Send message to Author

Paper short abstract

In post-dictatorial Chile, a form of Integrative Medicine emerged. Practitioners with a history of anti-Pinochet political engagement developed a community-based IM, emphasizing relational subjectivities. This shift became a political act that contests biomedical power and reconfigures healthcare.

Paper long abstract

My PhD research, conducted in the 2010s, explored Medical Pluralism in Chile. Specifically, I focused on a mode of integrative medicine (IM) practiced in two centers in northern Santiago, which was reframed by healthcare professionals as community-based and solidarian primary healthcare.

A key finding concerned the practitioners’ background: most were initially involved in the social and community medicine movements of the mid-twentieth century, and later, in the resistance against Pinochet's dictatorship (1973-1999). Their shift raised the question: why did these highly politically engaged physicians and nurses choose a form of healthcare detached from both the political project of rebuilding democracy and the official guidelines of the Ministry of Health?

My research revealed that the practitioners' trajectories during and immediately after the dictatorship led them to a deep critical assessment of their medical and political participation. This process resulted in new ways of understanding and practicing healthcare: a mode drawing on various approaches and medical systems, emphasizing the relational dimension of subjectivities rather than focusing on specific diseases or syndromes.

I used Jacques Rancière's perspective on political disagreements to understand how this mode of addressing and producing bodies and places of enunciation, served to reconfigure the field of health and healthcare, and ultimately implies a highly political act.

I will present a life story from my research to discuss how this particular form of Integrative Medicine organized medical pluralism and became a way to contest the biomedical power dominating the epistemic and practical realms of healthcare.

Send message to Author

Paper short abstract

This paper examines how psychotropic drugs in contemporary Lebanon are mobilized to treat social and political pain, while the care of the soul unfolds through multiple pathways, including spiritual practices, therapeutic work, political initiatives, and artistic projects.

Paper long abstract

This paper presents initial findings from a postdoctoral research project that examines experiences of suffering, mental health care (khadamāt al-soḥḥa al-nafsiyya), and recovery practices in contemporary Lebanon, amid widespread pauperization, war, forced displacement, and uncertainty about the region’s future. Drawing on ethnographic fieldwork, the analysis focuses on care pathways, situating mental health care alongside everyday resources and customary or alternative recovery practices.

The paper explores the hypothesis of a specific social relationship to psychotropic medications—commonly referred to as “nerve medicines” or “sleeping pills,—that appears relatively independent from other therapeutic choices shaping care trajectories. Psychotropic drugs are not perceived as fundamentally distinct from medications used to treat physical pain, such as those for migraines or stomach pain (e.g. paracetamol), which may also be mobilized for their calming or sleep-inducing effects. This relationship appears to date back to the Lebanese Civil War (1975–1990), a period marked by increased consumption of psychotropic and other psychoactive substances (Baddoura 1990), and persists through the continued non-prescription dispensing of these medications by pharmacies (Solberg, 2008).

The paper examines the social relationships surrounding psychotropic use, showing how these medications are often resignified as a form of quasi-collective support that enables endurance under protracted violence. Their use coexists with multiple spiritual, artistic, therapeutic, or collective pathways to recovery. Belief in partial efficacy does not imply acceptance of biomedical causality, suggesting a renewed approach to medical pluralism attentive to how therapeutic objects are differently inhabited and reworked in practice.

Send message to Authors

Paper short abstract

Drawing on research with Mapuche people living with HIV in Chile, this paper examines how patients navigate between biomedical and Indigenous healing. It focuses on the knowledge produced through lived experience and its role in how patients understand and decide about their care.

Paper long abstract

This paper examines the tensions and negotiations between biomedical and Indigenous medicine in Chile. It is based on research with Mapuche people living with HIV in Chile’s capital and in the region with the highest proportion of Indigenous population in the country. The paper explores the place of medical pluralism within care pathways, focusing on narratives of transmission, diagnosis, and treatment. Patients dynamically make sense of illness and navigate the practicalities of biomedicine and traditional Mapuche medicine—whether in terms of exclusion or complementation—according to their life trajectories, care pathways, and evaluations of practitioners’ legitimacy, shaped by encounters with biomedical doctors and machis (traditional Mapuche healers).

By considering how patients perceive themselves as morally, geographically, and ethnically close or distant from HIV, and how these perceptions shift following the biographical disruption of diagnosis, the paper examines how gender, sexuality, and physical proximity to Indigenous rural communities inform changing meaning-making and therapeutic decision-making in a context characterised by stigma. Drawing on previous and ongoing experiences, patients navigate between the differing openness of biomedical practitioners towards traditional healing and the diagnoses and claims of effectiveness made by machis. Ultimately, they evaluate therapies in relation to bodily effects and social risks.

Rather than viewing biomedical and Indigenous medical systems as being in conflict, this paper argues that, for Mapuche patients, medical pluralism constitutes a space in which they actively produce knowledge through lived experience, acknowledging biomedical hegemony while foregrounding patients’ dynamism in pursuing healing within the social worlds they inhabit.

Send message to Author

Paper short abstract

Drawing on ethnographic research on water cures in Portugal and Brazil we examine therapeutic itineraries framed water as “medicine” or “energy”. We compare medical and therapeutic pluralism, exploring their ethical, political and epistemological implications for knowledge legitimacy.

Paper long abstract

In Portugal and Brazil, thermal practices are classified and institutionalised in different ways according to their respective national health systems. In Portugal, thermalism is subsidised by the National Health Service and framed within the biomedical apparatus. In Brazil, thermal practices have been incorporated since 2006 into the Unified Health System (SUS) as Integrative and Complementary Health Practices. These arrangements stem from distinct historical and social processes (Quintela 2004, 2008, 2011) and allow thermalism to be understood both as a regulatory framework and as a site where therapeutic practices adapt to changing health configurations, increasingly shaped by notions of wellbeing, prevention and health promotion (Nairandas & Bastos, 2011).

Drawing on ethnographic research on “water cures” in Portuguese and Brazilian thermal spas, this paper analyses spa users’ practices and narratives that frame water as “natural medicine” and/or “energy”, as well as their therapeutic itineraries across different medical systems. Based on these materials, we propose a critical discussion of medical pluralism in dialogue with the concepts of therapeutic pluralism and therapeutic syncretism, highlighting processes of articulation, tension and negotiation between diverse forms of knowledge and care.

The contrasting medical frameworks within which thermal practices are embedded—biomedicine in Portugal and CAM in Brazil—raise questions about the analytical usefulness of medical pluralism (Leslie 1980; Hsu 2008; Khalinova, 2023), particularly in relation to its overlap with therapeutic pluralism and syncretism. To address the fragility of these conceptual boundaries, the paper engages with recent debates in medical anthropology, including Papalini’s (2024) contributions.

Send message to Author

Paper short abstract

This paper examines how medical pluralism is shaped through state-regulated Ayurvedic education in South India. It shows how training institutions organise and polarise future care pathways by integrating biomedicine while sustaining classical diagnostic reasoning.

Paper long abstract

This paper examines how medical pluralism is institutionally shaped through professional education, focusing on Ayurvedic colleges in South India. Rather than treating pluralism as the coexistence of multiple therapeutic options, I analyse how educational structures actively organise and polarise future therapeutic pathways.

Drawing on a comparative background of traditional medicine integration, I briefly contrast the Japanese case—where Kampō is incorporated into biomedicine through epistemic reduction—with the Indian context, where Ayurveda retains institutional and diagnostic autonomy. Using this contrast as an analytical lens, the paper centres on Ayurvedic medical education in South India and asks how epistemic plurality is sustained, negotiated, or reconfigured within training institutions.

Ayurvedic curricula formally integrate biomedical sciences while maintaining classical diagnostic frameworks such as doṣa, prakṛti, and samprāpti. I argue that this arrangement produces what may be described as epistemic bilingualism. However, rather than assuming this bilingualism to be stable, the paper interrogates how it shapes students’ orientations toward care: what kinds of diagnostic reasoning are legitimised, which therapeutic pathways become actionable, and where tensions or exclusions emerge.

The paper is informed by preparatory analysis of curricula, examinations, and regulatory frameworks, and it outlines the design of ongoing ethnographic fieldwork in three Ayurvedic colleges in South India. By treating polarisation as an institutional process rather than a binary opposition, this contribution highlights how medical pluralism is actively produced, managed, and contested at the level of professional training, with implications for the future organisation of care.

Send message to Author

Paper short abstract

This paper moves beyond analytical frames like medical pluralism by showing how medical industries in Madagascar furnish the raw materials for the construction and reconstruction of everyday life. It argues for decentering the consumption of therapeutic commodities as major objects of analysis.

Paper long abstract

In Fianarantsoa region of southern-central Madagascar, a pharmaceutical factory produces necessary antimalarial ingredients from the leaves of the Artemisia annua bush. But much is left behind in the villages where these medicinal plants are grown – like artemisia’s dried stems, which remain heaped up behind local houses once the valuable leaves are beaten off and sold to the drug company. This paper follows what that waste wood becomes: a woven fence protecting a village garden, struts for a new roof after cyclone damage, firewood for daily pots of rice and greens. In showing how medical industries furnish the raw materials for the fabric of everyday life in zones of production, it argues for ethnographic-historical methods that decenter consumption of therapeutic commodities as core objects of analysis. Nuanced methodological attention to medicine’s enmeshment with unfolding ordinariness – to how making medicine is in some ways also always making and remaking banal inhabited landscapes – in turn enables new theorizations of the relationship between biomedicine and ‘the normal.’ Dominant conceptual toolkits focus on the ways that modern biomedicine expands modes of being deemed pathological and shrinks modes of being deemed normal; this system’s intersections with other ways of practicing health constitute the grounds for analyses of medical pluralism. But medicinal-wood fences, roofs, and fires from Madagascar instead suggest the many ways that medical industries open unexpected potentials for the construction and reconstruction of ordinary life.

Send message to Authors

Paper short abstract

Based on ethnographic research in Ethiopia and Japan, this paper examines how medical pluralism is built through different infrastructures of care. It shows how aid programs and medicinal plants reorganize therapeutic pathways, producing uneven regimes of legitimacy, regulation, and intervention.

Paper long abstract

This paper revisits medical pluralism as a set of hybrid and unevenly organized care trajectories through two ethnographic case studies from Ethiopia and Japan. Approaching pluralism from different but related angles, the authors highlight the productive tensions that emerge as diverse medical knowledge practices intersect, overlap, and diverge in practice. The first case draws on ethnographic research in Tigray (Ethiopia), tracing contrasting care trajectories within a single family. Conditions targeted by supranational health aid programs are integrated into regulated biomedical pathways, while other conditions remain excluded and are addressed through informal, locally managed practices. These divergences show how global health priorities actively shape therapeutic legitimacy and hierarchies of care, producing polarized forms of care within the same social unit. The second case examines more-than-human practices of healing in Nara (Western Japan) by following medicinal plants as they mediate care across institutional, medical, and ecological domains in two herbal gardens. In these gardens, therapeutic knowledge is hybridized, agency is redistributed, and medical practices are detached from clinical institutions. By following plants, seeds, and cultivation practices, the case shows how grassroots activism reshapes medical pluralism as a multispecies practice of negotiating disease between systems under conditions of environmental and social uncertainty. Taken together, the two cases show that medical pluralism foregrounds how care is differentially organized, authorized, and sustained across sites. What comes into view is a shifting configuration of practices in which care is continually enacted, adjusted, and coordinated under uneven conditions of intervention.

Send message to Author

Paper short abstract

Patients with prolonged (muco)cutaneous leishmaniasis in the Ecuadorian Amazon pragmatically navigate diverse therapies in response to multiple forms of suffering, including biomedical after-effects. Medical pluralism reflects the coexistence of multiple ontologies shaping healing efficacy.

Paper long abstract

Leishmaniasis is a vector-borne neglected tropical disease that remains underdiagnosed and undertreated worldwide. In the Ecuadorian Amazon, Indigenous populations face structural barriers to biomedical care, often resulting in health-seeking delays of more than one month after symptom onset. This paper examines the healing pathways of patients living with prolonged (muco)cutaneous leishmaniasis, focusing on the reasoning that underpins therapeutic choices within contexts of medical pluralism.

This qualitative research with 43 patients from seven ethnic groups analyses therapeutic navigation, including biomedicine, local remedies, diets, prayers, behavioural moderation, and shamanic experiences. These practices form cumulative, personalised and non-linear assemblages of care rather than sequential or competing therapeutic regimes. Patients’ decisions are shaped by embodied experiences of treatment efficacy, moral evaluations of care, and (non-)human relational obligations. Coexisting therapies are not experienced as contradictory or hierarchical, but as a coherent response to illness understood through relational logics.

Using assemblage theory, healing pathways are conceptualised as forms of ontological navigation reflected in the movement across different logics of illness and care. Patients may engage biomedical treatment through a naturalistic ontology, while interpreting after effects or persistent discomfort as signs of social, spiritual or ecological imbalance, prompting complementary forms of care grounded in relational ontologies. Patients move pragmatically between ontologies, assembling responses that address multiple dimensions of suffering. As a result, the legitimacy and efficacy of therapies are evaluated contextually through lived experience rather than fixed institutional hierarchies of knowledge. Ontological plurality foregrounds medical pluralism as a non-exclusive, pragmatic process shaping therapeutic choice in forested settings.

Send message to Author

Paper short abstract

This study explores how individuals in Istanbul navigate mental distress through informal and relational processes within the pluralistic healthcare system of contemporary Turkey.

Paper long abstract

This study explores how individuals in Istanbul navigate mental distress through informal and relational processes within a pluralistic therapeutic landscape. Rather than making autonomous decisions between biomedical psychiatry and spiritual healing, individuals are often guided toward particular forms of care by people around them such as family members, neighbors, or acquaintances, through a process I describe as referral through proximity. Based on qualitative research in Istanbul, the article explores how therapeutic pathways are shaped by social closeness, gendered spaces, and moments of shared uncertainty. Rather than treating healing as a matter of individual preference or systemic integration, the article shows how therapeutic pathways often begin through informal suggestions. By focusing on proximity, trust, and everyday interactions, the article offers a relational perspective on how people navigate overlapping forms of care in contemporary Turkey.