Assignments

Essay #1

5-8 double-spaced typewritten pages
Discuss: Session #8
Due: Session #11

Many authors we’re reading in this course deal with the concept of disease as culturally constructed or socially produced. These concepts are briefly described in Hahn, pp. 77-78. Choose an example that illustrates either the cultural construction or social production of a specific disease. You can choose a current example or a historical example. Also tell us why you find this particular example interesting and especially worthy of analysis and discussion. In addition to your argument, tell us how your analysis fits with, or departs from, a conventional biomedical understanding of the disease.

Every essay, even those that discuss a topic appearing in the course readings, must use outside sources. You must adequately reference your sources; see note on plagiarism in the syllabus. Proper, comprehensive citation most definitely includes sources on the Web; any text you use that is not written by you must be cited, no matter what form it comes in. If you have any questions about how to do this, see or write me.

In general, relying on Web sources is like searching for food in a Dumpster; you will eventually find food, but its quality will be questionable and it might make you sick. Make sure your sources are reliable and responsible. Peer-reviewed professional journals and scholarly books published by well-respected publishers are the best. You may use magazines and newspapers, but be cautious: a lot of garbage gets published in even the best ones. Try to read critically, i.e., look for bias, for missing information, for evidence that people interviewed are simply taken at their word.

Questions? Ask them in class, after class, on the phone, or by e-mail.

You should have a definite paper topic by Session #8, when we will discuss your choices in class. You will understand the assignment much better at the end of this discussion. You need to contact me about your choice of topic. E-mail is fine. We will either agree on your topic or set up a time for you to come in and discuss it further with me. Please don’t wait until Session #8 to email me.

Note: The description of cultural construction in the Hahn reading is exactly what the assignment asks for. However, his discussion of social production and mediation has proved too complicated for students to work with. The definition of social production I gave you on the assignment sheet is both of Hahn's concepts lumped together. It is basically an expanded notion of epidemiology—all of the social factors that produce incidents of disease ("disease events"). You know what epidemiology is—the study of disease rates in populations (and their causes). Social production looks at the social factors, as opposed to the biological/geological/meterological ones.

Social production analyzes disease happenings, events, behavior.

Cultural construction analyzes ideas, beliefs, values, representations about disease.

Essay #2

Handed out: Session #10
Discuss topic: Session #14
Due: Session #18

Write a paper on some feature of biomedicine that is currently changing in a significant way. Part of your analysis should involve the institutional context within which the change is occurring. What are the causes of the change? Are they mostly internal to biomedicine or external? Who are the actors most involved (both inside and outside of biomedicine)? (Keep in mind that actors can be both individual people and institutions.) What is at stake for those actors most involved in the change? At what sites are the changes occurring (e.g., in private practice medical schools? U.S. Congress?)? What non-medical interests and institutions are involved in this change in a major way? What moral and ethical issues are involved? What major U.S. (or other country) values are involved? What are the likely consequences (the most significant ones) if the change becomes permanent?

One possible way to organize your essay is to analyze how this change is occurring in two countries in two countries. Providing some history of the change is not required but very welcome. Optional (and to be clearly differentiated from the analysis): your own opinion of this change.

Essay #3

6-10 pages
Handed out: Session #18
Discuss topic: Session #21
Due: Session #24

Choose a topic in the field of international health and write about it. Describe the medical aspects of your topic, using technical language sparingly—write for a general audience. Then describe the main social, cultural, political, and economic factors that constitute its context.

As always, if you have opinions, you may write briefly about them, drawing a clear distinction between any advocacy language (at the end of your paper) and your descriptive/analytical writing. Papers can be about contemporary issues or historical ones.

Examples:

• The introduction of some aspect of biomedicine in another country
• International development efforts to improve public health in a country, or that country’s own efforts (e.g., improve nutrition, increase the number of hospital beds, teach about boiling water, supply clean water to an area suffering from water-borne diseases)
• International health agencies like the World Health Organization
• A Non-Governmental Organization—e.g., Doctors Without Borders, Partners in Health, the Smile Train
• A Ministry of Health
• International pharmaceutical companies’ impact in an area of the world
• Other health-related multinationals
• A case involving a clash between biomedicine and local traditional healing systems
• Campaigns to reduce incidence of or eradicate diseases, for example, yaws, smallpox, malaria, AIDS
• A vaccination campaign

Any topic concerned with health in the international context is a possibility. The topic you choose should be amenable to a 6-10 page treatment, i.e., one that is not too narrow or too broad. The way to go about choosing a topic (which is an integral part of the assignment) is to think about what interests you (guaranteed, Something in international health interests you). If you’re stumped, think about our readings. If you're still stumped, go to the Web site of MIT's student organization, United Trauma Relief, or browse through the topics in the supplementary readings.