Picturing Students’ Ideals and Practices of Health in Wellington Through a Photo Essay
Paola Tiné; Gabbie Drury; Beatrix Sanders; Alexandra Lehmann; Ewan Lammie; Nathaniel Faull; Louis Hughes; Ella Lamont; Claudia Kearns; Finn Iles; Toni Lane; Daisy Bell Thompson-Munn; Sophie Lingham; Louisa Laing-Ots
Abstract What are the pillars of your personal ideals of health? How did they form, and what do they show about yourself and your society? But more importantly, do your ideals match your practices? A third-year cohort of students studying Medical Anthropology at Te Herenga Waka Victoria University of Wellington, New Zealand, answered these questions in the form of a photo essay. Students found this activity both discomforting and revelatory at the same time. They had to go through a self-discovery journey where their approaches and ideas of health were self-scrutinised. In the process, rebellion, anger, and dissatisfaction, as well as feelings of defiance, self-improvement, self-care, and self-reconstruction emerged. Stressing the notion of ‘self’, and the role of outside agents, including substances, landscapes, and relationships with others in their daily choices, these accounts reveal a difficult world that students have to navigate each with their specific bodies and genetics, as they transition to the next stages of adulthood. This work provides novel insights into some problematic aspects of health experiences among university students in Aotearoa New Zealand and their agentive responses. The paper concludes with a reflection on the pedagogic and self-reflective processes initiated by this assignment’s design, with instructions to the assignment provided as an appendix.
Keywords Health – adulthood – youth – visual methods – photo essay
Résumés Quels sont les piliers de votre conception personnelle de la santé? Comment se sont-ils formés et que révèlent-ils sur vous-même et sur la société? Plus important encore, vos idéaux sont-ils en accord avec vos pratiques? Des étudiants de troisième année en anthropologie médicale à l’Université Victoria de Wellington (Te Herenga Waka), en Nouvelle-Zélande, ont répondu à ces questions à travers un reportage photographique. Cette activité s’est révélée à la fois déstabilisante et révélatrice. Ils ont entrepris un véritable travail d’introspection, examinant de près leurs conceptions et leurs approches de la santé. De ce processus ont émergé des sentiments de rébellion, de colère et d’insatisfaction, mais aussi de défi, de volonté de s’améliorer, de prendre soin de soi et de se reconstruire. Mettant l’accent sur la notion de « soi » et sur le rôle des facteurs extérieurs, tels que les substances, les paysages et les relations avec autrui, dans leurs choix quotidiens, ces témoignages dévoilent un monde complexe que chaque étudiant doit appréhender, avec son propre corps et sa propre génétique, lors de sa transition vers l’âge adulte. Ce travail apporte un éclairage nouveau sur certains aspects problématiques du vécu sanitaire des étudiants universitaires en Aotearoa Nouvelle-Zélande et sur leurs réactions face à ces problématiques. L’article se conclut par une réflexion sur les processus pédagogiques et réflexifs induits par la conception de ce travail, dont les consignes sont fournies en annexe.
Mots-clés santé – âge adulte – jeunesse – méthodes visuelles – essai photographique
Zusammenfassung Was sind die Säulen Ihrer persönlichen Gesundheitsideale? Wie haben sie sich entwickelt und was verraten sie über Sie selbst und ihre Gesellschaft? Doch vor allem: Entsprechen Ihre Ideale Ihrem tatsächlichen Handeln? Studierende des dritten Studienjahres im Fach Medizinische Anthropologie an der Te Herenga Waka Victoria University of Wellington, Neuseeland, beantworteten diese Fragen in Form eines Fotoessays. Die Studierenden empfanden diese Aufgabe gleichermaßen als beunruhigend wie aufschlussreich. Sie begaben sich auf eine Reise der Selbstfindung, auf der ihre Herangehensweisen und Vorstellungen von Gesundheit kritisch hinterfragt wurden. Dabei traten Rebellion, Wut und Unzufriedenheit, aber auch Gefühle des Trotzes, des Strebens nach Selbstverbesserung, der Selbstfürsorge und der Selbstfindung zutage. Indem sie den Begriff des „Selbst“ und die Rolle äußerer Faktoren wie Substanzen, Landschaften und Beziehungen zu anderen bei ihren täglichen Entscheidungen betonen, offenbaren diese Berichte eine schwierige Welt, in der sich die Studierenden mit ihren individuellen Körper und deren Genetik zurechtfinden müssen, während sie in die nächste Phase des Erwachsenenalters eintreten. Diese Arbeit bietet neue Einblicke in problematische Aspekte der Gesundheitserfahrungen von Studierenden in Aotearoa Neuseeland und deren Handlungsfähigkeit. Der Beitrag schließt mit einer Reflexion über die durch die Konzeption dieser Aufgabe angestoßenen pädagogischen und selbstreflexiven Prozesse. Die Anweisungen zur Aufgabe sind im Anhang enthalten.
Schlagwörter Gesundheit – Erwachsenenalter – Jugend – visuelle Methoden – Fotoessay
What are the pillars of your personal ideals of health? How did they form, and what do they show about yourself and your society? But more importantly, do your ideals match your practices? I (Paola Tiné), teacher of Medical Anthropology at Te Herenga Waka Victoria University of Wellington, New Zealand, asked my third-year cohort of students (some of whom are the other authors in this paper) to answer these questions in the form of a photo essay. The aim of this assignment was to produce a photographic essay (5 images) and a short accompanying essay that documents your approach to health. The photographs had to convey some of the students’ daily practices and ideas of healthy and/or unhealthy behaviour. They then needed to explain these understandings and approaches in the written part of the assignment. They were asked to choose a theme acting as a narrative thread, to keep the essay focused, and to address 3 main prompts (self-ethnographic reflection, literature engagement, and critique of the methods used) and engage with all the images. The learning goal was to develop dialectical skills and critical thinking abilities on the ethical and practical aspects of researching health-related issues and to develop the ability to conduct autonomous data collection and data analysis.
Students found this activity discomforting and revelatory at the same time. They had to go through a self-discovery journey where their approaches and ideas of health were self-scrutinised. In the process, rebellion, anger, and dissatisfaction, as well as feelings of defiance, self-improvement, self-care, and self-reconstruction in a lived context characterised by contradictory messages and experiences emerged. The main themes are discussed here under the macro-areas of ‘biopower and docile bodies’, ‘matters of balance’, ‘chronic illnesses and medical authorities’, and ‘situatedness of health’. The paper concludes with a reflection on the pedagogic and self-reflective processes initiated by this assignment design, with instructions to the assignment provided as an appendix.
Alexandra Lehmann discusses avoidant strategies, Gabbie Drury talks about daily rituals of self-care against depression, and Ella Lamont reflects on the nexus between health and social justice. These accounts engage with notions of biopower (as developed by Michel Foucault) and “docile bodies”. Focusing on problematic experiences with body image, Alexandra writes about the experience of being without her parents and how she feels the need to establish self-control around her eating practices. She writes:
My family always had a complicated relationship with health and the body. My father’s fasting after Christmas, my mother’s concern at her clothes size and my Jewish immigrant grandparents feeding any guest to the point of bursting; how could I not have potentially harmful preconceptions about what it means to be “healthy”. Additionally, I have grown up in the technological age and particularly as a young woman online, I am fed health inspirations constantly (Davies & Mann 2023: 416). Through being separated from this environment (leaving home and deleting social media apps), I have begun to undergo a restructuring of my own pillars of health.
Despite her family background and her situatedness as a young woman in a society that dictates self-control around eating practices and modes of appearance, in moving to live alone as a student in a different town, Alexandra has gradually created her own ethos around the ways she approaches her physical health, her appearance, and her well-being. Through a process of nurturing the body and avoiding certain practices that dictate how she treats her body, Alexandra has found an avoidant strategy to reject biopower. Foucault’s (1976) theory of biopower concerns itself with the power asserted through everyday institutionalised activities and habits which subjugate the body, creating “docile bodies” (Pylypa 1998: 21). Foucault's work is useful when considering how individuals are complicit in performing their own oppression through self-surveillance and self-disciplinary practices (Pylypa 1998: 22). Subjugation derives from forced control or through self-disciplinary practices, which we each adopt, thereby subjugating ourselves. Others, such as Lock (1993: 141) have taken this approach by Foucault in the opposite direction, centring the ways in which – because of the centrality of the body in meaning-making, social control, power, and moralities – we might be the owners who can nurture our bodies, rather than ‘self-discipline’ it. The first thing Alexandra does to achieve this is to cross out the nutritional information of the food items in her cupboard (see Fig. 1). Another way she achieves this is by hiding the mirror in her house:
A practice I used to partake and which demonstrates biopower and self-surveillance, is when I used to stare negatively at my body. My mirror hung on this wardrobe and I could critique myself for hours. In sharing this with a friend, I became motivated to remove/hide the mirrors I owned. The process of taking this photo was uncomfortable. I felt embarrassed at the idea that something so normal to someone, could trigger such unhealthy practices for me.
She also reflects on the sofa in her house as a place of intentional rest, where she defies constraints of productivity:
Whilst health gurus on Instagram may say a sedentary lifestyle is unhealthy, I choose to rest on this sofa to keep myself active. The blanket knitted by my great-grandmother before she passed away and the cushion crocheted by my friend as a present – this sofa tells a story more than the idea that ‘sitting = lazy’. Through the act of sitting on the sofa, I am rejecting notions that to be productive, I cannot rest. This photo is an act of defiance.
Alexandra’s reflections continue as she considers the pervasiveness of biopower. Foucault states that “where there is power there are always resistances, for power inevitably creates and works through resistance” (Lupton 1997: 200, in Suijker 2023: 546).
Fig. 1 Food in the cupboard with nutritionalinformation crossed out. Photo: Alexandra Lehmann.
Similarly to Alexandra, Gabbie reflects on her daily rituals of self-care against depression:
Doctors will not prescribe 65–75 houseplants for depression; they will often over-medicalise situations and see the solution as physical treatments through prescription drugs. I understand the need for medication, but for myself, I view a reliance on chemicals that only best bring my mood to neutral as a long-term detriment to my health when my daily rituals have, at worst, the same effect, and at best, a much better one.
Taking salt for energy and iron tablets for dizziness may not seem like they are important for my mental health, but without them, I would lack the energy to water my plants, listen to music and go outside. Everything I do is pre-emptive to protect myself in all aspects of my health.
Social norms exercised under biopower show how we are subjugated to the societal standards we experience, and, as Gabbie reflects, by choosing to participate in her separate health journey, she has rejected the need to police herself and instead allowed her to nurture herself. The images she has chosen for her essay reflect this, as they are all focused on her own choices around her own health that do not immediately reflect societally normative health ideals (see for example, Fig. 2) And yet, for Gabbie, images escape what health “looks like”, and they are rather a glimpse of what she does routinely, where it is the routine that concretises her health. As she states: “I know what my health looks like, and that cannot be expressed through photos, but through the fact that I wake up every morning and do it all again.”
Fig. 2 A selection of my many, many houseplants that I use to boost my mood when at home. Photo: Gabbie Drury.
In a similar vein, reflecting on her own approach to health and elaborating this in terms of agency and resistance to hegemonies of gender, race, and class, Ella Lamont resorts to the theory of social suffering, which collapses the distinction between health and social problems (for example, poverty and depression), and recognises that socioeconomic and sociopolitical structures can both cause and prevent illness (Kleinman 2010). She noted: “photographing, examining and analysing my own approach to health has created a new avenue for research into how wealth and agency are linked, and if they can be unlinked, and how agency is inequitably distributed according to the dominant hegemonies of health, gender, race, and class.” In the image “A Costly Seat, $10.60/min. My Dentist Has 12 Cars” (Fig. 3), Ella commented:
Whether actually effective or not, possessing these over-the-counter medications enables a sense of control and agency over treatment, and to feel less like wellbeing is secured behind a paywall of a hefty appointment fee. When it becomes necessary to traverse the paywall, it becomes clear that agency has always been finite. Agency, like energy, cannot be created or destroyed, only converted and transferred. So, submitting to rubber-gloved hands, mouth agape, drills rattling the skull and tasting blood, it becomes clear that agency over health is not only converted by socioeconomic positioning, but also by the dominant ideology and frameworks available. The dominant Western ideology surrounding health is both highly individualised and values quantity over quality (Shanafelt 2019). This means when I visit the dentist, I go alone – my genetic family history of bad teeth does not come with me – and they see only my lack of care and failure to take up individual agency of my mouth health; they do not see every time I could not afford an electric toothbrush. Then, it is over, I am hit with a devastating fee, and told to brush harder.
Further, reflecting on the image “Breast Ultrasound Receipt”, she commented:
While conducting my self-ethnographic research, I thought of June 2023, when two appointments with a GP about a lump in my breast and a family history of cancer led to a referral for an ultrasound. I had to wait 6 weeks from my initial referral appointment to get the ultrasound, as there was no availability. It cost $225.00. A brief talk with a male friend revealed that the same scan for testicular lumps was free and had high availability. Clearly, agency and wealth are interlinked and are further situated within a wider set of socioeconomic structures. Yet it is also imperative to recognise how systemic oppression creates barriers to access for those who do not fit within the hegemonic archetype. Female patients with male physicians are misdiagnosed at a higher rate, and patients of female physicians receive higher levels of preventative screenings and services than patients of male physicians (Henderson et al. 2001).
Agency over one’s own health, Ella noted, is distributed according to the dominant hegemonies of class, race, and gender. The “default”, archetypal bodies – white, cis, male, and abled – are more readily believed, more accurately treated, and more readily given access to specialist appointments, diagnostic testing, and to medicines that were made for, and tested on their same archetypal bodies. Meanwhile, agency over health for the ‘othered’ – black, brown, trans, intersex, female and disabled bodies – is finite by design, where socioeconomic and cultural constructs like intergenerational poverty, historical disenfranchisement, and a lack of research have left these groups in poorer health, misdiagnosed, overmedicated, side-affected and footing the bill (Zucker & Prendergast 2020: 11).
Fig. 3 A Costly Seat, $10.60/min. My Dentist Has 12 Cars. Photo: Ella Lamont.
Fig. 4 Breast Ultrasound Receipt. Photo Ella Lamont.
Some students focus on the ways pursuing, considering, achieving – and sometimes not achieving – optimal ideals of health involve the balancing opposite forces (Claudia Kearns). For some this means reflecting on the management of the influence of addictions and substances to shape one’s own “self” (Sophie Lingham); focusing on the interplay of mind, body, and spirit (Louis Hughes); and discussing ideals of health as a goal that can only be reached through a constant striving for self-improvement (Ewan Lammie).
Claudia Kearns discusses her experience with balancing opposite forces by focusing on her bed (Fig. 5) to introduce the complexities of pain and pleasure and mind-body dichotomies:
The more I look at this photograph, the more it imprints itself as central to my web. You see, to me, this isn’t just a bed, it is where the connection to my world of health began – a hospital bed. Unconsciously, as an infant, it was a mere place for rest, later evolving into a conscious refuge for both my mind and body. While it still serves its primary purpose, it has become much more profound. It is a place where my mental illnesses have intensified, whether I am battling the flu or more likely, battling my depression and panic attacks, the bed has been witness to both health and illness, both mind and body.
Fig. 5 Bed/web. Photo: Claudia Kearns.
Then commenting on a picture showing the content of her bag which includes a selection of medicines, substances and various objects (Fig. 6), she asks herself a question: “are cigarettes and pills my friends, or enemies?” When the time comes to depart from either illness or slumber, I do so, leaving with this bag. In this photograph, the bag holds little significance, but rather significance exists within its contents; they offer a glimpse into my every day, my socially shaped life … my web.” Thought-provokingly, in this photograph, the bag contains both biomedical and nonbiomedical treatments; those that are culturally recognised as preferable treatment options from my direct cultural influences, and those from global distances. Seen are prescribed pills for bodily ailments, crystals, a book, and even cigarettes, which she sees “as a treat”, something which “gives her mind ease”, but also as a threat:
Whilst there is a dichotomy that exists between treatments of the mind and body, the experiences of health and illness, and of the mind and body themselves, still prosper as entangled. As cigarettes may help my mind, they cease to protect my body, and whilst a prescribed pill controls my reproductive organs, it disrupts my mind. Here, the web is at play. Often, my bag and I find ourselves at a bar, a setting that evokes human connection, laughter, and dance. Simultaneously, amidst perceived health, the alcohol entering my body is causing harm, just as my mind might receive the next day – the web too is at play here.
She reflects on her own positioning in the socio-cultural context she lives in: “raised in New Zealand, the consumption of alcohol was not rejected, it was rather encouraged – by media, discourse in the workplace, the actions of my parents and so forth, though still with the understanding that weekends were for drinking, weekdays for work.” Here, many people like Claudia, and in large part, students, strive for a “balanced” diet, and some harmony between work and play, rest, and exercise. People maintain or restore wellness by balancing opposite forces (Quinlan 2022: 324).
Fig. 6 Items in the bag. Photo: Claudia Kearns.
Along these lines, Sophie Lingham talks about addictions and a balancing of substances (medicines, supplements, and addictive substances like nicotine) to shape her “self”. She noted:
I felt uncomfortable reflecting on the idea of my health. This image conveyed my strong addiction to nicotine through multiple different products. I feel ashamed that this is a huge part of my life. My essay tells the story of creating a new identity for myself through the introduction of new addictions that counterbalance my old ones. I chose this specific image, because to me, my collection of nicotine products spoke louder than words. This image captures years of addiction, generational trauma, and health damage.
Displaying a collection of nicotine (Fig. 7) and alcohol bottles (Fig. 8), Sophie comments:
Directly resembling one another, these images also reflect my own environment where I grew up. The role alcohol plays in rural communities highlights the restricted social outlets available to young people (Valentine, Holloway & Jayne 2010). This also directly speaks to generational and cultural influences that impact adolescent life and carry through to adulthood. In stark opposition to these images, the image of the health supplements, you also have the sunlight there, which adds emphasis to the positivity of the content. This image reflects the person I aspire to be – healthy on the inside and the outside. I have also clung onto the belief that to let go of one addiction, I must swap it for another. I think my images tell a story of my own cultural and environmental upbringing that have led me to be vulnerable to addiction, but in contrast, my ideals of true ‘health’ are also shaped by my cultural upbringing.
Fig. 7 My collection of nicotine products. Photo: Sophie Lingham.
Fig. 8 Alcohol bottles. Photo: Sophie Lingham.
Fig. 9 My collection of health supplements. Photo: Sophie Lingham.
In stark opposition to the images of addictive substances, Sophie also includes a photograph of her health supplements, and reflects on how she tries to balances these to shape her own “self”.
Similarly to Sophie and Claudia, and adding the spiritual component, Louis Hughes focuses on the interplay of mind, body, and spirit. As noted by Louis, the search for well-being has become a common cultural phenomenon in the modern era, with a wide range of approaches, treatments, and theoretical frameworks associated with it. In this context, the pursuit of individual health has become a complex, multidimensional journey marked by self-discovery and reflection. People are faced with an abundance of choices and approaches, many claiming to provide answers and paths to health and happiness. But amidst all these different viewpoints, he suggests that there is a chance that we will forget what is essential to personal health, that is “a fine balance that goes beyond physical health to include aspects of mental, emotional, and spiritual balance”.
One of his daily rituals through which he tries to achieve this balance includes burning Palo Santo (Fig. 10). Palo Santo is known to cleanse negative energy. It originates from South America and is used predominantly by spiritual healers and Shamans:
My motif in preforming this ritual is to get rid of any negative energy and ease stress before my day starts. Cundiff-O’Sullivan et al. (2023), states that the experiences of disease and recovery are closely linked to spirituality, which provides a platform for expression through rituals and symbols and encourages the mobilisation of social support to validate suffering and promote recovery. Spirituality allows people to express their emotions, it allows people to feel connected and understand our struggles, it can be a source of strength, comfort, and connection in times when we don’t feel connected, it brings and gives us better understandings on our physical and spiritual body. I evidently have a holistic and spiritual approach to my ideas and navigation toward health. By documenting these images, I begun to realise how our approaches to health; whether they be behavioural, medical, or educational all end up being subjective to how we receive and promote individual health.
Like Gabbie, Louis emphasises the importance of natural elements in establishing human health, and he also includes the image of his monstera plant (Fig. 11) because, as he says “we both benefit each other’s health”. Using a notion by Patterson (1998), Louis suggests that the monstera is a unifying force: the monstera helps him breathe by providing him with fresh oxygen and he helps the monstera “breathe” and “drink” by watering her and producing fresh carbon dioxide for the plant:
Because of this, we are both unified as one benefiting each other by receiving and giving one another the essentials to live, the Monstera and I relationship is a health entanglement; we both give and receive benefits to one another’s health.
Fig. 10 Burning Palo Santo. Photo: Louis Hughes.
Louis also reflects on the limits that photographs have in revealing worlds and contents:
Photos alone don’t explain how these practices contribute to health. For instance, Palo Santo can be used for smudging or aromatherapy, and cannabis has various applications depending on the strain and consumption method. Images can pique interest and make health information more visually appealing, they can transcend language barriers and be understood by people with varying literacy levels. The images document and demonstrate, such as yoga poses or proper techniques, as the photo of me applying the essential oil demonstrates. Images capture what words cannot, for instance, the photo of the yoga pose shows the movement better than a description. Images can evoke emotions that resonate with viewers, promoting a positive association with health practices. This examination of individual health and well-being highlights how dynamic holistic health is. Through these, I've come to understand the interconnectedness of the physical, mental, emotional, and spiritual aspects in promoting resilience and vitality by reflection and investigation.
He also commented on mindfulness and self-awareness and improvement:
I firmly believe that maintaining one’s own health requires constant adjustment and development. I do this by practising mindfulness, compassion, and self-awareness. Let's stay dedicated to promoting a balanced lifestyle that recognises the complex interactions between the mind, body, and spirit as we navigate this always-changing environment. Doing so will help us live longer and be more fulfilled in life.
Fig. 11 My monstera. Photo: Louis Hughes.
So far, notions of selfhood, self-making, self-control and balance have been central. Similarly, Ewan Lammie reflected on his own self, and discusses how he strives to pursue better health through self-improvement:
Self-improvement is something I have noticed in my day-to-day life. I was first introduced to self-improvement many years ago when I myself was trying to better my life. The process is not easy, and it is safe to say I failed. Not only once, not twice but multiple times. Still, self-improvement is something I admire, and something I associate with good health and a good approach to health. My flatmate Jackson has been on his own self-improvement journey ever since we started university.
Ewan’s flatmate Jackson is his role model and the model of his photos, where he shows his feelings around the importance of having a healthy diet, exercising frequently, being grounded in the moment, or otherwise meditating, spending time in nature, and finally, improving one’s knowledge with informative texts such as books or articles (Fig. 12).
Fig. 12 Reading informative books. Photo: Ewan Lammie.
Some students stressed the other side of agency, and the determinism inflicted by chronic illnesses and medical authorities. Among them, Beatrix Sanders reflects on the entanglements of heritage, culture and kinship, Finn Iles talks about medical mysteries, Daisy Bell Thompson-Munn discusses the feeling of finding discomfort within the body, and Toni Lane writes about the medical gaze.
Reflecting on the entanglements of heritage, culture and kinship, Beatrix shows a photograph with her thyroid medications (Fig. 13), commenting:
Synthroid are pills I take daily because my thyroid has been removed. With these pills I am required to wait 45–60 minutes before eating anything. This changes my everyday routine as if I want to eat breakfast before heading out I have to wake up earlier. This is a link to my heritage, as so far five generations of my family have an overactive thyroid and had to get them removed, or in my great-grandfather’s case, lived with it until he died of it. This may be linked with epigenetics as he grew up in the Netherlands during the end of WW2. I am unsure if his parents had it as they died in Sobibor but it definitely affected his mental health. It feels discomforting that my health is something I can lose!
Fig. 13 Pills. Photo: Beatrix Sanders.
Like Beatrix, Finn discusses genetic disease by referring to an insidious genetic disease she is battling, and includes in her essay a photograph that “portrays the slow nature of her day or the magnitude of what rest means in her life”:
While I always knew something was slightly off with how my body worked and how different I was to other people, I only found out why as an adult. In 2020, I became deathly ill. So many seemingly unrelated symptoms flared up: seizures, tremors, fainting spells, temporary paralysis, chronic unwavering pain, allergies, and so many more. Every part of my body was affected in a different way and nothing made sense. My life was at a complete and utter standstill. I was too young and healthy for this- or so I thought at the time. I was a medical mystery for a long time, but eventually was given a diagnosis of a rare genetic disorder and many comorbidities. It’s a pain having to be cripplingly self-aware and not something I easily forget. From the moment I wake up I am hyper aware of what my body is doing. I cannot possibly at this point in my life, live like most people do. I cannot work full-time or study full-time. I am simply limited to my own ability.
This image can portray the slow nature of my day or the magnitude of what rest means in my life but it does not portray the associated shame, pain, guilt or physical symptoms that make up the hours in my day. An image, particularly in this context, is merely a glimpse at understanding my life. It allows for a lot of assumptions from people who do not exist within my situation, most of which are bound to be wrong. Being young, white, and conventional-looking supports the political echo chamber I hear about lazy beneficiaries and entitled young people.
Fig. 14 Holding a cup. Photo: Finn Iles.
Similarly, Daisy Bell Thompson-Munn reflected on finding discomfort within the body due to living with a chronic illness: “as a tertiary student of Health, a young adult, and as a patient of Aotearoa’s health system living with a, I am surrounded by competing perspectives of wellbeing on a daily basis”. In the guise of Michel Foucault’s theory of biopower, the patient’s power rests in their subjugation of the self through the practice of medication adherence (Pylipa 1998: 22), and yet, through indulging in athleisure wear (Fig. 15), she creates self-confidence and a perception of well-being that helps her navigate and escape that sense of limitation caused by her chronic illness:
Suffering from chronic illness often means living in a constant state of discomfort within the body. Athleisure wear provides the perfect cover: physical comfort from garments designed to aid the body in movement, while distracting from a cultural gaze that devalues individuals who do not fit Western ideals of thinness and fitness. It allows me to honour at times difficult-to-uphold pillar of health and wellbeing I value for myself – being comfortable in my body for my physical health and being confident in my self-perception through mental wellbeing.
Fig. 15 Branded Bodies. Photo: Daisy Bell Thompson-Munn.
Perera et al. (2024: 59) discuss the theory of enclothed cognition, in which clothing has an effect on the wearer’s physical and psychological behaviours, in people who wear athleisure wear. As Daisy Bell reflected, when one wears activewear, they are perceived as “fit and healthy” irrespective of their actual health status. And so too, Foucault’s theory of biopower is inherent in perceptions of the self and those around us – “conceptions of normality and deviance are manufactured so as to create the types of bodies that society needs…” (Pylypa 1998: 26). But despite these issues, Daisy Bell still experiences – and perhaps in a heightened manner – the same contradictions of early adulthood noted by many of the other students. “Gin, tonic, and erythropoietin” (Fig. 16) represents the kind of warped balancing act one performs as a member of the culture of young adulthood, while contradicting oneself “with daily health practices akin to those of an elder”.
Fig. 16 Gin, Tonic, and Erythropoietin. Daisy Bell Thompson-Munn.
Moving towards reflection on the inner side of the human body, Toni Lane – who has spent years collecting medical imagery of herself often altering it by layering or creating moving image works – used an ultrasound scan image (Fig. 17) to reflect on the medical gaze and how individual experiences are lost in the production of internal images of the body:
These ultrasound scans are the only record I have of the pain and scarring that exists internally, but imagery of internal surfaces erases any identifying markers of the human being. Illness created a distance between myself and my gender, reducing it to the state of my internal organs, causing a decline where I had less energy to keep up with particular societal standards.
Author and anthropologist Kaja Finkler (2000) introduced the concept of “life’s lesions” as a way to explain the way social and cultural experiences shape a person's experience of their body: “Such settings are an extension of our bodies, and under adverse social and moral conditions contribute to life’s lesions, which become the existential equivalents of noxious pathogens. They become inscribed on our bodies as a result of a combination of factors experienced in day-to-day life” (Finkler 2000: 449). And yet, if in the inside images the individuality risks getting lost, on the outside images can assist us to situate health in the social contexts that surround it, as we discuss in the next section.
Fig. 17 Internal surfaces. Photo: Toni Lane.
Louisa Laing-Ots and Nathaniel Faull situate health in space, with Louisa reflecting on the interconnections between our health and our homes, and Nathaniel discussing his personal engagement with “the city’s lungs”.
As stated by Quinlan (2022: 329), “it is natural and pragmatic for adults to treat their own ailments (and their dependents’) immediately and privately before bothering to seek help from some medical specialist”. Louisa’s theme of the home as a place of health relates to this as her photos, she suggests, “reflect a more “holistic” representation of health rather than one containing one or more distinct forms of medicines”. She noted: “I resort to the things portrayed in my photos to help sickness or a dip in my mood first, before turning to an expert.’’ “My cats, for example”, she writes, “are two creatures in my home who are an essential part of my health and wellbeing”.
Fig. 18 My cats. Photo: Louisa Laing-Ots.
Also reflecting on agentive ways to soothe herself, Beatrix turned to the foodscape in Wellington and the way it provides ways to nurture her body:
there are many different sweet treats around Wellington, and since there’s easy access, people are more likely to get them on the way to and from work. There is access to nutritious food, but it’s the convenience and dopamine hit that is needed. Health is something you can change with your everyday actions.
Moreover, linking to the situadeness of health, when reflecting on her chronic illness, Daisy Bell reflected on the importance of social support:
The positive impacts of a strong support system cannot be understated. Having a social support network is a key determinant of health and well-being. Humans are social creatures; companionship and understanding from those around you wrap you in a security blanket so that when one does face adversity, they do not have to face it alone.
Finally, linking his individual experience to the broader context he lives in, Nathaniel Faull connects his own health to the city’s lungs:
The selection of photographs I made serves as a visual narrative of my profound involvement with health within dynamic activities set in the surrounding environment, with a specific emphasis on engagements near and within the Wellington town belt. While the initial choice of these images was not deliberate, a pattern emerged as I captured them. These photographs vividly capture the essence of my profound connection with the natural and social landscape by positioning me at the focal point of these visual narratives.
The town belt, described as the city’s lungs (Wellington City Council 2024), consists of native and non-native bush. Within the bush, there can also be recreational spaces such as tennis courts, many running/walking trails throughout and DIY skate parks situated throughout it. The personification of the town belt as lungs allows me to understand why I’m drawn to this area. The fresh air it provides me when relaxing outside or engaging in dynamic activities is incredibly important.
Engaging in dynamic activities where my breath is heightened highlights the profound link between my physicality and the landscape, shaping both my health practices and sense of self. This landscape also allows for social interaction, self-expression, and personal growth, which have a positive effect on my mental, emotional, and social health.
As he notes, this approach, which revolves around engaging in dynamic activities throughout the city, serves as a clear example of the interconnectedness between human beings and their landscape. The connection between individuals and their surrounding landscapes plays a pivotal role in shaping health practices and overall well-being. Wellington’s integration of natural green spaces, such as the town belt and its coastal air, enriches physical health and fosters social connections and personal identity.
This interconnectedness between dynamic activities and the urban landscape shows how humans are inherently linked to their environment. The personification of the town belt as the “lungs of the city” encapsulates a profound insight into the symbiotic relationship between humans and their environments, showcasing the immense impacts urban landscapes have on humans (Chase & Chase 2016: 365). This emphasises the vital role of green spaces in sustaining life and bolstering urban resilience through their health benefits. This concept aligns with the broader field of medical anthropology, as landscapes are shaped and utilised socially, they emerge as significant social determinants of health. “Humans and their environments are co-constructed, relational, and constantly in flux” (Hoke & Schell 2020, in Leatherman & Goodman 2022: 31). Understanding the comprehensive scope and context of anthropogenic urban landscapes is crucial for future considerations regarding the impact of urban development on overall human health. This approach allows for inclusive and equitable strategies in urban development, particularly regarding public health (Chase & Chase 2016: 369).
Fig. 19 View of Newtown from a walking trail on the town belt. Photo: Nathaniel Faull.
Health is a social, cultural, and biological experience. Through this assignment, students reflected through a self-ethnographic visual project on what roles our cultural beliefs and practices play in shaping our understandings of health, well-being, illness, and medicine. In their reflections, they scrutinised their own ideas and practices of health, and reflected on the ways their bodies are part of broader discourses on well-being, but they also pointed out constrictions dictated by chronic conditions, and provided insights on how they navigate internal and external influences and pressures, how they seek ideals of balances, and how their situatedness in their specific socio-cultural and natural environments play a key role in these processes.
Students were invited to take this task like a “process”, giving themselves the time to develop their ideas, taking photos and analysing them across multiple days. The visual observation they had to carry out through the act of photographing and selecting their photographs was the starting point and the frame through which they examined their own ideas and practices. Those visual lenses through which they captured their own realities assisted them in reflecting on what filters they have carved for themselves in relation to their own health.
In a recent paper discussing the use of the photo essay in medical anthropology (Crowder & Cartwright 2021) present guidelines for the creation of ethnographic photo essays that do not simply combine image and text, but create a balance that allows words to provide context for the images to reinforce or challenge the text through engagement with central theoretical and topical concerns of medical anthropology. In this work, we have presented several key theories, such as those of biopower and medical authority, and important concepts such as those of self-nurturing, self-controlling, and self-improving. Here, then, theories, inspirations, and personal experiences were elaborated alongside and through visual creations. Elsewhere (Tiné 2021, 2022), I have discussed how using visual methods in anthropological research can productively involve integrating artistic expression into the research process to explore individual experiences and social dynamics. This approach allows for a more nuanced understanding of social realities by incorporating the researcher’s subjectivity and mediating between individual narratives and broader generalisations. That is, visual creations can be used to bridge the gap between individual experiences and broader social patterns, offering a way to explore the complexities of modernity through specific case studies while still contributing to larger theoretical frameworks. Using photographs in this self-ethnographic exercise brought the students to reflect on the social contexts they live in, and the positions they take among the possible choices and ongoing contradictions. Taken together, their responses provide novel insights into some problematic and contradictory aspects of health experiences among university students in Aoteaora New Zealand and their agentive responses. Stressing the notion of “self”, and the role of outside agents, including substances, landscapes, and relationships with others in their daily choices, these accounts reveal a difficult world that students have to navigate each with their specific bodies and genetics, and with their own ideals and goals, as they transition to the next stages of adulthood.
The aim of this assignment is to produce a photographic essay (5 images) and a short accompanying essay that documents your approach to health. The photographs should convey some of your daily practices and ideas of healthy and/or unhealthy behaviour. You will then need to explain these understandings and approaches in the written part of your assignment. You will need to choose a theme acting as a narrative thread, to keep your essay focused, and will need to address 3 main questions/prompts (outlined below) and engage with (mention/refer to/discuss) all the images. The learning goal here is to develop dialectical skills and critical thinking abilities on the ethical and practical aspects of researching health-related issues and to develop the ability to conduct autonomous data collection and data analysis.
This essay is an exercise in what ethnographic research is. You will need to take it like a “process”, and give yourself the time to develop your ideas: taking photos and analysing them across multiple days. Each time, you will understand something more. To start taking photos of what you do and what you see around you that inspires you or that you think is healthy/not healthy is a good way to approach this. To analyse the images and try to find a thread, ask yourself some key questions like: why do you do this; do your ideas match your behaviour and if they do/don't, why is it so? where did you get these ideas from? and what does each photo show? try to have a conversation with yourself, and write notes about the possible answers to each of these issues I mentioned. You will then come up with some possible explanations, and one of these might be your theme.
The photographs will assist you in discussing your approach to health and can be a combination of many things, for example, images that record some of your daily behaviour and practices; messages you see around you (influences of various kind that shape, support, or challenge your idea of health). The focus is yourself as a research subject, and you will need to make uncommon knowledge of what you see around yourself, and what you do in relation to your own health. Ask yourself: What are the pillars of your health ideals; How did they form; What do they show about yourself and your society? Do they correspond with those of others around you? Do your ideas correspond to practice? Your grade for this assignment is not based on your technical competence as a photographer.
The essay should be 1000 words. You will need to produce 5 images and these need to be put within a Word document together with the written short essay. Please give your essay a title that reflects the central visual and narrative theme you have chosen. There should be a maximum of 6 and a minimum of 3 references. You need to use at least two required readings from the Reading List. The additional references can be of your choice, but at least one of these extra readings should be scholarly, peer-reviewed material. When writing a reflective section, try to link this theme to health topics and themes seen in the lectures that you found interesting and useful to explain your personal view of health.
Chase, Arlen F. & Chase, Diane Z. 2016. Urbanism and anthropogenic landscapes. Annual Review of Anthropology 47, 1: 361–376. https://doi.org/10.1146/annurev-anthro-102215-095852
Crowder, Jerome W. & Cartwright, Elizabeth 2021. Thinking through the photo essay. Observations for medical anthropology. Medical Anthropology Theory 8, 1: 1–13 https://doi.org/10.17157/mat.8.1.5110.
Cundiff-O’sullivan, Rachel L., Roni Shafir, Desai Oula, & Colloca, Luana 2023. Cultural influences on placebo and nocebo effects. In Colloca, Luana, et al. (eds) Placebo effects through the lens of translational research. Oxford Academics: New York: 38–54. https://doi.org/10.1093/med/9780197645444.003.0004.
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Leatherman, Thomas L. & Goodman, Alan H. 2022. Critical biocultural approaches to health and illness. In Singer, Merrill Erickson, Pamela I. & Abadía-Barrero, César E. (eds) A Companion to Medical Anthropology. Sussex: Wiley: 26–48.
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Tiné, Paola 2021. Painting the self in a study of modernity: using art in anthropological research. Re: Think—A Journal of Creative Ethnography 3, 1: 1–14.
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Paola Tiné, PhD, is a medical anthropologist researching the interconnections between morality, relationships, and health. She has conducted ethnographic fieldwork in Nepal, Australia, and Italy. Here she explored themes of family and kin relationships and conflict, inter-generational communication, and constructions of moral personhood, and examined how these are entangled with experiences of health and disease (including depression, spirit possession, and digestive health) through qualitative ethnography and creative methodologies. She is a Senior Lecturer at Victoria University of Wellington, New Zealand.
Full Address: ???
e-mail: Paola.tine[at]hotmail.com
Louis Hughes holds a BA in Cultural Anthropology with interests in medical and environmental Anthropology, with particular attention to the cultural construction of health, wellbeing, and nature.
e-Mail: Louis.hughes2017[at]gmail.com
Toni Michelle Burton Lane is an artist, writer, and researcher currently completing her honours dissertation in Sociology at the Waipapa Taumata Rau University of Auckland. Their upbringing in rural Aotearoa New Zealand has profoundly shaped their multidisciplinary arts and writing practice, which navigates the gendered politics of illness by drawing parallels between the body as a recipient of the invasive medical lens and the earth as a victim of perpetual ecological deterioration. They have had artwork featured in various group shows and was a writer in residence at both Meanwhile Gallery in Pōneke Wellington and RM Gallery in Tāmaki Makaurau Auckland.
e-mail: toni.michelle36[at]gmail.com
Beatrix Sanders is a student at Victoria University in Wellington New Zealand. Their BA majored in Cultural Anthropology as well as History. She is currently studying a Masters in Information Studies, specialising in Libraries and Archives.
e-mail: betasanderson7[at]gmail.com
Nathaniel Faull is originally from Auckland, New Zealand, and has a BCom in Economics and Finance and a BA in Anthropology from Victoria University of Wellington. After over a year in consulting and accounting in Wellington, he is now travelling in Sri Lanka, northern India, and China.
e-mail: nathaniel.faull[at]gmail.com
Gabbie Drury has a Bachelor of Honours in Anthropology, and is now working on Postgraduate studies mixing sport, art and identity.
e-mail: gabriellemdrury[at]gmail.com
Claudia Kearns has a major in Cultural Anthropology with a minor in Development Studies. Now approaching my fourth year living abroad in Melbourne, Australia, I have found myself working in fashion while continuing my studies part-time. I have grown fond of the balance this lifestyle offers a unique combination that allows me to explore my passions across both academia and industry.
e-mail: claaaudiakearns[at]gmail.com
Daisy Bell has BA in Health Promotion and a Master of Public Health. She currently works in paediatric allied health services in Newcastle, Australia.
e-mail: daisybelltm[at]gmail.com
Ella Lamont has completed both a BA in Religious Studies and a Bachelor of Global Studies, is currently a Masters student at Te Herenga Waka, Victoria University of Wellington. She is completing part of it in Palermo, Sicily, in the Cooperation, Development and Migration Masters Programme. Her final thesis considers the relationship between pornography, violence, and politics.
e-mail: e.e.m.lamont[at]gmail.com
Ewan Lammie achieved his BA in cultural anthropology in late 2025, primarily focusing on ritual and collective life anthropology. He is now pursuing a role as a heritage specialist in Australia.
e-mail: ewantlam1[at]gmail.com
Sophie Lingham holds a BA in Criminology and Cultural Anthropology. I am very interested in Aotearoa’s criminal landscape and cultural history. I currently work at the Ministry of Justice as a Court Registry Officer.
e-mail: sophieeforsyth[at]gmail.com
Finn Iles is currently taking a gap period prior to commencing medical school. She aspires to pursue a career in Emergency Medicine, with a strong interest in integrating clinical practice with humanitarian work. Finn is particularly committed to serving marginalised communities and hopes to contribute to initiatives such as search and rescue operations and international medical aid organisations, including Médecins Sans Frontières
e-mail: finn.eva.iles[at]gmail.com
Alexandra Lehmann studied at Victoria university of Wellington, majoring in Cultural Anthropology and Political Science. She now works as a Ministerial Advisor in Wellington.
e-mail: alexandra.lehmanns[at]gmail.com
Louisa Laing-Ots studied at Victoria university of Wellington, majoring in Cultural Anthropology and Political Science. She now works as a Ministerial Advisor in Wellington.
e-mail: louloulaingots[at]gmail.com