Prenatal marijuana exposure and neonatal outcomes in Jamaica: an ethnographic study

OBJECTIVE. To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. DESIGN. Ethnographic field studies and standardized neuro-behavior assessments during the neonatal period. SETTING. Rural Jamaica in heavy-marijuana-using population. PARTICIPANTS. Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed mnonnates were compare at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-refulation and were judged to be more rewarding for caregivers. CONCLUSIONS. The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development (AU)

The Rastafarian community and the "gateway" theory: lessons to be learned

The findings presented in this paper are drawn from a national ethnographic study conducted in six Jamaican populations, one of which was composed of members of the Rastafarian religion recruited from Kingston and south coast villages. Ninety-one members of the Rastafarian sect were formally interviewed and observed. The ethnographic study purposely over-sampled the Rastafarian community (1) because it was not sufficiently represented in the 1987 survey and (2) in order to examine the relationship between use of ganja and crack/cocaine. If ganja is, in fact, a "gateway" drug to cocaine, we would anticipate a high prevalence of crack/cocaine in this population. The data revealed that, as a group, members of the Rastafarian community were the most vigorous in shaping the definition of the term "drug". Cocaine is considered a drug but ganja, despite its illegal status, is considered a "natural" substance with health rendering properties and ritual functions. Not surprisingly, 0.4 percent of the Rastafarians surveyed believed that ganja should be legalized. Of all the populations investigated, Rastafarians were most likely to report that crack/cocaine was easy to obtain and to rank crack and cocaine as the most commonly used drugs. As a group, they are, in many ways, the most at risk for crack/cocaine use and addiction; compared with the rest of the sample, they have more urban, tourist and overseas experience as well as high potential for exposure to crack/cocaine. Yet the Rastafarian doctrine and design for living frequently were cited as the justification for preventing and/or for relinquishing the use of crack/cocaine. In its exception to the gateway theory, the Rastafarians community suggests protective mechanisms that inhibit the shift toward crack/cocaine use in high risk populations. (AU)

Prostitution and the military: planning AIDS intervention in Belize

First world militaries based in "third world" countries offer an appropriate context for developing AIDS intervention models that are keyed to large-scale population movements and regional differences in HIV infection. In this work, the ethnographic concept of "social interface" replaces the epidemiological concept of "risk group" to allow for a more dynamic analysis of the particular forms of interactions between groups that may be linked to the sexual transmission of HIV. The social interface between military and sex workers in Belize displays two distinct forms of organization: (1) "recognized prostitution" in health-regulated brothels, and (2) "quasi-prostitution" in non-health regulated public sites such as bars and hotels. These two forms are also distinguished by the ethnicity, national origin, and professional identify of sex workers. Based on survey-form participant-observation in Belize and cross-cultural data on condoms use, the social identify of sex workers emerges as a factor crucial to understanding how public health information is incorporated by heterosexuals who put themselves at risk for HIV in different social contexts. The scope of analysis shifts between the personal and transnational; discussion of the possibilties for inter-governmental negotiations regarding AIDS policy issues is included.(AU)

Marijuana use among women: an anthropological view

This paper suggests that the concept of intra cultural diversity is a more useful framework for understanding non-conforming behavior among Jamaican rural women than social psychological explanations of deviance from culturally approved sex roles. A comparison of female cannabis smoking in two rural communities, permits us to identify some of the social processes which underly variation in the nature and extent of marijuana use by women in the two settings (AU)

The clinician as ethnographer

Ethnography is a process yielding a particular kind of knowledge. From the psychoanalytic perspective this bears on the question: how may individual lives which report their own experience, but cannot directly apprehend the unconscious factors behind that experience, be related to social life which does not report itself but is observed and interpreted by others? The person of the ethnographer and ethnographer-informant relationships are considered in this respect. Clinicians' informants include people to whom they related in the course of adaptation to the new community; those who are help-seeking (patients) with whom their relationship is both therapeutic and investigative; and clinets in health-service (e.g., family planning) contexts who may be studied with tests and structured interviews. The clinician's status, role, helping and scientific values are examined as factors determining the nature of knowledge gained under these various circumstances. To the degree that the clinician is an intentional, data emerge as the informant;s consciousness changes in the therapeutic or research process. Research or therapy-aimed interventions based on psychoanalytic theory add their won epistemological problems to the process. (AU)

Anthropology and psychiatry - An alternative approach

The subject matter of this paper is transcultural psychiatry. The suggestion made here is that transcultural psychiatry is characterised not by its subject matter but by its methods. This assumes that mental illness is not only a function of such objective indices as social class or the availability of services, but of the considerably less tangible idea of the unique experience of being a member of a particular society: a society with its own characteristic web of economic constraints, social relations and beliefs. This web or culture is mediated by particular symbols which exist at all levels of analysis and which bind the society together. Transcultural psychiatry is concerned with these symbols. It is concerned not only with aetiology and epidemiology but with meaning. To put it another way: the relation between transcultural psychiatry and social psychiatry is that between anthropology and sociology. (AU)

Spirit possession and mental health: a psycho-anthropological perspective

This paper offers a psycho-anthropological perspective on spirit possession and mental health in a variety of cultures and communities. Its prime focus is the distinction between two forms of possession: ritual and peripheral. The former is displayed in a ceremonial context and includes the social function of reinforcing cultural morality and established power. The latter, believes that he is unwillingly possessed by intruding spirits and functions as an indirect form of social protest. While both are reactions to stress, ritual possession operates as a socially sanctioned psychological defense mechanism, while peripheral possession constitutes a pathological reaction to individual conflict. (AU)

West Indian adolescent: an anthropological perspective

Adolescents from West Indian backgrounds in the United Kingdom face special problems because they are marginal, not only to adult society, but also to the "host" culture. Caribbean parents tend to have expectations for their children which do not correspond with those of the young people themselves. The boy may respond by selecting an image of masculinity based on a politico-religious protest cult which seeks a return to African roots. The peasant family support system is poorly adapted to an urban industrial culture. It fails when the adolescent girl becomes pregnant. Many difficulties faced by a proportion of West Indian adolescents can be related to the twice occuring loss of mother, in babyhood and again in later childhood, resulting in a long drawn out and often unresolved mourning (AU)