The New York Times Sunday Book Review discusses the books of Noah Coburn and Thomas Barfield,  two Boston University anthropologists who conducted fieldwork at Afghanistan:

Ten years after the Taliban’s leaders fled their country in apparent defeat, the war in Afghanistan has become what one observer calls “a perpetually escalating stalemate.” As in Iraq, the United States military has responded to bad news with counterinsurgency: eliminate troublemakers in the dark of night, with the most lethal arts, and befriend tribal elders by day, with cultural sensitivity and expertise. The Army has gone so far as to embed credentialed social scientists with front-line troops in “Human Terrain Teams” that engage in “rapid ethnographic assessment” — conducting interviews and administering surveys, learning about land disputes, social networks and how to “operationalize” the Pashtun tribal code. The military, in short, demands local knowledge.

Read the rest here:

Afghanistan: What the Anthropologists Say
By ALEXANDER STAR
Published: November 18, 2011

I am living with a large extended family, an experience that has been both comforting (people are always everywhere) and lonely (what a social misfit I am living so far from my own strong kinship ties!). Seven siblings (now ages 50–35) inherited the house I live in when their parents died. When one of the brother’s wives died in childbirth, a sister adopted his two small children, and is raising them as her own. Several years back, this sister and her husband moved into the parents’ room on the top floor. Their room is next to the largest kitchen in the house, the one that doubles as the main social gathering space. This sister cooks and does childcare for many of her nieces and nephews, and her husband takes on extra hours of construction work so that there is always enough food to feed everyone (even if plain fried tortillas are served as the main course a couple of times a week). I asked the husband shortly after we met whether his job was dangerous. He said yes, it was, but because of a recent promotion to oversee a construction team, he thought some of the danger had been minimized. He gave a blessing of thanks to God as he told me this.

In April, Emily (the author) returned to New York to attend her brother’s wedding. She wrote the following letter a few weeks later, shortly after getting back to the field.

I returned to the shock of discovering that a couple of Sunday mornings ago, when clocking some extra work hours before breakfast, the husband had fallen from the third floor of a building and died instantly. The grief … the confusion … the moments of laughter-relief release … the unspeakable, unthinkable weight of sadness … the impossible difficulty of rationalizing or making sense of this death against the relentless desire to do so. I’m afraid this sentence must end there, defying proper sentence structure, since right now I’m not sure what structure really gives us in the end. Tonight the dinner table was struck by an unusual moment of stillness that once allowed to enter overtook the space around us. I swear that everyone was thinking the same thing: “At any moment he could walk through the door”—only to have to remind themselves that he would never walk through the door again. How do you believe the unbelievable? There’s a sense of wanting more than anything for time to pass so that the pain is lessened, while also not wanting time to move a second ahead, as this means a second more of life without him.

The grief is not really mine. I only knew him a handful of weeks. I wasn’t here when he died. Someday soon I will need, because of my research, to switch families and will leave again. I’m trying to sit alongside their grief though. Family members have asked me to please stay. I know the $3 a day I give for room and board is needed and I’ve been told that my company is a good distraction; the busier they can stay the better. I have no idea how any of this ties into my fieldwork and it might not. I want to learn from it, but that desire is accompanied with such a strong feeling of guilt (what privileged distance I must have to want to make use of the pain of others). Perhaps the pain in this household right now might help me to better understand this country with the deep, layered, experiences of death and grief that it holds? But am I capitalizing on the pain of those around me by analyzing it, and do I have that right? Would it be better to keep my own mind still, and let the sorrow move around me where it wants to move?

And then, life goes on: a baby was born to one of the cousins in the family the day before yesterday (the first son at the great-grandchild level—I’ll attach a silly picture of me with the baby below). The eldest sister turned 50 a week ago and was celebrated with a huge party. And my days have been completely filled with semi-structured interviews with a range of different friends-offriends here (beauticians, aerobics instructions, “amas de casa” (lovers of the home, or housewives), teachers, students, farmers). I really don’t know where much of it is going yet—I’m going to try to spend more time in some of the outlying rural communities and I’m choosing between a few different clinics, taking my time with this since once I start working there, I’ll have less time with people at their jobs and in their homes. There are some major recurring themes that I’ve been marking: a new economy of time management alongside increased stress, which people say is affecting their appetites and metabolisms; the impact of working mothers on household diets; the general distrust of what is in the country’s food supply.

As for what I’m learning: sometimes I feel like everything is completely obvious and other times I feel like what people are telling me is unbelievable. I’ve been recording almost everything and am leaving some of the processing of it all until I’ve been here for a while longer. I suppose I am trying to do my best to follow the most enduring of our methodological techniques: to listen, although right now it seems as though mostly I am listening to that which is unspoken and which may never be able to be put to words.

Now I’m off to go finish fieldnotes for the night…

Emily Yates-Doerr, wrote this while a doctoral candidate at NYU and conducting ethnographic fieldwork in Guatemala, looking at changes in what people eat and how they understand a healthy diet. The traditional local diet of beans and tortillas is being challenged by imported foods and snacks (soda, chips, sweets, and the like), while medical clinics are spreading new ideas about nutrition and health. Emily is currently a research fellow at the University of Amsterdam.

So, what have I learned about medical anthropology in Bolivia?

A lot, although I’ve only begun scratching the surface of all these topics. For a med-anth dork like myself, this is a great situation- it seems like every day, some new potential research topic reveals itself to me. The excitement of discovering interesting local issues to explore feels all the more intense because for the most part, these are questions I can’t just research in the library. There has been a surprisingly small amount of research in medical anthropology in Bolivia. Apart from a few classic texts, like those by Joseph Bastien and Libbet Crandon-Malamud, there has been only the occasional scholar who has published about medical issues here in the past few decades. This creates in me a feeling of immediacy- the sense that I really could, and should, run off to investigate all of these issues as soon as possible.

Before I discuss the findings that relate to my original research plan, here, as a sampling, are some of the other questions which caught my attention this past summer.

Future Research Project # 1: Sexuality and contraception in Bolivia’s fastest-growing city

In one of my first weeks in Bolivia, I was having dinner with some more seasoned anthropologists. None of them worked on medical issues; archaeology and politics seem to see the most scholarly work in Bolivia at the moment. But upon hearing of my interest in gender and sexuality research, one of the women present suddenly remembered something a friend and informant had mentioned to her. “Apparently, young women are using all sorts of secretive means to control their fertility lately,” my archaeologist friend told me. The young woman who had shared this with her was from El Alto, the nearly all-indigenous city located just over La Paz, which is the fastest-growing city in Bolivia due to the high migration of Aymara people from the countryside. Although Aymara tradition encourages large families, these younger women living in the cities are seeing whole new worlds of economic opportunity opening up for them- a chance to acquire some wealth, if they didn’t have 6 or 8 children to provide for. So, sometimes with, and sometimes without, the collusion of their husbands, young women are commonly sneaking birth control and obtaining illegal abortions.

The striking thing to me was that, as this researcher recounted the story, the others who were present realized that they had heard similar reports, told in hushed tones by young women they knew in El Alto. I found everything about this situation fascinating. Not only were there the straightforward factual questions to investigate- Who are these women? How widespread is the phenomenon? Where and how are they accessing these birth control services?- but her description also underscored the reality of rapidly changing values regarding family roles, economic possibilities, and Aymara traditions. Furthermore, there is something of a lacuna regarding knowledge of Aymara sexuality in anthropological research. Aymara culture is generally known as a conservative, hard-working and closed-mouth culture, whose people are not forthcoming on issues of sex. Such mores, though, may be loosening under the influences of migration and urbanization.

Future Research Project #2: Alcohol, alcoholism, and gender

I was at a wedding in El Alto, the guest of my friend A., an anthropologist who has worked in Bolivia for many years. I had been forewarned about expectations regarding alcohol at events such as this. “You’re not really able to say no when you are given alcohol,” she told me. “There’s just no polite way to do it. You just have to prepare to be really, really sick tomorrow.”

Bolivians drink. And I say this as a girl who likes a good party, and who admirably met society’s expectations for teenage/college shenanigans: You can tag me out in the first hour of a Bolivian party, whereas they will continue on happily for another 16 (and then wake up and do it all again after a few hours of rest).

Here’s how it goes, as typified by this one wedding (which turned out to be not even close to the wildest celebrating I witnessed). It is polite to contribute a case of your own booze, since each person will consume at least this much. (Sadly for me as a beer-hater, the preferred beverages are beer, endless beer; singani, a type of liquor made from grapes; and chicha, a nauseating corn-based brew.) The social interaction of the entire event is a nonstop repetition of the following encounter: I pour you a (4-oz or so) plastic cup of beer. You spill a drop or two on the ground, as an offering to Pachamama (mother earth), toast me, and then down the entire cup in one gulp. Then, you fill my cup. I gulp it down in similar fashion. We rotate to the next person and repeat. It’s kind of like speed dating, except you chug instead of chat. As you might imagine, this is an effective way of getting inebriated, and within an hour you have people dancing, spontaneously falling over, and prone to egregious displays of what A. and I dubbed the “I love you, man.”

What separates Bolivian drinking from other types of revelry I have known is the amount consumed and the sheer endurance of the drinkers. Alcohol is not simply a social lubricant here, it is the 200 HP engine that powers the social scene. People will drink far past what I used to assume would be the point of alcohol poisoning, and they will continue this for days during a celebration: waking up early to start drinking and continuing into the wee hours of the night. And the celebrations are innumerable. In addition to weddings, baptisms, birthdays and the like, there are national and local holidays that provide near-weekly entertainment.

I have always been fascinated by cultural ideas about alcohol consumption and whether a culture possesses an idea of alcohol-ism. Here in Bolivia, I asked many people about this topic. Most people told me that the idea of having a “problem” with alcohol is not very widespread, in contrast to the disease model of alcoholism that is prevalent in neighboring South American countries and, of course, the U.S. If this is the case, I would like to find out more about how problems related to drinking are understood in Bolivia, because there seems to be incontrovertible evidence of- if not problems- issues related to alcohol. It is not uncommon to find men passed out in the street at any hour of the day, flat on their backs on the sidewalk. It’s also commonly discussed how men’s episodes of drunkenness correspond to beating their wives, which occurs with alarming frequency. There is, in general, a distinct gendered dimension to this issue, with the norms for male drinking entirely different from female drinking. In my mind, all of these questions deserve further inquiry.

Potential Research Project #3: Kallawayas: The end of a generation?

The Bolivian Andes possess their own mythical medicine men, called Kallawayas. Kallawayas are traveling healers, easily recognizable by the colorful pouches and medicine bags slung over their shoulders, who are said to have been the healers of the Inca kings. They possess extensive herbal knowledge, and perform divinatory and magical rituals for patients. They primarily speak Quechua (the other dominant language and ethnic group in Bolivia), but as healers also speak a secret language for the transmission of medical knowledge, which uses a vocabulary believed to descend from the now-extinct Puquina language.

The town of Charazani is known as the home of Kallawaya healers, and I visited this town over the summer. It is a beautiful, remote place, a small town of about 600 people nestled into the hills between two mountain ranges. Like every other town in Bolivia, they celebrate their annual town anniversary with a huge celebration, a giant 4-day orgy of drinking (see research project #2) and music, in this case provided with traditional pan-flutes and drums. At the time I decided to visit, I didn’t understand how fully this party would dominate life in Charazani over the entire weekend, but let’s just say it didn’t turn out to be the best time for gathering information on native healing practices. Still, by the end of the weekend I’d met some local families whose stories promised a wealth of anthropological riches I could potentially explore at a later time.

“You’re an anthropologist? This is beyond wonderful,” exclaimed Carlos in delight. Carlos, a Charazani native I’d met in the town square one day, was from an old local family, although not typical of Charazani, as he had attended Tulane and now lived in Miami. He, along with some friends and family, had been hoping to set up a project to record the stories of some of the very old Kallawaya healers in the area. “There is a whole generation of Kallawayas that is close to dying,” he explained earnestly, “and we don’t know how much of the knowledge will be preserved in future generations. We are hoping to capture as many of their stories as we can.”

Like most medical anthropologists, I imagine, I have a soft spot for learning about classic “traditional” medicine- ethnobotany, shamanism, what foods are prepared for what ailments, etc. The idea of collecting narratives from the famous healers of the Andes holds no small allure for me. I spent the day-long bumpy ride back to La Paz fantasizing about traipsing across the altiplano, traveling from one small village to the next (with a Quechua research assistant to translate) collecting life stories from wizened elder men as we sat drinking coca tea. But, I have other research questions in mind to be tackled, and over the summer, I think I have found an approach that examines both traditional medicine and modern city living….

Actual Research Problem #1: Sobreparto, a chronic and mysterious reproductive illness of the Andes

Over the course of the summer, I was fortunate to meet Carmen Beatriz Loza, a researcher of Bolivian history and medicine. Her partner is Walter Alvarez, who is both a Kallawaya healer and a biomedical doctor who went to medical school in Cuba. (The close ties between the Cuban health system and Bolivia, a newly socialist country, are Future Research Project Number 4, by the way. It’s a complex and intriguing relationship. Currently, there are a fair number of Cuban medical practitioners who practice in underserved areas of Bolivia, and Cuba operates scholarship programs to send poor indigenous students to medical school in Cuba.) Walter practices both traditional medicine and biomedicine in El Alto, and together with Carmen, formed a small research institute called the Bolivian Institute for Traditional Kallawaya Medicine. Here Walter and Carmen study, teach, and share traditional medical knowledge with their community, as well as research particular medical issues.

One such issue I learned about from Carmen is an illness called sobreparto. Sobreparto literally means “after birth,” and it refers to a type of illness that is known in many Latin American countries, but which has no biomedical counterpart. The illness can begin any time after birth, from the first weeks postpartum to years after birth. It is related to the belief that women are particularly weak and susceptible to sickness and spirit possession after their body has been “opened” by childbirth. Common attributions for the disease include heat or cold entering the body; evil spirits entering the body; and overwork or ill-treatment of the woman after the birth, when she is supposed to be resting and cared for by family. Ill treatment, such as physical or mental violence or neglect, by a husband is also cited as a cause of sobreparto.

Because my research centers on the topic of chronic pain, and whether emotional and interpersonal factors are understood to impact physical health, sobreparto is a fascinating case study. It is a common condition, respected and feared by Andean men and women. Its onset and course are highly variable, but the disease is often chronic. The symptomatology is also highly variable; sobreparto can include everything from skin rashes to persistent hot and cold feelings to stomach pains. It also appears tightly intertwined with local expectations of women and their work. Andean women generally lead difficult lives, in terms of both back-breaking labor and the perpetual cycle of pregnancy, birth and lactation they are in for most of their adult lives. But, as the case of sobreparto hints, it appears understood that there are moments when this stress can be too much.

Thus, I look forward to investigating this topic further as part of my dissertation research. There is a large project beginning at the Institute that I have been invited to collaborate on, which will utilize their connections to local networks of healers in order to investigate traditional ways of understanding and treating sobreparto. Walter’s clinical work and local patient base would provide access to sobreparto patients whom I could interview about their own experiences with the illness. It seems like a project that would integrate my interest in the concepts of traditional medicine with my interest in the changing, dynamic urban setting of El Alto.

This means my other potential research projects may have to be put on the back burner for now…. but from what I hear, it’s good to have future projects to think about when one is slogging through the tougher moments of a dissertation project. I’m certainly lucky to have an abundance of those to daydream about.

Abbe Rose Kopra is a doctoral student at the University of Chicago, studying medical and psychological anthropology in the interdisciplinary Department of Comparative Human Development. Her research focuses on the problem of chronic pain; she is interested in cultural interpretations and attributions for chronic pain, how individuals cope psychologically with chronic pain, and the connection between the two. She is currently spending the summer in the Bolivian Andes, studying the language of Aymara and doing preliminary research for her dissertation fieldwork next year. This is her first summer in her chosen field site, and here she reflects about different aspects of the experience in a series of essays for Anthropology Now’s ‘Fieldnotes’ category.

When one arrives at a new fieldsite, the only things one can know with any certainty are the changes in one’s own experience. Lacunas of knowledge burst into one’s consciouness like the appearance of crystal-clear lakes dotting the ground when viewed from an airplane. The sprawling complexity of a landscape simplifies to valleys of ignorance and peaks of impressions that lie waiting to be remapped into a coherent whole- or else the whole land will remain unknown and passed over by you.

I arrived in La Paz, Bolivia, the world’s highest capital city (11,000 feet) and a sprawling metropolis in one of Latin America’s poorest countries, in mid-June. I am here for three months to work on language training and conduct preliminary dissertation research, to be continued in earnest several months later. I have not arrived emptyhanded. Besides two giant suitcases of research materials and warm clothing (winter in the South American Andes chills to the bone, despite dermis-scalding heat during the day from a sun hanging merely feet above you), I come bearing a rather incongruous amount of ideas and questions. Having spent the past three years completing stateside research projects and anthropological theory courses, I am inclined to throw myself at my fieldsite like an overeager lover.

Here is what I want to know: How do people in the predominantly indigenous area of La Paz think about, attribute, and cope with chronic bodily pain? While not as well-known as the traditions of medicine in China or India, the Andes region, with its deeply indigenous history, has an ancient tradition of medicine all its own. Andean medicine is rooted in Andean cosmology, which is a circular and holistic system focused on the interrelatedness of person and environment. Regarding bodily health, Andean thought traditionally considers a person’s body in relation to the spirits that occupy each mountain and feature of the land, as well as in relation to other people (both those alive and those within the ancestral spirit world). Herbal knowledge and practices of divination feature prominently. I was drawn to this area because these holistic traditions of medicine, still a strong presence even in urban areas, stand in sharp contrast to the U.S. biomedical tradition that I have studied the past few years. In U.S. biomedicine, mind and body are considered separate realms, and material evidence of bodily dysfunction is paramount in receiving attention, care, and the hope of relief. Thus, by examining the problem of chronic pain in these two very different settings, I hope to shed light on the tacit assumptions of both cultures regarding the social status of people in pain, the moral dimensions of suffering and of attaining (or not) healing, and how these cultural frameworks affect the lived trajectories of people with chronic pain.

Masses of theoretical preparation, however, leave me only more aware of my clumsiness when approaching this singular, living and breathing, place: La Paz. La Paz is its own entity- pulsating, mysterious, self-contained- and she has no obligation to entertain my shy questions. The courting process of this place will be long. Thus, I work to educate myself on the topics people are actually discussing here. I read the daily papers and learn the recent history of the socialist (and first indigenous) president Evo Morales. I struggle through hours of daily classes in Aymara, a local indigenous language (over 60% of the population of Bolivia self-identifies as indigenous, and La Paz is considered the Aymara capital of the world), learning much more prosaic questions such as “How much are those oranges?” and the various words for animal dung (thaxa, llama dung, is most revered, in case you were wondering) and all of the specialized uses of said dung.

Constantly, I think about the things I do and do not know, and how they are literally re-shaping my sense of myself. The most basic moments of personal space and privacy that I have always taken for granted, have been mischievously rearranged. No longer do I stumble out of my bed in the morning to eat a bowl of oatmeal while checking my email; instead at first rise I sit myself around a table with my host family and strain my brain to decipher the rapid-fire speech, or even to participate once the first cup of wretched Nescafe begins to clear my morning fog. When I leave the house at night, I am subject to being grabbed and having my head flipped over while my “mother” grabs her blowdryer and dries my hair to her standards; it is not acceptable to leave the house in this winter weather with half-dried hair, as the cold will undoubtedly enter the body quickly and cause illness.

There are many moments of regression to social childhood like this, both the overt blowdryer-type ones and the constant nagging awareness of insufficiency at the business of caring for myself. Temperamentally, this is a challenge. And yet, there are small moments of success. Late one day, unused to a full household of people and constant motion, I find a quiet bench in a sunny park where I sit to watch children scamper over a playground. I am quickly reminded that even the simple choice to sit alone here, under the spotlight of my pale skin, does not belong solely to me. A small boy, a lustrabota (shoe-shiner) approaches me and we begin a lively back-and-forth about the necessity of having clean shoes. While I fully concede his point that mine are dirty, we are less in agreement about the undesirability of this state, and even less so about the monetary value of remedying the situation. (I’m a sweatshirt-wearing grad student; who cares?) I concede, of course, to a shoeshine after realizing that I am sitting in front of the boy eating a scoop of gelato, an undeniable luxury item. But at least my recent inquiries about this particular job (there is a huge number of lustrabotas in Bolivian cities- they are generally young men and children who are working to pay for school or other basic expenses), allows me to understand the situation and his remarkable persistence for this foreigner’s shoes. It also allows me to pay the culturally appropriate price for his service, rather than the fourfold “tourist” price initially demanded. I consider this a draw, in my daily learning game: the price of an unneeded shoeshine for a semi-competent cultural encounter.

Recently, I had my coca leaves read. (Coca is one of the most important plants in Andean culture, revered for its ability to give energy and suppress hunger, and for its medicinal and spiritual uses.) I was walking around El Alto, a deeply indigenous area around La Paz. Here there are many traditional healers, and I was exploring a long street lined with the small blue huts of curanderos (“curers”) and yatiris (literally, “one who knows,” from the Aymara verb “to know,” yatiña). Curious about the practices inside these little huts, I stopped at one whose sign read “Maestro curandero,” followed by a long list of his services and skills. Greeting the middle-aged man inside, I chose the most basic service- a reading of my coca leaves, to advise me about my future. I asked for advice about working in Bolivia and about which research questions, of the many interesting medical issues I’m discovering, to focus on. He tossed coca leaves over the table and examined the patterns in which they fell. Occasionally he selected specific leaves to arrange in front of him, murmuring to himself as he did so.

My questions, regrettably, were not answered nearly as specifically as I would have liked. But the overall message was positive: Bolivia will be good to me, he foresaw. I will have success here. All this came, however, with the repeated caveat: Conpaciencia. “With patience.” Not right away. But eventually… yes.

Con paciencia. Perhaps, as a response to my questions about the future, such an answer is a total cop-out. (Do people with abundant patience often try to read into the future?) Perhaps it is just solid advice for beginning in the field. I am certain at least of the latter.

Abbe Rose Kopra is a doctoral student at the University of Chicago, studying medical and psychological anthropology in the interdisciplinary Department of Comparative Human Development. Her research focuses on the problem of chronic pain; she is interested in cultural interpretations and attributions for chronic pain, how individuals cope psychologically with chronic pain, and the connection between the two. She is currently spending the summer in the Bolivian Andes, studying the language of Aymara and doing preliminary research for her dissertation fieldwork next year. This is her first summer in her chosen field site, and here she reflects about different aspects of the experience in a series of essays for Anthropology Now's 'Fieldnotes' category.