She had talked to her the day before, and she had seemed so healthy. She was only slightly past her due-date, and now she was dead. The baby too. How could this have happened? It might have been that guy down the road- people say that he practices black magic.
This is an adaptation from an illness narrative of an indigenous woman in Peru collected by a graduate student in the Department of Anthropology. I have never met this woman, but as a research assistant I have listened and translated her story. Through my expensive earphones in the Starbucks on Sherman Avenue, I am transported to a world of mysterious illnesses, witchcraft and health disparities, along with a fascinating culture on the brink of acculturation to westernization. In this adaptation, the woman is explaining that she feels the major health concern in her community is maternal mortality. Her friend died during childbirth, and no one knows why. Without a biomedical understanding of what happened, this woman turns to another explanatory model for the illness: witchcraft. Witches and black magic become the answer to the unexplainable, and these types of explanations can be harmful when they foster a lack of community trust, as well as divert attention from the real public health issues that this community faces.
An illness narrative takes a health condition outside of purely medical environments and places it into a more relevant sociocultural everyday context. I have learned in my global health courses that illnesses do not happen in a vacuum. They are never just caused by a mutation, bacteria, virus or accident. Take AIDS, for instance. While AIDS is caused by human immunodeficiency virus and can be treated with antiretroviral therapy, it is also caused by poverty: a lack of transportation and money to visit a clinic, lack of education, poor living conditions, and other social determinants of health. Therefore, a purely biomedical understanding of any illness will not lead to sustainable change, as biomedicine can only treat the symptoms and not causes of illness.
Arthur Kleinman, a famous medical anthropologist, has proposed that the act of sharing illness experiences can be therapeutic and cathartic for the tellers as well as for those listening who also suffer from the same illness. For me, at the heart of the field of Anthropology is a desire to give a voice to the voiceless and show how structural systems have an impact on the individual level. Illness narratives have the power to portray this.
In The Illness Narratives, Arthur Kleinman writes, “illness has meaning; and to understand how it obtains meaning is to understand something fundamental about illness, about care, and perhaps about life generally.” As in all fields of anthropology, medical anthropology collects a piece of the human experience so that it is not lost to the oblivion of human memory. In regards to my personal memory, I plan to keep these past and future stories in mind as I continue in my global health career.