Polycystic ovary syndrome, medical semantics, and the political ecology of health in India (original) (raw)

2019, Anthropology & Medicine

Within public health, investigations into the rise of metabolic syndrome disorders, such as obesity and type II diabetes, following on the heels of globalisation have tended to focus on the twin axes of diet and physical exercise. However, such a limited focus obscures wider transformations in bodily and health-related practices that emerge in response to globalisation. This paper is an exploration of public discourses about PCOS-a hormonal disorder that affects menstruation, is associated with obesity, heart disease, and type II diabetes, and has been on the rise in India since the liberalisation of its economy in 1991-and it examines the concerns regarding sociocultural, environmental, and political-economic changes brought by liberalisation that these discourses index. Attention to medical semantics, as revealed through public discourses about PCOS, can help counter the limited focus of diet and physical activity-centred models through an emphasis on the political ecology of health. Such engagement can reveal how an emerging relationship between the body and its environment, which is seen as characteristically modern, is implicated in the rise of metabolic disorders. It can also offer critical insights for biomedical and public health research into such disorders. In India, systems of nationalised 'indigenous' and alternative medicine-recognised through the Government of India's AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) ministry-exist alongside and in compatibility with biomedicine, and people regularly mix therapeutic options (Halliburton 2004). These indigenous frameworks of health are premised upon an ecological model of health, in which the body is a microcosm of its universe (Guha 2006; Leslie 1996; Nichter 2001). The body must be in balance with its environment for the maintenance of wellness, and it has to be protected from environmental changes, seasonal variation, and life-stage progression through the regulation of bodily practices. The body is therefore seen as responsive to social, economic, and political forces, and conversely, an afflicted body contributes to degeneration in the physical, social, and political realms. Menstruation is very important within these frameworks of health, particularly Ayurveda, as bodily rhythms such as those of hunger, defecation, sleep, and menstrual cycles are highly esteemed (Nichter 1981; Zimmermann 1980), and popular health culture still ARTICLE HISTORY