Medicine Anthropology Theory
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NGOs, partnerships, and public-private discontent in Nepal’s health care sector
Get PDFPublic-private partnerships (PPPs) have become increasingly popular models of collaboration in the global health arena to deliver, scale, and evaluate health care services. While many of these initiatives are multicountry, large-scale partnerships, smaller NGOs play increasingly central roles in new forms of privatization. This article draws on our collective experiences working in a PPP between the nongovernmental organization Possible and the Ministry of Health in Nepal to ethnographically examine the fragile and contested nature of these arrangements in the Nepali context, amidst an increasingly privatized health care landscape that is resulting in widespread discontent and distrust throughout the country, as well as financial hardship. We discuss the Possible PPP as one approach that simultaneously seeks to strengthen public-sector health care systems, yet still taps into some of the promises, anxieties, and blind spots – such as the broader social determinants of health – inherent in new forms of public-private global health work
Friends, partners, and orphans: Relations that make and unmake a hospital
Get PDFThe essay juxtaposes three moments of medical infrastructure and technology aid in Phnom Penh, Cambodia: 1960, 2010, and 2005. The operative terms of these moments are relationship terms: ‘friendship’, ‘partnership’, and ‘orphan’. The 1960 gift of a hospital, equipment, and training made a friend, and reciprocity involved political alignment at the level of the nation-state. The 2010 gift of equipment and training made a partner, and reciprocity involved brand alignment spread across diverse government ministries, public hospitals, private universities, and private businesses. Focusing on the materiality of technology and infrastructure gifts brings us to the orphan. The orphan is a gift that turns toxic. Its toxicity is health-threatening if there is no infrastructure to secure it. The elaborate partnerships required to identify and secure orphan sources of radiation show how gifts of medical technology and infrastructure exist beyond their immediate utility to humans. What technology of partnership will the medical physicist of 2050 unearth, and what ethic of relationality will come to care for, repair, and secure it
Introduction: Critical perspectives on US global health partnerships in Africa and beyond
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Sixty years of dog management in Nunavik
Get PDFFor centuries, Inuit have used the qimmiq (commonly known as the Canadian Inuit Dog) for transportation and hunting. Since the 1950s, these dogs have been framed by the Canadian authorities as dogs that may potentially transmit rabies and may thus be killed to prevent contagions. It is not the killing of dogs itself that has shocked the Inuit, since they have several rituals where dogs can be killed when there are threats of disease, but rather the massive aspect of the killing, which relies on Western categories, such as the distinction between sedentary and roaming dogs. A collaboration between veterinarians and Inuit people is therefore necessary to bridge the gap between incompatible views of dogs with rabies
Relocating obesity with multiauthor ethnography
Get PDFReflecting on the World Health Organization’s (WHO) account of obesity and recent developments in ethnography, I advocate for a collaborative, multiauthor approach to studying obesity and, more broadly, chronic disease. To illustrate this, I show how recent ethnographies of obesity and metabolism have convincingly challenged and reframed the WHO’s account of obesity. I further suggest that future ethnographic studies of obesity (and chronic disease) could expand their analytical scope – without sacrificing a critical and people-centred approach – through coordination and collaboration. A multiauthor approach to obesity research would increase the capacity of ethnography to demonstrate the many conditions that must be fulfilled for a person to become ‘obese’, productively foregrounding how ‘obesity’ emerges out of a web of social, economic, political, chemical, and historical connections. This would enable a more comprehensive understanding of the uneven emergence of obesity (and other chronic diseases) worldwide
Drone philanthropy? Global health crowdfunding and the anxious futures of partnership
Get PDFThis piece explores some of the dynamics of global health crowdfunding by examining the work of Watsi, a highly successful crowdfunding platform that raises funds to cover the costs of medical care for patients in countries throughout the global South. While Watsi relies on a somewhat traditional formula for fundraising that uses individual patient stories to attract donations, its origins, aims. and values reflect an imagined (and perhaps, probable) future of global health partnerships. What relationships and connections are enabled in this future space? What subjectivities, anxieties, and values are brought to the fore by Watsi’s modes of work? And what forms of intimacy and estrangement are enabled by such connections and relations? Watsi represents, I argue, a new kind of ‘drone philanthropy’ that both disrupts and evokes older forms of partnership, affiliation, and connection among donors, organizations, and individual recipients of aid
