6047 Silsby Hall
Hanover, NH 03755
Phone: 603-646-9356
Fax: 603-646-1140
sienna.r.craig at dartmouth.edu
As a cultural anthropologist, the major focus of my research, writing, and teaching is the social study of medicine. I am invested in understanding the multiple ways that so-called 'traditional' medical systems interact with biomedicine: from patient-healer relationships and the cultural meanings people ascribe to suffering and affliction; to the wider socioeconomic and political circumstances in which medical practitioners are trained, healing occurs, and medicines are produced, evaluated, and distributed. My current research and writing projects investigate contemporary Tibetan medicine, both in Nepal and Tibetan areas of China and as a globalizing "complementary and alternative" medicine. I analyze how practitioners of Tibetan medicine transmit knowledge between generations, and how they are professionalizing. I also address the translation of science across cultural, epistemological, and ideological borders by documenting what happens when Tibetan medicines are made to adhere to biomedical standards of drug safety and quality, and as they are evaluated through clinical research in Asia and the West. In Nepal and China, where I work, these dynamics reflect nation-building agendas and the politics of identity; they also illuminate an expanding global market for complementary and alternative medicines and point to the ethical, economic, and environmental challenges inherent in producing traditional medicines for mass markets.
These interests are reflected in several of my recent publications, including a co-edited volume Medicine Between Science and Religion: Explorations on Tibetan Grounds (London and New York: Berghahn Books, 2010), and Healing Elements: Efficacy and the Social Ecologies of Tibetan Medicine (Berkeley: University of California Press, 2012). These interests also inform a current (2010-2013) research project funded by the Wenner-Gren Foundation for Anthropological Research, in which I am collaborating with the Arura Group, China's largest Tibetan owned and operated Tibetan medical consortium, inclusive of a hospital, teaching college, research institute, and pharmaceutical factory based in Qinghai Province.
Beginning in Summer 2012 I am collaborating with biological anthropologist Cynthia Beall (Case Western Reserve University) and cultural and demographic anthropologist Geoff Childs (Washington University-St. Louis) on a National Science Foundation-funded study, "Genes and the Fertility of Ethnically Tibetan Women at High Altitude in Nepal." This research uses a biocultural approach to test the hypothesis that Tibetan women at high altitude in Nepal with the low-hemoglobin variants of the genes have more surviving children than those with the other variants. The expected outcome of this study is that women with forms of specific genes that are most frequent among ethnically Tibetan populations will have lower hemoglobin concentration, higher oxygen saturation of hemoglobin, and more surviving children. Results of the study will connect a severe environmental stress to biological and genetic variation and reproductive success to build a case for natural selection operating in a human population and improve scientific understanding of the processes of adapting to new environments. This U.S. – Nepalese collaborative research project has health implications not only for Tibetan populations in Asia but for people living at all altitudes around the world because these genes are necessary for intrauterine development and play central roles in the biology of diseases as diverse as osteo- and rheumatoid arthritis, heart failure, and cancer.
Much of my work is collaborative, interdisciplinary, and trained on applying critical medical anthropology perspectives and insights to ground truth health care realities in a variety of global contexts. In 1998, I co-founded Drokpa (www.drokpa.org), a non-profit organization whose mission is to partner with pastoral communities in the Himalaya and Central Asia to implement grassroots health and education projects and catalyze social entrepreneurship. Since 2001, I have been conducting collaborative research with practitioners of Tibetan medicine in Nepal, particularly focused on the conservation, cultivation, and sustainable use of high-mountain medicinal plants, and on these practitioners efforts to at once defend and transform their medical practice in the face of major political and socioeconomic change. From 2002-2004, I was part of a multidisciplinary research project based in Lhasa, Tibet, funded by the National Institutes of Health (NIH/NICHD) and the Gates Foundation. This project focused on maternal and child health, and included the first randomized controlled clinical trial of a Tibetan medicine in Tibet. I am currently Chair of the Medical Advisory Board of OneHEART Worldwide (www.onehearttibet), an organization with which I have worked since 2002 that is dedicated to improving maternal and child survival in some of the world's most marginalized communities - particularly in high Asia. Since 2009 I have been involved in a Gates Foundation-funded research project on the uses, formulation preferences, and administration practices of pediatric medicines. This project is part of a larger World Health Organization campaign "Better Medicines for Children." Fundamental to this work is the recognition that many essential medicines are not made in doses or formulations that are "child friendly," and that this contributes to a range of global health problems, including high mortality and morbidity rates from easily curable diseases in children under five. The broader context of this research project includes a recognition that medicines have both social and pharmaceutical "lives" and that many socioeconomic and cultural factors influence how and why children are given medicines.
I first traveled to Nepal in 1993, on an undergraduate study abroad program, and have been returning to this part of the world ever since. My earliest ethnographic work centered on ethnoveterinary practices and human-animal interactions, with a specific focus on the role of the horse in local culture and economy, as well as in religious symbolism and ritual practice, as well as life in pastoral communities at moments of intense and rapid socio-economic change. The research I conducted at this time forms the basis of my ethnographic memoir, Horses Like Lightning: A Story of Passage Through the Himalayas (Boston: Wisdom Publications, 2008). I also have an abiding interest in studies of ethnicity and identity, including how experiences of diaspora and exile impact subjectivities, concepts of "health" and health seeking behaviors. I have published several articles on these topics, focusing primarily on the translocal relationships between people in Mustang, Nepal, and their relatives who now live in New York City. In a future research project, I plan to conduct more extensive ethnographic research between Nepal and New York, with a focus on changing kinship relations (including birth, child rearing, and marriage practices), flows of capital, and patterns of medical pluralism within and between these locales.
