Paper short abstract:

This paper, based on ethnographic research with nurses and nursing students in the Eastern Highlands of Papua New Guinea, examines how local instantiations of TB prevention and education programs reflect middle- and working-class health workers' ambivalence about cross-class kinship.

Paper long abstract:

Papua New Guinea has one of the highest incidence rates of tuberculosis in the Asia-Pacific region, including multi-drug resistant tuberculosis. This paper, based on ethnographic research with nurses and nursing students in the Eastern Highlands of Papua New Guinea, examines how TB prevention and education programs reflect middle- and working-class health workers' ambivalence about cross-class kinship. Supposedly class-neutral prevention messages are reshaped in practice in ways that highlight the dangers of contact, commensality, and intimate sharing between the country's tiny "educated" minority and the rural majority. In a context of rapidly growing social inequality, TB education programs pathologize kinship practices that are socially positive, healthy, and adaptive in most contexts. In trying to promote middle-class, "Christian" nuclear family structures and what Charles Briggs has called "sanitary citizenship," TB education programs have to use existing social relations and stereotypes as a basis for comparison. As a result, they wind up targeting forms of kinship and relatedness that are essential to the social and material survival of the country's majority.