Justice and Global Health HUM 211 Profesors Matthew Sparke & Janelle Taylor Course Syllabus

Brief description: To understand and to address illness, we tend to look first to the body of the individual sufferer. Yet if we look instead to global patterns of power and inequality, illness comes into focus as a problem of injustice – and by the same token, it becomes clear how injustice can cause people to sicken, suffer, and die. This course highlights the problem of global health disparities, and introduces students to conceptual tools from medical anthropology and medical ethics for critically analyzing health and illness in global, social, and ethical perspectives. What do we as citizens of a wealthy and powerful country, or as citizens of the world more generally, need to understand about the connections between power and health? What are our responsibilities? What are some of the complications and difficulties that arise in trying to implement solutions to global health problems – and what are some examples of successful and positive efforts? These questions will guide our exploration of a range of topics, including poverty and structural violence, war and terror, and biotechnology and pharmaceuticals. Course materials will include films as well as readings, and our discussions will be enriched by several guest speakers. At the end of the course, you will be challenged to take all the lessons you have learned about justice, injustice and global health and apply them to a health topic that interests you and which you believe needs to be considered in a global as well as personal framework. You will work together with a small group of fellow students to present a professional poster on this topic in a way that conveys to an untrained but interested audience why we need to think about it and address it in global as well as local and personal terms. For photos of posters from 2006 click here

 

Required Texts

• Sickness and Wealth: The Corporate Assault on Global Health (eds. Fort, Mercer and Gish), Cambridge MA: South End Press, 2004. Available at the University Book Store.
• Reading packet, available at Prof Copy n Print, 4200 University Way NE (on the Ave at 4200)
• Course website http://faculty.washington.edu/sparke/globalhealth.htm

 

Assessment of student work

a) Short paper

Short paper (2-3 pgs) – what is structural violence? (4.0 scale) 10% Op-ed piece (2-3 pgs) – on structural violence and a health issue (4.0 scale) 25%
Component elements:
1) Identify newspaper or blog, and write-up one paragraph analysis of op-eds (5%)
2) Identify issue, and write-up the 3 key arguments you want to make (5%)
3) write op-ed (10%) click here for instructions
4) submit op-ed and use email to share and describe results (5%) click here for grading rubric
A great example of a student op-ed that has been published is online at http://www.pnwlocalnews.com/south_king/fwm/opinion/46023747.html

b) Group project

Group project: plan of action & poster (4.0 scale, combination of product/effort) 40%
Component elements:
1) students email topics, why interesting & important, persuade classmates (5%)
2) what is the health problem & how apparently linked to injustice? (5%)
3) who are the parties involved in creating/perpetuating the problem/injustice? (5%)
4) how have people addressed problem, what obstacles were encountered? (5%)
5) what do you propose as course of action, to whom will you address this? (5%)
6) POSTER: must contain elements described in assignment; will be graded on
final product as well as individual contribution. (4.0, grp with indiv adjustment) (15%)
7) Self-evaluation and peer evaluations (ungraded but REQUIRED)
For photos of posters from 2006 click here

c) Final exam

Final exam (4.0 scale) 25%
1) Essay 60%: The final exam will include one essay response to just one of the follwoing three essay topic essay titles:

a) How do inequality and poverty "get into the bodies" of individuals?

b) How are people in the Global South affected by the neoliberalization of drug development and delivery?

c) How are ethical ideals of medical research and universal access to care compromized by structural forces of for-profit medicine and inequality?

2) Short answer questions (40%): The remainder of the final exam will
consist of short-answer questions that ask you to or answer a brief
factual question, provide a brief definition for a key term, or to read
a definition and supply the appropriate term. All terms and questions
will come from assigned course readings and lectures (including films).

They include:
social structure
neoliberalism
negative responsibility
commodification
embodiment
3 flawed framings: individualizing, naturalizing, exoticizing
3 frame-breaking moves: collaboration, transnationalization, depathologization
structural adjustment policy
primary health care movement
gini coefficient
social determinants of health response
independent variable (IV) response
three recommendations of the WHO "Closing the Gap" report
verticalization
Nuremberg Code
Helsinki declaration
Placebo trials
treatment naivete
WTO
TRIPS
Doha Declaration
biological citizenship
3 economisms
IRB
ghostwriting

3) Extra credit lecture summaries (optional):
You may earn extra credit amounting to 2% of the final exam grade per lecture summary, on up to
3 different eligible lectures, for a maximum total of 6% of the final exam grade. To earnt his credit you must complete (within one week of attendance, and to the satisfaction of your TA) a paragraph summarizing the lecture.

Expectations and Policies:

Lecture and Section: This is a lecture-discussion course. Lectures take place twice per week on Tuesdays and Thursdays; discussion sections will meet once per week, on Mondays and Wednesdays. Students are expected to attend both lecture and section, as both are important for your learning in this course. While lectures will elaborate on readings, they will also offer new material which is not covered by the readings, including occasional film viewings, presentations by guest speakers, and in-class exercises. Sections will be used to discuss and analyze readings and lectures, and to discuss and review writing assignments.

Guest speakers: A number of guest speakers have graciously agreed to speak to this class about their own research, studying topics as diverse as medical migration, nuclear testing, and more. As you listen to each guest speaker, consider these questions: how did they become curious about this place and topic? How in their research do they work to put health, illness, medicine and caregiving in broader contexts? What does such research teach us about linkages among justice and global health?

Honesty: Honesty in academic work requires that you give credit where credit is due, by indicating clearly when you are quoting other people’s words and writings, and providing citations to your sources. Under no circumstances will plagiarism be permitted. If you are uncertain about how to cite sources or what constitutes plagiarism, please consult with your TA, the Writing Center staff, and/or library staff.

Electronics: We trust that you are already proficient at multitasking; in this class we will be working on uni-tasking – for the few hours that we spend together each week, we want to minimize distractions and temptations, so that all may better focus on the serious issues we will be addressing. Cellphones must be turned off and text messaging during class is unacceptable. You are welcome to use a laptop to take notes during lectures. Should you choose to do so, though you should sit in the very back of the classroom so that your screens do not distract other students. Game-playing and websurfing online in the classroom is unacceptable.

E-mail: Your TAs and Instructors will respond to course-related student e-mails as soon as possible, generally within two working days. We will however neither read nor respond to e-mails on evenings or weekends. We also will not answer e-mails asking questions that are answered in the syllabus (such as when a particular assignment is due, etc). Section leaders will each have their own e-mail policy, please familiarize yourself with it.

Disability Accommodations: Students with disabilities are invited to contact Disabled Student Services at (206) 543-8924/V, (206) 543-8925/TTY, (206) 616-8379/FAX or email uwdss@u.washington.edu. If you need academic accommodation for any reason, please discuss this with us early in the term.

Week 1

Tu 3/31 Introduction to the course – what is medical anthro / geography, structure of the course
Structural violence and justice

Th 4/2 What is structural violence?
Paul Farmer, “On Suffering and Structural Violence”
Matthew Sparke, “Paul Farmer’s Global Reframing of Care” online at
http://faculty.washington.edu/sparke/MBM.pdf

Week 2
Short Paper on Structural Violence, assigned in section (4/6 or 4/8)

Tu 4/7 Who is responsible? What are our obligations? (click for pdf of presentation)
Pogge “Responsibility for Poverty-Related Ill Health”
Nguyen, and Peschard, “Anthropology, Inequality, And Disease”Free markets and the future of health

Th 4/9 Health costs of free markets
Janes and Chuluundorj, “Free Markets and Dead Mothers”
Verdugo in Sickness and Wealth

Week 3
Short Paper on Structural Violence, due in section (4/13 or 4/15)

Tu 4/14 Income gaps and health (click for pdf of presentation)
Bezruchka and Mercer in Sickness and Wealth (For link to Prof. Bezruchka's recent talk on the economic crisis click for his talk and ppt)
Bezruchka, “Societal hierarchy and the health Olympics”
Parrish, “Defending My Life”

Th 4/16 National and global responses to inequality (click for pdf of presentation)
Adler and Newman “Socioeconomic Disparities in Health: Pathways and Policies”
WHO's Social Determinants of Health report on how inequality "is killing people on a grand scale" click here
PLUS Writing Op-Eds guide

Week 4
Op-Ed Piece part 1, due in section (4/20 or 4/22)

Tu 4/21 Poverty and health around the world
Bond in Sickness and Wealth
Holz and Kathur in Sickness and Wealth

Th 4/23 Steven Gloyd (UW Global Health) guest lecture
Gloyd in Sickness and Wealth
Hong in Sickness and Wealth
Gish in Sickness and Wealth

Week 5
Op-Ed Piece part 2, due in section (4/27 or 4/29)
Group Project part 1, due individually via email by 5pm Friday 4/31

Tu 4/28 Neoliberalism and the economic determinants of health (click for pdf of presentation)
Sparke, “Unpacking Economism and Remapping the Terrain of Global Health”
Labonté and Schrecker, “Globalisation and health”

Th 4/30 Free Trade, TRIPS and Big Pharma (click for pdf of presentation)
Shaffer and Brenner in Sickness and Wealth
Shiva in Sickness and Wealth
Heywood “Drug access, patents and global health”
Sparke, “IP law and globalization”

Week 6
Op-Ed Piece on Structural Violence and a Health Issue, part 3, due at end of lecture on 5/7

Tu 5/5 Ethical Standards for Research: Controversies
Petryna, “Globalizing Human Subjects Research”
Angell, “Investigators’ Responsibilities to Human Subjects in Developing Countries.”
Gray et al., “The Ethics of Research in Developing Countries”

Th 5/7
Globalization and drug access (click for pdf of presentation)
Susan Reynolds Whyte, et al, “Treating AIDS: Dilemmas of Unequal Access in Uganda,”

Week 7
Group Project Part 2 due in section (5/11 or 5/13)
Op-Ed Piece part 4, due via email by 5pm Friday 5/15

Tu 5/12 Following the money: From vaccine bonds to bonded ethics (click for pdf of presentation)
Macklin, “Avoiding Exploitation”
Elliott, “Pharma Buys a Conscience” and “Pharma Goes to the Laundry”

for more on Pharma ghostwriting click here

Th 5/14 Treatment Implementation
Abadia-Berrero, “Happy Children with AIDS”
Rennie and Behets, “AIDS Care and Treatment in Sub-Saharan Africa”
Davis and Fort in Sickness and Wealth

Week 8
Group Project Part 3 due in section (5/19 or 5/21)

Tu 5/19 Film: Critical Condition

Th 5/21 Health Citizenship in global times: contagion and community (click for pdf of presentation)
Wald, “Introduction” to Contagious
Nicholas King, “Security, disease, commerce”

Week 9
Group Project Part 4 due in section (5/25 or 5/27)

Tu 5/26 Health Citizenship in global times: embodied exceptions (click for pdf of presentation)
V-K Nguyen, “Government-by-exception”
Didier Fassin, “The Truth from the Body: Medical Certificates as Ultimate Evidence for Asylum Seekers.”

Th 5/28 Health Citizenship in global times: medical movements
Guest lecture by Amy Hagopian
Lorenzo et al, “Nurse sourcing”

Week 10
Group Project Part 5 due in section (6/1 or 6/3)

Tu 6/2 Struggling for Justice
Holly Barker guest lecture
Holly Barker, “Fighting Back”
Ceron et al in Sickness and Wealth
Mercer in Sickness and Wealth

Th 6/4 In-class final exam

Exam Period: 2:30-4:20 p.m. Friday, Jun. 12 Poster presentation and judging
Group Project Part 6 POSTER due, Part 7 must also be turned in