Part Four: International health care planning from an ethnomedical perspective: Critique and recommendations for change

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Abstract
Recent developments in international health are used as a platform for criticizing the biomedical and social science models dominating contemporary international medicine from the standpoint of ethno‐medicine. This critique is advanced both on the grounds of theory and of practical issues in the organization and delivery of clinical and public health services. Implications for cross‐cultural research and for the planning of international health and health care programs are discussed around four specific subjects: consequences of complementing existing models of sickness as disease with models of sickness as semantic illness networks; the desirability of rationalizing and facilitating family‐based therapy; limitations in our knowledge of the productivity of indigenous healers and of their suitability for integration into orthodox health care systems; and the need to teach clinicians and public health planners in non‐Western societies (and when working with ethnic minorities in the West) applied ethnomedical approaches to patient care and health maintenance which are both culturally appropriate to the populations they serve and self‐reflexively critical of the cultural biases of biomedical and bureaucratic norms. These subjects are very briefly illustrated by drawing upon relevant cross‐cultural materials, including the author's field research in Taiwan. A case is made for a larger role for an interpretative ethnomedical perspective (and the medical anthropologists and anthropologically‐oriented medical personnel who advocate it) in international health planning, as a necessary complement to the functional social science and empiricist biomedical approaches which presently dominate how we define and plan for global health.