11 research outputs found
Vein action: Performativity and the material body in haemodialysis
 For patients suffering from acute kidney failure technology is the only means of survival until a kidney graft can be secured1 - a process which may take several years. In this article I focus on patientsâ ongoing, situated, and embodied practices of knowing and doing as part of their caring for kidney failure. In these practices the action of blood, veins, needles, and the dialysis machine are of central import. I argue that kidney failure is »done« through a variety of cultural practices, including medical technology. It is a process of material re-shaping I term âvein actionâ. The concept of "doing" is elaborated upon by linking it to theories of neo-materialism and particularly Karen Baradâs notion of intra-activity. I investigate how flowing of blood between the patient and the dialysis machine is constituted by analyzing the material and performative qualities of these entities as part of living with kidney failure. I ask how does the materiality of the body, needle, and machine affect the doing of dialysis, and by extension the doing of kidney failure, in an everyday context? What does doing dialysis tell us about the nature of care-oriented agency
Good Lives, Hidden Miseries : An Ethnography of Uncertainty in a Finnish Village
This is an ethnographic study, in the field of medical anthropology, of village life among farmers in southwest Finland. It is based on 12 months of field work conducted 2002-2003 in a coastal village. The study discusses how social and cultural change affects the life of farmers, how they experience it and how they act in order to deal with the it. Using social suffering as a methodological approach the study seeks to investigate how change is related to lived experiences, idioms of distress, and narratives. Its aim has been to draw a locally specific picture of what matters are at stake in the local moral world that these farmers inhabit, and how they emerge as creative actors within it.
A central assumption made about change is that it is two-fold; both a constructive force which gives birth to something new, and also a process that brings about uncertainty regarding the future. Uncertainty is understood as an existential condition of human life that demands a response, both causing suffering and transforming it. The possibility for positive outcomes in the future enables one to understand this small suffering of everyday life both as a consequence of social change, which fragments and destroys, and as an answer to it - as something that is positively meaningful. Suffering is seen to engage individuals to ensure continuity, in spite of the odds, and to sustain hope regarding the future.
When the fieldwork was initiated Finland had been a member of the European Union for seven years and farmers felt it had substantially impacted on their working conditions. They complained about the restrictions placed on their autonomy and that their knowledge was neither recognised, nor respected by the bureaucrats of the EU system. New regulations require them to work in a manner that is morally unacceptable to them and financial insecurity has become more prominent. All these changes indicate the potential loss of the home and of the ability to ensure continuity of the family farm.
Although the study initially focused on getting a general picture of working conditions and the nature of farming life, during the course of the fieldwork there was repeated mention of a perceived high prevalence of cancer in the area. This cancer talk is replete with metaphors that reveal cultural meanings tied to the farming life and the core values of autonomy, endurance and permanence. It also forms the basis of a shared identity and a means of delivering a moral message about the fragmentation of the good life; the loss of control; and the invasion of the foreign.
This thesis formed part of the research project Expressions of Suffering. Ethnographies of Illness Experiences in Contemporary Finnish Contexts funded by the Academy of Finland. It opens up a vital perspective on the multiplicity and variety of the experience of suffering and that it is particularly through the use of the ethnographic method that these experiences can be brought to light.
Keywords: suffering, uncertainty, phenomenology, habitus, agency, cancer, farmingDenna avhandling, inom ÀmnesomrÄdet medicinsk antropologi, undersöker hur social och kulturell förÀndring pÄverkar finlÀndska bönders liv, hur de upplever förÀndring och hur de agerar för att handskas med den osÀkerhet som det kan skapa. Den beskriver vad som stÄr pÄ spel i bönders livsvÀrld och hur de trÀder fram som kreativa aktörer inom denna vÀrld. Begreppet socialt lidande anvÀnds som en metodologisk infallsvinkel för att undersöka hur förÀndring Àr kopplat till upplevelser, trÄngmÄlssprÄk och narrativer. Avhandlingen baseras pÄ ett Är (2002-2003) av etnografiskt fÀltarbete, dvs. deltagande observation och djupintervjuer utförda i en kustby i sydvÀstra Finland. MÄlsÀttningen var att fÄ en allmÀn bild av arbetsförhÄllanden och jordbrukarlivet.
Ett grundlÀggande antagande som gjorts i studien Àr att förÀndring Àr tvÄsidigt: det Àr bÄde en konstruktiv kraft som bildar nÄgot nytt och en prosess som skapar osÀkerhet angÄende framtiden. OsÀkerhet uppfattas som ett existentiellt tillstÄnd som krÀver ett socialt svar. Det Àr nÄgot som bÄde transformerar vardagens lidande samt orsakar det. Lidande, i likhet med osÀkerhet, har tvÄ sidor. Det orsakar nÄgot gott genom att engagera individer att agera för att garantera kontinuitet och att upprÀtthÄlla hopp inför framtiden. Samtidigt kan det fragmentera den sociala ordningen och dÀrmed skapa ytterligare osÀkerhet. NÀr fÀltarbetet pÄbörjades hade Finland varit en EU-medlemsstat i sju Ärs tid. Ett centralt antagande var att bönders liv och arbetsförhÄllanden hade pÄverkats av medlemskapet pÄ ett avsevÀrt sÀtt. Bönderna som ingick i studien klagade över att deras autonomi begrÀnsats och att deras kunskaper varken respekteras eller erkÀnns av EU-systemets bryÄkrater. Nya regler krÀver att de ska arbeta pÄ ett sÀtt som Àr moraliskt oacceptabelt och ekonomisk osÀkerhet har blivit mera framstÄende. Alla dessa förÀndringar antyder en potentiell förlust av hemmet och förmÄgan att garantera familjegÄrdens kontinuitet. NÀr det Àr frÄgan om familjejordbruk, som fortfarande Àr den vanligaste formen av jordbruk i Finland, Àr hem och arbete intimt sammankopplade. Att det nu finns hinder för hur man ska arbeta innebÀr ett allvarligt hot gentemot allt som ger livet mening.
Avhandlingen Ă€r en delstudie i ett forskningsprojekt Expressions of Suffering. Ethnographies of Illness Experiences in Contemporary Finnish Contexts finansierat av Finlands akademi. Ytterligare en vĂ€sentlig infallsvinkel i avhandlingen var att undersöka kulturskillnader i Finland genom att jĂ€mföra en by i östra delarna av landet (Nordkarelen) med en i vĂ€st. Medicinsk forskning har pĂ„visat att det inom Finland finns ett sĂ„ kallat östligt överskott i morbiditet och att man i de vĂ€stliga kustomrĂ„dena i Ăsterbotten lever lĂ€ngre och Ă€r lyckligare och friskare Ă€n i andra delar av landet. Studien ville dĂ€rför undersöka om samma situation gĂ€ller för de sydvĂ€stra kustomrĂ„dena Ă€r livet bĂ€ttre och hĂ€lsosammare i sydvĂ€st Ă€n i öst?
Under studiens gÄng uppkom upprepade anspelningar pÄ att det finns mycket cancer i fÀltstudieomrÄdet fastÀn sjukdomsstatistik pÄvisar att cancer inte Àr mera utbrett i den delen av landet. Vad Àr dÄ betydelsen av detta prat om cancer? Studien kommer fram till att detta cancerprat kan uppfattas som ett trÄngmÄlssprÄk som Àr fyllt av metaforer. Det uppdagar kulturbetydelser kopplade till jordbrukarlivet och centrala vÀrderingar sÄsom autonomi, uthÄllighet och bestÀndighet. Genom att prata om cancer lÀgger man grunden till en gemensam identitet - det Àr Àven ett sÀtt att föra fram ett moraliskt budskap om det goda livets fragmentering, förlust av kontroll, och intrÄng av det frÀmmande i hemmets intima sfÀr.
Avhandlingen pekar pÄ det vÀsentliga perspektivet att mÄngfald och variation karaktÀriserar upplevelsen av lidande och att det Àr genom att anvÀnda den etnografiska metoden som det blir möjligt att göra dessa upplevelser synliga.
Nyckelord: lidande, osÀkerhet, fenomenologi, habitus, aktörsperspektiv, cancer, jordbru
La vida alegre : Intimacy and Respect in the World of Prostitution in Managua
Only abstract. Paper copies of masterâs theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of masterâs theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmĂ€. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnĂ€ytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet pĂ„ nĂ€tet eller endast tillgĂ€ngliga i bibliotekets avhandlingsterminaler.This thesis analyses the specific moral discourses that popular class female sex workers and their regular clients create in the particular world of prostitution in Managua, Nicargua. My intention was to identify, through ethnographic narratives, what meanings sex workers and clients attach to intimacy and respect and how their street life (calle) and home making (casa) roles merge and interact. The specific kind of morality that emerges in sex workers' and clients' manner of speaking indicates how the limits of morality are fluid, pointing to where the spheres of calle and casa meet, intermingle and create specific meanings. This is not an investigation into deviant behaviour, although the actors are situated in a social world that is characterised as liminal. It is, rather, an ethnography of the particular aimed at dispelling stereotypical images portrayed of sex workers and clients. It attempts to bring a commentary to the ongoing discussion on masculinity and sexuality, where a stress is being placed on the multiplicity and shifting character of roles, and of the centrality of interaction between men and women. The study is based on ethnographical field work (Nov 1998 - Mar 1999) conducted in Managua. The main methodology used was taped life history interviews mainly with sex workers and clients; and, participant observation through site visits to both day time and night time locations. The total number of interviews conducted was 26 (women 18, men 8). Additionally, literary sources on sexuality and masculinity in Latin America were used. In the world of Managua prostitution we find popular class Managuans in their role as clients and sex workers, but we also glimpse their other, home making roles. The so called "ideal" picture of gender relations, and the real situation on the streets and homes of popular class Nicaraguans contradict each other. Men and women are conditioned to believe in romantic love, but in many Nicaraguan homes the reality is economic and emotional deprivation, violence, and abandonment. There is a lack of trust, of safety and of an opportunity for men and women to fulfil the roles of home making. Women and men live with the dream of having a home, a place of safety and love, understanding and communication. Through the game of courtship between sex workers and clients, respect and communication leads to a mutual sense of affection and a particular kind of morality. The safety arising from this interaction provides a means of making a home. In this process we find evidence of how the meaning of morality and masculinity is shifting and transformative
Solidarity beyond the grave: Yielding organs in a Nordic welfare state
According to a survey carried out in 2009, Finnish citizens are exceptionally willing to donate their organs after death, an attitude that paved the way for a 2010 amendment to the Tissue Law that introduced an âopt-outâ consent policy. Reactions to the legislative change ranged from taking a highly utilitarian stance on the issue to expressing indignation over the welfare state meddling with citizensâ right to self-determination and ownership of the body. In this article I consider how willingness to donate is linked to the notion that donation is a civic obligation, as well as a means to distribute the valuable national resource that organs are deemed to be. I explore how the welfare state relates to national attitudes towards donation, and I discuss culturally specific terms for donation as a way of understanding the emotions that surround it. By examining the rhetorical moves that turn the body into a community resource, I analyse the specifics of bodily citizenship in Finland, and particularly how the notion of solidarity can be used to explain citizensâ motivation to donate their bodies after death. A key finding is that solidarity is not only needed in order to bring about donation but also produced as a result of donation.</p
Conference âą NNHSH 2013 Theme: Transformations of Health Practices and Health Policies in the Nordic Welfare States
With the theme of the research conference of the NNHSH network we want researchers, both at doctoral and post-doctoral level, to reflect on how health practices and health policies in the Nordic Welfare States are being transformed and have been transformed in the past. The Nordic countries are all, more or less, in the midst of a transformation from a social democratic health care system, based on universal access for all citizens with no regard to their position, class or previous health practices, to a more neoliberal oriented health care regime with new - or perhaps in some ways very old - ideas about the body, health, and health care responsibilities. Sociologist S.N. Eisenstadt (1956) once suggested that the idea of "citizenship" in the development of a societal structure like the Western states of today served to establish a historically new position for individuals in preference to kinship and family status. Within different forms of government, such responsibilities are balanced differently between individual, family and state. For more than a century responsibility for health and healthiness in the Nordic countries has to a great extent been incumbent on the state. At the same time transformations of political ideologies have led to more pressure on individual - and familial - responsibilities. The conference aims at encouraging scholarly discussions highlighting the transformations of health politics in the Nordic countries and the consequences as observed and experienced by people in this context. Topics discussed can revolve around the role of governments in the furthering of transformations - be it regarding patient education, expectations of empowerment of the elderly in elderly care, or negotiations about the right to biological parenthood. It can also be about peoplesÂŽ embodied, verbalized and negotiated responses to the changes taking place. Furthermore, any health situation does not only concern patients or other people in need of care or help, but it also includes family-members as care providers, who may be drawn in to this role due to increasing expectations of kinship obligations and responsibilities
Miten Suomessa suhtaudutaan yhdenmukaisiin tupakkapakkauksiin? : Laadullinen haastattelututkimus
âI Was a Model Studentâ: Illness Knowledge Seeking and Self-care Among Finnish Kidney Recipients
The customer based ideology currently in use in the Finnish welfare state, as elsewhere, has transformed health care. Responsibility for health, that used to be lodged within society, has become the responsibility of the individual. Self-care is part of this growing trend, where there is an inherent assumption that informed patients are more capable of making decisions about their medical regime, which in turn empowers them. Finnish kidney transplant recipients are, through various sources and forms of health information, encouraged to follow the moral imperative of engaging in certain types of health maintaining behaviour that safeguards the transplant kidney. Being informed and sharing illness related information with peers is a manner of showing gratitude towards the state; a way to, in some fashion, reciprocating the valuable gift of a kidney through caring. Taking my lead from Molâs (2008) notion of care as a practice, as something that is done by all those involved in giving care, I ask how knowledge seeking and sharing on illness can be a form of self-caring. The aim of the article is, thus, to discuss what role illness-related information has in the process of caring for kidney failure. The data consists of in-depth interviews with 18 kidney transplant recipients narrating their illness trajectory, and additional information solicited on a number of central themes, two of which were the access to illness-related information and involvement in peer support activities
Solidarity beyond the grave: Yielding organs in a Nordic welfare state
According to a survey carried out in 2009, Finnish citizens are exceptionally willing to donate their organs after death, an attitude that paved the way for a 2010 amendment to the Tissue Law that introduced an âopt-outâ consent policy. Reactions to the