Western pharmaceuticals have the dubious distinction of being as popular and available around the world as Coca-Cola. International alarm has arisen over the exportation to developing countries of highly toxic drugs banned in the United States and Europe. Yet in developing nations such medicines are sold in the streets and open-air markets with no - or wrong - information on dosages or even on the type of illnesses that the medicines treat.
Research on the problem of Western pharmaceuticals was conducted in a rural chiefdom of Sierra Leone where the Mende live. Like many other anthropologists, I found myself cast as a Western medical expert and medicine supplier. The Mende regarded me as a potential source of Western medicine, and often inquired about the purposes of their unlabeled pills.
It became very apparent that the local perceptions of Western pharmaceuticals rarely corresponded with my understanding of their proper use. These perceptions stemmed from the Mende's logically structured - albeit different - ideas of medicine. Anthropologist Melville Herskovits recognized that newly introduced items can be culturally reinterpreted according to older cultural meanings. Although Western pills, therefore, may look the same to us in a different cultural context, local people may see them differently. This essay attempts to examine the cultural logic by which these people have incorporated the use of alien therapeutic agents.
Background
Sierra Leone, located in the equatorial lowlands of West Africa, has a population of about four million people. The people live in rural areas, in small villages or larger towns. The Mende, living primarily in rural southern and eastern chiefdoms of the country, comprise about a third of the population. Formerly slash-and-burn rice agriculturalists, many now engage in cash cropping, diamond mining, trades, and urban wage labor.
Public health services in Sierra Leone are poorly funded. The whole economy has suffered because of low world demand for the country's commodities and minerals. As a result, less money is available to buy petrol and kerosene to run refrigerators. This lack of refrigeration often destroys the effectiveness of certain vaccines that must be kept cold before injection. Moreover, despite high morbidity and mortality rates (the average age of both men and women is about forty), especially among children, the government, with many more pressing demands, assigns low priority to health care.
Several factors lie behind the widespread reinterpretation of the purposes and uses of Western pharmaceuticals. These drugs enjoy deep respect, as the Mende know that most Europeans and Americans live long, healthy lives and attribute this to their medicines. Although these medicines and those who distribute them have not replaced traditional medicines and healers, they are seen as increasingly acceptable alternatives.
However, some aspects of Western medicines are preferred over those of indigenous ones. Hospitals are valued for their facilities and skilled personnel, but are beyond the budgets of most. Besides, many local nurses, concerned with their images, urge patients to bring in fine towels, thermoses, and clothes, for their stays. Nurses also expect to be tipped
...
Read Full Article
|
