This thesis uses a critical medical anthropology approach to explore healthcare professionals’ perspectives of Hansen’s disease (HD) patients’ treatment-seeking experiences in the United States. During semi-structured interviews my eight informants discussed challenges patients face when seeking treatment. The number one challenge discussed was that of knowledge gaps among healthcare professionals which influence misconceptions of HD being highly contagious and dangerous. Such misconceptions negatively influence patients’ treatment from start to finish. My informants discussed their understandings of, and roles in minimizing challenges for their patients.

Recent studies on the Argentine public health system have demonstrated that the lack of medical resources in different parts of the country force pediatric oncology patients and their family members to travel to Buenos Aires in order to access care. This internal migration poses difficulties for these families as travel and resettlement are expensive, lead to the separation of family members, and interrupt the child's schooling. This dissertation was designed to document the everyday life experiences of traveling families in order to understand the barriers they faced while attempting to access medical treatment and the strategies they used to surmount these obstacles. Narrative research and Critical Medical Anthropology were combined in order to analyze individual treatment and migration experiences within the political and economic context of the Argentine public health system. The interviews, visual timelines, drawings, and participant-observation carried out with 35 families shed light on differences in the conceptualization of medical treatment and migration between children and their parents, the ways in which the process of parenting was affected by relocation, and the changes that need to be made in the current Argentine public health system to provide timely and high quality pediatric oncology treatment and avoid delays in diagnosis and treatment.

This thesis explores the health-related decisions Latin American immigrant women make in MetroWest Massachusetts. Within public health and biomedical literature, women from Spanish-speaking communities are often measured by their adherence to biomedical guidelines. Several programs have been designed to increase compliance with recommended cancer screenings like Pap smears and mammograms in an effort to reduce health inequities between Latina populations and their white counterparts in the United States (Peek and Han 2009). Community Health Organizations often prioritize biomedical models of care, as Community Health Workers are typically trained in public health and biomedicine. Yet little research has been done on women’s conception of their own health. Using the theoretical concept of patterns of resort, this research examines what women prioritize for their own health needs, why, and what local resources women use to meet these needs. Women have a broad understanding of their own health, and use varying resources to meet the needs of physical, emotional, mental, social and spiritual health needs. By understanding these specific health needs, researchers and those invested in immigrant communities may create more effective programs with women’s health in mind.

The absence of federal government consensus on various nicotine policy matters, such as the legality of menthol cigarettes and flavored e-cigarettes, gives rise to distinct agendas, policy landscapes, and public attitudes at the state and local levels. As a result, nicotine activist groups and interested stakeholders are actively engaged in shaping the future of nicotine policy and use. This thesis explores the culture of local activist groups in Central Florida to understand how they influence nicotine-related policy change and set the tone for nicotine use in their communities. Drawing on data collected through participant observation and semi-structured interviews with activist group members, key actors, and nicotine users in Volusia County and Orange County, I argue that various external and internal factors compel activist groups to adopt a reactive strategy in addressing nicotine-related use and disparities rather than a proactive one. This thesis provides a novel, holistic perspective on nicotine-related policy change from both the activist and user viewpoints, and contributes significantly to scholarship on nicotine policy change by filling a previously unexplored gap in the anthropological literature.

Because infants are the most vulnerable members of a community, their deaths – and the resulting infant mortality rate (IMR) – are said to signal more fundamental problems that are likely to affect the general health of a community. However, a focus on proximate- and intermediate-level risk factors in epidemiological analyses presents a decontextualized picture and ignores the role of larger forces on health, disease, and illness. In response to this trend, this project will contribute to a revitalization of the use of infant mortality as an index of larger social problems by tempering statistical analyses with critical reflection regarding the effects of the liminal position of Malta within the British imperial system, prior to the Second World War. In addition, by bringing together several analytic approaches which often proceed in parallel, rather than in dialogue – historical epidemiology, social history, and the analysis of colonial discourse – this dissertation highlights the problematics of knowledge production at both the theoretical and methodological level. As a result, my work is not just about Malta, one moment in history, the calculation of infant mortality rates, or the disentanglement of various determinants of infant mortality in this context; it is about the dynamics and repercussions of power differentials and of social, economic, and political inequalities, as they define and structure health outcomes and experiences. Specifically, I will show that fluctuations in international tensions affected Malta’s population on a number of levels because of the island’s importance as a British military and naval base and its location in the middle of the Mediterranean. I will demonstrate how Malta’s “strategic position” restricted political and economic development in the island and articulated with colonial perceptions of the Maltese as “Other” and Malta as “overpopulated.” Finally, I will argue that international tensions, Malta’s location within Empire, and perceptions of the island and its inhabitants in the early twentieth century affected the ways in which infant deaths were explained and understood and the strategies of intervention initiated in the island to curtail infant mortality – all of which had a tremendous impact on the rates at which infants in Malta died.

Because infants are the most vulnerable members of a community, their deaths – and the resulting infant mortality rate (IMR) – are said to signal more fundamental problems that are likely to affect the general health of a community. However, a focus on proximate- and intermediate-level risk factors in epidemiological analyses presents a decontextualized picture and ignores the role of larger forces on health, disease, and illness. In response to this trend, this project will contribute to a revitalization of the use of infant mortality as an index of larger social problems by tempering statistical analyses with critical reflection regarding the effects of the liminal position of Malta within the British imperial system, prior to the Second World War. In addition, by bringing together several analytic approaches which often proceed in parallel, rather than in dialogue – historical epidemiology, social history, and the analysis of colonial discourse – this dissertation highlights the problematics of knowledge production at both the theoretical and methodological level. As a result, my work is not just about Malta, one moment in history, the calculation of infant mortality rates, or the disentanglement of various determinants of infant mortality in this context; it is about the dynamics and repercussions of power differentials and of social, economic, and political inequalities, as they define and structure health outcomes and experiences. Specifically, I will show that fluctuations in international tensions affected Malta’s population on a number of levels because of the island’s importance as a British military and naval base and its location in the middle of the Mediterranean. I will demonstrate how Malta’s “strategic position” restricted political and economic development in the island and articulated with colonial perceptions of the Maltese as “Other” and Malta as “overpopulated.” Finally, I will argue that international tensions, Malta’s location within Empire, and perceptions of the island and its inhabitants in the early twentieth century affected the ways in which infant deaths were explained and understood and the strategies of intervention initiated in the island to curtail infant mortality – all of which had a tremendous impact on the rates at which infants in Malta died.

Following cultural anthropological inquiry, this dissertation examines the adoption of shamanic healing techniques into Western medicine and the resultant hybrid modality of health care fostered by two disparate healing traditions. As the U.S. populace increasingly turns to alternative forms of healing in conjunction with, or in lieu of, conventional Western medicine, shamanic healing has been added to the list of recognized non-conventional therapies. Shamanism, once prevalent throughout most of the world in various cultural forms, is purported to be the oldest healing modality, dating back to the Upper Paleolithic in Siberia. Historical excoriation and extermination from religious and political dogma have plagued shamanic cultures for centuries while their healing practices have been rebuked by Western concepts emergent from the Scientific Revolution--whereupon the Cartesian Split and a corporeal view of the body transformed the field of medicine. In the United States, over the last decade, a new and growing subculture of health care practitioners, including "Western" educated medical practitioners, is seeking out shamanic training for personal and professional development. This study examines how the adoption of a healing paradigm borne out of indigenous cultures oriented toward communal living and local economies is adapted to a Western culture steeped in individualism, commercialization, and commodification. Through surveys, interviews, and ethnographic research, the investigator provides numerous examples and analysis of the practice of shamanic healing techniques in medical clinics, health care centers, and hospitals. In particular, this study will focus on the shamanic training of health care practitioners, their motivations, the manner in which they incorporate shamanic healing techniques into their treatment protocols, as well as patient/colleague/administrative responses and institutional barriers. A comparative analysis provides discussion on both the metamorphosis of shamanic healing traditions appropriated within a biomedical framework as well as the influence of spiritually-based healing practices upon the established medical culture in the United States today. Through the lens of highlighted individual experiences, the investigator offers insight into an emerging hybrid healing modality embedded in cultural contrasts that also serves as a catalyst for the renegotiation of the meaning of healing.

As the repercussions of the nearly 50-year U.S. War on Drugs are revealing themselves to be harmful and life-threatening, especially to lower-class and minority populations, social movements aimed at drug policy reform have been on the rise. While today's generation of college students were raised on abstinence-based discourses, which constantly warned and threatened them about the dangers of drug use, these same students often change their perspective, some as early as high school, when they begin having their own experiences with drugs and engage in more drug-related conversations. As a result, many students become motivated to change drug policy and education and address the stigma associated with drug use in order to reduce drug-related harm to individuals. This thesis examines the ideas and efforts of students at a university in the southeastern United States who are actively engaged in making these changes. Based on interviews with students involved with two drug policy reform groups in 2018, this thesis highlights the role of student activism in the larger drug policy reform movement. Student activists raise awareness of the need for a critical examination of U.S. drug policy frameworks and their place in this endeavor. I argue that student activists' involvement in the drug policy reform movement is motivated by the numerous disparities they experience and observe in the dominant abstinence-based drug approach. Based on these students' perspectives, I argue for a shift towards a more holistic harm reduction education that aims to increase the quality of care and livelihood for drug users, an accomplishment they believe is inextricable from U.S. policy.

This thesis explores the ontological content of the integration of complementary and alternative medicine (CAM) in biomedical education, through a critical exploration of “CAM" policy related documents from the World Bank, the World Health Organization and Health Canada, as a means of contextualizing "CAM" in biomedical education. It also interrogates curriculum documents from a project that seeks to standardize “CAM” in biomedical education. This thesis suggests that there are ontological parallels to the colonial era conversion of indigenous medicine evoked in the contemporary 'integration' of CAM in biomedical education.

During the 2013/16 Ebola virus disease outbreak in West Africa, numerous restrictions were placed on the movement and public gathering of local people, regardless of if the area had active Ebola cases or not. Specifically, the district of Koinadugu, Sierra Leone, preemptively enforced movement regulations before there were any cases within the district. This research demonstrates that ongoing regulations on movement and public gathering affected the livelihoods of those involved in agricultural markets in the short-term, while the outbreak was active, and in the long-term. The forthcoming thesis details the ways in which the Ebola outbreak international and national response affected locals involved in agricultural value chains in Koinadugu, Sierra Leone.