A Heart for the Work - 9780226893273

Burnout is common among doctors in the West, so one might assume that a medical career in Malawi, one of the poorest countries in the world, would place far greater strain on the idealism that drives many doctors. But, as A Heart for the Work makes clear, Malawian medical students learn to confront poverty creatively, experiencing fatigue and frustration but also joy and commitment on their way to becoming physicians. The first ethnography of medical training in the global South, Claire L. Wendland's book is a moving and perceptive look at medicine in a world where the transnational movement of people and ideas creates both devastation and possibility.

Wendland, a physician-anthropologist, conducted extensive interviews and worked in wards, clinics, and operating theaters alongside the student doctors whose stories she relates. From the relative calm of Malawi's College of Medicine to the turbulence of training at hospitals with gravely ill patients and inadequate supplies, staff, and technology, Wendland's work reveals the way these young doctors engage the contradictions of their circumstances, shedding new light on debates about the effects of medical training, the impact of traditional healing, and the purposes of medicine.

"Wendland delivers a tour de force on the culture of biomedicine and biomedicine as African healing. A Heart for the Work details how the clinical experience for Malawian interns yields a very different outcome than in the global North, despite similar courses and curricula. Rather than emotional detachment from their patients in a stance of scientific objectivity, they commit to `love, passion, and spirit'---`having a heart for the work, for their patients' in a moral economy shapped by extensive kinship ties, religious ideals, the need for hope when medicines are scarce, Umunthu (humanity), and political engagement. Wendland argues for the cultural understanding of all medicine, including that in the North driven by technology, pharmaceutics, and `objective' science." John M. Janzen, University of Kansas

"Drawing on an impressive amount of original, empirical research and written in an engaging style, A Heart for the Work is an extermely interesting look at medical training in Malawi. Wendland argues that trainee doctors, facing an enormous gap between the ideals of their training and the conditions of medical practice, forge their own set of practical ethics and their own professional culture." Megan Vaughan, University of Cambridge.

"Wendland tells a rich and important story about medical students and interns who are taught a form of medicine they are unable to achieve because they lack access to the most basic supplies and technologies. They then create a form of practice all their own, one that takes determination, a deep identification with the poorest of their patients, and a quality they call `heart'. The book offers a rare glimpse of the world of African medicine as it is, not as imagined by donors or promoted in press releases." Steven Feierman, University of Pennsylvania