The experiences of African students learning to be doctors in an underfunded Malawi hospital challenge the equation of biomedicine with values of reductionism, individualism, and detachment. Research on medical training in the North typically demonstrates that students become depoliticized, emotionally detached, cynical, and focused on the individual body and on opportunities for technological intervention. These changes often intensify as students transition from textbooks to the bedside. Malawi’s students at the same juncture show a very different response. When they “turn theory into practice” on the crowded hospital wards, many are deeply troubled by the compromises that workload necessitates, their experiences of personal risk, and the poverty of their patients and of the health sector. Some seek escape. In a response that reflects regional concepts of healing, many reevaluate the purpose of medicine to incorporate a sense of connection with patients, a heightened political consciousness, and an analysis of clinical problems that attends to their social and public health roots. I use these data to argue that medical values (acquired in training or exported as medicine globalizes) form no durable or hegemonic moral order but rather a flexible moral economy that responds to conditions of practice.
Animating Biomedicine’s Moral Order: The Crisis of Practice in Malawian Medical Training - ResearchGate. Available from: http://www.researchgate.net/publication/259712466_Animating_Biomedicines_Moral_Order_The_Crisis_of_Practice_in_Malawian_Medical_Training [accessed Sep 5, 2015].