Short Abstract:
The workshop interrogates how diversifications are constructed, represented and encountered through medical practices in situations of crises. It explores how crises are managed through medical practices, how knowledge practices construe crises, and how crises are dealt with by controlling difference.
Long Abstract:
The idea of crisis, as an increasing uncertainty about the future and an accelerating emergency is very present in the field of health and medical knowledge. This is apparent in daily news about swine flue, declining public funds for health care due to the financial crises, the eradication of biodiversity properties caused by environmental damage and exploitation of natural resources. In this workshop, we aim to explore how medical knowledge and crises become interrelated in different ways through the topic of diversification. We ask how perceived crises are assessed and managed through different medical practices (e.g. medical pluralism, new technologies), how knowledge practices construct crises (e.g. knowledge about epidemics, divination practices), how crises is dealt with by constructing and controlling difference (genetics, spirits), and how diversity is envisioned as endangered resource (biodiversity).
We attempt bringing together different perspectives and invite contributions addressing, among others, the following issues:
New technologies and therapies do not only respond to crises but can create new differences which result in uncertainties. How are these perceived and controlled?
Sickness crises results in the utilization of different therapeutic practices. How does this help people to deal with crises they are encountering?
Disappearing medical knowledge traditions and endangered bio properties are experienced as crisis to their holders. How is this dealt with on community, state and transstate level?
Imaginations of crisis are constructed through classifications of normalities and deviations based on medical sciences. How is this accomplished and perceived and in whose interest? Who are the actors involved?
Accepted papers:
Session 1
Human biological diversity in times of crisis
Alexandra Widmer
(York University)
Veronika Lipphardt
(University of Freiburg)
Paper long abstract:
Throughout the 20th century, human biological diversity has been a challenging research topic for life scientists. Its political implications constantly undermined the ideal of scientific objectivity, while the analytical tools for studying variation in other organisms could not adequately address the imperative of empirical research on human test subjects in situ. Human biological diversity has also been implicitly or explicitly employed by medical researchers, epidemiologists or human geneticists to represent or understand crises of various kinds. This paper examines how categories of human biological diversity are instrumentalized in times of health, environmental and reproductive crisis or mobilized in preparation for avoiding potential crises. Our analysis draws from (post)colonial case studies as diverse as biomedical studies related to Soviet nuclear legacies, depopulation in the Pacific islands and human genetics in Africa. We focus on scientists' practices, in particular in how the notions of experiment and intervention might be part of their observations and techniques in the field.
'Health crisis' in the Kingdom of Tonga: critical observations on the obesity issue
Gaia Cottino
(Università degli studi di Genova)
Paper long abstract:
During the past decade the Obesity issue has been under the International Organizations' spotlight.
According to the 2007 WHO Report on Obesity the six "fattest" Countries are all located in Oceania, which created a state of alarm.
"Obesity is a potential crisis on the scale of climate change", "obesity epidemics", "obesity represents a greater threat then weapons of mass destruction" are just a few of the numerous institutional comments on the issue.
This paper, through the presentation of an ethnographic fieldwork in the Kingdom of Tonga- at the fifth place for obesity according to the WHO Report- will critically analyze, from one side, the political construction of the obesity crisis, with particular attention to the BMI debate and the real local health problems, and, on the other side, the "therapeutic practices", usually planned elsewhere, and their results on the population's health and wellbeing.
Individual and national crises: management of inherited blood disorders in the Sultanate of Oman
Claire Beaudevin
(CNRS, Cermes3)
Paper short abstract:
Paper long abstract:
This paper is based on an ethnographic research conducted in Oman and focused on inherited blood disorders (sickle-cell, thalassemia), which can be examined through two "crisis levels": individual, since sickle-cell is a chronic condition punctuated by painful seizures; and national, since the growing part of inherited disorders within the death causes is a challenge for a system focused on primary health care. The management of these chronic genetic diseases in Oman has led to the use of new diagnostic (screening, sequencing) and treatment (exchange transfusions, iron chelators) methods. Besides, these disorders are tackled by the government's biopolitics as a crisis which has to be solved, including by controlling the citizens' bodies: scrutinizing matrimonial behaviours; planning mandatory premarital genetic testing. Recent use of genetic technologies to search for heterozygous individuals creates new abnormality categories within the — historically very complicatedly stratified — Omani population. This "disruption" leads to unusual forms of biosociality.
Health finance diversities: implementing mutual health insurance in Senegal
Angelika Wolf
(FU Berlin)
Paper long abstract:
The global flow of biomedicine is accompanied by an increasing concern of how to finance medical services. To provide health insurance for their citizens African states and other actors are trying to establish Mutual Health Organizations. However, this introduction has temporal dimensions since the idea of insurance is based on certain perceptions about the future and its possibilities for planning and prearranging health and thus preventing crisis.
The importance of health financing, its social meaning and its related practices have been rarely investigated by scholars of medical anthropology. Drawing on fieldwork in Senegal I will take a look into health finance practices as they contrast with a more general idea about social security. Paying for health services is also embedded in a social field of reciprocal obligations and dependencies often within families and larger kinship relations. Emerging biobureaucracies and a variety of factors within wider society create health finance diversities.
Market of health in time of crises: biomedical drugs, traditional remedies and plural medical system in Mekelle, Ethiopia
Pino Schirripa
(University of Messina)
Paper short abstract:
A drug can be seen as any organic or mineral compound which is considered as able to face of, and often to defeat, what in that context is thought as sickness.
The paper will sketch the Mekelle medical system, focusing on the perception and use of pharmaceuticals.
Paper long abstract:
A drug can be seen as any organic or mineral compound which is considered as able to face of, and often to defeat, what in that context is thought as sickness.
The A. will sketch Mekelle's medical system in its plurality, showing how it will be analyzed using the bourdean concept of field of forces. In this way the different social actors in the arena can be seen as competing each other to gain a position.
All resources use something that can be considered as a drug. The A. will analyze the role of these different pharmaceuticals within the field of forces stressing their role in defining the different position of any actor.
Focusing on the current financial crises and on the effects of the global pharmaceutical market on the local context, the A. will describe how it builds diversification in production and use, and inqualities.
Consultation with spirits - constructions of crisis and the problem of meaning
Vibeke Steffen
(University of Copenhagen)
Paper long abstract:
There is a long-standing anthropological tradition of studies where divination and therapeutic rituals are associated with crisis and the re-establishment of order. The risk of this approach, however, is that the intensions may be mistaken with the results, and that the role of crisis, the management of problems and the construction of meaning is overestimated. This paper demonstrates that instead of providing answers and solutions, the engagement with spirits may just as well open up for new questions and new problems. The subject of the study is spiritualism and second sight as practised in contemporary Danish society. In this context, spirits are not necessarily something extraordinary that people turn to when facing severe crisis, but rather a way of dealing with social relations in everyday life.
Second sight is provided by mediums passing on messages from deceased relatives or other spirits at platform demonstrations or in private consultations. The messages often deal with distance and proximity in social relations, and the medium may provide suggestions on how to protect your self against feelings of being drained of energy or invaded by other human or spiritual beings through spells, invocations, and other kinds of magic manipulation. This seems to be an ongoing project of diversification between good and bad influences rather than a bounded activity of establishing order and meaning. Thus, the paper aims to challenge the relevance of the concept of crisis in studies of spiritual interventions and the assumption that therapeutic rituals per definition create meaning and order.
'Contraceptives are killing us through the women': Interrogating difference in local constructions of the AIDS pandemic in South Africa
Vendula Řezáčová
Paper short abstract:
The paper will examine the ways in which notions of ´female pollution´ as a source of ´male illness´, and the social relations in which these have been embedded, are being transformed in attempts to articulate a local perception of the AIDS pandemic in a rural region in South Africa.
Paper long abstract:
Several recent studies focussing on southern African societies, including my own conducted in former Venda, South Africa, have identified an ethnomedical model of HIV/AIDS sexual transmission which has constructed women who have used contraceptives and/or undergone abortion as ´givers´ of disease to men as ´recipients´. In this paper I will interrogate this model as to the ways in which it has mobilized constructs of difference - of male/female and ´traditional healing´/biomedicine - to articulate and act upon anxieties over transformations of gendered authority structures and cultural identity in the post-apartheid, neo-liberal context. One of the suggestions of this paper is that local perceptions of ´AIDS prevention´ following from the model and centring on controlling women's engagement with biomedical technologies, have provided an arena in which contestations over women's increasing autonomy and (re)productions of a ´Venda medical tradition´ have taken place in the same language of embodied signs and disease aetiologies.
The crisis of futility: clinical ethnography and the moral landscape of community psychiatry
Paul Brodwin
(University of Wisconsin-Milwaukee)
Paper short abstract:
Futility is a crisis for clinicians; it disrupts the logic of care that grounds biomedical practice. But the crisis can inhere in routine technologies. Fieldwork in US community psychiatry shows how futility implicates the norms of chronicity and the history and micropolitics of work.
Paper long abstract:
This paper builds a fully ethnographic account of clinical futility. Treatment failure disrupts the logic of care (Mol 2008), and it provokes a crisis for front-line providers: it subverts the hegemony of hope common to biomedical settings, and it pushes people to question the moral legitimacy of their work. The genealogy of such crises depends on specific therapeutic ideologies and technologies. A two-year ethnography of Assertive Community Treatment (a popular mental health service model in the US and UK) reveals how the technologies for everyday work enforce a mandatory narrative of progress. This temporal structuring creates an impasse for clinicians when treatments fail. Their readiness to intervene is a habitual disposition, in Bourdieu's sense. When ACT providers cannot alter the course of disease, they struggle with a mismatch between their trained disposition and the real opportunities to act. The mismatch - and crisis of futility - implicates the biopsychiatric construction of chronicity, the faultlines of mental health services, and the local micropolitics of work.