Towards a critical ethnoepidemiology of social suffering in postcolonial Martinique

Based on a conjugation of a political economy of health services approach a nd a critical phenomenology of suffering, American critical medical anthrop ology suggests to set the contributions of anthropology to epidemiology in the arena of the study of structural, political and economic, causes of ill ness. In order to keep its credibility, anthropology must take up the chall enge of a creative linkage between an interpretativist analysis of illness local meanings and a critical analysis of the asymmetric social and economi c relationships that partly explain variations in its prevalence and incide nce. Based on data from a research project on the causes of psychological d istress and social suffering in Martinique, this paper suggests that a crit ical ethnoepidemiology of distress should be able to face such a challenge. It means that it will have to study the articulation between three levels of determinants: a) the postcolonial macro-societal structures that reinfor ces the political and economical dependency of Martinique; b) at an interme diate level, the daily living conditions (i.e. underemployment, intrafamili al conflicts) and c) at the cultural level, the collective identity stigmat a caused by colonialism and the anxieties generated by witchcraft practices and "quimbois". This redefinition of the anthropological endeavour at the crossroads of micro-social and macro-societal level of analysis is proposed as a means to counter the risk of medicalisation of medical anthropology.