title: Negotiating "The Social" and Managing Tuberculosis in Georgia.
abstract: In this paper I utilize anthropological insights to illuminate how health professionals and patients navigate and negotiate what for them is social about tuberculosis in order to improve treatment outcomes and support patients as human beings. I draw on ethnographic research about the implementation of the DOTS (Directly Observed Therapy, Short Course) approach in Georgia's National Tuberculosis Program in the wake of the Soviet healthcare system. Georgia is a particularly unique context for exploring these issues given the country's rich history of medical professionalism and the insistence that the practice of medicine is a moral commitment to society. I argue for critical attention to the ways in which treatment recipients and providers navigate what, for them, is "social" about therapeutic practices and their significance for avoiding biological and social reductionism.
authors.affiliation: Department of Anthropology, University of Kentucky, 211 Lafferty Hall, Lexington, KY, 40506-0024, USA. erin.koch@uky.edu.
authors.forename: Erin
authors.initials: E
authors.lastname: Koch
mesh_terms: D060432:Anthropology, Medical; D000995:Antitubercular Agents / Q000008:administration & dosage*; D003226:Congresses as Topic; D023801:Directly Observed Therapy / Q000941:ethics / Q000266:history / Q000639:trends; D005846:Georgia (Republic); D014943:Global Health; D006282:Health Personnel / Q000941:ethics / Q000266:history; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D028681:Moral Obligations; D017008:Negotiating; D018802:Patient-Centered Care / Q000941:ethics / Q000266:history / Q000639:trends; D026684:Personal Autonomy; D015397:Program Evaluation; D011634:Public Health; D012935:Social Justice / Q000266:history / Q000639:trends; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000266:history / Q000635:transmission
chemical_list: D000995:Antitubercular Agents
keywords: Georgia; Global health; Social disease; Tuberculosis