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- Convenors:
-
Helle Samuelsen
(University of Copenhagen)
Pia Bjertrup (University of Copenhagen)
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- Chair:
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Lea Pare Toe
(Institut de Recherche en Sciences de la Santé -IRSS)
Short Abstract:
In this panel, we invite papers that explore epidemic temporality and how epidemics affect our ability to speculate, anticipate, prepare and deal with 'the next'.
Long Abstract:
In recent decades, the world has witnessed a series of global health crises, with the Covid-19 pandemic as the latest and most serious. As formulated by Kelly et al (2019) 'pandemics are the dark side of modernity, medical and political progress'. In this panel, we seek to explore how pandemics (and epidemics) affect temporal orientations and the governing of time. Anthropologists have shown how people and institutions in various contexts deal with uncertainty and how anticipatory practices serve as 'speculative forecasts' (Adams et al 2009). In addition, anthropologists have demonstrated tensions in the depictions and imaginations of epidemics as events with clear beginnings and ends, and local communities contesting the 'outbreak narrative' (Lynteris 2014, Wald 2008).
In this panel, we open up for speculations about the next pandemic by drawing on ethnographic insights from previous epidemics. How can anthropology contribute to such constructive speculations and to a future 'well' world? We welcome papers that, for example, discuss insights on the governing of time, tensions of defining epidemic beginnings and ends, and how passed epidemics shape how people and institutions imagine and anticipate the 'next'. We especially welcome empirical perspectives from the Global South and contributions, which methodologically and theoretically address the speculations, anthropology need to do in such endeavors.
Accepted papers:
Session 1 Wednesday 12 April, 2023, -Paper short abstract:
In this paper we examine how temporal frictions between citizens and government developed and changed during the COVID-19 pandemic in Burkina Faso and we speculate about how epidemics affect and are affected by the relationship between citizens and the state in unstable places.
Paper long abstract:
In the early phase of the COVID-19 pandemic, it was not the disease itself that caused disruptions in Burkina Faso, but rather the restrictive measures that in radical ways transformed the rhythm of everyday life. The lockdown hit hard and pushed many families into situations where it was extremely difficult to provide for the next meal. With severe security problems, political turbulence and an under-financed health system, the government of Burkina Faso faced particular challenges at the unset of the epidemic where swift actions were needed. In this paper, we argue that the government’s pre-emptive lockdown strategy, acting on a not-yet situation on the basis of mathematical modelling and scenario development, created temporal frictions between ordinary citizens and the government, particularly during the first phase of the pandemic, where the disease was still unexperienced and ‘invisible’ to most citizens. Local skepticism about the actual existence (and severity) of the pandemic and about the government’s way of handling the situation emerged. Later, as the most severe restrictions had been lifted, the government was praised for its actions and its (at least momentary) visibility and interest in caring for the health of the population. In this paper we follow how these temporal frictions developed and changed during the pandemic and we speculate about the ’next’ epidemic in an unstable place like Burkina Faso and more generally, about how epidemics affect and are affected by the relationship between citizens and the state.
Paper short abstract:
Long Covid (currently estimated at 65 million people) has been dubbed “an emerging pandemic” or a ‘mass disabling event’ with enduring consequences. How can a pandemic’s long tail be considered the beginning of a new pandemic? What tensions are created between the competing temporalities of patient advocacy groups, biomedical researchers, and government policy makers?
Paper long abstract:
As recognition of Long Covid builds in medical science, governments and lay populations, public sphere commentary has suggested that Long Covid – currently estimated at 65million people suffering worldwide - might be “an emerging pandemic” or a ‘mass disabling event’ with enduring consequences.
Frustrated by the lack of answers, treatments and responses offered by biomedical science and governments, Long Covid patients have formed advocacy groups that urge constructive actions in a timely manner to address this unforeseen aspect of the Covid pandemic.
How can the long tail of an existing pandemic be considered the beginning of a new pandemic? How can the experiences of Long Covid patients and advocacy groups assist in anticipating this ‘next’ pandemic? What kind of tensions are created between competing temporalities: the long waits for treatment in Long Covid clinics; patient groups’ sense of urgency for governments to act; and the slower pace of medical research and governments to provide ‘answers’ and responses. How can previous epidemics (for example, HIV) inform the temporalities of different stakeholder groups, as they act towards securing a future ‘well’ world in a time of medical uncertainties, rapidly-changing configurations and intense debates?
Paper short abstract:
In this presentation, the authors examine trust from the perspective of citizens during the COVID-19 pandemic in Burkina Faso.
Paper long abstract:
Global health and anthropology both emphasize the importance of trust in times of infectious disease outbreaks such as the COVID-19 pandemic, however, often conceptualise it differently. In this presentation, the authors examine trust from the perspective of citizens during the COVID-19 pandemic in Burkina Faso. Here, trust and mistrust are closely related to precarity, contingency and power and following Michael Bürge’s (2019) conceptualisation of trust, the authors propose that a more fitting term to describe people’s experiences with the state might be to “miss trust”. To miss trust signifies a missing and a longing for the state and for state institutions to tend to (material) needs. Such longings underline hope, rather than certainty, which might spur some people to action and taking matters into their own hands. Such actions could, in turn, be at odds with the COVID-19 restrictions imposed by the government. Lastly, the authors discuss how an approach of missing trust sheds light on the situated concerns of people, their actions and narratives in attempts to overcome challenges and vulnerability imposed by others.
Paper short abstract:
The paper explores how PrEP users in Dar es Salaam anticipate an HIV-negative future through the temporal use of PrE-exposure prophylaxis as HIV prevention. I explore the uncertainties and affective states introduced by using PrEP. We speculate on whether PrEP can be the end of an epidemic.
Paper long abstract:
At a study site in Dar es Salaam, 'risk subjects' (Rose, 2007), in this case, transgender women and men who have sex with men, come to gain access to Pre-exposure prophylaxis (PrEP) - a novel HIV prevention pill. The pill holds the promise to 'end HIV by 2030' according to the WHO.
This paper draws on ten months of ethnographic fieldwork between 2021/2022 at a PrEP study site in Tanzania. The paper explores how some PrEP users anticipated an HIV-negative future with PrEP as a temporal possibility (Adams et al., 2009) and hope for the best possible future for themselves, their partners and their community. The paper found that using PrEP not only introduced hope for the future but PrEP also introduced novel uncertainties and affective states into their users' lives, such as rumours about the spread of PrEP as an ineffective drug and uncertainty about PrEP's effectiveness caused by stress related to HIV status.
Furthermore, PrEP users were concerned about the potential stigma they could experience as PrEP users, as PrEP was associated with promiscuity, sex work and HIV positivity. Lastly, the projectivisation (Prince, 2014) of PrEP and the unstable provision at the beginning of the PrEP scale-up in Tanzania caused anxiety and uncertainty to its users.
Finally, I speculate on whether biomedical interventions, such as PrEP, can hold their promise of ending an epidemic in solitude. I anticipate a need to include social and structural perspectives in present public health interventions to 'end AIDS' sometime in the future.
Paper long abstract:
Introduction: Epidemic prevention is a public health challenge in Burkina Faso. An early detection process through the surveillance system allows all suspected epidemics to be reported for a prompt response. However, this system is facing some challenges within the CSPS (Centre for Social Health Promotion), which is the first point of contact for the population in the health system. In fact, cases of epidemics such as measles are often not reported by these actors working in the basic structures. This study aims to understand the issues around the early detection and reporting of measles epidemics in the CSPS.
Method: The qualitative approach allowed us to collect data using semi-structured interview guides. The choice of respondents was based in a reasoned manner and 55 people made up our sample. The study was conducted in Kimini, Soumousso and Karangasso-Vigué.
Results: The reporting of epidemic cases leads to increased awareness activities, field visits for investigations and the production of daily reports, which increases the workload of the actors. In addition, reporting measles outbreaks is also considered by line managers as a failure to implement preventive measures such as vaccination. Finally, financial motivations have an impact on the quality of relations by causing conflicts of interest between actors.
Conclusion: Epidemic prevention is essential in surveillance. However, response actions are often impeded by the late or non-reporting of detected cases by front-line health workers. This situation makes a rapid response difficult and facilitates the spread of cases.