Welcome back to the CMP blog! For the next two weeks we will post short descriptions of our newest articles from September 2014, which includes a special section addressing medical learning in South Asia as well as other thought-provoking pieces in the cultural construction of medicine, health, and illness. These updates are intended to offer a taste of the research we’re excited to share with you through the journal.
In this article, the authors discuss the various ways that a student can be trained in Tibetan medical practice. They argue that there is not one means of medical training for Tibetan medicine, but rather numerous means of learning that alter the way the Tibetan practitioners learn and deliver medical care. In particular, three means of learning are highlighted: traditional apprenticeship under a Tibetan medical caregiver, classroom learning through a Buddhist institute, and lastly at a Tibetan medical organization intended to educate future practitioners from poorer rural regions with fewer resources than those attending the elite Buddhist school. The argument weighs the prestige and the social acceptance of each methods of training, noting that “institutionalisation tends to relegate ‘traditional training’ to an inferior level, in particular due to its heterogeneity and the social image of rural backwardness it presents.” It also addresses how different forms of learning are legitimated by the government and local authorities, and demonstrates the shift from skill-based learning via apprenticeship towards formal, institutional learning that emphasizes education over “enskillment.”
Kilroy-Marac draws from her ethnographic research in Senegal to offer a vivid picture of the shift in the role of the accompagnant, an attendant who stays with mental health patients for the duration of their hospitalization. Although this attendant was in previous generations a family member of the patient, there has been a sudden rise in professional accompagnants who are paid to stay with the patient at the clinic. The author notes that the “neoliberal turn” in Senegal towards increased wealth and commodification of services is exemplified in the professional accompagnant, whose services form a monetary transaction in lieu of fulfilling a familial duty to the patient: providing work for others and freeing up families who, in the newly-bolstered economy, often have other career and personal obligations. However, the author complicates this notion by noting how much the families cherish the attendant’s work and offer them gifts outside of typical payment agreements, and how these connections can often be special between families and the accompagnants.