Momwe Capitalism Yamakono Idapangira Vuto Lathu Laumoyo Wamaganizo. Kuyang'ana kodzutsa ndi kodabwitsa momwe anthu akumayiko akumadzulo akusamvetsetsana ndikuzunza matenda amisala. Zabwino kwa mafani a Empire of Pain ndi Dope Sick. Ku Britain kokha, oposa 20 peresenti ya anthu akuluakulu amamwa mankhwala amisala m’chaka chilichonse.
Pa Epulo 9, 2022, Irene Hernandez Velasco, mtolankhani wa nyuzipepala yaku Spain. El Mundo, adafalitsa kuyankhulana kodabwitsa ndi Dr. James Davies, wolemba "Osweka: Chifukwa Chake Psychiatry Ikuchita Zovulaza Kwambiri Kuposa Zabwino“. Kwa iwo omwe samalankhula Chisipanishi, timapereka apa kumasulira, koma choyambirira chake chimapezeka mu izi kugwirizana.
James Davies, Pulofesa wa Anthropology ndi Psychotherapy ku Yunivesite ya Roehampton (UK). Mu “Zokhazikika: Momwe Capitalism Yamakono Idapangira Vuto Lathu Laumoyo Wamaganizo” amaulula zomwe zili zolakwika kotero kuti, ngakhale kuti kumwa mankhwala osokoneza bongo akuchulukirachulukira, matenda amisala sasiya kukwera.
Zolemba zachipatala zawonjezeka ku UK ndi 500% kuyambira 1980, ndi mayiko onse akumadzulo akulembetsa kukwera kwakukulu. Komabe, mavuto amaganizo sanachepe koma akula. Zitheka bwanji?
Ndikuganiza kuti kwenikweni ndi chifukwa chakuti tatenga njira yolakwika, njira yomwe imayambitsa mankhwala ndi mankhwala osokoneza bongo zomwe zimamveka bwino momwe anthu amachitira pazovuta zomwe timakumana nazo nthawi zambiri.
Kodi ndizochitika mwangozi kuti kuwonjezeka kumeneku kwa kumwa mankhwala amisala kunayamba m'ma 1980?
Ayi, sizinangochitika mwangozi. Kuyambira zaka za m'ma 1980 gawo laumoyo wamalingaliro lasintha kuti likwaniritse zofuna za capitalism yamasiku ano, neoliberalism, movutikira anthu osowa. Ndipo izi zikufotokozera chifukwa chomwe zotsatira zamaganizidwe sizinayende bwino panthawiyi: chifukwa sizokhudza kuthandiza anthu, koma kuthandiza chuma.
Kodi mungatipatse chitsanzo cha ulalo womwe ulipo pakati pa misala ndi neoliberalism yomwe mukunena?
Kuchokera ku lingaliro la neoliberalism, njira yamakono yogwiritsira ntchito mankhwala osokoneza bongo imagwira ntchito pazifukwa zingapo: choyamba, chifukwa imapangitsa kuti anthu azivutika, amalingalira kuvutika m'njira yomwe imateteza chuma kuti chisatsutsidwe. Timaona chitsanzo cha kusakhutira kwa antchito ambiri. Koma kusakhutira kumeneko, m'malo moyambitsa mkangano wokhudza mikhalidwe yosauka ya moyo wamakono wogwira ntchito, kumayankhidwa ngati chinthu cholakwika mkati mwa wogwira ntchito, chinthu chomwe chiyenera kukumana ndi kusinthidwa. Ndipo ndikhoza kukupatsani zitsanzo zina zambiri.
Ndiye ndiye za kusandutsa vuto lachitukuko kukhala vuto laumwini?
Inde. Ndiko kuchepetsa kuvutika kwa kusokonezeka kwa mkati, ku chinachake chomwe chiri cholakwika mkati mwathu, m'malo mochiwona ngati momwe thupi lathu limachitira zinthu zoipa zomwe zikuchitika padziko lapansi zomwe zimafunika chisamaliro chathu ndi chisamaliro chathu.
Deta imasonyeza kuti anthu omwe ali ndi mavuto azachuma kwambiri, omwe amakhudzidwa kwambiri ndi ulova ndi umphawi, ndi omwe amapatsidwa mankhwala osokoneza bongo kwambiri. Kodi izi zilinso ndi chochita ndi chuma?
-Ndithudi. Tangowonani zomwe zachitika panthawi ya mliri. Azimayi olera okha ana omwe amakhala m’mizinda ikuluikulu ya m’mizinda ikuluikulu ndi amene amakhala ndi vuto la kuvutika maganizo ndi nkhawa kuwirikiza katatu kuposa anthu amene ali ndi nyumba m’dziko lokhala ndi dimba lalikulu. Mikhalidwe yomwe munthu amadzipeza yekha kuti adziwe momwe alili. Koma m'malo moyang'ana pazimenezi kudzera mukusintha kwa ndale, zomwe timachita ndikuchiritsa vutoli ndikuganiza kuti tikhoza kuchiza m'zipatala ndi zipatala. Ilo lakhala vuto lalikulu kwa zaka 40 zapitazi, lingaliro lodzikuza kuti kupyolera mu piritsi tikhoza kuthetsa mavuto omwe sali ozikidwa mu neurochemistry, koma padziko lapansi. Ndipo, pamapeto pake, ndikusintha kwandale komwe tiyenera kuganizira ngati tikufuna kuthetsa vutoli.
Ndipo mukuganiza kuti njira yazamisala yogwirizana ndi neoliberalism ndi dala?
Chabwino, pakhala pali zokonda zamphamvu zamafakitale zomwe zathandizira kuchulukitsa kwamankhwala m'moyo watsiku ndi tsiku. Izi zakhala zabwino kwambiri kwa makampani opanga mankhwala, chifukwa anthu ambiri omwe angatchulidwe kuti ndi odwala m'maganizo kapena osokonezeka maganizo, msika waukulu wa mankhwala omwe amawoneka kuti athetse vutoli. Makampani opanga mankhwala alimbikitsa kwambiri lingaliro limeneli m’zaka 30 zapitazi. Komano, zikafika maboma sindikuganiza kuti akhala akugwirizana ndi makampani opanga mankhwala. Ndikuganiza kuti zakhala zikugwirizana ndi malingaliro ndi malingaliro omwe akuwoneka kuti akugwirizana ndi awo, ndipo mwanjira imeneyi ali ndi mwayi wolowererapo ndikuganizira za kupsinjika ndi zowawa zomwe zimagwirizana ndi zomwe akufuna. M'lingaliro limeneli, nkhani yochotsa ndale ndi yabwino pazandale. Mgwirizanowu pakati pa makampani opanga mankhwala ndi mphamvu zandale zakhala zikuyenda pang'onopang'ono kwa zaka 40 ndipo ndizomwe zatifikitsa ku zomwe tikukumana nazo tsopano. Sindikuganiza kuti mgwirizano unawerengedweratu, zinali zotsatira zosapeŵeka za kupeza chithandizo chamtundu wina mwa wina ndi mzake.
Kodi neoliberalism ndiye lingaliro chabe lazachuma?
Ayi. Tikudziwa kuchokera m'mbiri ya chikhalidwe cha anthu kuti malingaliro akuluakulu azachuma pa nthawiyo amaumba mabungwe a chikhalidwe cha anthu, kuwaumba kuti agwirizane ndi dongosolo limenelo. Chotero mabungwe onse a chikhalidwe cha anthu, kumlingo wina kapena umzake, amasintha n’kuyamba kutumikira malo apamwambawo. Taziwonapo m'masukulu, m'mayunivesite, m'zipatala… Chifukwa chiyani siziyenera kuchitikanso pazaumoyo wamaganizidwe? Inde zimachitika.
Pomaliza, kodi matenda amisala akuvulaza kwambiri kuposa zabwino?
Ndikukhulupirira kuti ngati psychiatry sadziwa kuti ndi gawo lotani la dongosolo lomwe limavulaza, ndiye kuti likuvulaza. Psychiatry imatha kusinthika, kuwona momwe ilili yophatikizika ndipo imatha kusintha. Psychiatry ndi chikhalidwe cha anthu chomwe mwachibadwa sichivulaza, zonse zimadalira momwe zimagwirira ntchito monga chikhalidwe cha anthu. Ndipo panthawiyi ngati bungwe lothandizira anthu, ndikupatsidwa mwayi, ndinganene kuti nthawi zambiri likuvulaza kwambiri kuposa zabwino. Deta yomwe ndimapereka m'buku langa ponena za mankhwala a nthawi yayitali a mankhwala osokoneza bongo ndikuganiza kuti akuwonetsera izi bwino kwambiri. Deta iyi ikuwonetsa kuti mankhwalawa samangotulutsa zotsatira zomwe tingayembekezere kuchokera ku ntchito yabwino, komanso kuti akuvulaza anthu ambiri omwe amakhudzidwa ndi mankhwalawa kwa nthawi yayitali. Ndipo chachitatu, mankhwalawa amawononga ndalama zambiri. Kuyika zonsezi pamodzi, ndikukhulupirira kuti psychiatry monga chikhalidwe cha anthu sikuchita momwe ziyenera kukhalira panthawiyi.
Amanena kuti matenda amisala ndi odwala ambiri… Koma ndikuganiza kuti pali anthu omwe amafunikiradi mankhwala, sichoncho?
Inde ndikuvomereza. Sindine anti-mankhwala kapena anti-psychoatry. Psychiatry imagwira ntchito pagulu, mankhwala amisala amagwira ntchito kwa anthu omwe akuvutika kwambiri. Ndipotu, kafukufuku amasonyeza kuti kupereka mankhwala a psychotropic afupipafupi kungakhale kothandiza komanso kopindulitsa. Chomwe ndimatsutsa ndikuchulukirachulukira kwa dongosolo lomwe tsopano likuyandikira gawo limodzi mwa magawo anayi a anthu athu akuluakulu akupatsidwa mtundu umodzi wamankhwala amisala pachaka. Dongosolo limenelo silingathe kulamulira. Ndizowonjezera izi zomwe ndimatsutsa, chithandizo chamankhwala cha mavuto omwe alidi okhudzana ndi chikhalidwe cha anthu komanso amaganizo choncho ayenera kuthandizidwa ndi zochitika zamagulu ndi zamaganizo. Inde, pali gawo lazamisala pakati pa anthu, koma osati lomwe likuyimira pano.
Mukakamba za kulowererapo m'malingaliro, mukutanthauza kuchita chithandizo?
Ndikuganiza kuti pali njira zosiyanasiyana zopitira. Ndikuganiza kuti chithandizochi chimagwira ntchito, koma ndikuganiza kuti tiyeneranso kuzindikira kuti chithandizo chamankhwala m'mbuyomu chakhala chikuthandizira kuchepetsa mavuto amkati, machitidwe am'banja, kapena zochitika zakale. Tiyenera kumvetsetsa kuti mabanja amalowetsedwa mumagulu akuluakulu a chikhalidwe cha anthu. Kuvutika sikungachepetsedwe m'banja, chifukwa banja nthawi zambiri limasonyeza chinthu china. Bambo amene amabwera kunyumba ali wokhumudwa akhoza kuchita zimenezi chifukwa chokhumudwa ndi ntchito yake, ntchito yake ili pangozi, kapena chifukwa choti malipiro ake ndi osakwanira. Izi ndi zinthu zomwe zingapangitse moyo wabanja kukhala wovuta kwambiri, ndipo ngati ochiritsa sadziwa zimenezo, limakhala vuto lalikulu. Ndikukhulupirira kuti chithandizo chomwe chimaganizira za ndale ndi chikhalidwe cha anthu chingakhale chothandizira kwambiri podziwitsa anthu osati nkhani zaposachedwa, komanso zamagulu ochulukirapo komanso momwe izi zimakhudzira thanzi. Chithandizo chamtundu wotere ndi chamtengo wapatali. Pali njira zambiri zamaganizidwe zomwe zingakhale zothandiza kwambiri, koma sindikuganiza kuti tiyenera kusiya pamenepo.
Ndi chiyani chinanso chomwe chiyenera kuchitidwa?
Ndikuganiza kuti tiyeneranso kuzindikira kuti pali zovuta kwambiri komanso zenizeni zomwe zimapangitsa kuti anthu asamavutike, ndipo njira yokhayo yothetsera vutoli ndi kudzera mu ndondomeko za chikhalidwe cha anthu. Tiyenera kuganizira mozama za mtundu wa ndondomeko zomwe ziyenera kukhazikitsidwa kuti tithetse mavuto omwe tikukumana nawo panopa. Kusintha kwa ndale kuyenera kukhala mzati wapakati pa kusintha kulikonse kwa thanzi la maganizo.
Ndipo mukuganiza kuti zidzachitika?
Ngati mbiri ndi chitsogozo chilichonse, tikudziwa kuti malingaliro azachuma amakwera ndikugwa. Tawona izi pazaka 200 zapitazi, ndipo ndikukayikira kuti anthu ambiri akuganiza kuti neoliberalism ngati lingaliro lazachuma likutha. Ponena za zomwe zimabwera pambuyo pa neoliberalism, ndikuyembekeza kuti chidzakhala chinachake chokhala ndi chikhalidwe chaumunthu, mtundu wa capitalism yosakanikirana yachuma. Ndikukhulupirira kuti izi zikhoza kugwirizana ndi masomphenya a thanzi labwino lomwe limapereka mwayi wolowerera ndale, chikhalidwe cha anthu komanso maganizo pa mankhwala osokoneza bongo, podziwa kuti pali malo ogwiritsira ntchito mankhwala osokoneza bongo, koma osachepera omwe akukhala nawo tsopano. Ndizovuta kwambiri kudziwa kumene tidzakhala, koma ndikukhulupirira kuti sipadzakhala kusintha kwa thanzi la maganizo mpaka pakhale kusintha kwa ndale ndi zachuma.
Kodi akatswiri amisala achita bwanji ndi buku lanu?
Mpaka pano zomwe zachitika zakhala zabwino kwambiri. Ndili ndi anzanga omwe ndi asing'anga, sindimawona asing'anga kapena madotolo akuchipatala ngati adani mwanjira iliyonse. Ndi anthu abwino omwe akuyesera kuchita ntchito yabwino pansi pa zovuta kwambiri, ndipo nthawi zambiri amakhala ozunzidwa ndi dongosolo lalikulu la zomangamanga, monga momwe anthu amadza kwa iwo kudzawathandiza. Akatswiri amisala omwe ndalankhula nawo ali ndi chidwi ndi kusanthula komwe ndikuchita, kusanthula komwe ndikuyesera kuti ndipite kupitilira kudzudzula dokotala wamisala kapena chipatala ndikuwunikanso zifukwa zomwe zatifikitsa ku vutoli. Ndipo ndikuganiza kuti ndizosangalatsa kwa asing'anga ambiri. Iwo akhoza kuvomereza kapena kutsutsa mfundo yanga, koma ambiri akuwoneka kuti akugwirizana ndi kusanthula ndi cholinga chake. Komanso,
Kodi mliriwu wapangitsa kuti ziwonekere kuti tikufunika kusintha kwa paradigm?
Ndikuganiza choncho. Ndikuganiza kuti mliriwu wawonetsa momwe mikhalidwe, maubwenzi ndi zochitika zimakhudzira thanzi lamaganizidwe, ndipo nkhaniyo yalimbikitsidwa chifukwa chiwerengero chonse cha anthu chasintha zinthu zomwe kwa anthu ambiri zakhudza kwambiri momwe amamvera. ndi ntchito. Chitsanzo cha chikhalidwe cha nkhawa ndi kupsinjika maganizo chapeza kudalirika chifukwa cha zomwe taziwona. Ndipo tawonanso anthu ambiri akuvomereza kuti kuvutika kwamankhwala sikumangothetsa vutoli, ndizosatheka. Ku UK, mwachitsanzo, pakhala pali kukakamiza kwakukulu kuti athetse kupsinjika maganizo ndi kupsinjika maganizo chifukwa chithandizo chaumoyo sichingathe kulimbana nacho. Kwa nthaŵi yoyamba m’zaka 40, mabungwe akuluakulu monga Public Health ya ku England anati: ” Kusautsika kwanu ndi kupsinjika maganizo sikuli mavuto amankhwala. Osabwera kwa ife, manja athu ali omangidwa. Tili ndi anthu ochuluka pakali pano, ndivuto la chikhalidwe. Zimangosiyana ndi zomwe takhala tikuuzidwa kwa nthawi yayitali. Kukhulupirira kowonjezereka kukuperekedwa ku nkhani zatsopano tsopano, tiyeni tiwone momwe zimasinthira.
