Medical Anthropology at the Intersection of Civil Liberties, National Responsibilities, and Political Reform
Panel Organizer: Daniela Pěničková (Multikulturní Centrum Praha and Anglo-American University)
The presented panel offers closely interwoven accounts of reforms in construction of sexuality and the fundamental right to health from intercultural perspective – both reconceptualizing and counterpointing the varying responsibilities of the individual, the corporation, and the state. Through an examination of ethnographic account from rural Slovakia, Bužeková gives attention to the inter-generational transformation in adherence to religious prescriptions in conceptualization of female body and reproduction. The two following closely related papers by Hall and Prokopík take the anthropological analysis of sexuality to the area of cultural models of romantic relations and perceptions of rights to health in the Czech LGTB community in the context of global public health and activist movement. Drawing on their UCLA funded long-term fieldwork the former explores how authenticity in gay sexual behavior yields counterpoints to Western-derived queer and homosexual identities and the basis for effective HIV prevention policies, while the latter points to the medical hegemony in transgender issues in Czech society that sharply contrasts with other Western paradigms. Gender is problematized also in the last contribution of the first part of the panel in Klepal’s analysis of Balkan war veterans’ masculinity. He traces its biological, emotional, and social enactment in the PTSD diagnosis, which he understands as a socio-cultural rather than medical process.
The second part of the panel opens with Pěničková’s ethnographic account exploring the experiences of Russian speaking migrants ineligible for national health insurance in the Czech Republic. The paper points to the process of coercion of the fundamental right to health into commodified “personal responsibility” amidst social state health care with a special focus on women and mothers. The concluding contributions bring the themes of health, gender, and politics into the realm of science and knowledge legitimization. While Kościańska probes the changing motives and aspirations of sexology in Poland from the 1980s to the present, she brings the analysis of sexuality deconstruction to a systemic level. Pešťanská’s paper then illuminates how the authoritarian medical knowledge yielding institutional responsibilities and individual emotional experiences are interplayed in the model of public hospital birth in Central Slovakia.
Programme
Saturday September 13, 2014
ROOM B
09:00-12:30
Medical Anthropology at the Intersection of Civil Liberties, National Responsibilities, and Political Reform
Chairs: Daniela Pěničková and Timothy McCajor Hall
Part I
09:00–09:10 Daniela Pěničková and Timothy Hall: Introduction
09:10–9:30 Timothy Hall:
Intimacy, Authenticity, and Prevention Policies: Patterns of Romantic Relationships Among Czech Gay Men
09:30-09:50 Petr Prokopík:
Conceptualization of Gay, Lesbian and Transgender Topics in the Czech Republic and Global Context
09:50-10:10 Jaroslav Klepal:
“Our Cocks Are Soft as Butter:” Transforming Masculinity and Its Predicaments among Veterans with PTSD in Bosnia and Herzegovina (GSC)
10:10-10:30 Pavla Jonssonová: Discussion I
Coffee break: 10.30-11.00
Part II
11:00-11:20 Daniela Pěničková:
Whose Right to Health? The Exclusion of non-EU Migrants from the Czech National Health Care
11:20-11:40 Agnieszka Kościańska:
Sexology in Transition: Polish Cultural Approaches to Sexuality and Sexual Science
11:40-12:00 Tatiana Bužeková:
Conceptions of the female body: Sexuality, reproduction, and religious norms in Slovakia
12:00-12:30 Edit Szénássy: Discussion II (GSC)
12:30-14:00 Lunch
1.
Intimacy, Authenticity, and Prevention Policies: Patterns of Romantic Relationships Among Czech Gay Men
Timothy McCajor Hall
Health Sciences Clinical Instructor
Psychological Anthropologist
Center for Behavioral & Addiction Medicine
Center for HIV Identification, Prevention, and Treatment Services
UCLA Department of Family Medicine
Culturally shared models of and for romantic relationships are significant both practically for their relevance to public health and policy, and theoretically, for our understanding of the interaction among culturally shared conceptual models, patterns of behavior, and individual experience of the self. This paper draws on the author’s 4 years of fieldwork among gay and bisexual Czech men in Prague from 1999 to 2006 and their recent revisions. Informants’ ideas and practices around romantic relationships reflect local Czech cultural models of authenticity, personhood, and the uncontrollable nature of certain feelings. However, romantic relationships among Czech gay and bisexual men demonstrate some differences likely due to different social environment compared to heterosexual peers. These have practical importance, as the emphasis placed on intimacy and the uncontrollable nature of romantic feelings likely contribute to early discontinuation of condom use despite rapid turnover in relationships and prevalence of overlapping relationships. In regard to HIV prevention, this takes place against a sadly ironic backdrop of social geography and political economy: While the Czech Republic embraced a progressive plan of HIV education in the early 1990s, the expected first wave of HIV infections failed to materialize and funding has both decreased and shifted to target medical care of persons living with HIV. As Czech society largely continues to frame private sexual behavior as a private and secular matter, it allows greater private freedom for sexuality, but also discourages formation of politicized movements based on sexual identities. Contemporary Czech Republic thus presents a provocative counterpoint to Western-derived models of queer/homosexual identities, as well as a more general anthropological challenge to models of health decision-making and HIV prevention based on theories of disembodied rational choice.
2.
Conceptualization of Gay, Lesbian and Transgender Topics in the Czech Republic and Global Context
Petr Prokopík
Independent researcher
Collaborates with:
Center for Behavioral & Addiction Medicine
Center for HIV Identification, Prevention, and Treatment Services
UCLA Department of Family Medicine
The last decade saw a significant transformation in the recognition of Gay and Lesbian associated socio-political topics across the world. While only two decades ago, the commonly emerging themes associated with the LGBT community were almost exclusively related to the medical and entertainment fields, today the voiced issues address much wider array of questions intersecting multiple social and political areas from psychology to human and political rights to civic engagement. Although the Gay and Lesbian rights became a top agenda for political activists, media, and state institutions also in the Czech Republic and the CEE region, they remains reflecting both the larger world movement and regional idiosyncrasies. This paper is presented from a position of both a social scientist and LGBT activist and its focus is the analysis of the global movement and the specific situation in the Czech Republic. Firstly, it addresses the question of which LGBT topics are considered valid and preferentially selected by Czech and global activists, how they are constructed and what strategies are used for assuring the attention of media, the general public, and state institutions across the different geographical boundaries. Secondly, it offers a comparison of perception of transgender related issues. While the Euro-Atlantic societies are going through the time considered Gay and Lesbian Enlightenment in which Gay and Lesbian subjects are discussed with an increasingly open and liberal perspective, there are themes staying out of the activist and public spotlight in the Czech Republic. One of them is the Right for Health of transgendered people. Transgender issue in Czech society remains restricted to the medical realm in which a person must fit the biologically defined category of either a male or female sex, while the issue of psychological conceptualization of gender is suppressed. The paper addresses the consequences of such attitude on both individual and political level while reflecting differences abroad.
3.
“Our Cocks Are Soft as Butter:” Transforming Masculinity and Its Predicaments among Veterans with PTSD in Bosnia and Herzegovina (GSC)
Jaroslav Klepal
Department of General Anthropology
Faculty of Humanities, Charles University in Prague
“We are all fucked up. We are supposed to be the heads of our families but we are of no use. Our dicks are of no use; we are of no use. We are lost. Yesterday, I beat up my wife again. I kicked her down. Our wives feel all right only when we are not at home. When we get out. They have learnt to say: ‘Go out, go to [the organization of war veterans suffering from PTSD] because you are OK there.’ Do you think that my teenage son obeys me? Damn, what can I say to him? He knows that I am fucked up; he has no reason to pay attention to me, a teenage prick! Our cocks are soft as butter. That is our problem. We are losers.” In this paper, based on these Edin’s words spilled out on me in winter 2008 when he learnt that my relationship had broken up, I map different ways of forming masculinity among the war veterans suffering from posttraumatic stress disorder (PTSD) in the city of Tuzla, in North-Eastern Bosnia and Herzegovina, where I conducted my fieldwork between 2007 and 2012. Using ethnographic vignettes I show how the predicaments of veterans’ masculinity are “enacted” (Mol 2002) as biological (erectile dysfunction), emotional (domestic violence, public weeping), and social (failed breadwinners) realities that give authenticity to the psychiatric diagnosis and help the war veterans to appropriate PTSD within competing “hierarchy of sufferers” in Bosnian postwar society (Petryna 2002). Even though masculinity related to PTSD is staged as deficient, especially in comparison to manhood before the 1992 – 1995 war and “heroism” during the war, it is often reframed as “hegemonic masculinity” by the veterans (Aciksoz 2012). Due to psychiatric treatment and its social, moral, and political difficulties, the war veterans with PTSD transform these predicaments into “therapeutic heroism” which turns them into the defenders of the Bosnian state once again. This time, however, they do not fight against an external enemy but they fight against dangers of their psychiatric condition, and protect Bosnian society from themselves. From a theoretical standpoint the paper contributes to the discussion on gender and health aspects of war and their impact on post-conflict societies.
Discussion I – Pavla Jonssonová
___________________________________________________________________________________________
PART II
4.
Whose Right to Health? The Exclusion of non-EU Migrants from the Czech National Health Care
Daniela Pěničková
Projekt Migrace do centra
Multikulturní Centrum Praha
and
Anglo-American University
School of Humanities and Social Sciences
Prague, Czech Republic
The last two decades have witnessed fundamental changes in health insurance systems worldwide. While nations of Western Europe have become to face unprecedented challenges to their historic traditions of social insurances combined with private sector, the CEE nations have largely followed the suit of adopting private sector reforms to their formerly socialist health care systems while keeping the concept of national health care. Overall trend, however, can be characterized as marked by an increasing push for conversion of health into a privately purchased commodity. In the Czech Republic this effort is most vividly demonstrated in the state policies towards migrants from non-EU countries. While general health insurance is available to all EU citizens and migrants with permanent residency, other migrants from non-EU countries, who do not have an “employee status,” and who typically work in low-paid, high risk jobs, or who are students not covered by international agreements, are excluded from participation in the Czech national health care (the total estimated number is 100,000-120,000 migrants, Hnilicova, 2011). They are obliged to purchase commercial health insurance that is often beyond their financial means or severely limits the extent of their health care coverage. Drawing on ethnography carried among Russian speaking migrant mothers living in the Czech Republic, this paper opens a crucial debate on the role of anthropology in revealing how the notion of individual responsibility for health has become enmeshed with privatization and commodification of health care. On the example of Russian speaking migrant minority, this paper shows the efficiency of anthropological analysis as a tool in paying critical attention to how the notion of health as a fundamental right is asserted, contested, and co-opted and how states and various interest groups within them have defined the notion of health as a personal responsibility versus means of political and racial repression.
5.
Sexology in Transition: Polish Cultural Approaches to Sexuality and Sexual Science
Agnieszka Kościańska
Department of Ethnology and Cultural Anthropology
University of Warsaw
The 1970s and 1980s were the years of the so called Golden Age of sexology in Poland. Sexual science developed during this period as a holistic discipline embracing achievements in medicine, psychology, sociology, anthropology, philosophy, history and religious studies, providing a wide array of recourses for sex education and therapy. Sexuality was perceived as multidimensional aspect of human psyche and behavior embedded in personal relations, culture, economy and society at large. Since the 1990s, sexology in Poland has been changing under the influence of global trends such as biomedicalization as well as the local and global development of feminist theories and the LGBT movement. In this paper, I draw on my archival and ethnographic research on sexual science in Poland under three socio-political structures: socialism, during the post-socialist transition and in the present. Following Foucault and other historians of sexuality, I assume that sexology plays an important role in constructing sexuality and sexual identities. Hence, research on sexology can shed light on how identity forms and re-forms in changing social and political context. While transnational feminist debates on sexuality and gender are mostly based on developments in western and postcolonial contexts, the discourses developed in the so-called second world countries remain largely unnoticed or underestimated. This paper contributes to a possible change of this trend by opening up an ethnography-based debate on the part of the former socialist world. It focuses on the following question: Can sexual policies and sciences in socialist countries contribute to the transitional critique of male, western, and middle class perspective on sexuality? What can we learn from the post-socialist transition in the field of sexuality?
6.
Conceptions of the female body: Sexuality, reproduction, and religious norms in Slovakia
Tatiana Bužeková
Department of Ethnology and Museology
Faculty of Philosophy
Comenius University in Bratislava
Conceptions of the body belong to the most important aspects of social norms. They are essential in terms of gender roles, especially in conceptualisation of sexuality and reproduction. Perhaps one of the most essential areas affecting social norms related to the sphere of sexuality and reproduction are religious prescriptions. People’s adherence to religious rules change across time in accordance to the specific socio-political conditions. In guiding the concepts of sexuality construction they might be perceived either as moral norms or conventions, depending on particular socio-political settings. they My fieldwork carried out in one of the Central Slovakia villages illustrates, however, that the distinction between moral norms and social conventions is not always clearly defined and presents one of the essential problems in anthropology of morality. In the analysis of my research, I explore the following questions: (1) in what way do religious representations influence perception of the female body in terms of sexuality, reproduction and ageing (including medical issues); and (2) what are the generational differences in observance of religious prescriptions related to the female body? In examination of these two areas, I focus on the role of emotions in perception of religious rules related to the female body. Following the argument of medical anthropologists Margaret Lock and Nancy Scheper-Hughes, I posit that emotions present the “mediatrix of three bodies” – individual body, social body, and body politic. The mediatrix model, I argue, offers a suitable anthropological tool to capture generational transition in perception of female sexuality across recent socio-economic and political changes in Central Slovakia.
Discussion II – Edit Szénássy (GSC)