Frontiers of wellbeing

National Healths
August 5, 2005

How do constructions of sexuality and gender travel? And how are sexuality and gender mediated by, and contingent on, conditions of health and illness? This volume sets out to address these questions through a compilation of essays grounded in diverse cultural contexts and disciplinary formats. In this wide-ranging collection, the reader can engage with a number of bundles of related critical issues. Many of the essays highlight the role of the nation and, in particular, the role of national identity in creating conditions in which health and illness are experienced and perpetuated.

Two essays that illustrate particularly well how dislocation, exile and mobility between nations affect the health profiles of specific populations are Audrey Prost's "Infectious social change: Tuberculosis and exile among Tibetan refugees in Dharamsala" and James Agar's "Remembrance of health lost: Dis/ figuring Africa in European Aids writing".

Another group of essays highlights the fundamental instability of the concept of health through analyses of the politics of its representation.

In particular, Margaret Healy's "Dangerous blood: Menstruation, medicine and myth in early modern England" and Lynda Morgan's "Vulnerable margins: The iconography of blood, dirt and disease in the early 20th-century South African settler novel" show how the iconography of illness is open to regular and forceful contestation. Taken together, this bundle of work contends not only that the meaning of illness is always contingent on other cultural and social forms, but also that the very materiality of illness can in no way be taken for granted as a baseline for understanding either health or illness.

Finally, a highly provocative bundle of essays addresses the practical implications of and limitations to understanding health as a primarily cultural phenomenon.

In "Female genital mutilation: Contesting the right to speak of women's bodies in Africa and the West", Nahid Toubia argues that while health is embedded within a cultural context, understanding the health experience of various groups cannot be reduced to seeing health as merely a function of their cultural condition. Readers are thus given the tools that will help them to deconstruct the nation, nationality and location of health and illness, as well as to interrogate the health implications of location - in its multiple senses of epistemology, geography and culture.

Nevertheless, the collection of essays raises more problems than it resolves. Both editors argue that health is not a stable concept. However, I am not sure that the essays' divergent engagement with "health" underscores this point. Rather, "health" is put to such disparate uses.

Such diversity frustrates rather than aids the reader striving to think broadly about the distinct ways in which the concepts of health, sexuality and gender intersect, antagonise and are implicit in the construction of each other.

Additionally, while the volume is ambitious in its range and scope, its contents are dispersed in terms of disciplinary location and geographical focus. At a certain level, one must ask whether or not this expansiveness is at the cost of an overall intellectual coherence, particularly when the individual contributions are many but short - most chapters are about ten pages long. I fear that breadth may come at the expense of critical depth.

The individual essays in the volume will be of interest to medical sociologists, medical anthropologists and those interested in the cultural studies of health and illness. Historians of medicine and literary critics will also find some essays of interest in the book.

Sarah Hodges is lecturer in history, Warwick University.

National Healths: Gender, Sexuality and Health in a Cross-Cultural Context

Author - Michael Worton and Nana Wilson-Tagoe
Publisher - UCL Press
Pages - 232
Price - £35.00
ISBN - 1 84472 017 9

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