| This dissertation brings together the theoretical perspectives and analytical tools of the fields of medical anthropology, the anthropology of development, Caribbean studies, and medical ethics to critically examine how the clinical practice, medical ethics, and everyday lives of health practitioners in Santo Domingo, the Dominican Republic, are affected by changes in the regional and national political economy, state projects of modernization, efforts at mental health system reform, local political conflicts, and long-standing struggles over Dominican national and cultural identity. Against the backdrop of the celebrations of the Quincentennial of the Discovery of America, this study documents and interprets the moral economies of poverty in which psychiatrists engaged in public hospital practice and religious healers based at the National Cemetery and in marginal neighborhoods are embedded. Attention is paid to the interpenetration of local and global healing systems, and the ways in which the formidable challenges faced by healers in this setting not only provoke great suffering, rhetorics of resignation, and the commission of ethically questionable acts, but also elicit practices of resistance, compassion, innovation, and community-building. |
