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May 3, 2007

   

Fulbright Winner Hannah Reiss:
When Healing Styles Collide

This week, Bryn Mawr Now continues a series of profiles of graduating seniors who have won Fulbright Fellowships for the 2007-08 academic year. The number of senior Fulbright winners has risen to five; it was recently announced that Indira Neill has been awarded an English Teaching Assistantship to Bremen, Germany. This week, we look at Hannah Reiss, who will spend next year in Bali, Indonesia, on a Fulbright research fellowship.

Reiss

During her sophomore year, anthropology major Hannah Reiss '07 didn't know that she would someday be applying for a Fulbright fellowship to conduct an ethnographic study of the health-care choices made by pregnant women on a remote Indonesian island. Nevertheless, she was already beginning to prepare herself for it.

"I had intended to major in chemistry and French," Reiss says, "but the anthropology courses just kept sounding so interesting. That year, I took a course about recent immigrants in Philadelphia, and I met some Indonesians while working on a project about the experiences of non-Middle Eastern Muslims in the United States. I wanted to volunteer for the programs that work with Indonesian patients at the Drexel University School of Public Health's Chinatown Clinic, but they basically told me I'd be no use unless I could speak Indonesian. So I learned Indonesian."

Reiss enrolled at the Southeast Asian Studies Summer Institute, an intensive eight-week language-training program at the University of Wisconsin at Madison. Upon returning to Bryn Mawr from a semester abroad in Indonesia, she began serving as a volunteer interpreter for Indonesian patients at the clinic. In that capacity, she has assisted doctors from the Drexel School of Public Health in a study of the Philadelphia Indonesian community's health beliefs and practices surrounding chronic illness. But her work at the clinic also contributed to her own thesis research, begun last summer in Indonesia, on the Balinese island to which she will return for her Fulbright year.

"My thesis is a critical examination of the power relationships that emerge between patient and practitioner — both biomedical doctors and traditional healers."

The study compares the Philadelphia clinic with a national health clinic on Nusa Penida, a small island southeast of Bali. Reiss began researching the relationship between traditional midwifery and biomedicine on Nusa Penida as an independent research project that completed a semester in the School for International Training's study-abroad program, which provided intensive Indonesian language training and a lecture series on Balinese history, culture and art. She continued it through the summer with the aid of a Hanna Holborn Gray Undergraduate Fellowship.

Health-care options for women on Nusa Penida, which reportedly has one of the highest infant and maternal mortality rates in Indonesia, include traditional midwives and midwives trained in biomedicine and employed by Indonesia's national health service.

"Government midwives and nurses are not trained to handle caesarians and abnormal births," Reiss explains. "These cases are sent to a government hospital on the mainland of Bali. This trip is dangerous, time-consuming and expensive. It is common for a woman to be informed that her pregnancy is 'abnormal' in some way. This seems to create a dilemma for many women who are frightened by surgery and have cultural expectations that a woman should give birth at home."

During her first stay in Nusa Penida, Reiss was able to cover a lot of ground. She traveled to several satellite clinics operated by the national health service and met several traditional midwives, one of whom she interviewed at length.

"She described her process to me in detail," Reiss says. "She has had 17 children of her own and delivered several generations of babies for other women. When I told her I was an only child, her jaw dropped."

When she returns to the island, Reiss says, "I will look at the overlapping systems of medicine, biomedical and traditional, how they function together, and the personal and cultural reasons for the health-care choices women make. I will focus on how these choices are affected by location, socioeconomic status, education, beliefs, age, caste and religion."

According to Reiss, the strait between the main island and Nusa Penida will be served by a modern ferry for the first time this year; also for the first time, the national health service will employ a full-time obstetrician on Nusa Penida.

"It is an important time to be there doing this research," she says. "I can observe how better access to biomedical care affects women's choices — whether their health-seeking behavior changes."

 

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