Paper short abstract:

This paper explores the value of the concept of care in analysing aspects of the health realm in Papua New Guinea. Through ethnography of TB treatment and patient-health staff relations in the Lihir islands I question whether concepts of care, or tnanie, shape health practices.

Paper long abstract:

This paper explores the value of the concept of care in analysing aspects of the health realm in Papua New Guinea. Care has recently been conceptualised in anthropology as critical to understanding work in the health sector as moral and relational practice of embodied compassion (Buch, Kleinman, Mol). In previous work I explored a concept most closely resembling 'care' in relation to ageing and death, the Lihirian term tnanie or nurturance: a highly valued moral practice which recognises continuing social connectedness. Papua New Guinea's health sector manages a high burden of illness under conditions of economic strain with limited resources, and a key focus on acute and curative medicine. The country is facing an emergency situation of Tuberculosis (TB) infection and growing disease resistance. In response, much discourse is laying blame with non-compliant patients and problematic 'cultural beliefs'. In this paper I ask how reframing the provision of TB diagnosis and treatment through the lens of "care" might be analytically constructive. TB treatment involves the long-term provision of daily medication: a healthcare relationship unusual in the acute curative focus of health in PNG. Through ethnography of TB treatment and patient-health staff relations in the Lihir islands I question whether concepts of care, or tnanie, shape health practices. And further, how might employing the concept of care allow for the re-examination of relationships between health staff and patients?