Libbet Crandon Malamud's ethnography From the Fat of Our Souls

¶ … Fat of Our Souls

The book From the Fat of Our Souls by Libbet Crandon-Malamud is a practical and theoretical work containing a narrative regarding the author's experiences in Kachitu as well as the theoretical derivations she made from these experiences. As such, the book offers an engaging and interesting read. At its basis, the book sets out to prove how medical resources in the region are used in order to accomplish secondary resources and gain secondary goals. In my view, the book generally accomplishes its goals while providing the reader with a clear view of the main cultural and social integrations occurring in the region.

It is interesting that the author has used an integration of various medical and social systems to illustrate the main thesis of her book; that medical resources lie at the heart of much of the social mobility, either upward or downward, that occurs in the region.

The preface begins by explaining the point the book is attempting to make. While it is a good preface with a clear and logical explanation, I find myself a little confused regarding the apparent importance of medicine in its role with regard to integrating the various systems of class and belief systems. In other words, I am not certain that the author's claim that the medical profession acts as a medium and a means towards social mobility is entirely true, since there are many other factors, including belief, superstition, and other systems, play a role in these. I feel that the preface could have made this somewhat clearer. These are only my first impressions, and it is possible that further reading of the book will help me to modify this.

In the first chapter, the author uses a compelling story to illustrate the integration of superstition, religion, and the medical sciences. What is interesting here is that, despite an apparent absolute belief in an entity known as the "Khan Achachi," the first response of a family suffering from various illnesses resulting in death was to consult a physician. When this resulted in further failure, the family sought the help of the clergy. The entire tale includes an integration of medical science and the clergy to eliminate a problem that was in fact created and perpetuated by poverty and a concomitant low standard of living. Furthermore, the communication barrier between the Western doctor and his local charges made it difficult to establish all the necessary information to truly accomplish healing. In this chapter then, the author makes the point that medical assistance is used as a primary resource to gain access to secondary resources.

With this first chapter, then, the author demonstrates, illustrates, and firmly establishes the main point of the book, which is that medical resources can be used as a means towards other, secondary resources. For this reason, the author also points out the importance of anthropological study that focuses not only on the apparent root of medical conditions, but also on the ways in which various professionals attempt to find remedies for these conditions. Concomitantly, the reasons and means of seeking help from the medical profession also has its own ulterior motives, such as membership in the Methodist church, which could result in upward social and economic mobility.

This chapter seems to have accomplished, in a much stronger way, what the preface failed to do, which is to establish the main position of medicine within the community being investigated. This role goes far beyond a simple healing of physical ailments. It is, in fact, viewed as a primary resource vehicle towards accomplishing secondary goals and gaining secondary resources.

The second chapter focuses on medical pluralism as a thriving system of healing within Kachitu, the region of investigation, by means of examples from the author's own experiences in Kachitu. This pluralism forms part of the same phenomenon discussed in the first chapter, which is to use whatever means necessary for multiple reasons and to accomplish a multiplicity of goals. A person who suffers from a physical ailment, for example, has more goals than simply physical healing. There are also economic and religious goals, as discussed. With a system of medical pluralism within the region, citizens can choose which one to use according to the specific secondary goals associated with them.

Chapter 3 concerns the historical context of medicine within Kachitu. Historically, according to the author, the concepts of health and medicine have evolved according to the local ideas regarding their specific experiences of life and how they explained these to themselves. Hence, a large amount of superstitious belief remains as one of the principle tenets of practicing medicine in the region, as well as the reasons for seeking medical assistance. It is interesting that this chapter is only third in the book. It might have been logically used as an opening chapter in the book to contextualize both the practical and theoretical aspects of medicine to be discussed.

Chapter 4 considers the various dependencies experienced by the people in Kachitu, where it is pointed out that health systems are one of the ways in which citizens depend upon their environment to sustain their lives.

In Chapter 5, the author becomes more specific in terms of the relationship between medicine and the ability of citizens in Kachitu to use this for the improvement of their social situation. One important factor to consider here is the reiteration of the fact that, although professionals sometimes do not share the belief systems of their clients, they nonetheless use these to maintain their relationships with the same clients. This was also mentioned in chapter 1, where medical professionals and the clergy all modified their belief systems in order to promote the physical health of a client and gain trust while also extending their influence in the region. In this way, not only medicine, but also the beliefs behind it, is used for secondary resource gain.

From Chapter 6 towards the end of the book, in Chapter 12, the author moves towards a Political and power focus by means of using medicine as focus. The author points out that not only society and clients in general, but also professionals themselves, could use medicine as a means towards an end that would gain political and social power. Hence, as mentioned, the tendency to use medicine as a vehicle towards greater social or political power.

Chapter 7 concerns the ability of individuals to use medicine for negotiating identity. Here also, the author uses a practical example to illustrate her point. By being in good standing with certain types of medical profession I Kachitu, an individual can gain not only political prowess, but also halt socially downward mobility by gaining access to agricultural and other resources.

Chapter 8, in turn, demonstrates once again how medical professionals might manipulate ethnic boundaries and other factors in order to gain influence in the region. This is a motif that has run throughout the book.

Chapters 9 and 10 focus on the politically integrated nature of power and medicine, and how these have evolved to become tools in the hands of both professionals and clients in order to gain the resources they require or those they believe they need.

Chapter 11 focuses on the fluid nature of what might be gained by using the medical profession as a vehicle towards other sorts of gains. Like human beings, these resources are in a constant state of flux and can be acquired by a learning or evolutionary process.

Chapter 12 is a good culmination of these ideas. According to the author, there is both a social and medical process occurring in Kachitu, which has created the evolution of both medical and social pluralism. This means that there are mutual influences between these two analytical processes. Hence, both the medical profession and social position can be negotiated, often by using one to accomplish the other. As a final chapter, this is a good culmination of the supporting points the author uses throughout her work.