The curse of professionalism and specialisation

We live in an age of increasing specialisation, both on a group and individual level. Just 200 years ago, for example, if a particular community was faced with the need for a bridge, or a road, or by a natural disaster, it was, largely that community which had to respond; no-one else would.

But after hundreds of thousands of years of this mode of organisation, the last 150 years, particularly, has accustomed us to state responses to social need or crisis. These responses have the advantages of course, of usually drawing on greater resources, consolidated expertise and economies of scale.

Has our new conditioning, to rely on such responses, weakened us socially?

Consider the HIV/AIDS epidemic. The modern response to an epidemic is to expect experts, in this case doctors, bureaucrats and scientists, to come up with solutions to this problem. After all, other epidemiological crises have succumbed to assault by specialists.

The problem is, specialist solutions to HIV/AIDS are helpful, but not sufficient. People cannot get proper treatment for an illness when they avoid diagnosis. Medical science is useful in treatment diagnosed illness, but struggles to overcome the human factors (sex) that catalyse transmission. Above all, the specialist response is terribly crippled when denial on the part of key social actors (the government, in South Africa) means that the specialists do not have uniform social support. And in the meantime, communities are far less practised in mounting their own responses, than they may have been in other eras.

A recent New Scientist article (July 20, 2007) “Western Medicine doesn’t have all the answers” recounts arguments that:

… western public health officials involved in international development have been ignoring the fact that indigenous people have their own strategies for disease control and prevention. Combating disease in countries in Africa and elsewhere could be much more successful if only they would recognise this fact and find ways for traditional ideas to complement western ones

Of course this is a stereotype, but the notion that the medicine practised by rural people in African countries is rooted in witchcraft, superstition and black magic runs deep. So it is hardly surprising that many health professionals, including western-educated Africans, consider rural medical practices to be worthless at best, and even potentially harmful.

This view was propagated by some of the 20th century’s most famous ethnographers and is still being restated by some modern anthropologists. Yet it is far from the truth, says applied medical anthropologist Edward Green of the Harvard Center for Population and Development Studies. He and others have found that while traditional attitudes to mental illness contain strong elements of superstition, most ideas about infectious disease do not. In fact, they have much in common with modern western medicine.

In other words, African communities are accustomed to mounting their own responses to even crises of infection, often with significant success. In our age, though, the kneejerk inclination to look outwards and upwards, to a state which may or may not be committed or competent in our particular crisis, can be our downfall.

About David

I am an environmental writer, journalist and speaker living in Cape Town, South Africa.
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