Anthropology 215 Introduction to Medical Anthropology and Global Health Summer 2014 Instructor: Jennifer Carroll Contact Information

n Email: jencarr2@uw.edu Office Hours: Denny XXX, XX-XX and by appointment.

Course Overview Course Goals This course serves as an introduction to medical anthropology and the role that medical anthropology has played in the field of global health. Students will gain an understanding of a number of major theoretical concepts in medical anthropology as well as recent ethnographic contributions from medical anthropologists who have engaged with global health projects. Throughout this course students will read a combination of ethnographic case studies, theoretical position papers, and public health research. In doing so, students will explore the socially contingent aspects of global health and learn why qualitative social research is an essential element for any successful project to improve the health of communities around the world. Required Texts Biehl J & Petryna A, eds. When People Come First: Critical Studies in Global Health (2013) Princeton: Princeton University Press. Koch E, Free Market Tuberculosis: Managing Epidemics in Post-Soviet Georgia (2013) Vanderbilt University Press. Nguyen, V-K Republic of Therapy: Triage and Sovereignty in West Africas Time of AIDS (2010). Duke University Press. Course Assignments and Grading Grading Scale Course grades will be determined on a 100-point scale, consisting of scores from the following assignments: Reading Responses: 10 points 2 Midterms: 20 points each Class Participation: 20 points Final Paper: 30 points

Reading Assignments and Responses (10 points) Students are required to post a written response to a minimum of ten readings (which means readings from ten different class periods) over the course of the quarter on the class bulletin board. These responses should be approximately 100 words, excluding any quotations, and should directly address the readings for that day. Appropriate content for these responses include questions that have arisen from the readings, critiques of the authors methods or arguments, and further thoughts relating the readings to other course materials, to content or lessons from other classes, or relevant current events. Responses must be posted by 12pm PST on the day of class when those readings are due in order to be counted for credit. Students are encouraged to engage in online discussion and respond to each others postings. Expectations for scholarly conduct in the classroom extend to this on-line forum. Midterms (2 @ 20 points each) There will be two written, open-book, midterm exams. Students will be given a reasonable period of time in which to compete these midterms at home. These tests will cover material from readings as well as from class lectures and discussion. Both midterms will be comprehensive. Participation (20 points) Dialog and debate are central to the discipline of anthropology. Satisfactory participation requires students to come to class prepared to discuss all of the readings assigned and to actively engage in discussion about those readings and the topics at hand. Active engagement in discussion does not simply mean talking. Asking questions, active listening, making room for and inviting others to participate, and making other meaningful, if small, contributions to class are all appropriate forms of classroom engagement. Being a part of a class of this size (especially a cultural anthropology class!) requires each of us to recognize that different individuals have different reaction times, different speeds of speech and lengths of conversational pauses. Some students may not be native speakers of English or may process information differently and at different speeds. Some people take a longer time to consider their words, and others sometimes speak without thinking! There is no concrete outline for how a student should participate in class, but everyone is required to make a consistent, concerted effort to actively engage. Final Paper (30 points) This course requires students to write an original paper analyzing a particular issue: the Seattle Compromise. This is a position paper, meaning that students must argue

EITHER the Seattle Compromise should have been protected and maintained, OR that it should have been prohibited and the practice brought to an end. The assignment will require students to consider the social values and meanings of the practices proposed in the Seattle Compromise as well as the social value and meaning of preventing or regulating those practices. Papers must be between 1500 and 2000 words in length, not including citations or footnotes. Papers above or below the word limit will not be accepted. All papers must be titled. Final drafts ready for submission should be in Times New Roman 12-point font, double-spaced, with one (1) inch margins on all sides. Pages should be numbered. Please include a heading with your name, course, and the date. There is no need for a title page. All references must be properly and adequately cited, including course materials. A complete prompt for this paper as well as the format that will be used for grading papers will be made available on the course website. Extra Credit Extra credit assignments may be given at the discretion of the instructor. If the instructor specifies a due date for an extra credit assignment, no extensions will be allowed, and the assignment will not be accepted after that date. Grade Disputes The University of Washington has procedures in place to handle grading disputes and appeals. This and other information about grading policies can be found online at http://www.washington.edu/students/gencat/front/Grading_Sys.html ! Student Expectations Anticipated Absences If you are unable to come to class due to illness, personal or family emergency, or any other reason, you are responsible for informing the instructor prior to that class period. If you miss class for a reason that was unforeseen (traffic accident, etc.), you are responsible for informing the instructor as to the reason for your absence as soon as possible. It is expected that the instructor will be informed as to the nature of every absence, regardless of the cause. The excusing of absences is at the discretion of the instructor. If you are ill, you must bring a doctors note in order for that absence to be excused.

Classroom Behavior and Preparation All reading assignments are listed in the schedule on the day that they are due to be read and will be discussed in class. Things that I welcome you to do in the classroom include: Eating and drinking. Taking notes on a laptop or tablet. Excusing yourself when necessary. Telling me if something that we are doing in this course is really not working for you (discussion format, course deadlines, etc.) Things that I find very inappropriate to do in class: Checking email/checking scores/Facebooking/doing anything that isnt class related on your computer. Texting, etc. Cross talk and side conversations Electronic Document Submission via Catalyst Dropbox Whenever an assignment is submitted as an electronic document, it is the students responsibility to make sure that the file is correct and complete. If an electronic document is submitted and is unreadable or in anyway corrupted, the assignment will be considered incomplete and late penalties will apply until a proper, functional document is submitted. All written assignments should be submitted in .doc, .docx, or .pdf format. All filenames should reflect the students name and the assignment. Individual Student Needs and Disability Support Every student deserves the opportunity learn in the best and most appropriate environment possible. If you have a question, concern, comment, request or other need please come and talk to me in person or send me a detailed e-mail as soon as possible. I can make adjustments or accommodations for individuals or the entire class, but only if I am made aware of them. Students with medically recognized and documented disabilities and who are in need of special accommodation have an obligation to notify the University of their needs. Students in need of accommodation should contact the Office of Disability Resources for Students at 206-543-8924 (Voice) or 206-543-8925 (TTY) You can also find more information online at http://www.washington.edu/students/drs/. If you need course adaptations or accommodations because of a disability, if you have emergency medical information, or if you need special arrangements in case the building must be evacuated, please make an appointment with me as soon as possible

Academic Honesty I take academic honesty very seriously. When flagrant cheating or plagiarism occurs, it is an insult to me, to the students in this course, and to the guilty student. It is an insult to the time we spend here teaching and learning from each other. Academic instruction, particularly in the liberal arts, is unique in its focus on intellectual fluency and collaborative effort rather than task-based competition and self-promotion. Your college education does not consist of a collection of hoops that you need to get through. This course requires you to engage with course materials, with other students, with the instructor, and with the greater academic community in a productive and innovative fashion. Academic dishonesty defeats the purposes of this class and of this institution, and it will not be tolerated. Especially in a discipline that requires you to be able to engage with the ideas of others and to cite multiple unique sources, plagiarism is an incredibly self-defeating activity. Plagiarism is, at the very least, grounds for a zero grade for that assignment. If a student is suspected of deliberate plagiarism on an assignment, that student will be reported to the Dean Representative on Academic Conduct in accordance with UWs Academic Honesty Policy. More information on UWs academic honestly policies can be found online: http://www.washington.edu/uaa/advising/help/academichonesty.php

Course Schedule WEEK 1 Defining Global Health and Medical Anthropology Day 1 Differentiating between the methods and goals of global health and medical anthropology. Qualitative and Quantitative data and methodologies Day 2 knowledge production in Global Health; how categories and indicators are created; the move to big data. Required Readings: Jeffrey P Koplan, T Christopher Bond, Michael H Merson, K Srinath Reddy, Mario Henry Rodriguez, Nelson K Sewankambo, Judith N Wasserheit, "Towards a common definition of global health," The Lancet 2009; 373: 199395 Gold MR, Stevenson D, Fryback DG. HALYS and QALYS and DALYS, Oh My: similarities and differences in summary measures of population health. Annual Review of Public Health 2002; 23:115-34. WEEK 2 Seeing and understanding the social context of disease Day 1 The role of medical anthropology in global health research Required Readings: Chapman RR and Berggren JR. Radical contextualizations: contributions to an anthropology of racial/ethnic health disparities. Health 2005; 9(2):145-167. Day 2 Exploring tensions between individual and population logics of disease prevention and treatment Required Readings: Petryna A and Biehl J. Introduction in When People Come First: Critical Studies in Global Health Biehl J & Petryna A, eds. (2013) Princeton: Princeton University Press. Cueto M. A Return to the Magic Bullet: Malaria and Global Health in the Twenty-First Century in When People Come First: Critical Studies in Global Health Biehl J & Petryna A, eds. (2013) Princeton: Princeton University Press. Chapter 1.

WEEK 3 Evidence-based practice Day 1 Defining evidence-based medicine, the science behind it, and the social values embedded with in it. Required Readings: Adams V. Evidence-Based Global Public Health in When People Come First: Critical Studies in Global Health Biehl J & Petryna A, eds. (2013) Princeton: Princeton University Press. Chapter 2. Day 2 The social and practical limits of evidence Required Readings: Amon JJ The Right to Know or Know Your Rights: Human Rights and a People Centered Approach to Public Health Policy in When People Come First: Critical Studies in Global Health Biehl J & Petryna A, eds. (2013) Princeton: Princeton University Press. Chapter 3. WEEK 4 Critical Responses to Evidence-Based Global Health Practice Day 1 Evidence on the ground: how hierarchies and social relationships muddy the waters of science-based protocols Required Readings: Nguyen, V-K Republic of Therapy: Triage and Sovereignty in West Africas Time of AIDS (2010). Duke University Press. Introduction and Chapter 1 Geissler PW Public Secrets in Public Health: Knowing not to Know While Making Scientific Knowledge American Ethnologist (2013); 40(1): 13-34. Day 2 Local re-interpretations of evidence and evidence-based practice Required Readings: Carroll JJ Evidence-Based Medicine and the Construction of Moral Agency in Ukraine CARGO: Journal for Cultural and Social Anthropology (2011); (1,2): 25-50. **Midterm #1 due Friday at midnight

WEEK 5 On the right side of medicine: morality, citizenship, and the priorities of power Day 1 Biological citizenship and therapeutic citizenship Required Readings: Nguyen, V-K Republic of Therapy: Triage and Sovereignty in West Africas Time of AIDS (2010). Duke University Press. Chapter 4 Day 2 Is there a therapeutic kinship, or just a lot of hot air? Critical responses to the notion of therapeutic citizenship Required Readings: Whyte SR et al. Therapeutic Clientship in When People Come First: Critical Studies in Global Health Biehl J & Petryna A, eds. (2013) Princeton: Princeton University Press. Chapter 5. Stillo J We are the Losers of Socialism: Tuberculosis, social cases, and the limits of care in Romania. Paper presented at the 2nd Annual Helath in Transition Conference, Bucharest Romania (June 7-8, 2012). WEEK 6 Global health and social order: turning medical patients into social subjects Day 1 Unpacking the concepts of bio-power and subjectivity Required Readings: Nguyen, V-K Republic of Therapy: Triage and Sovereignty in West Africas Time of AIDS (2010). Duke University Press. Chapter 5. Day 2 What makes a good subject? The mechanisms and results of biopower in action Required Readings: Zigon J, A Disease of Frozen Feelings: Ethically Working on Emotional Worlds In a Russian Orthodox Church Drug Rehabilitation Program Medical Anthropology Quarterly (2010); 24(3): 326-343. Carr ES. Scripting Addiction: The Politics of Talk and American Sobriety. (2010) Princeton University Press. Selected Excerpts

WEEK 7 SAPS and structural/economic forces shaping global health Day 1 Economic realities and medical consequences: the mutual reinforcement of inequalities Required Readings: Gloyd S, "SAPping the Poor: The Impact of Structural Adjustment Programs in Sickness and Wealth: The Corporate Assault on Global Health, Fort MP, Mercer MA, and Gish O, eds. Chapter 4. Becker G, The Uninsured and the Politics of Containment in U.S. Health Care Medical Anthropology (2007); 26(4): 299-321. Day 2 The health effects of economic collapse; attempts to respond to political and financial uncertainty Required Readings: Nguyen, V-K, Republic of Therapy: Triage and Sovereignty in West Africas Time of AIDS (2010). Duke University Press. Chapter 6. WEEK 8 Social assumptions and technological slippage: the case of DOTS Day 1 The free-market logic of standardized approaches to global health Required Readings: Koch E, Free Market Tuberculosis: Managing Epidemics in Post-Soviet Georgia (2013) Vanderbilt University Press. Introduction and Chapter 2 Ecks S and Harper I. Public Private Mix: The Market for Anti-Tuberculosis Drugs in India in When People Come First: Critical Studies in Global Health Biehl J & Petryna A, eds. (2013) Princeton: Princeton University Press. Chapter 9. Day 2 When evidence-based medicine breaks bad: the failure of DOTS in the Georgian prison system Required Readings: Koch E, Free Market Tuberculosis: Managing Epidemics in Post-Soviet Georgia (2013) Vanderbilt University Press. Chapter 4 **Midterm #2 due Friday at midnight

WEEK 9 Case Studies: anthropological research in global health Day 1 Female Circumcision (and the Seattle Compromise) Required Readings: Obermeyer CM, Female Genital Surgeries: The Known, the Unknown, and the Unknowable. Medical Anthropology Quarterly (1999); 13(1): 79106. Mackie G, Female Genital Cutting: A Harmless Practice? Medical Anthropology Quarterly (2003); 17(2): 135-158. Day 2 HIV and Sexual Concurrency Required Readings: Abu-Raddad LJ and Longin Jr. IR. No HIV Stage is Dominant in Driving the HIV Epidemic in Sub-Saharan Africa. AIDS (2008); 22(9): 1055-1061. Goodreau SM, Cassels S, Kasprzyk D, Montano DE, Greek A. and Morris M. Concurrent Partnerships, Acute Infection and HIV Epidemic Dynamics Among Young Adults in Zimbabwe. AIDS and Behavior (2012); 16(2): 312-322. **Final paper due August XXX NO EXTENSIONS.