Free Market Tuberculosis

Erin Koch

Description

The Soviet health care infrastructure and its tuberculosis-control system were anchored in biomedicine, but the dire resurgence of tuberculosis at the end of the twentieth century changed how experts in post-Soviet nations--and globally--would treat the disease. As Free Market Tuberculosis dramatically demonstrates, market reforms and standardized treatment programs have both influenced and undermined the management of tuberculosis care in the now-independent country of Georgia. The alarming rate of tuberculosis infection in this nation at the crossroads of Eastern Europe and Asia cannot be disputed, and yet solutions to attacking the disease are very much debated.

Anthropologist Erin Koch explores the intersection of the nation's extensive medical history, the effects of Soviet control, and the highly standardized yet poorly regulated treatments promoted by the World Health Organization. Although statistics and reports tell one story--a tale of success in Georgia--Koch's ethnographic approach reveals all facets of this cautionary tale of a monolithic approach to medicine.

This book is the 2011 recipient of the annual Norman L. and Roselea J. Goldberg Prize for the best project in the area of medicine.

Sujets

• Santé et bien-être
• Santé du quotidien
• Diseases
• CAB Direct (database)
• Health
• Fitness

Informations

• Publié par: Vanderbilt University Press
• Date de parution: 15 février 2013
• Nombre de lectures: 0
• EAN13: 9780826518941
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Free Market TUBERCULOSIS Mànàging Epidemics in PosT-SovieT GeoRgià

ERIN KOCH

Free Market Tuberculosis

Free Market TUBERCULOSIS Managing Epidemics in PostSoviet Georgia

ERIN KOCH

VANDERBILT UNIVERSITY PRESS Nashville

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hŝ ook ŝ e recpe o e norma . ad Roŝeea J. Goderg Prze rom Vader Uverŝy Preŝŝ or e eŝ projec  e area o medce.

hŝ ook ŝ pred o acd-ree paper. Mauacured  e Ued saeŝ o Amerca

LIbrary of Congress CatalogIng-In-PublIcatIon Data on ile

C coro umer 00 Dewey caŝŝ umer .'--dc

ïSBN -0--- (co) ïSBN -0--- (paperack) ïSBN -0--- (eook)

For Laura, my sister, in loving memory. •

Contents

Acknowled gments îX

Acronyms and Abbreviations Xîîî

Note on Transliteration Xî

Introduction 1

1 The Hand of Medea GEORGIAN MEDICINE IN HISTORICAL CONSCIOUSNESS 33

2 Medicines on the Market 64

3 R endering Tuberculosis MANAGING MICROBES AND EVERYDAY LABORATORY WORK 109

4 Free Market Tuberculosis Incarcerated 152

Conclusion 189

v

FREE MARKET TUBERCULOSIS

Notes 199

Biblio graphy 207

Index 225

Illustrations Map of the Transcaucasus R egion 36

Polyclinic in Tbilisi where D OTS Services Are Offered 66

Daily R egimen for the Treatment of MDR-TB at a TB Treatment Center O u tside of Tbilisi 107

L aboratory Staff Pro cessing Tuberculosis Cultures 111

Diagram of the Spu tum Collection Ro om 181

Acknowledgments

am umed y e geeroŝy o everyoe wo eped make poŝ- ŝe my reŝearc ad ŝ compeo w ŝ ook. î expreŝŝ my deepeŝ graude o everyoe  Tŝ wo aŝŝŝed me, eŝpe- caya e naoa Tuercuoŝŝ Program (nTP), e îeraoa Commee o e Red Croŝŝ (îCRC), ad oer nGO ad ad workerŝ ocay voved w Tb coro. numerouŝ peope ook me ou o er aready uŝy veŝ o arrage ervewŝ ad oŝervaoŝ ad acceŝŝ oer reŝourceŝ, ad o geeray ep me uderŝad e deep cuura ad poca aŝpecŝ o uercuoŝŝ coro  Georga. To maa ŝ or er coIdeay, î do o ak ayoe y ame ere. To oŝe o you wo ereded ad ed me, waked me rom oe oŝpa o aoer, arraged vŝŝ o oer cca ŝeŝ ad prŝoŝ, eped w raŝaoŝ, ŝpe ourŝ akg w me, ad paey aug me everyg î ever waed o kow aou Geor- ga medce, everyday aoraory work ad Tb dagoŝcŝ—ad you kow wo you are—ank you. Dr. H. Kee Waker, Dr. Zvad Krava, ad e ae Dr. Arc Koaadze ecouraged my eareŝ - ereŝŝ  medce  Georga ad eped me eŝaŝ coecoŝ w e nTP. î exed exra akŝ o everyoe a e naoa Reer- ece aoraory (nR). he nR ecame o oy a acor or my reŝearc, u aŝo a ceer o my ŝoca e. î remaŝ oe o e paceŝ  Tŝ were î awayŝ ee a ome. hŝ ook ŝ prmary aŝed o e aayŝeŝ, opoŝ, ad expereceŝ o oŝe  Georga wo par- cpaed  e projec, u e aropoogca erpreaoŝ ad aayŝeŝ a î preŝe are erey my ow ad î am reŝpoŝe or ay errorŝ.  Perŝoa reaoŝpŝ are udamea o aropoogy, ad ye coducg reŝearc ad wrg ca e e oeeŝ afarŝ. Ex- cee compay, meaŝ, excurŝoŝ, ad more a ayg eŝe, redŝp erced my e  Tŝ. î addo o redŝ ad coeagueŝ a e nTP ad aiaed orgazaoŝ, î ak Doroy

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