Date: Sun, 9 Apr 1995 14:04:56 -0600 (MDT)
From: Robert Johnson <johnsorl-AT-Colorado.EDU>
Subject: Re: Fistula operations.. reply (fwd)



	This exchange occurred on a list group which seeks to correct
	many injustices in the mental health "industry" which has operated
	on a "medical" model of mental health rather than a socio-cultural
	paradigm.

---------- Forwarded message ----------
Date: Sun, 9 Apr 1995 09:40:21 -0700
From: Robert Fink <rafink-AT-IX.NETCOM.COM>
To: Multiple recipients of list NUVUPSY <NUVUPSY-AT-SJUVM.STJOHNS.EDU>
Subject: Re: Fistula operations.. reply

You wrote:

>
>I wanted to add my two cents to the evolving discussion of fistulas and
>the question of what they tell us about "third world" cultures. I write
>as a non-physician who knew nothing about the issue before it was
raised
>on this list but as someone who lived in a small West African town for
>four years and has travelled extensively throughout that continent.
>
>As much as I appreciate Bob White's human concern for the plight of the
girls
>depicted in the documentary he viewed, I am concerned that his remarks
>can be read as indicting of "third world cultures".
>
>The term "Third World" is a construct that has very limited usefulness
>other than as a kind of rather crude global map and scorecard for the
>conduct of international diplomacy and politics. There is no Third
World
>in any meaningful anthropological or sociological sense. The Bandi, the
>tribe with whom I lived in the part of Liberia where the forrest ends
and
>the savannah begins, do not share a common "culture" in any meaningful
way
>with the mountain people of Ethiopia. They are differently racially,
speak
>completely different languages, eat completely different foods and
>organize their families and communities in completely different ways to
>produce their livelihoods. The two groups would find each as strange
and
>exotic or alien as any Middle American might, yet to our "First World"
>view they are inhabitants of the same cultural territory.
>
>It is also important to distinguish what one is viewing when talking
about
>alien communal practices - the indiginous culture itself or the often
>destructive impact of the West upon that culture.
>When I was in Liberia twenty years ago, for example, sexual and family
>practices look very different in the areas close to Western cultural
>influence than in distant villages. Life in the former was
>characterized by a much higher degree of family instability, venereal
>disease, alcoholism and other social problems than life in the
>latter where the passage into sexual maturity and adulthood was
carefully
>regulated by key cultural rites and institutions, and the lives of
>individuals were heavily embeded in communal tradtions.
>
>An outsider forming an impression of "Third World culture" as evidence
by
>life in the Westernized towns would come to very different conclusions
>than one basing those impressions on life in the small, traditional
>villages.
>
>I don't mean to romanticise pre-industrial societies. They have
stregths
>and weakness as does our own. Nor am I conversant with the context for
>the health problems of sexually active but underage girls in northwest
>Africa.
>
>I do know that history is replete with examples of colonizing interests
>blaming idiginous people for the problems they inflict on them (western
>settlers removed native Americans from their hunting lands and
introduced
>them to alcohol then stigmatized them as lazy and alcoholic). My
>experience tells me not to jump at the conclusions Bob White's
description
>of the documentary suggests. I might be missing the forrest for the
trees.
>The documentary he's described might really be saying as much or more
>about "First World" culture and its pernicious influence than on the
>cultures of the Third.
>
>Herb
>
>

I agree with the above.  In the mid-seventies, I spent some time on
Majuro, in the Marshall Islands (Pacific), and the cultural attitudes
towards sexuality were much more positive than the Western European
model.  The Islands, under control at that time by the U. S. Government
(through a United Nations Trust), were suffering (IMHO) from the
"assimilation" brought about by the Western influence.  My earlier
response defined "Third World" in a narrow context, this related to the
availability of modern medical technology, and does not speak to
cultural aspects.

Best,

Bob

--
********************************************************

Robert A. Fink, M. D., F.A.C.S.   Phone: 510-849-2555
Neurological Surgery              FAX:  510-849-2557
2500 Milvia Street  Suite 222
Berkeley, California 94704-2636
USA

E-Mail:  rafink-AT-ix.netcom.com
CompuServe:  72303,3442
America Online:  BobFink          "Ex Tristitia Virtus"

********************************************************



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