What is the relationship between social science research and public health policy, particularly in the developing world? This question is at the heart of this collection of essays drawn from Rockefeller Foundation-sponsored conferences at Harvard University. The book examines the theoretical impact of social science research as well as specific case studies of successful applied research.

Beginning with a section on broad issues and the conceptualization of behavioral change, the volume then examines the anti-smoking movement in the United States; measures to prevent and control HIV infection in the United Kingdom, Sweden, and the United States; anti-malaria measures; and the application of dietary management and lot quality assurance sampling to public health issues in Peru. The volume concludes with a section re-examining ways social science research can have an impact on improving public health. Scholars and researchers as well as policy makers involved with health research and international development will find this collection particularly valuable.

Prior to and during the Second World War, the Japanese Army established programs of biological warfare throughout China and elsewhere. In these "factories of death," including the now-infamous Unit 731, Japanese doctors and scientists conducted large numbers of vivisections and experiments on human beings, mostly Chinese nationals. However, as a result of complex historical factors including an American cover-up of the atrocities, Japanese denials, and inadequate responses from successive Chinese governments, justice has never been fully served. This volume brings together the contributions of a group of scholars from different countries and various academic disciplines. It examines Japan's wartime medical atrocities and their postwar aftermath from a comparative perspective and inquires into perennial issues of historical memory, science, politics, society and ethics elicited by these rebarbative events. The volume's central ethical claim is that the failure to bring justice to bear on the systematic abuse of medical research by Japanese military medical personnel more than six decades ago has had a profoundly retarding influence on the development and practice of medical and social ethics in all of East Asia. The book also includes an extensive annotated bibliography selected from relevant publications in Japanese, Chinese and English.

Prior to and during the Second World War, the Japanese Army established programs of biological warfare throughout China and elsewhere. In these "factories of death," including the now-infamous Unit 731, Japanese doctors and scientists conducted large numbers of vivisections and experiments on human beings, mostly Chinese nationals. However, as a result of complex historical factors including an American cover-up of the atrocities, Japanese denials, and inadequate responses from successive Chinese governments, justice has never been fully served. This volume brings together the contributions of a group of scholars from different countries and various academic disciplines. It examines Japan's wartime medical atrocities and their postwar aftermath from a comparative perspective and inquires into perennial issues of historical memory, science, politics, society and ethics elicited by these rebarbative events. The volume's central ethical claim is that the failure to bring justice to bear on the systematic abuse of medical research by Japanese military medical personnel more than six decades ago has had a profoundly retarding influence on the development and practice of medical and social ethics in all of East Asia. The book also includes an extensive annotated bibliography selected from relevant publications in Japanese, Chinese and English.

In 1974, the World Health Organization began research on the effectiveness of mental health services in the developing world. Through their efforts they found that treatment methods were extremely limited in their usefulness and, in some cases, even inappropriate and harmful.

Little has changed in the last quarter century, but the research in these countries has shown that psychological need often stems from poor physical conditions. Elements including social and economical inequalities, gender discrimination, political violence and malnutrition and poor physical health all contribute to the social and psychological decay of both individuals and communities.

Currently, the goal of the WHO is to document previous studies on communities of developing countries and to build on this information in order to move forward in research. Using real cases based in the South Pacific, Asia, South and Latin America and Europe, this volume sets out examples of community-based interventions that have succeeded by implementing:

• outreach to the families and community to identify those in need;
• reliable and adequate drug supplies;
• treatment interventions;
• healthy psychosocial environments.

This book will interest mental health professionals, international public health workers, global program administrators, and clinicians and healthcare workers, all working with low-income areas.

Despite general agreement that psychosocial factors play an important role in various facets of the etiology, onset, treatment response and outcome of depressive disorders, the replicability of research results has left much to be desired. Because much of this unreliability has been attributed to variability in diagnostic criteria, this volume focuses on efforts to identify sources of variability in the definition and diagnosis of depressive disorders within Western society and cross-culturally. It also explicates the elusive role of aversive life events in the development and course of depressive disorders, deals with the interpersonal experiences and dispositions related to the vulnerability and maintenance of depression, and addresses an often neglected issue: how stress and social support affect the quality and response to treatment received. The text concludes with the presentation of an integrative framework for vulnerability to recurrent depressions which emphasizes the interaction of biological and psychosocial factors as largely mediated by personality and temperament.

China has experienced a tremendous turn-around over the past three decades from the ethos of sacrificing life to the emergent appeal for valuing life. This book takes an interdisciplinary look at China during these decades of transformation through the defining theme of governance of life. With an emphasis on how to achieve an adequate life, the contributors integrate a whole range of life-related domains including: the death of Sun Zhigang, the peril caused by rising tobacco consumption, the emerging suicide intervention, the turning points in the fight against AIDS, the intensely evolving birth policy, the emerging biological citizenship, and so on. In doing so, they explore how biological life has been governed differently to enhance the wellbeing of the population instead of promoting ideological goals. This change, dubbed "the deepening in governmentality," is one of the most important driving forces for China's rise, and will have huge bearings on how the Chinese will achieve an adequate life in the 21st century. This book presents works by a number of internationally known scholars and will be of interest to students and scholars of anthropology, sociology, political science, history, Chinese philosophy, law, and public health.

Sometimes described as "the nemesis of the primary care physician," somatoform disorders are frustrating, expensive to treat, and under-investigated. Somatic Presentations of Mental Disorders provides a fascinating and practical review of the epidemiology, diagnosis, and treatment of this ill-defined category of disease. Somatic Presentations of Mental Disorders summarizes the proceedings of a unique international conference that convened experts from across disciplines to review perspectives on somatoform disorders. The broad range of experience and specialization results in a compendium that addresses both theoretical and practical issues presented in somatoform disorders. For the researcher, the book offers a thorough and critical overview of the research landscape, surveying and synthesizing the available literature from around the world on all aspects of the disorder. Acknowledging the unique challenges presented in studying such a heterogeneous collection of disorders, the authors identify specific gaps in the research literature. Somatic Presentations of Mental Disorders also addresses controversial issues of nosology in advance of the publication of DSM-V.

Despite its utility for researchers, the book primarily serves as an invaluable reference and resource for the practitioner. Organized with the clinician in mind, Somatic Presentations of Mental Disorders surveys the latest data on phenomenology; etiology and clinical course; and treatment options. Unlike other literature on this difficult topic, the authors thoroughly explore the entire range of this category of disorders, including conversion disorder, chronic pain and fatigue, and the multitude of presentations of medically unexplained symptoms. Aimed at both primary care and mental health practitioners, the book addresses crucial issues for effective diagnosis and treatment, including: - Comorbidity and association with anxiety and depressive disorders- Unique insights into cultural factors affecting the presentation and treatment of somatic disorders around the globe- The prevalence of misdiagnosis, and contemporary diagnostic tools and techniques to help avoid a missed organic diagnosis- The complicated interrelationship of somatoform disorders and substance abuse- The efficacy of various treatment modalities, including pharmacology and cognitive behavioral therapy- Collaboration between primary care and mental health providers to maximize treatment outcomes

Comprehensive, thoughtful, and up-to-date, Somatic Presentations of Mental Disorders is a must-have both for researchers in the field and for clinicians with somatizing patients.

Using real cases based in the South Pacific, Asia, South and Latin America and Europe, this volume sets out examples of community-based interventions that have succeeded by implementing outreach to the families and community to identify those in need, reliable and adequate drug supplies, treatment interventions, healthy psychosocial environments. This book will interest mental health professionals, international public health workers, global program administrators, and clinicians and healthcare workers.

Bringing together the experience, perspective and expertise of Paul Farmer, Jim Yong Kim, and Arthur Kleinman, "Reimagining Global Health" provides an original, compelling introduction to the field of global health. Drawn from a Harvard course developed by their student Matthew Basilico, this work provides an accessible and engaging framework for the study of global health. Insisting on an approach that is historically deep and geographically broad, the authors underline the importance of a transdisciplinary approach, and offer a highly readable distillation of several historical and ethnographic perspectives of contemporary global health problems. The case studies presented throughout "Reimagining Global Health" bring together ethnographic, theoretical, and historical perspectives into a wholly new and exciting investigation of global health. The interdisciplinary approach outlined in this text should prove useful not only in schools of public health, nursing, and medicine, but also in undergraduate and graduate classes in anthropology, sociology, political economy, and history, among others.

The SARS epidemic of 2003 was one of the most serious public health crises of our times. The event, which lasted only a few months, is best seen as a warning shot, a wake-up call for public health professionals, security officials, economic planners, and policy makers everywhere. SARS (Severe Acute Respiratory Syndrome) is one of the new epidemics. SARS in China addresses the structure and impact of the epidemic and its short and medium range implications for an interconnected, globalized world. After initially stalling and prevaricating, the Chinese government managed to control SARS before it became a global catastrophe, an accomplishment that required political will and national mobilization. Recent warnings from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) regarding avian flu make it clear that SARS may have been a prelude to bigger things. The contributors to this volume include a journalist, WHO's representative in Beijing, and health care professionals, several of whom found themselves on the frontlines of the battle to understand and control SARS. the boundaries of their respective disciplines and write for a wide audience. The authors of this volume focus on specific aspects of the SARS outbreak - epidemiological, political, economic, social, cultural, and moral. They analyze SARS as a form of social suffering and raise questions about the relevance of national sovereignty in the face of such global threats. Taken together, these essays demonstrate that SARS had the potential of becoming a major turning point in human history. This book thus poses a question of the greatest possible significance: Can we learn from SARS before the next pandemic?

In The Empty Bowl: Poems of the Holocaust and After, Holocaust survivor Judith H. Sherman strives to make art from trauma. Her poems, written largely in the words of a fifteen-year-old survivor, provide historical entry into the Holocaust. Put simply, the poems explore the reality of the events experienced by Sherman in her determination to survive--from first leaving home to illegal border crossings, hiding, capture, imprisonment by the Gestapo, the horrors of the Ravensbruck concentration camp, liberation, and, finally, a full life of joys and challenges that came after, including the unyielding intrusions of the past and hopeful celebration of a compassionate future.

The SARS epidemic of 2003 was one of the most serious public health crises of our times. The event, which lasted only a few months, is best seen as a warning shot, a wake-up call for public health professionals, security officials, economic planners, and policy makers everywhere. SARS (Severe Acute Respiratory Syndrome) is one of the new epidemics. SARS in China addresses the structure and impact of the epidemic and its short and medium range implications for an interconnected, globalized world. After initially stalling and prevaricating, the Chinese government managed to control SARS before it became a global catastrophe, an accomplishment that required political will and national mobilization. Recent warnings from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) regarding avian flu make it clear that SARS may have been a prelude to bigger things. The contributors to this volume include a journalist, WHO's representative in Beijing, and health care professionals, several of whom found themselves on the frontlines of the battle to understand and control SARS. the boundaries of their respective disciplines and write for a wide audience. The authors of this volume focus on specific aspects of the SARS outbreak - epidemiological, political, economic, social, cultural, and moral. They analyze SARS as a form of social suffering and raise questions about the relevance of national sovereignty in the face of such global threats. Taken together, these essays demonstrate that SARS had the potential of becoming a major turning point in human history. This book thus poses a question of the greatest possible significance: Can we learn from SARS before the next pandemic?

This timely volume analyzes the growing burden of mental, behavioral and social problems in low-income countries, examines the sources of the substantial morbidity rates and their relation to development, and assesses current efforts to cope with them. It identifies opportunities for effective mental health interventions, methods of treatment, culturally appropriate prevention programs, and sound policy formation. It relates the mental health consequences of violence, dislocation, poverty, and the disenfranchisement of women to the most pressing economic, political, and environmental problems of our time.

What does human suffering mean for society? And how has this meaning changed from the past to the present? In what ways does "the problem of suffering" serve to inspire us to care for others? How does our response to suffering reveal our moral and social conditions? In this trenchant work, Arthur Kleinman - a renowned figure in medical anthropology - and Iain Wilkinson, an award-winning sociologist, team up to offer some answers to these profound questions. A Passion for Society investigates the historical development and current state of social science with a focus on how this development has been shaped in response to problems of social suffering. Following a line of criticism offered by key social theorists and cultural commentators who themselves were unhappy with the professionalization of social science, Wilkinson and Kleinman provide a critical commentary on how studies of society have moved from an original concern with social suffering and its amelioration to dispassionate inquiries. The authors demonstrate how social action through caring for others is revitalizing and remaking the discipline of social science, and they examine the potential for achieving greater understanding though a moral commitment to the practice of care for others. In this deeply considered work, Wilkinson and Kleinman argue for an engaged social science that connects critical thought with social action, that seeks to learn through caregiving, and that operates with a commitment to establish and sustain humane forms of society.

In many African countries, mental health issues, including the burden of serious mental illness and trauma, have not been adequately addressed. These essays shed light on the treatment of common and chronic mental disorders, including mental illness and treatment in the current climate of economic and political instability, access to health care, access to medicines, and the impact of HIV-AIDS and other chronic illness on mental health. While problems are rampant and carry real and devastating consequences, this volume promotes an understanding of the African mental health landscape in service of reform.

In some parts of the world spending on pharmaceuticals is astronomical. In others people do not have access to basic or life-saving drugs. Individuals struggle to afford medications; whole populations are neglected, considered too poor to constitute profitable markets for the development and distribution of necessary drugs. The ethnographies brought together in this timely collection analyze both the dynamics of the burgeoning international pharmaceutical trade and the global inequalities that emerge from and are reinforced by market-driven medicine. They demonstrate that questions about who will be treated and who will not filter through every phase of pharmaceutical production, from preclinical research to human testing, marketing, distribution, prescription, and consumption.Whether considering how American drug companies seek to create a market for antidepressants in Japan, how Brazil has created a model HIV/AIDS prevention and treatment program, or how the urban poor in Delhi understand and access healthcare, these essays illuminate the roles of corporations, governments, NGOs, and individuals in relation to global pharmaceuticals. Some essays show how individual and communal identities are affected by the marketing and availability of medications. Among these are an exploration of how the pharmaceutical industry shapes popular and expert understandings of mental illness in North America and Great Britain. There is also an examination of the agonizing choices facing Ugandan families trying to finance AIDS treatment. Several essays explore the inner workings of the emerging international pharmaceutical regime. One looks at the expanding quest for clinical research subjects; another at the entwining of science and business interests in the Argentine market for psychotropic medications. By bringing the moral calculations involved in the production and distribution of pharmaceuticals into stark relief, this collection charts urgent new territory for social scientific research. Contributors. Kalman Applbaum, Joao Biehl, Ranendra K. Das, Veena Das, David Healy, Arthur Kleinman, Betty Kyaddondo, Andrew Lakoff, Anne Lovell, Lotte Meinert, Adriana Petryna, Michael A. Whyte, Susan Reynolds Whyte

In most places on the African continent, multiple health care options exist and patients draw on a therapeutic continuum that ranges from traditional medicine and religious healing to the latest in biomedical technology. The ethnographically based essays in this volume highlight African ways of perceiving sickness, making sense of and treating suffering, and thinking about health care to reveal the range and practice of everyday medicine in Africa through historical, political, and economic contexts.

In most places on the African continent, multiple health care options exist and patients draw on a therapeutic continuum that ranges from traditional medicine and religious healing to the latest in biomedical technology. The ethnographically based essays in this volume highlight African ways of perceiving sickness, making sense of and treating suffering, and thinking about health care to reveal the range and practice of everyday medicine in Africa through historical, political, and economic contexts.

The essays in "Violence and Subjectivity, " written by a distinguished international roster of contributors, consider the ways in which violence shapes subjectivity and acts upon people's capacity to engage everyday life. Like its predecessor volume, "Social Suffering, " which explored the different ways social force inflicts harm on individuals and groups, this collection ventures into many areas of ongoing violence, asking how people live with themselves and others when perpetrators, victims, and witnesses all come from the same social space.
From civil wars and ethnic riots to governmental and medical interventions at a more bureaucratic level, the authors address not only those extreme situations guaranteed to occupy precious media minutes but also the more subtle violences of science and state. However particular and circumscribed the site of any fieldwork may be, today's ethnographer finds local identities and circumstances molded by state and transnational forces, including the media themselves. These authors contest a new political geography that divides the world into "violence-prone areas" and "peaceful areas" and suggest that such descriptions might themselves contribute to violence in the present global context.

From the Preface, by Arthur Kleinman:Patients and Healers in the Context of Culture presents a theoretical framework for studying the relationship between medicine, psychiatry, and culture. That framework is principally illustrated by materials gathered in field research in Taiwan and, to a lesser extent, from materials gathered in similar research in Boston. The reader will find this book contains a dialectical tension between two reciprocally related orientations: it is both a cross-cultural (largely anthropological) perspective on the essential components of clinical care and a clinical perspective on anthropological studies of medicine and psychiatry. That dialectic is embodied in my own academic training and professional life, so that this book is a personal statement. I am a psychiatrist trained in anthropology. I have worked in library, field, and clinic on problems concerning medicine and psychiatry in Chinese culture. I teach cross-cultural psychiatry and medical anthropology, but I also practice and teach consultation psychiatry and take a clinical approach to my major cross-cultural teaching and research involvements. The theoretical framework elaborated in this book has been applied to all of those areas; in turn, they are used to illustrate the theory. Both the theory and its application embody the same dialectic. The purpose of this book is to advance both poles of that dialectic: to demonstrate the critical role of social science (especially anthropology and cross-cultural studies) in clinical medicine and psychiatry and to encourage study of clinical problems by anthropologists and other investigators involved in cross-cultural research.

In many African countries, mental health issues, including the burden of serious mental illness and trauma, have not been adequately addressed. These essays shed light on the treatment of common and chronic mental disorders, including mental illness and treatment in the current climate of economic and political instability, access to health care, access to medicines, and the impact of HIV-AIDS and other chronic illness on mental health. While problems are rampant and carry real and devastating consequences, this volume promotes an understanding of the African mental health landscape in service of reform.

Western medicine treats sick patients like broken machines -- figure out what is physically wrong, fix it, and send the patient on their way. But humans are not machines. When we are ill, we experience our illness: we become scared, distressed, tired, weary. Our illnesses are not just biological conditions, but human ones. It was Arthur Kleinman, a Harvard psychiatrist and anthropologist, who saw this truth when most of his fellow doctors did not. Based on decades of clinical experience studying and treating chronic illness, The Illness Narratives makes a case for interpreting the illness experience of patients as a core feature of doctoring. Before Being Mortal or The Body Keeps the Score, there was The Illness Narratives. It remains today a prescient and passionate case for bridging the gap between patient and practitioner.

The guiding inspiration of this book is the attraction and distance that mark the relation between anthropology and philosophy. This theme is explored through encounters between individual anthropologists and particular regions of philosophy. Several of the most basic concepts of the discipline--including notions of ethics, politics, temporality, self and other, and the nature of human life--are products of a dialogue, both implicit and explicit, between anthropology and philosophy. These philosophical undercurrents in anthropology also speak to the question of what it is to experience our being in a world marked by radical difference and otherness. In "The Ground Between," twelve leading anthropologists offer intimate reflections on the influence of particular philosophers on their way of seeing the world, and on what ethnography has taught them about philosophy. Ethnographies of the mundane and the everyday raise fundamental issues that the contributors grapple with in both their lives and their thinking. With directness and honesty, they relate particular philosophers to matters such as how to respond to the suffering of the other, how concepts arise in the give and take of everyday life, and how to be attuned to the world through the senses. Their essays challenge the idea that philosophy is solely the province of professional philosophers, and suggest that certain modalities of being in the world might be construed as ways of doing philosophy.

"Contributors." Joao Biehl, Steven C. Caton, Vincent Crapanzano, Veena Das, Didier Fassin, Michael M. J. Fischer, Ghassan Hage, Clara Han, Michael Jackson, Arthur Kleinman, Michael Puett, Bhrigupati Singh

The guiding inspiration of this book is the attraction and distance that mark the relation between anthropology and philosophy. This theme is explored through encounters between individual anthropologists and particular regions of philosophy. Several of the most basic concepts of the discipline--including notions of ethics, politics, temporality, self and other, and the nature of human life--are products of a dialogue, both implicit and explicit, between anthropology and philosophy. These philosophical undercurrents in anthropology also speak to the question of what it is to experience our being in a world marked by radical difference and otherness. In "The Ground Between," twelve leading anthropologists offer intimate reflections on the influence of particular philosophers on their way of seeing the world, and on what ethnography has taught them about philosophy. Ethnographies of the mundane and the everyday raise fundamental issues that the contributors grapple with in both their lives and their thinking. With directness and honesty, they relate particular philosophers to matters such as how to respond to the suffering of the other, how concepts arise in the give and take of everyday life, and how to be attuned to the world through the senses. Their essays challenge the idea that philosophy is solely the province of professional philosophers, and suggest that certain modalities of being in the world might be construed as ways of doing philosophy.

"Contributors." Joao Biehl, Steven C. Caton, Vincent Crapanzano, Veena Das, Didier Fassin, Michael M. J. Fischer, Ghassan Hage, Clara Han, Michael Jackson, Arthur Kleinman, Michael Puett, Bhrigupati Singh

The moving memoir of a doctor who became a family caregiver and learned why care is so central to all our lives 'Beautiful and deeply moving. A truly extraordinary work that will change how we think about our lives and the society we live in' Michael Puett, author of The Path When Dr Arthur Kleinman, an eminent Harvard psychiatrist and social anthropologist, began caring for his wife, Joan, after she was diagnosed with early-onset Alzheimer's disease, he found just how far the act of caregiving extended beyond the boundaries of medicine. In The Soul of Care, he delivers a deeply inspiring story about what it means to grapple with illness from both sides, as an experienced doctor and a loving husband. Caregiving is long, hard, unglamorous work - at moments joyous, more often tedious, sometimes agonizing, but always rich in meaning. Describing the practical, emotional and moral aspects of caring, Kleinman explores how we must ask uncomfortable questions of ourselves and of our doctors. Poignant and honest, The Soul of Care is an uplifting story about what really matters in our lives.