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Indigenous Theories of Contagious Disease, by Edward C. Green
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Far from being the province of magic, witchcraft, and sorcery, indigenous understanding of contagious disease in Africa and elsewhere in the developing world very often parallels western concepts of germ theory, according to the author. Labeling this 'indigenous contagion theory (ICT),' Green synthesizes the voluminous ethnographic work on tropical diseases and remedies_as well as 20 years of his own studies and interventions on sexually transmitted diseases, AIDS, and traditional healers in southern Africa_to demonstrate how indigenous peoples generally conceive of contagious diseases as having naturalistic causes. His groundbreaking work suggests how western medical practitioners can incorporate ICT to better help native peoples control contagious diseases.
- Sales Rank: #2767611 in eBooks
- Published on: 2000-01-01
- Released on: 2013-07-17
- Format: Kindle eBook
Review
Anthropologist Edward Green offers here a highly readable contribution to medical and applied anthropology. Based on over twenty-five years of fieldwork and development assistance in Africa, Southeast Asia and other regions, the author of the authoritative sourcebook STD and AIDS in Africa deepens his examination of indigenous healing and disease prevention strategies. ....Anthropologists and other readers interested in the evolutionary and other bio-cultural underpinnings of indigenous systems ofcontagious illness will find the book's theoretical reflections, summarized in the final chapter, especially thought-provoking... (Daniel T. Halperin, Community Health Systems Department, University of California, San Francisco Social Science & Medicine, (2000))
Edward C. Green, experienced anthropologist and prolific writer, offers what can only be described as an engaging comprehensive account of ICT (indigenous Contagion Theories).... Overall, this book appears to be geared towards those who have little or no knowledge of social explanatons of illnessses or of "layman" beliefs. The author does manage to convey quite successfullly the details of indigenous medical explanations in a langauge that is easily accessible. This book is a good introduction to the area for undergraduate social scientists, health professionals and the general public. (Catherine Heffernan, (University of Oxford) Medical Sociology Online, Vol 26.2, June 2002)
This important new book paves the way for effective working relationships between indigenous healers and the providers of biomedical health services, and for more effective health promotion and disease prevention across the world.... I would recommend Indigenous Theories of Contagious Disease to medical anthropologists and the others who are interested in the bio-socio-cultural and historical underpinnings of ICTs, as well as to anyone with a concern for indigenous knowledge and development. (Mirjam J.E. van Ewijk, European Research Centre of Migration and Ethnic Relations Indigenous Knowledge and Development Monitor, Vol. 8, Issue 1)
Anthropologist Edward Green offers here a highly readable contribution to medical and applied anthropology. Based on over twenty-five years of fieldwork and development assistance in Africa, Southeast Asia and other regions, the author of the authoritative sourcebook STD and AIDS in Africa deepens his examination of indigenous healing and disease prevention strategies.....Anthropologists and other readers interested in the evolutionary and other bio-cultural underpinnings of indigenous systems of contagious illness will find the book's theoretical reflections, summarized in the final chapter, especially thought-provoking. (Daniel T. Halperin, Community Health Systems Department, University of California, San Francisco Social Science & Medicine, (2000))
About the Author
EDWARD C. GREEN is a medical anthropologist and Senior Research Scientist at the Harvard Center for Population and Development Studies, part of Harvard University's School of Public Health.
Most helpful customer reviews
8 of 8 people found the following review helpful.
Well-written, innovative approach to cross-cultural healing
By Daniel Halperin
Anthropologist Edward Green once again has produced an important and highly readable contribution to the fields of medical anthropology and international development work. In his latest book based on decades of extensive fieldwork and development assistance in Africa, Southeast Asia, and elsewhere, the author of STD and AIDS in Africa and other pioneering works has deepened his examination of indigenous healing and disease prevention strategies. This innovative study models an effective bridge and integration between what Green terms "indigenous theories of contagious disease" (or "ITC"), with Western biomedical norms of disease etiology and treatment.
His thoughtful, measured analysis of ITC and its implications for public health arrives as a long-awaited and crucial response to the all-too-frequent dismissal of -- if not downright opposition to -- indigenous healing practices and belief systems on the part of foreign aid workers, development "experts" and often even by Western-educated nationals of African and other developing regions. Green's creative ideas for integrating ITC with biomedicine are of paramount and timely importance towards addressing a number of today's health plagues, from AIDS to TB, malaria and a host of other contagious scourges. As he reasons, "We do no injustice to science and medicine, and certainly not to public health, if we build on - rather than ignore or confront - indigenous contagion beliefs in our attempts to mitigate the ravages of infectious diseases" (p. 18).
The author clearly strives to avoid either/or polarizations in his analysis of ITC's potential - and above all fundamentally down-to-earth -- contributions to efficacious public health prevention and patient care. As one cogent example:
"Critics of the approach of this book might argue that it is impossible to separate ethnomedical beliefs that are traditional from those that have been influenced - perhaps heavily so - by Western biomedical ideas and education. My response is that African ethnomedicine, like African religion, seems always to have been an open, changing, adaptive system that incorporates new ideas and beliefs even if it reworks them to suit existing beliefs. And, from a practical viewpoint, it does not matter how much biomedical ideas about, for example, microbes has influenced indigenous "germ" theories of unseen insects. What is important is the nature and content of the present belief system, however blended and syncretistic it might be. The fact that some Swazi bogobela - master healers who train initiates - teach that bilharzia [Schistosomiasis] is caused by snail-contaminated water only proves that new, foreign ideas have been adapted and adopted into the present etiological system by its most conservative and influential participants. It is the present belief system - not an imagined pure system of the past - that needs to be understood by those in public health who would influence popular health beliefs and practices in ways deemed compatible with public health (p. 202)."
Anthropologists and other readers interested in the evolutionary and other bio-socio-cultural (pre)historical underpinnings to ITC will find the book's theoretical reflections, summarized in the final chapter, especially thought-provoking. Green argues for a more visible place at the table for his and similarly adaptive anthropological perspectives concerning the complex interface between environment, disease and population in human societies. His conclusion is that "Undue focus on witchcraft beliefs and practices by anthropologists and others has not contributed to the incorporation of ethnomedical findings in public health programs - something many anthropologists bemoan as a serious oversight. However, we are more likely to see health programs informed by ethnomedical research if we place more emphasis where it deserves to be: not on witchcraft beliefs - which is probably the area of least compatibility between indigenous medicine and Western public health - but instead on naturalistic understandings of contagious illnesses" (p. 269-70).
My only criticism of this consistently high-caliber work concerns a reference in Green's book to the frequently cited notion of "super-strains" or unusually virulent subtypes of HIV (p. 181). Max Essex, chair of the Harvard AIDS Institute, and some other researchers have speculated that certain strains, or "clades," of HIV may be more prevalent and hence more infectious among heterosexual populations - thereby explaining, at least in part, the striking discrepancies in HIV rates apparent between different world regions. However, the current consensus among most epidemiologists and virologists is that Essex's initial speculation was incorrect. Melissa Pope of Rockefeller University and Essex himself have tried and failed to reproduce his preliminary results in the laboratory. In Haiti and some other Caribbean and Latin American countries, there are heterosexual epidemics with predominately the same "clade B" virus found in the U.S. and Western Europe, and the Philippines and some other low-HIV countries have exposure to those clade C and E "superstrains" ravaging through such high-HIV areas as Thailand and the "AIDS Belt" of Eastern/Central and Southern Africa. Inspired by Green's own manner of thinking, should we not look primarily to different social environments and cultural-behavioral practices to account for such epidemiological phenomena?
This minor point aside, few readers will be disappointed by Edward's Green's latest and most incisive contribution to the evolving exploration into the multiplicity of human cultures and their rich and complex array of traditional (and modern) healing systems.
1 of 1 people found the following review helpful.
Interesting
By Amazon Customer
This book contains a variety of information about how people (mostly Africans) without an extensive formal education view contagious disease. Green reports that traditional healers and their patients throughout Africa attribute diseases such as AIDs, diarrhea, and tuberculosis to such things as poor hygiene or promiscuity rather than to witchcraft or black magic. He goes on to argue that since traditional healers are so much more numerous, accessible, and approachable than medical practitioners, public health programs must include them rather than dismiss their work out of hand, noting that their theories of contagious disease aren't irreconcilable with medical accounts after all. As a general anthropological book, the coverage is a little disappointing since it focuses so closely on Africa- -I would have liked to have seen more comparisons of theories of disease held by people of other cultures with similar levels of education. Green tends to assume that readers have fairly extensive knowledge of both medical and anthropological terminology, since he uses words like "etiology" and "fontanel" without explanation. Overall, this book should be of interest to medical anthropologists, particularly those specializing in African cultures.
0 of 0 people found the following review helpful.
Outstanding study
By Charles M. Good Jr.
Green ranks among the foremost practitioners of applied medical anthropology who work in developing societies. His focused contract work and extensive published scholarship reflect a strong commitment to separating myth from reality in public health and medical pluralism. In this book, focused mainly on Subsaharan Africa, he exposes the practical and theoretical underpinnings of indigenous systems of medical knowledge, ignorance of which limits the value of biomedical treatment and stifles beneficial collaboration. Green argues that biomedicine has been handicapped and diminished by its failure to learn about and work with pre-exisiting, indigenous medicine. Many problems mirror this weakness, including child survival efforts and STD and HIV/AIDS control. Ironically, as 21st Century begins, biomedicine remains politically powerful, yet it is conceptually and therapeutically underdeveloped in its ability to advance human health in Africa and the developing world.
Green�s careful, balanced analysis of indigenous theories of contagious disease is an antidote for ignorance. His book represents a crucial first step toward abandoning inter-cultural and professional prejudices that hinder best practices in healing, wellness, and community health. He argues that popularized theories of disease causation in Africa, including witchcraft, sorcery ,and magic, have fostered a "myth of excessive supernaturalism." This myth has evolved with little reference to ethnographic facts and is part of the belief system of Western-educated anthropologists and medical professionals. Acceptance of this particular "story" of disease causation has helped entrench a theoretically unsound basis for biomedical praxis in multicultural settings. Green asserts that indigenous African etiologic models reflect a high prevalence of ideas about naturalisitic and impersonal causes, much of which is linked to contagion and pollution. The models and evidence he discovered do not support the notion that supernatural forces reign paramount in African disease frameworks. Instead, Africans emphasize naturalistic and impersonal causes of illness, rather than human agency and unseen forces.
Green�s aims to create a more balanced view of ethnomedicine and to make the case for an Indigenous Contagion Theory (ICT). This, he believes, can help to foster mutual awareness of common ground shared by the two systems. The etiologic overlap holds promise as a basis for cooperation between biomedicine and traditional healers.
Early chapters review a broad spectrum of African health beliefs and etiologies, Bantu ideas about pollution and other forms of contagion, and the relationship of disease resistance and the internal snake/equilibrium concept. These are followed mid-book by essays about notions of contagion in childhood diarrhea, STDs and AIDS (arguably the finest chapter) , and infectious diseases such as malaria, TB, Bilharzia, epilepsy, and other syndromes identified with specific ethnic groups in southern Africa.
In the penultimate chapter, Green places ICT in a broader, even global perspective and asks: "Does it matter if illness is thought of in natural or personalistic terms" (p. 217)? He connects this question to the issue of fostering a change in outlook and practice among health professionals who have carried "a negative, dismissive, etic mind-set." Green seeks common ground, identifying the elements of African ICT (naturalistic infection, mystical contagion (pollution), environmental hazards, and illness from taboo violations). He argues persuasively that public health initiatives will be more effective if those who design and implement them have "an empirically based understanding of existing ethnomedical beliefs" (pp. 217-18). In "Theoretical Implications," the final chapter, Green cites "archaic templates of contagion" as a basis for interpreting the similarity of models of contagious illnesses among Bantu societies. There is extensive discussion of hypotheses about and critiques of adaptive models of health beliefs.
Biomedicine has never, anywhere, at any time, been poured into "empty vessels." This is unfortunate myth is sustained by the professionalization of health care and biomedicine�s presumed omnipotence. Further, there is the corollary that scientific medicine cannot be reconciled with indigenous therapy because the latter is believed to be too heavily invested in human agency and the supernatural. In Africa this has led to a situation in which doctors and clinical assistants, nurses and public health professionals, and Ministry of Health officials and international agencies operate in a landscape of de facto medical and public health "apartheid." Whereas biomedical resources remain thin, there is little reliable, useful information in circulation about the indigenous systems that serve the majority of the population. The latter are usually assumed to be either dangerous or irrelevant. Meanwhile, it remains well-established that most people do not choose between indigenous or modern practitioners, but rather seek help across the range of available alternatives for particular conditions. Professional myopia concerning the nature and health implications of this behavior inhibits good health care, prevention, and promotion. Green�s effort to dig up the facts and stimulate professional action could lead to measurable benefits for the clients of the various indigenous and biomedical healing professions.
Green's case for ICT is compelling. This reviewer also believes that naturalistic and impersonal disease causation has long been underestimated. Also, few developments promise more positive health results than sustainable collaboration between traditional healers and biomedical sector. Yet, one cautions against allowing the pendulum of causation to swing so far as to unduly minimize supernatural and personalistic interpretations. Fieldwork by this reviewer in Kenya among rural and urban Akamba healers revealed, two decades ago, that 98 percent ranked �God-given�/natural causes first. Yet witchcraft was the second most common cause of illness, reported by 86 percent of the healers. Not all diseases have mutually exclusive causes. Circumstances may allow for a naturalistic interpretation in one episode and a personalistic (witchcraft) explanation at another time or with a different patient. Furthermore, both interpretations may apply. Today, few Africans remain unaware that STDs and HIV primarily spread through sexual contact. However, human agency--manifested as a desire to send a harmful "message" to someone--may be the ultimate explanation of why the virus victimized a particular person.
Green writes well and provides a high standard of scholarship. The book should deservedly enjoy a broad readership among health workers, social scientists, and those in a position to influence health policies. (Adapted from C. Good, J. of Alternative and Complementary Medicine (2000).
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