Current and future issues for medical social scientists in less developed countries. (notice bilbiographique)

Gilles BIBEAU, Laval University. Québec. Canada


This paper deals with « medical social engineering » which is now required to solve health problems in developing countries. The first section prescrits an historical background for social scientists participation in the health field and explores their involvement in classical public health approaches, such as direct interventions, epidemiology and ecology.

In a second section, more recent types of participation, associated with the health political model, are discussed in reference to community medicine, ethnomedicine and clinics.

The third section examines three promising recent developments in medical social science :

- health planning and evaluation,

- population studies

- emergence of an indigenous social science.

Finally, an interface is proposed between social and bio-medical sciences and a reconceptualization of health and disease is explored which fills the gaps between these sciences.


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29. Hoffman D. & Jr. and Warren K. S. Schisiosomiasis IV Condensations of the Selected Literature 1963-75. Hemisphere, Washington, D.C., 1977. Many arcas 36 where dams, lakes and irrigation works have produced schistosomiasis arc under a permanent process of evaluation. For exampic, De Wolfe Miller F. et al. Im 37 pacts of the Aswan high dam on the prevalence of schistosomiasis in Egypt. Paper presented at the international Symposium on the Encironmental Efféris of 38. Hydraulic Engineering Works. Knoxville, Tennessee

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33. Literature on medical systerris of the worid has considerably increaseci in the last decade. On the ciassic medical systems of India and China, recommend : Leslie C. (EdJ Asian Medical Sysiems. Univ. of California Press, Berkeley, 1976, Kleinman A., Kundstadier P., Alexander E. R. and Gate J. L. (Eds) Culture and Realing in Asian Socieries. Schenkman, Cambridge, MA, 1978. For Aftican medical systerris, two recent comprchensive books arc outstanding : Ademuwagun Z. A., Ayoade J. A. A.. Harrison 1. E. and Warren M. D. (Eds) African Therapeutic Systems. CrossToads Press, Waltham, MA, 1979, Janzen J. M. and Feierman S. The Social History of Disease and Medicine in Africa. Special Issue of Soc. Sc. and Med. 13B, 4 1979. No such comprchensive volume exist so fat on Latin America, although few important monographies art available, for example : Fabrega H. Jr and Silver D. Illness and Shamanisiic Curing in Zinacantan. Stanford Univ. Press, Stanford, 1979.

34. Bannerman R. H. WHO Programme for the Study of Traditionai Medicine, WHO Chron. 31, 1 L 1977. The WHO document has proposed the following objectives : (1) to collect ail available data on traditionai heaiers and indigenous systents of tnedicine-the resuits of survey and rescarch findings. of studies of traditional practices. and of training programs for traditional heaiers and indigenous practitioners, (2) to analyze the available information in order to determine the relevance of traditional healing to the primary heaith care needs of the various populations. (3) to study, in the field, existing systems of traditional or indigenous medicine in cach region, (4) to suggest the main directions for action with special regard to the training and utilization of traditional heaiers in the heaith system.

35. In the only domain of medicai anthropology, many books were published in the last few years : Bauwens E. E. (Ed.) The Anthropology of Heaith. Mosby, Saint Louis, 1978 ; Foster G. M. and Anderson B. S. Medicaf Anthropology. Wiley, New York, 1978-. Landy D. (Ed.) Culture, Disease and Healing : Studies in Medicul Anthropology. Macmillan, New York, 1977 ; Logan M. and Hunt E. Reaith and the Human Condition : Perspectives on Medîcal Anthropology, Duxbury Press, North Scituate, 1978 ; McElroy A. and Towscnd K. Medical Anthropology in Ecological Perspective. Duxbury Press, North Scituate, 1979 ; Morley P. and Wallis R. (Eds Culture and Cuping. Anthropological Perspectives on Traditional Medical Beliefs and Practices. University of Pittsburgh Press, Pittsburgh, 1978 ; Zimmerman M. foundations of Medical Anthropology. Hoit, Rinchart and Winston, New York, 1980.

36. Leslie C. (Ed.) Theoretical Foundations for the Com. parative Study of Medical Systems. Special Issue in Soc. Se. Med. IZ M 1978.

37. I recommend especially Brownice A. T. Community, Culture, and Care. A Cross-Cultural Guide for Health Workers. Mosby, Saint Louis, 1978.

38.Bibeau G, Corin E., Mulinda H. B., Mabiala M., Matumona M., Mukuna K. M. and Nsiala M. M. Traditional Medicine in Zaire : Present and Poiential Contribution ta the Health Services. international Development Rescarch Centre, Ottawa, 1980.

39.Kleinman A. Patients and Healeps in the Coniexi of Culture. Univ. of California Press, Berkeley, 1980.

40. Foster G. M and Anderson B. G. op. cit., 1978, p. 232.

41. Polgar S. Hcaith action in cross-cultural perspective. In Handhook of Medical Sociology (Edited by Frcemen H. E., Levine S. and Reeder L. G.). Prentice-Hall. Englewood Cliffs. 1963.

42. Excellent case studies of projects utilizing village heaith workers have been edited by Ronaghy H. A., Mousseau-Gershman Y. and Dorozynski A. Village Heaith Workers, Proceedings of a workshop held ai Shiraz, Iran. International Development Rescarch Center, Ottawa, 1976.

43. Navarro V. Medicine Under Capitalism p. 42. Prodist, New York, 1976.

44. Fairweather G. W. and Tornatzky L. G. Experimental Methods for Social Policy Research, p. 42. Pergamon Prm Oxford, 1977.

45. The field of evaluation rescarch has grown up and achieved maturity in the last years. One good adapted evaluation document for use in social and health project assessment in developing countries is now available : Freeman H. E., Rossi P. H. and Wright S. R. Doing Eraluation. Organization for Economic Cooperation and Development, Paris, 1980.

46. Such a work has been donc recently by Bossert T. (Ed.) Selected Issues in Health Policies in Africa and Latin America. Special Issue in Soc. Sci. Med. 13C 2.1979.

47. I refer readers to Segal J. and Winikoff B. (Eds) 59. Health and Population in Developing Countries. Special 60. Issue in Soc. Sci. Med. 14C, Z 1980.

48. Wolfson M. Changing Approaches to Population Problems. Developrnent Centre of the OECD in cooper- 61 ation with the Worid Bank, Paris, 1978.

49. Hsu F. and Textor R. Third worid anthropologists and the reappraisal of anthropological paradigins. Anthr. Newsleti. 19, 11, 1978.

50. Wilson E. 0. On Human Nature, p. 7. Harvard Univ. Press, Cambridge. 1978.

51. Ibid., p. B.

52. I oppose this new « medical anthropology to the old*’. associated with Foster, Barnett, Clark and von Mering.

53. Fabrega H. Jr. The scope ethnomedical science. Cuit. Med. Psychiat. 1, 2M 1977.

54. Ibid., p. 212.

55. Fabrega H. Jr. The study of medical problerris in picliterate settings. Yale J. Siol. Med. 43, 392, 1971.

56. Fabrega H. Jr. Discase viewed as a symbolic category. In Mental Health : Philosophical Perspectives (Edited by Engelhardt H. T, Spicher S. F. I Reidel, Dordrecht, 1976.

57. Good B. J. The heart of what’s the matter. The semantics of illness in Iran. Cult. Med. Psychiat. 1, 1, 1977.

58. Good B. M. and DelVecchio Good M. J. The meaning of symptoms : a cultural hermeneutic model for clinical practice. In The Relevance of Social Sciences for Medicine (Edited by Eisenberg L. and Kleinman A.). Reidel, Boston, 1980.

59. Ibid, 174-5.

60. Kleinman A. Medicines symptomic reality : on a central Problem in the philosophy of medicinc. Inquiry 16, 209, 1973.

61. Engel G. L The need for a new medical model : a challenge for biomedicine. Science 194, 4286, 1977.

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