| This dissertation explores medical pluralism using the theoretical and methodological foundations of biocultural anthropology. In so doing, the evaluation of medical ideology and healing practices occurs simultaneously with cultural interpretations of biologic outcomes and biomedical assessments. Medicine in Echang hamlet (Koror, Republic of Palau) embodies the complexity of cultural adaptation to transformative social, biologic, and ecologic contexts. A presentation of the historical and political circumstances surrounding the resettlement of southwest island communities in Echang provides a lens through which to understand the social marginalization of this population. It also contextualizes the transformation of human encounters with therapeutic and dietary landscapes that has influenced emergent disease patterns, health disparities, and medical practices. Conventional applications of the epidemiologic transition concept are inappropriate in this locale where high rates of infectious and chronic diseases co-exist. Indigenous theories of illness etiology and therapeutic action shape processes of selection, utilization, and cessation of medicines in a setting where a variety of medical paradigms flourishes. The potential physiologic significance of plants in food, medicine, and polypharmacy is considered. The nutritional impact of the declining use of wild and cultivated plants receives special attention. This study contributes to the anthropological literature on medicines in the context of social transformation, medical pluralism, diet and health, and pharmaceutical anthropology. |
