Zamyn regards health – the health of individuals and populations – as an issue that intersects with the whole of the cultural field. In this respect Zamyn’s position differs from the standard view that questions of health are best left to medical experts and their ethical advisors to resolve. Health is not a matter that belongs to an elite of experts, for the good reason that the matter of health interacts in intricate ways with the whole complexity of cultural life, in specific times and places.

Although health tends, at present, to be placed under the banner of science, this is a relatively recent development. When, during the course of the French Revolution, it was decided that there should be doctors for all classes and not only for the wealthy, that decision was reached, not as a result of science, but through placing medicine within a new conception of the citizen and the state.

Similarly, it is for cultural, rather than scientific, reasons that our present societies believe that while provision should certainly be made to safeguard the health of fellow members of one’s own nation, this does not necessarily concern the health of those in other regions of the world. Our thinking here is still bound and enclosed by the logic of the nation state. It will take a cultural shift – rather than a medical breakthrough – to move to a more planetary style of thinking, in which the level of health of those in other countries (including life expectancy and mortality rates, and the provision of medication and supporting infrastructure) counts as much for us as the health of our fellow nationals.

Such a shift entails working with a historically unprecedented set of problems. Medical issues are interpreted in different ways according to specific cultural circumstances. In one time and place, a condition is viewed as a disease (such as women’s hysteria in the nineteenth century); in other places and times (such as now) it is not discoverable as a disease at all. How individuals are to be regarded when viewed as having troubled health varies according to religious and social traditions, economic circumstances, levels of education, political and corporate structures, and conventions regarding age and gender – to name only some of the many key cultural variables.

Zamyn seeks to understand how questions of health vary according to their place and their impact within many cultures – what the presence and absence of health mean in different regions of the world. Before, when the largest unit that could be imagined was the nation state, such understanding of regional and global diversity was largely irrelevant. But within the framework of a growing awareness of health as a global issue – within the framework of emerging planetary mentalities – understanding the cultural construction of health, and the cultural variables at work in that construction, now becomes a matter of paramount importance.

Norman Bryson, Professor at UC San Diego, for Zamyn

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