The enculturated gene : sickle cell health politics and biological difference in West Africa
著者
書誌事項
The enculturated gene : sickle cell health politics and biological difference in West Africa
Princeton University Press, 2011
- : pbk
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注記
Bibliography: p. 307-328
Includes index
内容説明・目次
内容説明
In the 1980s, a research team led by Parisian scientists identified several unique DNA sequences, or haplotypes, linked to sickle cell anemia in African populations. After casual observations of how patients managed this painful blood disorder, the researchers in question postulated that the Senegalese type was less severe. "The Enculturated Gene" traces how this genetic discourse has blotted from view the roles that Senegalese patients and doctors have played in making sickle cell "mild" in a social setting where public health priorities and economic austerity programs have forced people to improvise informal strategies of care. Duana Fullwiley shows how geneticists, who were fixated on population differences, never investigated the various modalities of self-care that people developed in this context of biomedical scarcity, and how local doctors, confronted with dire cuts in Senegal's health sector, wittingly accepted the genetic prognosis of better-than-expected health outcomes. Unlike most genetic determinisms that highlight the absoluteness of disease, DNA haplotypes for sickle cell in Senegal did the opposite.
As Fullwiley demonstrates, they allowed the condition to remain officially invisible, never to materialize as a health priority. At the same time, scientists' attribution of a less severe form of Senegalese sickle cell to isolated DNA sequences closed off other explanations of this population's measured biological success. "The Enculturated Gene" reveals how the notion of an advantageous form of sickle cell in this part of West Africa has defined - and obscured - the nature of this illness in Senegal today.
目次
List of Illustrations viii Preface ix Acknowledgments xxv Chapter One: Introduction: The Powers of Association 1 Chapter Two: Healthy Sicklers with "Mild" Disease: Local Illness Aff ects and Population- Level Eff ects 45 Chapter Three: The Biosocial Politics of Plants and People 77 Chapter Four: Attitudes of Care 119 Chapter Five: Localized Biologies: Mapping Race and Sickle Cell Difference in French West Africa 158 Chapter Six: Ordering Illness: Heterozygous "Trait" Suff ering in the Land of the Mild Disease 197 Chapter Seven: The Work of Patient Advocacy 221 Conclusion: Economic and Health Futures amid Hope and Despair 250 Notes 275 References 307 Index 329
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