MEDICAL ANTHROPOLOGY HEALTH POLICY AND THE STATE: A CASE STUDY OF SUDAN |
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| Authors: | Ellen Gruenbaum |
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| Affiliation: | ELLEN GRUENBAUM spent five years in Sudan, lecturing at the University of Khartoum and researching rural health services. Since 1979 she has been a research associate in the Department of Community Medicine at the University of Connecticut Health Center, where she served as editor of the Comparative Health Systems Newsletter and coordinated the Cross-National Study of Health Systems Program. She received her B.A. from Stanford University, M.A. in anthropology from the University of Connecticut and is currently completing her Ph.D. in anthropology at the University of Connecticut. The title of her dissertation is "Health Services", Health, and Development in Sudan: The Impact of the Gezira Irrigated Scheme. |
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| Abstract: | Medical anthropologists have frequently limited themselves to studying cultural factors in illness, curing or resistance to the acceptance of modern Western medical services. This prevailing "socioculturalist" approach has serious analytical shortcomings resulting from underestimating the importance of the social formations in which cultural factors occur. Consequently, the policy recommendations produced in medical anthropology are often crippled by theoretical limitations. It is argued that the historically specific constellation of social relations governing production and the appropriation and distribution of the economic surplus-commonly embodied in the functions of the state-have profound effects on the pattern of health and illness as well as on the availability of health services. In underdeveloped countries an analysis of the role of the state in health is especially important, since the organs of state power play a stronger role in health care than in countries with well developed markets for medical services.
In the case of Sudan, the interests of the state in colonial and postindependence periods required a development strategy involving large-scale irrigated agriculture utilizing seasonal migrant labor. The labor and health policies aimed at economic productivity and political stability are analyzed here in relation to the adverse health effects and serious maldistribution of health services which resulted. |
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