Evolution And History

Globalization, Health, and Structural Violence 315

Fore women preferred eating their loved ones who had

died in a relatively “meaty” state from kuru compared to

eating individuals wasted away from malnutrition. This

temporary practice was abandoned as the Fore subsistence

pattern recovered, and the Fore learned of the biological

mechanisms of kuru transmission.

Medical Pluralism

The Fore medical system had its own explanations for the

causes of kuru, primarily involving sorcery, that were com-

patible with biomedical explanations for the mechanisms

of disease. Such blending of medical systems is common

throughout the globe today.

Medical pluralism refers to the presence of multiple

medical systems, each with its own practices and beliefs in

a society. As illustrated with the Fore, individuals gener-

ally can reconcile conflicting medical systems and incor-

porate diverse elements from a variety of systems to ease

their suffering. While Western biomedicine has contrib-

uted some spectacular treatments and cures for a variety

of diseases, many of its practices and values are singularly

associated with the Euramerican societies in which they

developed. The international public health movement

attempts to bring many of the successes of biomedicine

based on the scientific understanding of human biology

to the rest of the world. But to do so successfully, local cul-

tural practices and beliefs must be taken into account.

Both mad cow disease and kuru illustrate that no sick-

ness in the 21st century can be considered in isolation; an

understanding of these diseases must take into account

political and economic influences as well as how these

forces affect the ability to treat or cure.

Globalization, Health,

and Structural Violence

One global generalization that can be made with regard

to most diseases is that wealth means health. The World

Health Organization defines health as “a complete state

of physical, psychological, and social well-being, not

the mere absence of disease or infirmity.”^15 While the

international public health community works to im-

prove health throughout the globe, heavily armed states,

from the United States, who were doing fieldwork in the

region, were recruited to contribute documentation of

Fore kinship relationships. It was hoped this knowledge

would reveal an underlying genetic mechanism for the

disease.^14

When kinship records did not reveal a pattern of ge-

netic transmission, the medical team turned instead to the

notion of infectious disease, even though the slow progres-

sion of kuru seemed to weigh against an infectious cause.

Material derived from infected individuals was injected into

chimpanzees (see Chapter 3 for a discussion of the ethics

of this practice) to see whether they developed the disease.

After 18 months, injected chimpanzees

succumbed to the classic symptoms

of kuru, and their autopsied

brains indicated the

same pathologies as seen

in humans with kuru. At

this point, the disease

was defined as infectious

(garnering Gajdusek a

Nobel Prize). Because

prions had not yet been

discovered, scientists

defined this infectious

agent as an unidentified

“slow virus.”

Scientists knew that kuru is infectious, but they still

did not understand why some individuals were infected

but not others. For the explanation, a wider anthropologi-

cal perspective is required, as Lindenbaum explains in her

book Kuru Sorcery. Lindenbaum demonstrates that kuru is

related to cultural practices regarding the bodies of indi-

viduals who have died from kuru and the way global fac-

tors impacted local practices.

Culturally, Fore women are responsible for preparing

the bodies of their loved ones for the afterlife. This prac-

tice alone put women at a greater risk for exposure to kuru.

Lindenbaum also discovered that women and children were

at risk due to a combination of these local practices with

global economic forces. In Fore society, men were responsi-

ble for raising pigs and slaughtering and distributing meat.

The middle of the 20th century was a time of hardship and

transition for the Fore people. Colonial rule by Australia

had changed the fabric of society, threatening traditional

subsistence patterns and resulting in a shortage of protein

in the form of pigs. The limited amount of pig meat avail-

able was distributed by men preferentially to other men.

Fore women told Lindenbaum that, as a practical so-

lution to their hunger, they consumed their own dead.

medical pluralism The presence of multiple medical sys-

tems, each with its own practices and beliefs in a society.

AUSTRALIA

PAPUA

NEW GUINEA

Pacific

Ocean

Coral

Sea

INDONESIA

(^14) Lindenbaum, S. (1978). Kuru sorcery: Disease and danger in the New
Guinea highlands. New York: McGraw-Hill.
(^15) World Health Organization. http://www.who.int/about/definition/en.
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