Asthma has become one of the most commonly talked about and politically charged health topics in India. Yet, less than a decade ago, international studies reported that rates of the disease in the country were among the lowest in the world. This dissertation examines how asthma rapidly became a preeminent health concern in Tamil Nadu. I document and critically examine factors that have led to the phenomenon of asthma, from the multiple perspectives of its sufferers, the practitioners who diagnose and treat the disease, and the pharmaceutical companies that develop and market products for its management. I examine how popular representations of asthma and allergy--which view the disease as the result of an increasingly toxic environment, a more susceptible population, and new, modern ways of life--have influenced the social meaning and medical management of asthma. Using a variety of data, I describe patterns of health care seeking, the therapeutic regimens prescribed for asthma, and the important role played by factors such as the affordability of medications, and the perceptions of the activity and potential harm of medications, such as steroids. I look at increasing coverage of asthma in the Indian print media, and the efforts of the private health care industry and Indian environmental organizations, to draw further attention to the disease. Through detailed clinical observations and interviews with a wide range of allopathic and traditional Indian medical practitioners, I outline the variety of professional understandings and therapeutic approaches toward asthma, describe important differences in the interpretations of its symptoms, and examine the medical and social factors contributing to misdiagnoses, underdiagnosis, and undertreatment. In addition to medical knowledge about asthma, practice patterns are determined by a variety of practical logics, including economic competition in the pluralistic marketplace, the social relations of disease labels, and the pressures to forge a stable relationship between practitioner and patient. Finally, I describe the variety of techniques through which some of the leading drug companies in India have actively promoted asthma and allergy, and provide an ethnographic account of the introduction of new asthma drugs--the leukotriene receptor antagonists--to the Indian market.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/290053 |
| Date | January 2004 |
| Creators | Van Sickle, John David |
| Contributors | Nichter, Mark A. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Dissertation-Reproduction (electronic) |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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