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  21. Adams refers to global health as a concept that stresses interconnectedness, and this is illustrated well thorough Holmes’ representation of the fluidity (among many other things) between the Mexican and US borders.

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  36. it?” when he talks about the signs in the church prior to crossing the border. And he explains that when you really think about it, the risks associated with crossing the border, many of which result in death, appeared to be more promising than the confirmation of certain death staying in Mexico. So often health professionals, and many individuals of the “Western Mindset” blame people for their circumstances (ex. well he shouldn’t have crossed the border if he didn’t want to end up in prison/killed–he should have stayed in Mexico). Many people blame individuals for putting themselves in risky situations…but what happens when there’s no other optio

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  39. ell as detailed. It is shocking to hear what some people chose to do just for survival, just for a chance at another life. To see someone die nearly everyday who is striving to get the same thing you are can be disheartening, but to have the motivation to continue is remarkable. I think this story was tremendous and I would imaging that there would be more people who went through the same situation that have told theirs. it shows the importance of someone telling their story from their perspective. It gives support to Tuhiwai’s article and the point she made about the conflicts that arise when indigenous populations are not able to tell their

  40. icate with each other and how, especially, the indigenous people could express their discomfort about how they have been treated for so long. Moreover, to think about them as naïve or ignorant because, for example, they don’t have the same education system as “normal” people do, is disrespectful and inhuman.

  41. olmes’ accounts of his experiences in Mexico and attempt to cross the border were captivating. As Holmes (1975) recounted his “cold silence” greeting at San Miguel, the linkages between his story and Tuhiwai Smith began to make sense. He spoke of how the indigenous groups had separated themselves from each other in language, dress, trust, etc. because they were suspicious of all outsiders. Additionally, throughout his narrative, Holmes expressed the numerous times he was believed to be a U.S. spy or a coyote an

  42. er option. Instead of blaming and trying to “fix people” the focus should be on the larger structural issues, the faults that put them there, WHY are they trying to leave, etc. This idea can be mapped on to many if not all health issues. Instead of looking at the person, the community and blaming them for their behaviors, look at the social structure and environmen

  43. Holmes’ accounts of his experiences in Mexico and attempt to cross the border were captivating. As Holmes (1975) recounted his “cold silence” greeting at San Miguel, the linkages between his story and Tuhiwai Smith began to make sense. He spoke of how the indigenous groups had separated themselves from each other in language, dress, trust, etc. because they were suspicious of all outsiders. Additionally, throughout his narrative, Holmes expressed the numerous times he was believed to be a U.S. spy or a coyote and there was a level of mistrust associated with that. Furthermore, the larger concept I discerned from Holmes story is the idea that “is it worth it?” when he talks about the signs in the church prior to crossing the border. And he explains that when you really think about it, the risks associated with crossing the border, many of which result in death, appeared to be more promising than the confirmation of certain death staying in Mexico. So often health professionals, and many individuals of the “Western Mindset” blame people for their circumstances (ex. well he shouldn’t have crossed the border if he didn’t want to end up in prison/killed–he should have stayed in Mexico). Many people blame individuals for putting themselves in risky situations…but what happens when there’s no other option. Instead of blaming and trying to “fix people” the focus should be on the larger structural issues, the faults that put them there, WHY are they trying to leave, etc. This idea can be mapped on to many if not all

  44. leave, etc. This idea can be mapped on to many if not all health issues. Instead of looking at the person, the community and blaming them for their behaviors, look at the social structure and environment that harvested these outcomes–only then will we begin to find a resolution.

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  46. This entry tries to make germane points, sometimes hitting, sometimes missing. Perhaps a longer discussion on these issues would lead to a fuller understanding and better dialogue. You have to take sides on mos things for the sake of debate, and I found your observations a useful, though at times erroneous, contribution to the conversation.

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  48. Something that I could get from this week’s readings and that I also think does connect them is the insider/outsider role of a researcher. For example, the Smith’s chapter about imperialism and colonialism includes some aspect of indigenous history that made me think about how society in general often discriminate and marginalize these people just because they don’t express themselves in a “correct” way. What someone could see as an outsider is that these people don’t know about politics, economics, or how to “contribute” to the society because they don’t share the same beliefs or values, and sometimes they might be seen as naïve or ignorant for doing so. On the other hand, how these people see themselves in the inside is completely different, in terms of how they can’t contribute because there is some power above them that don’t allow them to do it. Between indigenous society and “the rest of the world” there is this really big gap regarding how they can communicate with each other and how, especially, the indigenous people could express their discomfort about how they have been treated for so long. Moreover, to think about them as naïve or ignorant because, for example, they don’t have the same education system as “normal” people do, is disrespectful and inhuman.

    Regarding Adams’ chapter, I found really interesting, as I could understand, what he discussed about the differences between the so called “real scientists” and social scientists or researchers. And it was interesting because as soon as this week I was discussing something similar with a friend, in terms of qualitative vs. quantitative methods. Even though, I consider both methods equally important to conduct research, he was arguing about the degree of involvement of a researcher when conducting qualitative research and that it doesn’t happen that way in quantitative research. My point of view, even though I have a strong background in quantitative research, was that it depends on what are your aims and what you really want to get from your target population. In some way, I found his statements against qualitative research very odd, because he haven’t worked with this type of research before and might be influenced by the use of a protocol or a structured methodology to conduct research, which sometimes is consider more trustworthy because it “gives” you the evidence you need to prove something . We didn’t finish our discussion, I guess because we didn’t want to fight over it, but I’m looking forward to keep that conversation, not to convince him about one method being better than other, but to look at them as resources that you might use depending on how your population want and need to be heard.

    Reading Holmes’ chapter, I found his experiences as a participant observer in the border really interesting. Moreover, that’s when I find qualitative research more valuable. I think that it’s not until you put yourself in other’s position when you could truly understand why they act in a way or other. That’s why I also like to do ethnography by being an active researcher and getting involved in the participant or group activities I’m observing. However, like Holmes discussed in the chapter, it’s not always easy to be accepted within a group or a culture if you come from the outside. It isn’t easy as well to try to integrate in a community that has been used before as lab rats and hasn’t gotten any benefit from the research or academia field. I found the chapter really entertaining in the way he wrote it, because he included storytelling as a way to ethnographically report his findings, something I am very interested in learning further. Like I have talked in class, in the Performance ethnography class I’m taken this semester I have learned that there are other forms of reporting your findings, and that performance could be an excellent tool to represent how marginalized and oppressed groups feel about certain issues by hearing at their stories and creating and/or theorizing knowledge to represent their concerns.

    The truth is that, like I said before, there’s no way to understand marginalized societies if we don’t put ourselves in their skins. It is so easy to judge someone when you are not dealing with the same things and they are the ones that carry the heaviest part. It is so easy to do research from the outside when you are receiving a paycheck and justified it by saying that you are contributing to the community, but does the community feel the same way? There is always a thin line between what a researcher consider good for a certain group and what that group really thinks is what they need or what is good for them. So, as researcher and public health workers, that’s something we should work harder to connect.

  49. I found “Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States: “Introduction: ‘Worth risking your life?’” by Holmes and “Decolonizing Methodologies: Research and Indigenous Peoples: “Imperialism, history, writing and theory” by Tuhiwai Smith very very intriguing.

    Article by Homes was very powerful. The concept of pull and push was intriguing. Often times migration is seen as a choice. And Homes talks about this in the chapter that people are -pushed- out due to their circumstance and -pulled- towards the dream of better life. So migrating is not necessarily a personal choice rather peoples’ circumstances forces them to leave their friends/family and everything they know. I don’t think anyone would want to do that. Through the personal stories and snippets provided by Holmes we saw this very clearly. I definitely appreciated that. I know that when I have talked about my own adversaries of an immigrant to this country, I often get the sense that people think “well you decided to come”. And it’s true (well semi true my parents brought us here) but had our lives been different/better back home then I doubt we would ever left. So no, when sharing stories I am not looking for pity I am just sharing my experience …my reality. But I feel like people want to give prompt/defensive response.

    There was something that did not settle well with me in the article by Holmes. His rational for wanting to cross the border was to get a more authentic experience. But was his experience really authentic? Is he the best person to share this story? I do not know the answer. I do not claim to know the answer. Rather I say this because as a white man he carried privilege with him whether or not he wanted to. For instance, I am thinking of what happened in border jail. He received very different treatment. I mean this is just an example there many more. With this sort of story it is easy to read the chapter and walk away saying “wow the author is the hero for doing all that”. That would totally be defeating the point. As reader we have a responsibility so it is important to put ourselves in check and not “glorify” or “hero-tise” the story tellers!

    Smith introduces the readers to the following concepts: imperialism, history, writing, and theory… from the perspective of ingenious people. This article made me think a lot about the power dynamic and mental models that exists in our society. Ingenious people are depicted and viewed as inferior/barbaric. This type of thinking is deeply rooted in our history…but is still present in our society today. I think that is the most frustrating part. Overtime we have deeply evolved physically however, it is a shame that we can not say the same about out the way we think.

  50. The Adams article was really intriguing to me… while studying anthropology and in my own experiences with health and medicine, I have often struggled with the health vs science issue. And now being in public health, I feel like I am even more so in a position where I am confronted with peoples ideas about health and what health means and the nexus of health and science. In one of the CDSMP classes that Alice and I facilitated, we were discussing a health diet and part of the curriculum discusses eating/drinking only low-fat dairy items. One of our participants was from Poland and was very confused by this- she told us that in Poland, everyone drinks fresh milk from the cows and are very healthy. It was tricky- I agreed with her! But also, there is the script, the science, the evidence. As Adams discussed, its hard to not feel swayed or pressured to be scientific.

    Like others have said, both Adams and Smith remind us of the importance of context, history, and power when considering health and as the migration story showed, what structural issues are in place that are forcing people to risk their lives and health.

    For the Body Mapping project, I am adapting a guide that focused on undocumented migrant workers. Holmes’ article brought so much of what I have been reading/seeing in the Body Map examples to light. One of the activities in the Body Mapping guide is the Migration Journey- reading Holmes’ description of the physical pain that the people endured the cactus pins, the rattlesnake bites, etc. makes me wonder if more people read and saw these descriptions, would it be so easy to blame the individual? As Holmes’ pointed out, people are choosing between a slow demise or a major life-threatning risk, not such an easy choice.

  51. When reading ‘Against Global health’ by Adams, it amazes me how far technology has come and how the evolution of medicine has impacted the human race. It is easy for us now to believe that some of the methods that were once used were crazy and more detrimental to the people. By using home remedies, concoctions, or even superstition, that is how they once lived in hopes to rid a certain condition had to work at least once, right? If not, would’t they have stopped doing it all together. That is very interesting to me and it is with stories that were told in this chapter that makes me wish I could go back in time just to question motive. With that being said, who decides what is the right remedy and who decides which is the wrong? This makes me further think of public health professionals nowadays and how often people from outside the community attempt to come in and “correct” what is wrong. Therefore, if the people who are engaging in remedies feel that there way is and has been working for them and they are content with the results thus far, then who or why should someone on the outside try to change that? So the question that arises is, are we (public health professionals) working according to science, health, or should there means to combine the two.

    In reading the article by Tihawai, she made a very interesting point that I really liked. She says: “The struggle to assert and claim humanity has been a consistent thread of anti-colonial discourse on colonialism and oppression” and later went on to address the idea of human rights. This had me thinking about how it applies in todays culture, primarily with accessibility to health care and health care services. I feel that is a powerful quote and does indeed apply to todays culture as well.

    In the last reading by Holmes, I thought it was a great story, compelling as well as detailed. It is shocking to hear what some people chose to do just for survival, just for a chance at another life. To see someone die nearly everyday who is striving to get the same thing you are can be disheartening, but to have the motivation to continue is remarkable. I think this story was tremendous and I would imaging that there would be more people who went through the same situation that have told theirs. it shows the importance of someone telling their story from their perspective. It gives support to Tuhiwai’s article and the point she made about the conflicts that arise when indigenous populations are not able to tell their stories, they are either lies, or they are made to be seen as if they never existed.

  52. In chapter 1 (Imperialism, history, writing and theory), the author points out imperialism still hurts indigenous people. Indigenous people thought imperialism from Europe countries ignored indigenous people’s history through writing and theory. So, if indigenous people do not look at the writing and theories without criticism, they might easily forget their own history by untruthful writings. I think this is not easy because many people think writing and theories from Western countries’ are undoubtedly truth. History does not only mean tradition. The meaning of history include “truth”. Generally, people from indigenous group know their history better than outsiders.

    In Vincanne’s writing, the author argues that global health can be treated not only by science but also by non-science and nonsense approaches. Of course, each of these three approaches has strong point and weak point together. For instance, as the author says in this chapter, non-science approach such as traditional belief can be dangerous. However, physicians are not always prepared to treat disease and promote health in the context of an evidence-based study (p.54). I understand that sometimes evidence-based approaches are time consuming at the beginning of intervention. During that time, many people die because it does not seem that we have an appropriate scientific approach yet. Today, as health professionals, we need to think carefully what kind of health interventions are suitable in global health. Sometimes suitable approach can be done with evidence-based approach and non-science approach. More important thing is that each field cooperates to provide best intervention for global health.

    In Holmes article, it shows pretty realistic situation, which is happened in border between Mexico and U.S. The author was brave and he had passion to know what is real problem in our globalizing world. He found that migration was not individually chosen but there was a pressure to individuals to cross the border. There was no choice to leave their own country because crossing the border is necessary to survive. It is also caused by political and economic structures. Through his findings, I can easily imagine that there is a power which can control people beyond boundary of each countries. As a health professionals, we need to think what are the appropriate approaches to build a good relationship with governments in this era. I think that individual effort does not appeal no more to global health.

  53. Adams chapter provides an important frame of reference for understanding the evolution of the concept of global health. As she describes, the concept of international health developed out of the colonial era and stressed serving the “downtrodden” and those who were perceived as being unable to help themselves. Despite reading the chapter, I am still not sure I understand the difference in the concepts of international and global health. The concept of global health in many ways opened the door for increased international trade, particularly within the pharmaceutical industry. In this way, I see a similar paternalistic approach to health that just takes on a different name. As she states: the “political causes of disease are as important as microbial ones, but social science is still not ‘science’ in the same way as that word is used in the term ‘health sciences’” (Adams, p. 45). Although Adams uses this definition to refer to international health as opposed to global health, this mentality continues to predominant in much of public health. Every week I get an email with research updates from ASPH and I am struck by how limited the range of research publicized is, and what is prioritized from a research agenda.

    In discussing the concept of programming that works ‘against health,’ Adams addresses the role of “evidenced based” programing in undervaluing the legitimacy and value of programming that is more holistic and often more effective. A theme I see in public health programs in general is a lack of sustainability. I see this as directly linked to over valuing of evidenced based programs that are often only effective for the length of a grant. In discussing what global health programming should look like, Adams asks the critically essential question: what exactly is the meaning of a “good scientific outcome?” (Adams, p. 49). For organizations is it often boiled down to numbers of people impacted, but the disregard for people in this definition is something that needs to be reconsidered and reevaluated.

    Adams refers to global health as a concept that stresses interconnectedness, and this is illustrated well thorough Holmes’ representation of the fluidity (among many other things) between the Mexican and US borders. What I am personally struck by with the emergence of the Global Health field, is that it values some cultures and peoples over others. Why are some countries and issues “sexy” while others like the extreme violence at the border, are rarely spoken of? Smith touches on this concept in her discussion of the legacies of imperialism in the modern day, and her discussion of the fact that the multiple cultures are silenced for the sake of societal “development.” I like the format that Holmes uses to present his findings: a blending of ethnography and a critical account of what was occurring. In this way, it functions as a methodology that redresses the concept of history as a Western construct that assumes that the “story of history can be told in one coherent narrative” (Smith, p. 32). In thinking about the concept of decolonialism, it is closely aligned with the concept of cultural humility (as opposed to the all-knowing cultural competency). As a way to work towards health as opposed to against it, both decoloniality and cultural humility require self-exploration and analysis before engaging with communities and in this way might eventually fit into part of the definition of good scientific research.

  54. As someone who grew up with a family involved in agriculture, my own sense of belonging and coming from somewhere is quite physically rooted in land. I have strong emotional responses to certain earthy smells that I recognize from my upbringing, both pleasant and blooming smells as well as the acrid and pervasive odor of pig and chicken manure. In reading the introduction by Holmes, I was struck by how complex the idea of farming without a sense of one’s own place is to me. To be traveling and risking exposure – in many senses – is vast enough already, but to be investing that care into land you aren’t even supposed to be connected to complicates it so much further. The many levels of uprooted-ness depicted in this chapter struck me in a surprisingly visceral way, as farming in my life has certainly been about complexity but all in the name of a very harmonious ideology about nourishment. The transience and temporary nature of the migrant workers Holmes followed illustrated to me a strong connection between ideas of land and body sovereignty posed by Smith and Adams in the other two readings. For migrant workers sense of place isn’t something that can be planned for or counted on as the ebb and flow of work and border crossing dictate and necessitate migration. How complicated that this drifting in and out of work is to farm, a lifestyle that lends itself to such a poetic image but in reality rests in the hands of people who must travel under he cover of darkness from one short-lived position to another.

    Smith and Adams shed light on the ways that histories are such a structural part of understanding health and migration in the current day. The idea of noteworthy data, useable methods and the construction of the truth are weighted in a history with the tricky pastime of measuring humanity – as though some humans were less so than others. With this legacy of imperialism, Smith urges us to investigate the vey underpinnings of the methods we use to understand and validate information. In reading the Adams (2010) chapter I was struck by the description of “hard” versus “soft” science – something I myself refer to – and the implications this idea has for understanding health (p.45). The way Adams unpacked the idea of sampling and testing health – polarized good/bad health – made me think deeply about the dichotomies we are so reliant on in the health world, including in public health. Just as Smith named the imperialism and colonizing of people’s habitats, Adams named a similar history having taken place upon the bodies of marginalized people.

    Adam’s writes about how certain types of truths are authorized and deemed truth in a way that mirrors historical separating of traditional methods versus scientific ones, exploring the idea of biopower in this context. I’m unsure of how to reconcile this next bit and am eager to hear thoughts from others; is there/what is the line between preserving tradition and trying on someone else’s traditions? For example how do we validate traditional medicine and how does this embody or not embody histories of colonialism? I’m thinking in particular of Eastern Medicine practices that are becoming more mainstream and the cultural revival of midwifery and doula-movements. What are your thoughts?

  55. This week’s readings brought up one ambiguous question: who decides what’s what? As I started reading about global health from Adams’ perspective the concepts of science vs. non-science (nonsense) resonated with me. The ideas of non-science terms such as traditional beliefs, demonic possessions, witchcraft, use of herbs and rituals, etc. are labeled non-science. In Western culture, there is a consistent belief that anything not scientifically based is less adequate. However, the Adams highlights the fact that it is important to explore and understand cultures and that it is critical to the understanding of people and communities to do so. I do not believe that these ideas and practices are nonsense, but rather glimpses into the culture of those who we are trying to understand and serve. Instead of just administering a vaccine because it’s “good science” and an “effective treatment option” –it is important to learn why this may/may not work for some people.

    This view was complemented by Tuhiwai Smith (1999) who explained how imperialism, history, writing, and theory are problematic from an indigenous perspective. These four areas are responsible for every aspect of producing knowledge. I never really understood the issue from this perspective, but this reading made it come to life. Tuhiwai Smith suggested that these 4 concepts speak to the countless ways indigenous languages, knowledge, and cultures have been silenced, misrepresented, ridiculed, or condemned. That is powerful. And it’s true. Indigenous societies were not seen as fully human, often referred to as primal or barbaric, despite the fact that people are people. So again, I ask–who is to say what is right/wrong, or what’s what? It is the dominant culture, those that have more POWER. History, as Tuhiwai Smith states, is about power. The most poignant quote for me in this reading was, “…in this sense, history is not important for indigenous peoples because a thousand accounts of the “truth” will not alter the “fact” that indigenous people are still marginal and do not possess the power to transform history into justice” (p.34). This is true and all the more frustrating.

    Holmes’ accounts of his experiences in Mexico and attempt to cross the border were captivating. As Holmes (1975) recounted his “cold silence” greeting at San Miguel, the linkages between his story and Tuhiwai Smith began to make sense. He spoke of how the indigenous groups had separated themselves from each other in language, dress, trust, etc. because they were suspicious of all outsiders. Additionally, throughout his narrative, Holmes expressed the numerous times he was believed to be a U.S. spy or a coyote and there was a level of mistrust associated with that. Furthermore, the larger concept I discerned from Holmes story is the idea that “is it worth it?” when he talks about the signs in the church prior to crossing the border. And he explains that when you really think about it, the risks associated with crossing the border, many of which result in death, appeared to be more promising than the confirmation of certain death staying in Mexico. So often health professionals, and many individuals of the “Western Mindset” blame people for their circumstances (ex. well he shouldn’t have crossed the border if he didn’t want to end up in prison/killed–he should have stayed in Mexico). Many people blame individuals for putting themselves in risky situations…but what happens when there’s no other option. Instead of blaming and trying to “fix people” the focus should be on the larger structural issues, the faults that put them there, WHY are they trying to leave, etc. This idea can be mapped on to many if not all health issues. Instead of looking at the person, the community and blaming them for their behaviors, look at the social structure and environment that harvested these outcomes–only then will we begin to find a resolution.

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