Accepted Paper:

Installing trust: medical data infrastructures and the production of anticipatory knowledge in Rwanda  


Norman Schräpel (University of Halle/Wittenberg)

Paper short abstract:

This paper follows medical data infrastructures (facilitated by new digital technologies) and the trust in numbers in Rwanda. It shows how new indicators on infectious diseases are expected to cope with uncertainties and how in this process anticipatory knowledge is supposed to install new trust.

Paper long abstract:

Medical practice is largely depending on medical data. Many of the therapeutic interventions and decision-making processes in medicine are in need of a set of data that carefully overlooks the spread of a disease, the reaction of a body to a drug or the effects of an intervention, to name a few. Rwanda's response, a context where this data was often unavailable, is an extensive investment in information and communication technologies. In recent years this created various new data infrastructures for the production and circulation of medical data.

This paper introduces an ethnographic account of these medical infrastructures in Rwanda. In particular it focuses on a cell phones based diseases surveillance system that connects all health facilities in the country to a centralized database.

In combining approaches from Medical Anthropology and Science and Technology Studies it will be argued that an analysis of medical data infrastructures become particular interesting when talking about uncertainties and trust in medicine. To extend this argument two points will be made:

1) Studying the design of an infrastructure does not just tell a story about the actors and their involvement in the (global) health system, it will also reveal the risks and uncertainties that are identified by these actors.

2) The availability of new data can be translated into anticipatory knowledge. Certain actors systematically promote this process in order to cope with uncertainties and to install trust. Thus following these translations reveals in-depth knowledge on the role of uncertainties and trust in medicine.

Panel W132
Uncertainty and trust in medicines and therapeutic techniques