The obstetrical fistula, by this time disappeared in the flourishing Western Countries, is yet dramatically present among the poorest brackets of the female population in the Third World, which are often malnourished and socially disadvantaged in spite of the funds and the several interventions in favour of the motherly health in these countries. An analysis on the social origins of this disease led in Tigray (Ethiopia) showed how the violence of social forces structurally suppressive and unequal jeopardize some subjects to sicknesses that have a place in their bodies. Throught the biography of obstetrical fistula’s victim this study aims to explicate the deep connexion between poverty, inequalities and disease, which has too often been ignored by the global health politics in Africa. The reasons have to be searched in a compassionate ethos (Fassin, 2006; 2010) and also in a cognitive-behavioural perspective which tends to individualize the social processes of the disease (and depoliticize them) and obfuscates the real dynamics (economic, social and political) that generate contexts of risk. Key words: obstetrical fistula, structural violence, inequality, health politics, “compassionate ethos”.

In this article, I explore a very debated theme in scientific literature (in particular Brazilian) which describes, in synthesis, population’s noncompliance to dengue vector control policies, despite people usually show a high degree of knowledge about the contagion. I also consider how the anthropological sciences and the ethnographic research approach have been called into question in health promotion programs developed in the different contexts analyzed. This allows me to shed light on the growing involvement of anthropologists who are called to explore, in the local contexts, the meaning of the disease, of the infection and its mode of reproduction, and to point out the use and abuse of the term “culture” in such scenarios. In the conclusion, I propose to explain one of the main concerns emerged from literature, namely the lack of population’s participation to dengue control policies, in the light of an anthropology of vulnerability, risk and responsibility. Key words: Anthropology, dengue, health policies, structural violence, agency, risk.

The issue of reproductive rights in the Mexican indigenous context is so relevant that it is considered by the Comisión Nacional para el Desarrollo de los Pueblos Indígenas as a fundamental indicator of female well-being. Nevertheless, the fully autonomous women’s exercise of their reproductive self-determination, a crucial element of their agency as persons, is often undermined by two main factors. On the one hand, the partners frequently don’t accept the women’s will of planning their pregnancies and prevent them from doing it by taking advantage of their position of power within the domestic gender relations. On the other hand, the hospital medical staff insists on imposing a wide post-partum contraceptive coverage to the patients, in order to achieve the demographic goals of population policies given by the different Secretarías de Salud of the States. The present article focuses on this second element, and in particular on the contraceptive method most widely used in the indigenous context of my research, namely the female sterilization. More in detail, this paper analyses the decisional process that brings women to choose this kind of contraceptive method. Furthermore, it stresses on how the biomedical influence plays a determinant role in all the circumstances in which the decision to be sterilised is taken. Eventually, the analysis of the hospital procedure to sign the ‘Informed Consent Module’ for the supply of the post-partum contraceptive highlights how women’s will is taken into account only when it is not conflicting either with medical and demographical imperatives or with the partner’s will. Key words: Mexico, violence, indigenous women, reproductive health, medical antropology. 

In Japan, the redefinition of human death on neurological criteria in relation to organ transplantation has been at the centre of a heated and long-lasting debate (Lock 2002). The legacy of such controversy is that Japan is among the few countries that do not define brain death as a uniform criterion of human death, and to date it ranks at the very bottom of international statistics on cadaveric organ procurement. In the article I examine the Japanese policy on organ donation from an anthropological point of view, and drawing on qualitative interviews with intensive care physicians and neurosurgeons I explore the meanings and practices of the clinical diagnosis of brain death. Through this analysis, I tease out the practices through which the shifting meanings and ontologies of the body, as a dying person and an object of donation, are negotiated and brought to life. The Japanese case, I submit, offers a relevant contribution to the on-going debate on brain death, which has often remained limited to a merely speculative critique, in that it provides original insights into the practical implications of this clinical category in relation to both the problem of end-of-life care and the issue of effectiveness in organ procurement. Key words: Japan, body, organ transplantation, brain death, policy.

Every year 250,000 women still die all over the world because of cervical cancer (WHO, 2010),which is nowadays a highly preventable and treatable desease. In this article I would like to offer an analysis of three different health programs that work on intervention strategies in the Mexican indigenous contexts for the prevention and treatment of cervical-ute­rine cancer. These programs are “Oportunidades”, “Planificación familiar” and “Prevencio?n y Deteccio?n Oportuna del Ca?ncer Ce?rvico Uterino”. Aim of these pro­grams is to show how a not properly structured medical intervention, not only does not promote an actual reduction of risk factors associated with the disease, buti it does encourage its spread. Key words: Cervical cancer; Human Papilloma Virus (HPV); screening programs; health policies; indigenous contexts; Oportunidades; Family planning programs.

The Ethiopian Federal government is implementing a process of health care decentralization, with the aims of spreading the primary health care and achieving the health-related Millennium Development Goals. The ethnographic research conducted in the district of Kilte Awlaleo (Tigray Regional State) has shown the continuity between the health care programmes directed at the rural areas and the practices of mobilization of the peasant population developed by the Tigray People’s Liberation Front (TPLF) during the civil war against the Derg. Under this experience, TPLF legitimates the current strategies to “fight poverty”, that merge with transnational discourses on community empowerment and participatory development, engendering creative governmental techniques. Starting from two specific health care programmes – the Health Extension Programme and the Women Development Army –, the article focuses on the processes of governance observed in the area under investigation, and on the ways in which subjects involved in development interventions embody the State.

Key words: Ethiopia, Tigray, rural areas, primary health care, development, governance.