Medicine Anthropology Theory
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Affinity through Vulnerability: The Politics of Positionality in Child Welfare
No full textChild welfare is a challenging space for professionals, parents, and most of all children. The labour of care within this space is an intersection of personal histories and ongoing narratives that synthesise self, family, medicine, and the state. I explore how encounters with children in care brought me into this nexus and redefined my position as a researcher. Competing perspectives on the role of experience in shaping affinity reveal a contentious discourse about what it means to be a foster child. In this Position Piece I find that sharing vulnerability through the traumatic experience of family estrangement is one path to mutual understanding that may transcend cultural boundaries. Further, mobilising and reflecting on the vulnerability of estrangement demonstrates the social embeddedness of mental health and healing.  
Unruly Waters, Unsanitary Bodies Abject Terrains, Rehabilitation, and Infrastructures of Dispossession on the U.S.–Mexico Border
No full textDrawing on ethnographic fieldwork among homeless deportees living in the Tijuana River canal, I examine how the ‘rehabilitation’ of toxic terrains can have corporeal and social consequences for those inhabiting such spaces. For decades, the Tijuana River basin traversing the U.S.–Mexico border has been perceived by officials from both countries as an unruly body of water. Prone to persistent flooding, the canal also experiences flows of toxic sewage from Tijuana’s maquiladora industry. In recent years, the riverbed in Tijuana has been inhabited by homeless and drug using communities, many of whom have been deported from the U.S. In response, rehabilitation of the canal and forced drug rehabilitation have been conjoined and promoted by the state as solutions for managing this unruly terrain and its residents. I take the deployment of the term ‘rehabilitation’ targeting both homeless deportees and the canal as an opportunity to consider how the concurrent disciplining of landscapes and human populations has been a central and evolving feature of the Anthropocene. I examine how my homeless interlocutors have experienced ‘rehabilitation’ as a violent process of abjection, dispossession, and captivity, which has converted this transborder landscape structure into a carceral zone under the guise of urban sanitation and health promotion
“I’m Trapped Here”: Ethnography, Structural Violence, and Moral Injury
No full textIn scenes of deep poverty and precarity, intimate relationships are shaped by the moral aftermath of a life of surviving scarcity. These moral histories are riddled with interpersonal harm, experiences of harming others and being seriously harmed oneself. As intimacy deepens, so does the prospect of harm, mistrust, and humiliation. These relational experiences can erode moral agency, or the sense that one is deserving of love and has the capacity to be seen as a ‘good’ person (Myers 2019; Blacksher 2002). Within the hermeneutic of moral injury—a concept largely defined by and elaborated in clinical settings—this Position Piece explores the messy relational life of scarcity in the context of conducting ethnography. Further, it examines the ethnographer’s responsibility to respond to such lives with an attention to moral injury and moral agency (Carpenter-Song 2019). This journey, guided by personal commitment, can lead to engagements that do not feel like care, yet are. This essay explores this reformulation of care as moral labour while concluding with the political stakes of this mode of intimate work
Turning Cancer into Medicine: Storying Healing through Imagery
No full textThis Photo Essay explores my experience with cancer and healing using Indigenous traditional medicines. I use Photo First Voice, a form of auto-ethnography, to story my ‘living’ experience with cancer, which includes getting in touch with and honouring my Indigenous roots (Algonquin/French) attending healing ceremonies, and becoming an Oshkaabewis (a healer’s helper) myself. I integrate photographic images into this essay to illustrate my experiences and to enhance the meaning of the words I have committed to these pages. Each image represents a different aspect or level of knowledge and healing. These images and text are followed by a discussion in which I weave fragments of experience together to narrate a living (inter)relationship with the earth, towards a more balanced whole. Indigenous medicines set in motion major changes in my life, which are fundamental to my ongoing healing. In this context, the term ‘medicine’ refers to Indigenous knowledges that contribute to healing, healing ceremonies, teachings, and plant medicines (mainly Ojibwe)
River Swimming Through Uncertainty: Pandemic Immersions in a Therapeutic Chalkscape
No full textIn this Field Note, I share my experiences of an immersive period of ethnography undertaken with river swimmers in and along the River Beane and River Lea in the county town of Hertford, South-East England, from July 2020 until January 2021. As well as my personal experiences of being a swimmer, I include insights and observations from those I swam alongside to reflect on the feeling of wellbeing that river swimming instills in those dipping, swimming, and ‘dwelling’ in their local rivers. I use these insights to expand the notion of therapeutic landscapes, noting not only their temporality during a pandemic period of uncertainty and disconnection but also their minerality. I explore how therapeutic connections and closer relations between humans, non-humans and rivers, all watered by the same chalk aquifer, might be framed through the connective substance of chalk.  
The Plantation as Hotspot: Capital, Science, Labour, and the Earthly Limits of Global Health
No full textCentral American sugarcane plantations have become ‘hotspots’ of chronic kidney disease (CKD). Although CKD is frequently caused by diabetes or hypertension, most sugarcane plantation workers who have it have no history of either condition. They are among a growing number of people worldwide afflicted by chronic kidney disease of nontraditional causes (CKDnt). The ‘hotspot’ concept resonates with those who study CKDnt in part because work-related heat stress has been the factor most strongly associated with the disease. Drawn from ethnographic research on CKDnt in Nicaragua and a close reading of scientific and policy documents, this research article frames the plantation as a health hotspot in three ways. First, plantations are sites of intensive, environment-altering capital investment. Second, public health research on the connection between heat stress and CKDnt remakes plantations as sites of intensive experimental scrutiny. Third, plantations produce innovative genres of political action. Nicaragua’s epidemic has given rise to a form of health activism, or ‘hotspotting’, in which workers and their allies use digital media to circulate evidence of environmental harm. This tripartite view of plantations as hotspots highlights what I suggest are some of the ‘Earthly limits’ of global health
Making Sense of New Disease Categories: Naming, Spatialising, and Serialising in Genomic Medicine
No full textIntrigued by geneticists’ framing of new gene names as somehow devoid of meaning, I set out to explore how patients and families make sense of naming practices in the field of genomic medicine. The aim for ever-more precise disease categorisation has resulted in names for medical conditions that are more akin to car-licence plates, such as DPF2 and G246A. Conducting fieldwork in Denmark, I followed the introduction of personalised medicine—that is the aim to tailor prevention, diagnosis, and treatment to the individual based on genomic and other data—in the field of rare diseases and diabetes. Engaging with theories of naming, spatialisation and serialisation, I suggest that it is exactly because of their unsettled meaning and presupposed lack of history that new gene names provide patients extra room for creative identity work. I argue that some patients and families use the new genetic disease labels to escape unwanted moral regimes, relocating disease aetiology from a moralised landscape to a ‘molecularised’ genetic one. I discuss how practices of serialisation enable patients to feel recognised as unique persons. In conclusion, I suggest that while the new genetic names may not stigmatise, they do change the patients’ idea of who they are in surprising ways, some of which the geneticists had not anticipated
Fake-talk as Concept and Method
No full textIn a world seemingly awash with fakes—or at least accusations of fake-ness—it is not only difficult to discern what is ‘real’ but also to know what to make of such a proliferation of worries about fakes. In this article, a manifesto of sorts for the Special Section, we outline how the problem of ‘fake drugs’ in particular allows us to understand the phenomenon of fakes in general. We introduce the conceptual and methodological tool of ‘fake-talk’ as it allows us to make sense of claims about fake drugs and of the power these claims hold. We develop our argument through a close reading of specific ethnographic examples drawn from the work of our colleagues in the project ‘What’s at Stake in the Fake? Indian Pharmaceuticals, African Markets and Global Health’. We show that fake-talk thrives on a lack of evidence, imports urgency, and is expressive. Taking fakes seriously as a force in themselves enables us to see how fakes are freighted with—and deploy—everyday articulations of otherwise unfathomable discomforts, predicaments, and anxieties of our time
Shifting Stigma: Why Ukrainian Health Care Workers Favor a High Barrier Treatment Modality for Tuberculosis
No full textThis research article seeks to understand how the cultural context of tuberculosis (TB) care in Ukraine influences healthcare workers’ perception of their patients and the choices they make in offering TB treatment. Specifically, we aim to explore healthcare workers’ predilection towards inpatient treatment of TB in Ukraine in lieu of other, evidence-based treatment approaches. Based on qualitative research with TB care providers in Ukraine, we argue that a preference for inpatient treatment instead of the standard outpatient regimen is rooted in the care workers’ assessment of the patient’s desire to get well. In other words, the preferred treatment modality is not based on any biological characteristic of TB infection; instead, it is based on the perceived strengths and weaknesses of patients’ psychology
An Ethical Question: Acknowledging Contentious Ethics in Medical Anthropology and Allied Fields
No full textEditorial to the April issue of 2023