Medicine Anthropology Theory
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Invoking Senghor: Universal Healthcare Coverage and the Place of Culture in Senegal
No full textSenegal introduced Couverture Maladie Universelle (CMU), its version of universal health coverage (UHC), in 2013, basing it on the establishment of mutual health insurance. Mutual health organisations (mutuelles de santé) manage the pooling of funds, including member enrolment fees and government subsidies; in an effort to extend the reach of UHC, the Senegalese cultural sector created a mutuelle of its own. As part of ethnographic fieldwork focused on CMU, I attended a ceremony at the Grand Théâtre National de Dakar on the occasion of this mutuelle receiving a large cheque from the government. In this Field Note I examine the centring of Senegalese culture during this event to reflect on the national project of development itself. The event’s celebration of the arts sector coupled with its emphasis on mutualism and solidarity invoked Senegal’s post-colonial developmentalist visions and aspirations that were motivated by négritude and African socialism under its first president, Léopold Sédar Senghor. Engaging with renewed calls for African values and morality to be put at the centre of development, I argue that ambitious endeavours like CMU present such an attempt and help buoy it, but that, in the context of continued healthcare underfunding, one-off gifts like that presented during the ceremony are unsustainable. 
Pandemic and Politicisation in Argentina: Nursing Professional Trajectories in the Conurbano Bonaerense Region
No full textThe article analyses the politicisation of nursing personnel during the COVID-19 pandemic in Argentina, focusing on the trajectories of nurses trained in the public universities of the so-called ‘conurbano bonaerense’, especially in the young universities of the ‘Bicentenario’, rooted in a territory with strong traditions of popular political participation. The pandemic context accelerated the struggles for professional recognition among nurses. Analysing this process constitutes a significant contribution to the social studies of health and illness in Latin America, particularly regarding the role of gender. The pandemic has highlighted the necessity of making the history and demands of the nursing profession visible. Against this background, this article emphasises the challenging working conditions and lack of recognition faced by the nursing profession in Argentina, both materially and symbolically. Based on the analysis of narratives provided by nurses in the context of the COVID-19 pandemic, the article analyses three politicisation trajectories of nursing graduates of Universidad Nacional Arturo Jauretche, on the conurbano bonaerense, the metropolitan area of Buenos Aires. We demonstrate the importance of the institutional context of the universities in this territory and underline its significance for the politicisation process we have observed
The Butt of the Joke: Humour and Queer Care at an Anal Dysplasia Clinic
No full textBased on 12 months of ethnographic fieldwork I conducted at an anal cancer prevention clinic in Chicago, USA, this article considers queer camp humour as a care practice to better understand how providers and patients navigate clinical interactions centred around a stigmatised disease in a taboo body part. Humorous moments infused daily life at the clinic, and I came to see them as a critical feature of the clinic’s uniquely queer environment and a central aspect of the staff’s queer care practices. I argue the campy queer style of humour in the clinic was a vital tool for providing culturally appropriate care, and describe how humour mediated patient-provider interactions, had palliative effects, and managed dirt and bodily excess. The article concludes with a brief discussion of the importance of anthropological attention to humour and joking as forms of care. 
Solace of Substance: Agency, Surrender, and Consolation in Addiction and Polydrug Use
No full textAlthough preceding its association with substance use, early uses of the term ‘addiction’ signified intense attachment or ‘devotion’ to an activity or pursuit, indicating compromised autonomy, a necessary ‘culling’ of conflicting obligations, such as family and other concerns, and a potentially dangerous surrender (Lemon 2018). Recent advances in biomedical and neuroscientific understandings of addiction, as a relapsing neurological disorder, have sharpened notions of substance use as being outside of conscious control. Yet framing addiction in terms of individual, neurobiological predispositions towards addictive behaviour, continues to impact how we view agency, responsibility, and autonomy, even as substances are ascribed their own powerful agencies.
Based on long-term ethnographic fieldwork with individuals and third sector services in south-east Scotland, this article attends to ambiguous notions of agency attributed to and by people who use substances, and to substances themselves. It asks how responsibility for recovery becomes divested onto individuals, and how a moral ‘devotion’ to one’s recovery is mandated by medical and judicial institutions. The article further highlights how dyadic and intimate relationships with heroin are emplaced within wider webs of relations, and how heroin itself is suffused with agency and intentionality: becoming at once a force for destruction and source of life-giving surrender
Mother of All Labour: Vulnerability and Immunity in Times of Ebola
No full textWonkifong Ebola treatment unit was unique at the time of the outbreak that hit the Guinea in 2014. Contrary to other infrastructures run by Western workers, Wonkifong mainly employed personnel from Guinea, the Democratic Republic of Congo, and Cuba. Even so, the unit constituted a racialised landscape where proximity to white agencies granted privileges to certain groups of racialised people while excluding others. In a humanitarian infrastructure aimed at empowering knowledge of epidemics in the Global South, Black children were quarantined without their parents and left mostly unattended. After many months, former patients were hired as nannies to remedy the infrastructure’s blind spot. These women were employed to care for the children thanks to their immunity to the virus. Building on the concept of a ‘politics of life’ and exploring how these women were exploited as ‘medical superbodies’, my article sheds light on how the humanitarian infrastructure produced a gendered labour that mirrors other economies exploiting female Black bodies such as the colony or the plantation. Relying on an ethnography of practices of care and mobility within the unit, this piece underlines how the postcolonial segregation at play during the outbreak operated not strictly in terms of skin colour, but in terms of gender and closeness to white power.
How to Categorise Disease? Endometriosis, Inflammation, and ‘Self Out of Place’
No full textEndometriosis is a condition where tissue similar to the uterine lining develops outside the uterus; it ‘bleeds’ during periods, forms lesions, and causes chronic pain. Despite affecting around 10% of menstruating people, its aetiology is poorly understood, and diagnostics and treatments are highly inadequate. Current efforts to reconceptualise the disease generally centre around inflammation. In this Field Note I describe my fieldwork during the pandemic, which was largely based on in-depth interviews with patients and clinicians in and around Edinburgh, Scotland. This research interrogates the socio-cultural context in which endometriosis is changing from a ‘gynaecological disorder’ to a ‘systemic disorder’ implicating the endocrine system (a ‘hormonally driven condition’), the neural system (‘neuropathic pain’) and/or the immune system (an ‘inflammatory condition’). It explores how the lived experience of endometriosis challenges ingrained ways of thinking about the body and bodily ‘systems,’ which are reflected in the design of healthcare systems. Considering endometriosis alongside changing conceptions of immune response invites thinking beyond self-versus-non-self (as in older concepts of immunity), and self-attacking-self (as in auto-immune conditions), to something like ‘self-out-of-place,’ simultaneously calling into question the suitability of our social and material relations
Cultivating Care: Notes from a Mental Health Organisation in India
No full textThis Field Note reflects on the ethics and work of professional mental health care in the context of a non-profit counselling organisation in the city of Bengaluru, India. During fieldwork, having conversations with the counsellors and attending their group meetings brought the practices of cultivating care to the forefront. Deep listening and empathy are central to the care work of counselling. Yet these do not simply emerge from spontaneous feelings of love and compassion. Rather, they are cultivated through systematic individual and collective work. In this Field Note I focus on the collective modalities of cultivating care in terms of learning how to listen to the unsaid, recognise one’s ‘biases’, and establish the limits of care. These constitute the ethics of care work
Labile Bodies: A Hospital Ethnography of Medical Professionals’ Struggles in Deceased Organ Donation
No full textThis article presents an ethnographic study of the donor body in deceased organ donation. Drawing on the science and technology studies’ incitement to study bodies being enacted and acted upon in situated practices, I explore the body being done and becoming undone in the practices of organ procurement at a Catalan hospital. The hospital has uniquely high rates of organ donation and transplantation, and deceased organ donation has become routinised and integrated into everyday hospital activities. I attend ethnographically to the medical professionals’ accounts of and interactions with bodies and organs in their work dealing with both donors after brain death diagnosis and uncontrolled donors after circulatory death diagnosis. During fieldwork, I followed the struggles of the transplant coordination team grappling with unruly bodies under different maintenance technologies. The body being done in these hospital practices is an active and unstable materiality that must be contended with: a labile body, or a fragile assemblage of interdependent functions, requiring multiple interventions provided by a host of dedicated hospital practitioners. The article shows that staying close to the medical professionals’ situated accounts is a valuable route to gaining novel understandings of the donor body
The Immune System, Immunity and Immune Logics: Troubling Fixed Boundaries and (Re)conceptualizing Relations
No full textSpecial issue \u27The Immune System, Immunity and Immune Logics: Troubling Fixed Boundaries and (Re)conceptualizing Relations\u27, guest edited by Andrea Ford and Julia Swallow
Pandemic Life-lines: A Multimodal Autoethnography of COVID-19 Illness, Isolation, and Shared Immunities
No full textAs a crosscutting concept in biology, anthropology, and philosophy, immunity has been a critical ‘site’ of debate on the relations between self and other, organism and environment, risk and responsibility, the corporeal and the political. In this Research Article, I trace how these relations and everyday life during the COVID-19 pandemic relied on a web of coordinated—and sometimes unexpected—lines of communication, restriction, and solidarity. Using an experimental approach that combines multimodal autoethnography and multiscalar relational analysis, I present a first-person account of travelling during, testing for, and falling ill and isolating with COVID-19 in late 2021. I explore how pandemic life-lines, including public health measures, vaccinations, devices, and helplines, as well as mundane gestures of care and ecologies of support, acted together as shared immunities. In this exploration, I propose to reconceptualise ‘immunity’ as a process network rather than a defence apparatus, shedding light on how these life-lines may influence differential trajectories of disease and healing. To conclude, I discuss how my conceptual and methodological approach contributes to a social ecological understanding of immunity, that goes beyond the biopolitical, in times of pandemic and in the future