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Camilla Hoffmann Merrild (U. Aalborg, Denmark)
Belinda Spagnoletti (U. Melbourne, Australia)
Camilo Sanz (U. Indianapolis, USA)
Natalia Luxardo (U. Buenos Aires, Argentina)
Jorge Iriart Bernstein (Universidade Federal da Bahia, Brasil)
Applying an ethnographic lens to sexual and reproductive health inequalities and challenges in Indonesia
This presentation describes the range of ethnographic approaches and iterative layered analysis applied in a study that explored the reproductive health experiences and decisions of predominantly middle-class women in Yogyakarta, Indonesia. It describes ethnographic findings developing a three-pronged conceptual framework (the WRED Framework) that takes into consideration the concepts of reproductive agency, reproductive modernity and reproductive politics to understand women’s reproductive experiences and decisions. As an analytical tool that considers reproductive health across multiple levels of influence, the WRED framework can assist policymakers, programme managers, and women’s health advocates to conceptually ‘join the dots’ between the intimate, interpersonal, institutional, and political spheres shaping women’s reproductive health. The WRED Framework emphasises the need for each of these levels to be taken into consideration simultaneously when designing health policy and programs in Indonesia.
'Everything’s just as it was': Low-income cancer patients and the ethics of exhaustion in Colombia
This presentation focuses on cancer, therapeutic futility and the paradoxes of the universal health care mandate in neoliberal Colombia. While the 1993 national health care reform seeks to guarantee access to medical services to all Colombians, it has set up the terrain for what Sharon Kaufman calls Ordinary Medicine (2015). This concept refers to a development in modern medicine by which more aggressive interventions become standardized, normal and ethically appropriate, especially in patients who are older or suffering from advanced or terminal diseases. In the case of cancer care in Colombia, I argue, the combination of ordinary medicine and the national mandate for universal health care has created the conditions by which aggressive and high-cost chemotherapy became the ethically appropriate treatment, especially for low-income patients who are often diagnosed when their disease is advanced and incurable, and who can seldom access high-cost treatments on time.
Camilla Hoffmann Merrild
Health inequalities in a welfare state; reflections on assumptions, constructions, policies and interventions
Departing in contemporary discussions on social inequality in health and illness, I want to explore how the situatedness of health, illness and the body, relate with ways of addressing the socioeconomic position, social vulnerability or at-risk status within health promotion and illness prevention. Departing in my own research on early/timely diagnosis and care-seeking, I am particularly interested in discussing how we as anthropologists engage with categories used to describe health inequalities, and how we grapple with these theoretically as well as methodologically.
Jorge Alberto Bernstein Iriart
Inequities in access to cancer diagnosis and treatment in Brazil
Brazil is an unequal country in socioeconomic and health-related terms. Drawing on ethnographic research in the field of oncology in Salvador, Northeast Brazil, this presentation will discuss the contribution of an ethnographic approach to the study of inequities in patients’ access to cancer diagnosis and treatment. Understanding these inequities as unjust, systematic, and preventable (Whitehead and Dahlgren, 2006), the presentation focuses on the challenges patients face to access high-cost personalised technologies, which include targeted cancer drugs and immunotherapies.
Despacito: Research on health inequalities among structurally vulnerable communities in Argentina
Drawing on a five-year research study with structurally vulnerable communities in Argentina, this presentation will focus on some conceptual, epistemological and ethical reflections. The presentation will first define some critical approaches to health inequalities used in the study, such as social epidemiology, Latin American Social Medicine and Collective Health. It will then define analytical concepts such as ‘violence continuum’, ´structural vulnerability’ and ´modos de vida´ (ways of life). Afterwards, this presentation will include a discussion of some empirical results taking into consideration the ethical and methodological challenges faced during fieldwork.
About the Speakers
Belinda Spagnoletti is a Research Fellow in Sexual and Reproductive Health at the Nossal Institute for Global Health at the University of Melbourne, Australia and a Visiting Researcher at Gadjah Mada University, Indonesia. She was awarded her PhD in International Health from the University of Melbourne in 2019. Her doctoral research was an ethnographic study exploring the experiences of Indonesian women in relation to family planning, breastfeeding and balancing work with parenthood, and one of the articles based on this work was awarded the 2018 Wang Gungwu Prize for best article in Asian Studies Review. Belinda’s current research focuses on cervical cancer in Indonesia.
Camilo Sanz is an anthropologist of science and medicine. His research interests revolve around questions of temporality, health care inequalities, knowledge production and the mind/brain relationship, with a geographical focus on Colombia and the Americas. His work draws upon diverse scholarly fields, especially medical anthropology, bioethics, consciousness studies and science & technology. He is currently an assistant professor in the Department of Anthropology at the University of Indianapolis, Indiana (U.S).
Camilla Hoffmann Merrild is a senior researcher and associate professor at the Center for General Medicine, at Aalborg University. She has worked on social inequality in health for almost 10 years, doing fieldwork and interview studies among different social groups in Denmark. Her research centres on experiences and practices of the body, and the interaction with the health care system among people living less privileged lives.
Jorge Alberto Bernstein Iriart is an Associate Professor in the Institute of Collective Health of the Federal University of Bahia in Salvador, Brazil. He holds a PhD in Anthropology from Université de Montréal, Canada. His research interests lie at the interface of biomedical technologies, oncological practice, patient’s illness experiences and health inequities in Brazil.
Natalia Luxardo is a Social Worker with a PhD in Social Sciences (2007) and in Culture & Society (2011). For the last 18 years, she has worked as a researcher at the National Scientific and Technical Research Council in the Sociology and Demography Commission (Argentina). Natalia’s expertise is in collaborative research exploring the cancer continuum among vulnerable communities in Argentina, Greece and the USA. Natalia also teaches at the University of Buenos Aires. She is currently exploring the daily lives of fishermen, farmers and garbage collectors, in order to identify the challenges for cancer prevention and diagnosis in primary care.