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Tales of treatment and new perspectives for global health research on antimicrobial resistance
  1. Marco J Haenssgen1,2,
  2. Nutcha Charoenboon3,
  3. Patthanan Thavethanutthanawin4,
  4. Kanokporn Wibunjak4
  1. 1Global Sustainable Development, University of Warwick, Coventry, UK
  2. 2Institute of Advanced Study, University of Warwick, Coventry, West Midlands, UK
  3. 3Population Health Sciences, University of Bristol, Bristol, UK
  4. 4Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
  1. Correspondence to Dr Marco J Haenssgen, Global Sustainable Development, University of Warwick, Coventry, UK; marco.haenssgen{at}warwick.ac.uk

Abstract

Global health champions modernism and biomedical knowledge but tends to neglect knowledge, beliefs and identities of rural communities in low-income and middle-income countries. The topic of antimicrobial resistance represents these common challenges, wherein the growing emphasis on public engagement offers a yet underdeveloped opportunity to generate perspectives and forms of knowledge that are not typically incorporated into research and policy. The medical humanities as an interdisciplinary approach to illness and health behaviour play a central role in cultivating this potential—in particular, through the field’s emphasis on phenomenological and intersubjective approaches to knowledge generation and its interest in dialogue between medicine, the humanities and the broader public.

We present a case study of public engagement that incorporates three medical humanities methods: participatory co-production, photographic storytelling and dialogue between researchers and the public. Situated in the context of northern Thailand, we explore subcases on co-production workshops with villagers, tales of treatment shared by traditional healers and dialogue surrounding artistic display in an international photo exhibition. Our starting assumption for the case study analysis was that co-produced local inputs can (and should) broaden the understanding of the sociocultural context of antimicrobial resistance.

Our case study illustrates the potential of medical humanities methods in public engagement to foreground cultural knowledge, personal experience and ‘lay’ sensemaking surrounding health systems and healing (including medicine use). Among others, the engagement activities enabled us to formulate and test locally grounded hypotheses, gain new insights into the social configuration of treatment seeking and reflect on the relationship between traditional healing and modern medicine in the context of antimicrobial resistance. We conclude that medical-humanities-informed forms of public engagement should become a standard component of global health research, but they require extensive evaluation to assess benefits and risks comprehensively.

  • exhibitions
  • health policy
  • science communication
  • social science
  • medical humanities
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Contributors Study conceptualisation, design and theoretical framing: MJH, NC, PT and KW. Study protocol development: MJH and NC. Data cleaning and coding: MJH and NC. Data analysis: MJH and NC. Manuscript draft: MJH. Manuscript review and approval: MJH, NC, PT and KW.

  • Funding This project was funded by the Antimicrobial Resistance Cross Council Initiative supported by the seven research councils in partnership with the Department of Health and Department for Environment Food & Rural Affairs (grant ref. ES/P00511X/1, administered by the UK Economic and Social Research Council). NC was further supported by a doctoral studentship associated with the project 'One Health Drivers of Antibacterial Resistance in Thailand' (grant ref. MR/S004769/1 from the Antimicrobial Resistance Cross Council Initiative, supported by the seven UK research councils and the National Institute for Health Research). The ‘Tales of Treatment’ exhibition at the Warwick Arts Centre was further supported by the University of Warwick’s Humanities Research Fund and the Global Research Priority on Connecting Cultures.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval The research was reviewed and approved by the University of Oxford Tropical Research Ethics Committee (Ref. OxTREC 528-17), and it received local ethical approval in Thailand from the Mae Fah Luang University Research Ethics Committee on Human Research (Ref. REH 60099). The service evaluation of the photo exhibition involved anonymised data collection and received a waiver for ethical approval from the University of Warwick Humanities & Social Sciences Research Ethics Committee (HSSREC). However, all evaluation form respondents explicitly consented to the data being reported in research publications.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public repository via safeguarded access on the UK Data Service via the following reference: Haenssgen, M. J., P. Ariana, H. F. L. Wertheim, R. C. Greer, C. Jones, Y. Lubell, et al. 2019. Antibiotics and activity spaces: rural health behaviour survey in Northern Thailand and Southern Laos 2017-2018 (data set). Colchester: UK Data Service. doi: 10.5255/UKDA-SN-853658.

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