Health and Sustainability

Although much of this blog has been about travel, I also want to use it to take the opportunity to write about how my trip is influencing my research. I came to India hoping to explore two topics that are already a focus of my research. Although the funding fell through for one, and the class I had hoped to was vetoed (limiting one path to exploring the other), I am still hoping to learn something about both.

My first locale-specific research goal was centered on health care decision making. In the U.S. I begin a project exploring how individuals with a chronic disease cope with differing opinions on how to treat a condition that is (primarily) in their own hands. We focused this work on Lyme disease, and discovered that patients were shifting across two conflicting models of care over time, and that this process took place online. Our work (still in a U.S. context) also showed that patients developed a resistance identity during their shift from one model to the other.

India is an ideal place to take up this thread of research further. It is a country in which multiple models of medicine exist. In speaking with people here, the list they mention includes, at a minimum: Ayurvedic, Unani, English (Western Medicine), Naturopathy and Homeopathy. The different methods do not seem to overlap much. For example, when attending a first aid class, the discussion was entirely focused on western medicine. In contrast, the Ayurvedic doctor I took my daughter to when she had a high fever used almost not artifacts common to western medicine (not even a thermometer). Yet people I speak with seem to mix and match from across multiple models of care as they see fit. I would like to understand how and when people chose among them, and how this might differ across regions of India and different socio-demographic categories. I am currently reading the ethnography “No Aging in India” [1], which explores what happens to elders in a country where the responsibility of the family for elders is no longer a given. I would particularly like to understand how the differences in the social context of healthcare as well as the differences in what options a person chooses might affect the success of technological interventions such as those that some NGOs use to bring health care to rural communities.

My second locale-specific research goal is centered on sustainability. I have taken the opportunity to read quite widely on the topic in the last few months, touching on such diverse topics as economics (such as dematerialization [2]), futures studies [3] and biodiversity [4]). From these readings and ongoing thought I have developed a perspective on sustainability that argues for the value of information technologies in exploring a very broad set of issues from education to politics, in a culturally-relevant (but globally-focused) way. However, none of these readings is all that helpful in integrating the experience of being in a developing country into my understanding of sustainability.

For this I must better understand the experience of living in India, again across both regions and socio-economic classes. My personal experience is one of a country that is more careful with energy than the west (every plug, for every appliance and wall element has a switch off, for example, and is switched off if not in use). Among the upper class, high-tech individuals I have come to know, sustainability and environmentalism are common, and very important. In helping with a clean up of a local natural preserve, I witnessed the organizers pledge the students who came to help them to continue taking care of their natural environment. In Agarwal’s study of forestry management in rural India [5], environmentality (as he calls it) develops only through personal involvement by individuals and in fact is affected negatively by governmental involvement of the wrong kind. Even assuming universal environmentality within India, the question still remains: what is the right future for India (and for each of the countries in the developing world)? How in the world do we move forward, continue to develop, and simultaneous address the climate crisis? If we put aside the simplistic assumption that developing countries should somehow not develop, the alternative must be a leapfrogging of the most egregious technologies used in recent history in the first world, combined perhaps with a designed recent ion of cultural elements that enable a more sustainable lived experience.

While my prescription for success is grand, as we often say in research, the devil is in the details. And I cannot speak to the details with what I know yet, I am hoping that some of the nascent collaborations I am developing here, combined with user research, will create a beginning.

[1] Cohen, L. (2000). No aging in India: Alzheimers, the bad family, and other modern things. University of California Press.

[2] Luzzati T. (2001). [PDF] Growth theory and the environment: How to include matter without making it really matter. In Salvadori, N., The Theory of Economic Growth: A Classical Perspective.

[3] Bell, W. (2003). Foundations of Futures Studies: Human science for a new era: History purposes and knowledge (volume 1). Transaction Publishers.

[4] Pimm, S. L., Russell, G. J., Gittleman, J. L. & Brooks, T. M. (1995). The future of biodiversity. Science269(5222):347-350

[5] Agrawal, A. (2004). Environmentality: Community, intimate government, and the making of environmental subjects in Kumaon, India. Current Anthropology, 46(2):161-190.