Doctoral Dissertation Research: The Nature of Medicine: Colonial Regulation, Nature, and Medicine in South Africa

本研究探讨了在南非和那些谁实践它的土著医学的地位，调查历史和殖民地的叙述如何形成医学的法律的景观和方式，真正的医学复苏的代表性在目前动员，在政策和实践。在殖民地时期的南非，土著人与生物医学之间的关系很紧张，因为殖民地官员规定土著人如何行医。土著医生仅限于使用当地的天然产品，如草药来治疗，只有白色医生可以合法使用欧洲的药物和治疗方法;非洲人使用这种工具被禁止，“土著”、“自然”和“生物医学”做法之间形成了法律的划分。 今天，南非官员在讨论艾滋病毒的治疗方法时，也同样主张使用甜菜根和大蒜等“传统”天然材料来治疗疾病，这提出了殖民时代人们所熟悉的问题。这项研究问：随着艾滋病毒/艾滋病等新疾病和新疗法的出现，殖民观念在当前围绕医学的陈述和斗争中在多大程度上表现出来？具体而言，南非艾滋病毒/艾滋病药物政策中的叙述如何创造、复制或改变殖民地医疗政策中的叙述？从业人员使用药物的情况如何不同于或反映关于土著医药的叙述？使用档案数据来揭示殖民话语，再加上与当今临床医生，当地从业者和决策者的访谈，以了解当代的辩论，其次是叙事政策分析，以检查当前的政策结构。这项研究旨在确定目前的辩论是否以及如何不仅仅是关于艾滋病毒/艾滋病和南非的治疗政策，但在一定程度上是一套结构化的条件，从社会历史出现的一个关节。了解生物医学和本土医学之间的斗争对今天的南非具有重要意义，那里的辩论围绕着艾滋病毒/艾滋病的当代健康危机，估计感染了29%的成年人口。通过了解“土著”治疗方法、“自然”治疗方法和“生物医学”的使用和管理中所包含的社会假设，我们可以更好地预测和调解目前在南非理解和治疗艾滋病毒方面的冲突。 对医疗政策和论述及其历史根源的更清楚的理解，可以用来揭示对有效治疗（无论是本地还是“西方”生物医学）的偏见，这些知识可以用来设计更有效的治疗艾滋病毒/艾滋病的临床和教育计划。 此外，了解殖民叙事如何在当前的政策和实践中重申自己，可以帮助消除那些在生物医学规范之外行医的人只是出于对现代生物医学好处的无知而这样做的有害想法。土著医学可被视为传统医学和现代医学的一种复杂组合，两者结合起来可能对患病者有用，从而能够更客观地分析其局限性和对公共卫生的益处。该项目由地理和区域科学计划以及国际科学与工程办公室共同支持。

This study examines the status of indigenous medicine in South Africa and those who practice it, investigating how historical and colonial narratives form the legal landscape of medicine and the ways that resurgent representations of authentic medicine are mobilized in the present, in both policy and practice. In colonial South Africa the relationship between indigenous and biomedicine was strained as colonial officials regulated how indigenous people could practice medicine. Indigenous healers were limited to using only local natural products, such as herbs, to heal and only white medical doctors could legally use European medicines and treatments; the African use of such tools was banned, and legal divisions developed between "indigenous", "natural", and "biomedical" practice. Today South African officials debating treatments for HIV similarly argue for the use of "traditional" natural materials such as beetroot and garlic to cure illness, raising issues surprisingly familiar to those from the colonial era. This research asks: to what degree do colonial conceptions manifest themselves within current representations and struggles around medicine with the advent of new diseases and treatments such as HIV/AIDS? Specifically, how do the narratives found in South African policy around HIV/AIDS medicines create, reproduce or alter the narratives found in colonial medical policy? How does the use of medicines by practitioners vary from or reflect narratives about indigenous medicine? Using archival data to uncover colonial discourses, plus interviews with current day clinicians, local practitioners, and decision-makers to understand contemporary debates, is to be followed by narrative policy analysis to examine the current policy structure. This research seeks to determine whether and how the current debate is not just about HIV/AIDS and South Africa's treatment policies, but is in part an articulation of set of structured conditions emerging from social history. Understanding the struggles between biomedicine and indigenous medicine has important implications in South Africa today, where the debate surround the contemporary health crisis of HIV/AIDS, which infects an estimated 29 percent of the adult population. By understanding the social assumptions embedded in the use and regulation of "indigenous" treatments, "natural" cures, and "biomedicine", we can better anticipate and mediate current conflicts in understanding and treating HIV in South Africa. A clearer understanding of medical policies and discourses, and their historical roots, can be used to uncover biases against effective treatments (whether local or "western" biomedical) and this knowledge can be used to devise more effective clinical and education programs for the treatment of HIV/AIDS. In addition, understanding how colonial narratives reassert themselves in current policy and practice can help undo the pernicious idea that those practicing medicine outside of the biomedical norm are doing so merely out of ignorance of modern biomedicine's benefits. Indigenous medicine might instead be viewed as a complex configuration of the traditional as well as the modern, which together may be useful to those suffering from illness, allowing more objective analysis of its limitations and benefits for public health. This project is jointly supported by the Geography and Regional Science Program and the Office of International Science and Engineering.