it.
   They express frustration at being treated with suspicion and not being heard, despite
   their close community ties.

Question 23

R4: Implications for social anth

Answer 23

This literature invites anthropologists to critically examine how knowledge
systems interact, especially under global health regimes.
It shows the need for culturally sensitive and inclusive health policies that don’t just “tolerate” traditional systems but engange them as equals.
It challenges simplistic binaries like modern/traditional or scientific or superstitious
Most importantly, it underscores how power operates in health- determining whose knowledge counts, whose practices are legitimate and who gets to shape interventions

Question 24

Reading 5:

Answer 24

Caring and Curing: The Sectors of Health Care
Hellman C

Question 25

R5: 1. Health Care as a System

Answer 25

Health care is a complex system combining cure, care, and prevention. It consists of multiple sectors: public, private, voluntary, and informal. The system is both reactive (responds to illness) and proactive (prevents disease).

Question 26

R5: 2. Major Sectors of Health Care

Answer 26

Primary Care: The first contact point includes general practitioners,community clinics. Secondary Care: specialist care, usually after referral (eg hospital outpatient) Tertiary Care: Highly specialized treatment (e.g., surgery, oncology). Quaternary Care: Experimental or cutting-edge medical procedures.

Question 27

R5: key sector Divisions

Answer 27

Public Sector: Funded and operated by the government. Examples includes NHS (UK), public hospitals Private Sector: Funded through insurance or out-of-pocket payments; includes private clinics, hospitals oluntary Sector: Non-profit organizations offering support services (eg hospices, NGOs) Informal Sector: Care provided by family, friends, or unregulated providers (especially in developing countries)

Question 28

R5: 4. Roles within the System

Answer 28

Doctors & Nurses: Clinical professionals focused on diagnosis, treatment, and care. Allied Health Professionals: Physiotherapists, occupational therapists, pharmacists, etc. Support Workers & Carers: Provide essential daily support, especially long-term or palliative care Public health professionals: work on preventation, health promotion and epidemiology

Question 29

R5: 5. Health Care Challenges:

Answer 29

Funding & Access: Disparities in access and resource allocation between and within countries. Aging Population: Increased demand on long-term care and chronic Rapid advances require updated training disease management. Technological Change: ethical consideration. Workforce Pressures: Staff shortages, burnout, and recruitment/retention challenges

Question 30

R5: 6. Integration and Reform

Answer 30

Integrated Care Models: Combine services and improve outcomes. Patient-Centered Care: focus on treating the patient holistically rather than just the illness Global influence: global health policies, pandemics and international cooperation increasingly shape national systems

Question 31

Reading 6:

Answer 31

Summary of Chapter 7: Illness and Accompaniment by Fiona Ross

Question 32

Reading 6 overview

Answer 32

This chapter, written by Fiona Ross, is part of a broader ethnographic exploration into health, illness, and caregiving withi the South African context, particularly focusing on the lived experiences of women in informal settlements. Heres a breakdown designed for anthropology students

Question 33

R6: Context and background

Answer 33

Fiona Ross’s research is based in Cape Town, South Africa, primarily among women living in poor, informal settlements. Her ethnography explores how they navigate illness—not just as physical suffering, but as social, moral, and relational events. This chapter is especially concerned with accompaniment, a concept tied to care and solidarity.

Question 34

R6: Core Concepts

Answer 34

1. Accompaniment Refers to the act of being with someone through illness, pain or hardship- not just physical presence but moral, emotional and spiritual support Ross draws on liberation theology and the work of Paul Farmer, emphasizing accompaniment as ethical and relational. In these communities, accompaniment often extends beyond kinship ties to neighbours and friends 2. Suffering and Social Worlds Illness is deeply embedded in social life- it affects not just the individual but their whole network. The experience of being ill brings to light relationships of care, responsibility and sometimes neglect or abandonment 3. Gendered Care Work * Women resources, are often the primary caregivers, systemic failures, and their navigating limited own vulnerabilities. * Care involves emotional labor, time, and moral decision-making— often at great personal cost. 4. Precarity and Moral Struggles * The chapter shows how people respond to illness under conditions of poverty and inadequate public healthcare. * Choices around care are not just logistical—they are moral struggles about what one ought to do, who one must prioritize, and how to act with dignity amid adversity. . Witnessing and Testimony * Accompaniment involves witnessing suffering, which can create forms of testimony and moral truth that are often silenced in official narratives. * Ross shows how sharing stories of care and suffering gives voice to marginalized experiences.

Question 35

R6: Etnogrpahic Sensibility:

Answer 35

* Ross exemplifies the anthropological method of deep engagement, showing how participant observationand empatheic listening reveal complex moral worlds

Question 36

R6: Illness as a Social Fact:

Answer 36

Illness isn’t just biological—it's shaped by inequality, history, everyday social interactions.

Question 37

R6: Care as Relational Practice:

Answer 37

* Care is not just a set of tasks; it's a moral and affective practice shaped by broader structures of power and intimacy.

Question 38

R6: Intersectionality

Answer 38

Gender, class, and the legacy of apartheid intersect in shaping how people experience and respond to illness.

Question 39

Reading 7

Answer 39

Collaboration Between Traditional Healers and Western Health Staff in South Africa. University Of KZN. Campbell Hall V et al

Question 40

R7: why it Matters:

Answer 40

In rural South Africa, people often use both traditional and Western biomedical systems to treat mental illness. This reflects medical pluralism- key concept in anth

Question 41

R7: Dual Systems of Care

Answer 41

Many people believe mental illness is caused by things like witchcraft or angry ancestors. But they also use Western clinics, especially for access to disability grants or medication. This back-and-forth can cause treatment problems—mixing medicines, stopping meds early, etc.

Question 42

R7: different viewa, unequal respect

Answer 42

Traditional healers offer emotional and spiritual care. Many want to collaborate and learn more about Western methods. Western health staff are often dismissive- seeing traditional healing as unscientific or irrelevant. Traditional healers feel undervalued and excluded from paient care feedback or referrals.

Question 43

R7: How to Work Together Better

Answer 43

Set up forums where both from each other. systems can talk, refer patients, and learn Train Western staff to understand patients’ trust with healers. cultural beliefs and build Encourage mutual respect—not one system dominating the other.

Question 44

R7: Anthropology Angle:

Answer 44

It’s not just about medicine—it’s about beliefs, power, and recognition. This is a real-world case of how colonial legacies, cultural worldviews, and state systems shape health care

Question 45

Tut 1:

Answer 45

Guiding Question: Is a mutually beneficial and respectful relationship between traditional healing practitioners & biomedical practitioners possible? What could it look like? No: There is a power imbalance currently with Western Medical system. There’s no incorporation of traditional healing in how medicine is studied currently. There’s no acceptance and enforcement of trad at the current time. Accessibility = most can’t afford Western med and it’s also about the positionally and the body you hold. Western medicine has been studied and researched on White Male Bodies. There’s also a struggle for women western in modern societies. What could a mutually beneficial relationship look like?