Lived Lives and Social Suffering: Problems and Concerns in Medical AnthropologyAuthor(s): Linda GreenSource: Medical Anthropology Quarterly, New Series, Vol. 12, No. 1, The Embodiment ofViolence (Mar., 1998), pp. 3-7Published by: Wiley on behalf of the American Anthropological AssociationStable URL: http://www.jstor.org/stable/649474 .

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INTRODUCTION

LINDA GREEN

Department of Anthropology Columbia University

Lived Lives and Social Suffering: Problems and Concerns in Medical Anthropology

ar, violence, and repression remain a way of life for many women, men, and children in the world today. The articles in this special issue of MAQ relate poignant stories of violence and suffering in multiple geographical

and cultural locations including Nicaragua, Palestine, Mozambique, Tibet, Croatia, and Bosnia-Herzegovina. These articles focus on examining the meanings and complexities of the lived experience of repression and terror and reveal the extraordinary and subtle means by which people subvert, contest, and appropriate violence. They also question the common perception that political violence and repression operate in the same way everywhere.

Medical anthropologists have begun to pay closer attention to war, conflict, and human aggression and also to how everyday forms of violence and suffering (Das 1996; Farmer 1996; Kleinman 1996; Scheper-Hughes 1992, 1996) structure people's everyday reality and social relations. As a collective effort, the articles presented here pay close attention to quotidian life-the humble, familiar, and mundane aspects of everyday experience, what Henri Lefebvre (1991) has called the "revolution of everyday life." In doing so, these articles reveal not only the suf- fering and alienation that violence and warfare produce, but also the human possi- bilities that violence and warfare engender. This human potential is optimistically demonstrated in Carolyn Nordstrom's article about the recent war in Mozambique, which illuminates the creative ways in which people unmake violence. And it is tragically described in Linda Pitcher's portrayal of the intentional death of the Pal- estinian shaheed, or martyr.

Bodies and Embodiment

Although medical anthropology has long been concerned with the physical and emotional suffering of the body that results from illness, disease, and death, the

MedicalAnthropology Quarterly 12(1):3-7. Copyright ? 1998 American Anthropological Association.

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MEDICAL ANTHROPOLOGY QUARTERLY

body itself remained unproblematized until quite recently (Lock 1993). Even re- cent work discussing the body has often not addressed the phenomenological as- pects of human experience. Instead, this work has looked at issues such as bodily representation, sexuality, and illness from a political economy of suffering per- spective, which has tended to produce an incomplete portrait of the body that Ter- rance Turner (1994) has described as the "disembodied body." Such theorizing has largely neglected the concrete and specific suffering of people, particularly the complex consequences of that suffering.

In this issue the authors focus explicitly on how violence and suffering are embodied. They highlight the complex relationships among the individual, social, and political bodies (Scheper-Hughes and Lock 1987), and between lived experi- ence and culture. While these concerns are far from new to sociocultural anthropol- ogy and medical anthropology, the articles presented here, by examining empiri- cally the relationship among violence, culture, and the social order, bring these concerns into sharp focus. Often using a critical medical anthropology perspective, the works in this collection, by linking problems of structural and political vio- lence, reinterpret our understandings of the body and embodiment.

By problematizing the notion of embodiment as lived experience, or "being in the world" (Csordas 1994), the articles in this issue challenge conventional under- standings of mind/body dualism, and call into question our distinctions between structure and agency, object and subject, materiality and meaning, social and indi- vidual, sex and gender. By examining the relationship between violence and em- bodiment, they also demonstrate vividly the inseparability of sensate experience and cultural representation in lived reality, and reveal how power, history, and gen- der operate through embodied subjectivity and concrete bodily activity.

Maria Olujic, in a powerful article, examines mass rape and gendered vio- lence in peace- and wartime in the former Yugoslavia. By focusing on the ways in which meanings of rape and violence were communicated in Yugoslavian popular culture in peacetime, she challenges the widespread assumption that these forms of domination and aggression are solely grotesque acts of war. James Quesada re- minds us that the distress of war and its aftermath powerfully affects the minds and bodies of even the youngest members of society. His article tells the story of how an eleven-year-old boy in post-Sandinista Nicaragua experiences the distresses of war as a "lived sense of insecurity," as a "heroic effort to exist," and, woefully, also as an imperative for considering death/suicide as a family survival strategy.

"Memorias de Sangre"

My own interest in the embodiment of violence arose from work with Mayan widows in rural Guatemala who lived through the civil war that raged there in the late 1970s and early 1980s between the Guatemalan state and a guerrilla insur- gency (Green in press). These women suffered doubly because they were both vic- tims and survivors of violence. As victims, they witnessed unimaginable atrocities, which included the disappearance or brutal death of their husbands, sons, or other family members. As survivors, they continued to experience the violence in both their bodies and memories.

Political violence of this sort maims and kills people literally and spiritually. As the widows struggled to survive in an ongoing climate of violence and repres-

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LIVED LIVES AND SOCIAL SUFFERING

sion, they suffered from hunger, fear, and multiple, chronic health problems. These women experienced headaches, gastritis, stomach ulcers, weakness, diarrhea, irri- tability, insomnia, and weak blood, illnesses usually termed posttraumatic stress disorders. They also experienced "folk" illnesses such as nervios (nerves), susto (fright), and pena (pain, grief, sorrow). To categorize their suffering simply as a manifestation of a clinical syndrome or as a culture-bound construction of reality dehistoricizes and dehumanizes the lived experiences of these women.

The widows themselves attributed a political cause to their bodily distress and pinpointed the onset of their physical problems to the events that surrounded the death or disappearance of their husbands. But in a broader sense, their experiences of bodily illness constituted more than individual, psychological, and sensory re- sponses to distress. Their illnesses embodied the violence of their social reality. In- deed, through illness, the bodies of these Mayan widows testified to and consti- tuted social memories of the death and disappearance of their loved ones. Their illnesses were in fact physical representations of the widespread violence against Mayan civilians (for which there has yet to be a just resolution).

Memories of violence can thus be embodied through illness. In Guatemala, the women's memories of violence were so powerful and essential that they consti- tuted what Carina Perelli (1994:40) has called "memorias de sangre," or blood memories, which ran through their veins literally and figuratively. These memories were imbued with politics and history. Like history, their memories were shaped by breaks, discontinuities, and ruptures, through which the "perceived continuum of [their] li[ves]" were broken down into a "before" and an "after." And their bod- ies stood as evidence of the violence perpetrated against them and their families.

Violence and repression in rural Guatemala were embedded not only in the social landscape and in women's bodies, but also in the geographic landscape it- self. According to the Guatemalan Forensic Anthropology Team, there are perhaps thousands of clandestine mass graves of men, women, and children that have yet to be excavated in the rural areas of Guatemala.

Ethnographic Engagement

Theorizing and writing about violence, oppression, and suffering are fraught with conceptual problems. Janis Jenkins addresses some of these in her commen- tary. Oftentimes, representations of violence are detached from the concrete and specific suffering of people, a problem that reduces theorizing to an autonomous, disembodied activity. Perry Anderson (1976) has referred to the work of academ- ics who retreat from the realities of political struggles as "studied silence." Gerald Sider has eloquently pointed out that anthropologists have often failed to see the Other in understandable ways, and failed to "give voice to our sight, to say what we have actually seen. There is a silence at the center of the anthropological vision-a profound void, a destructive silence, a silence about suffering" (1989:14). There is a pressing need to probe the empirical realities of suffering that "emphasizes the heterogeneity of experiences of injustices" (Harvey 1993) that make visible "the small war and invisible genocides" (Scheper-Hughes 1996).

The shared experiences between fieldworkers and ordinary people are never egalitarian ones (Marcus and Fisher 1986). In fact, shared experiences are inevita- bly charged by the political and economic inequalities that structure the world in

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MEDICAL ANTHROPOLOGY QUARTERLY

which we live. As anthropologists we go to the field in an attempt to render intelli-

gible the contradictions and complexities of people's lives. In doing so, we become at least temporarily both witnesses of and participants in those very lives. We re- turn from the field with two languages at our disposal: the language of the intellec- tual with its sophisticated theoretical apparatus, and the language we have learned in the field, not simply the spoken language but the language of people's practices. What is called for is not a simple translation from one perspective to the other, but an effort to address the complex linkages between the perspectives. As such, an-

thropology can significantly contribute to create a more just and humane world. The articles explore the multiple ways in which suffering takes hold, not only

the obvious suffering that is produced by recent political violence and repression, but the microsocial processes of that suffering. Yet, as Vincanne Adams correctly points out, in order for there to be any hope of creating effective political alliances or political actions, our understandings of suffering must be informed by a knowl-

edge of race, class, gender, and cultural and epistemological differences.

Although it is embedded within what Edward Said (1978) has called "univer-

salizing discourses" about the Other, anthropological writing can be used as a tool of struggle (Binford 1996), so that individual and social histories and memories are not forgotten. As the poet Carolyn Forche has noted, memory can act as a "reli-

quary in a wall of silence-it is important to have scenes that will continue to

speak" (1994:5).

NOTES

Acknowledgments. I would like to thank Marcial Godoy-Antivia, Roger Lancaster, Carolyn Nordstrom, Jim Quesada, and Gerald Sider for stimulating discussions on these topics. Also, many thanks to Gay Becker for her encouragement, patience, and enthusiasm that greatly assisted in bringing this project to fruition and to Norman Fineman and the MAQ staff for their superb editorial assistance.

Correspondence may be addressed to the author at the Department of Anthropology, Columbia University, New York, NY 10027.

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