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Waiting for "Good Care". Biomedicine and the Elderly in North Sulawesi, Indonesia

Van Eeuwijk, Piet. (2021) Waiting for "Good Care". Biomedicine and the Elderly in North Sulawesi, Indonesia. Moussons Recherche en sciences humaines sur l’Asie du Sud-Est, 38 (2). pp. 29-56.

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Abstract

Older persons in North Sulawesi (Indonesia) shared a long experience with biomedical health interventions during Soeharto's New Order administration. These vertically and top-down structured development activities in health no longer fit current demographic, epidemiological, and social transformations in Indonesia. The rapidly aging communities, the sharp increase in non-communicable diseases, and aging impairments along with rapidly changing household assemblages call for a biomedical public health that ideally covers cure and care in equal shares. This understanding and vision of "good care" leads to a dynamic appropriation of biomedical services initiated by older persons. Here the monthly local health post sessions for elderly people occupy center stage of this appropriative process: a highly formalized and ritualized medical check-up based on the administration of drug which covers basic curative needs. In addition, the local cadres for aged persons play a significant role as intermediary and broker between an elderly patient, his/her caregiver(s), and the health professionals. Yet, except for the cadres' home visits, the existing biomedical health system is not very concerned with eldercare (or social care) at household level- for ill older persons fully dependent on kin care truly a "missing link." Biomedicine in turn increasingly attempts to appropriate elder health as its new market commodity. Thereby, the four fields of pharmaceuticalization, national health insurance scheme, biomedicalization as control and exercise of power in care, and commercialization of elder health support biomedicine in its pursuit of the hegemonic appropriation of older persons' health and illness. However, dislocations and disjunctures due to the Covid-19 pandemic clearly reveal the structural vulnerability of this biomedical health system: Its sudden unreliability and unsustainability leads not only to a loss of trust in it, but also to a higher degree of vulnerability on the side of older persons in need of cure and care.
Faculties and Departments:04 Faculty of Humanities and Social Sciences > Departement Gesellschaftswissenschaften > Fachbereich Ethnologie
04 Faculty of Humanities and Social Sciences > Departement Gesellschaftswissenschaften > Fachbereich Ethnologie > Medizinethnologie (Obrist )
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Medical Anthropology (Obrist)
UniBasel Contributors:Van Eeuwijk, Piet
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Presses Universitaires de Provence
ISSN:1620-3224
e-ISSN:2262-8363
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:09 Jun 2022 13:15
Deposited On:09 Jun 2022 13:15

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