1.  18-24 months in different community 
2. language important to understand CULTURAL CATEGORIES 
3. need to write ethnography 
4. the hallmark of anthropology

History of healing traditions 

Drugs/ herbs/ medical technologies 

Curing rituals 

The training, knowledge base, credentials, medical tools of the HEALER

The class, ethnicity, education of patient. Why did they chose a particular healer 

• Each culture is a coherent system that must be understood on the basis of its own internal logic.

• Assuming that one's own culture or society is the "best."
• Using one's own cultural standards or ideas to evaluate or judge another culture

1. Biomedicine - garabu tubaab 
2. Wolof medicine - garubu wolof 
3. Islam ideas of health and proper behavior 

1. Popular health care sector 
2. Professional health care sector 
3. Folk sector 

What everyone knows and can do largely for themselves

(Ex. Take vitamin C, drink tea and fluids, get rest) 

Healing done by non- professional specialists who might learn by apprenticeship, inherit healing ability from family member

Ex. Peruvian curanderos, Hmong shamans, lay midwives, Wolof healers 

Healing done my professional specialist that: 

1. Have formal training 
2. Credentials or licenses 
3. Structured relationships with other professionals 
4. Organizations which enforce standards 

Ex. Masters of Doctorate (M.D that went to medical school) 

What does Starr mean by social authority?

Social authority is when a person from a different cultural group that yourself has knowledge or power. 

(Ex. A patient may go along with the treatment because of healer's/ doctor's advice not because necessarily agree) 

What does Starr mean by cultural authority?

Where does medical authority come from?

Two key processes:

• Healers can acquire some degree of social and cultural authority
• Social and cultural authority can be converted into economic and political control over the medical domain

Why is it complicated to link medical authority and the efficacy of the treatment?

Where does biomedicine’s authority come from?

• Doctors standardized medical education and lobbied against competitors
• Colonial administrations exported biomedicine
• Advancements in science (germ theory of disease, discovery of antibiotics) improved results
• Biomedicine was linked to other development projects and “modernization”

“How medicine constructs its objects”

What does this title mean?

What are the key arguments that Good is making?

HOW is he making these arguments?

Saint Louis Medical District

District includes 10 health posts, two family planning centers, and administrative offices
Attended monthly district staff meetings
Visited health centers
Interviewed doctors, nurses, and midwives who work in the health posts

Field Site #2 Pikine

Poorest neighborhood in Saint Louis
Population 45,000
One health post with no water or electricity
One school with 15 classrooms
53% of residents have water at home
43% of residents have electricity at home
Most residents work in the informal sector

• Interviewed staff members and the health committee at the health post
• Did interviews and focus groups with members of women’s community associations
• Worked with a grassroots women’s group that was working on health education

Field Site #3 Daru Muumbaay

1300 residents, 100 households
Economy based on onion farming
Most villagers have little access to cash
Increasingly men migrate to work as fishermen in the Gambia

• Participant observation: lived in the village for 8 months
• Worked with the village health workers at the health hut
• Interviewed residents about main health problems
• Followed what happened when people got sick

emphasizes that political and economic forces shape health, disease, illness

experience, and health care.