Paper short abstract

The pandemic exposed weaknesses in Peru’s health system, producing care poverty for older adults with COVID-19. This paper analyses how this deficit generated extra-institutional care strategies that, though unequal and risky, sought to sustain life with limited resources.

Paper long abstract

This paper analyses the production of care poverty through the reorganisation of care when older adults with COVID-19 were unable to access institutional healthcare in Peru, where near-universal insurance coverage coexisted with the highest COVID-19 mortality rate globally.

This paradox reflects long-standing structural weaknesses. Before the pandemic, Peru’s health system—fragmented, unequal, privatised, and underfunded—lacked the capacity to meet the needs of an ageing population. During COVID-19, these conditions produced severe barriers to care, including misinformation, mistrust of public hospitals, failures in emergency response, and informal age-based triage in overwhelmed facilities.

Drawing on qualitative research for a doctoral thesis—including 59 in-depth interviews with older COVID-19 survivors, relatives of deceased patients, and healthcare workers, and analysis of 119 policy documents—this paper traces care-seeking trajectories from symptom onset to exclusion from formal healthcare. As hospitals became inaccessible, families became primary care providers, generating extra-institutional arrangements ranging from unsupervised home care to privately supported and hybrid forms involving primary care or community actors.

While these responses reflected moral commitment and efforts to preserve dignity and proximity, they were shaped by unequal economic and social resources, relied on women’s unpaid labour, and carried high emotional and financial costs. In moderate and severe cases, home-based care resulted not from cultural preference but from cumulative exclusion, often leading to delayed hospitalisation or death outside institutional settings. By foregrounding lived care trajectories, the paper conceptualises care poverty as a relational and moral process, contributing to ethnographic debates on care inequalities, ageing, and health systems in the Global South.

Paper short abstract

Informal dementia carers in Hungary may experience care poverty. This paper explores how carers developed the knowledge and skills to meet the ever-emerging challenges they faced, through various sources, trial and error, and peer support, when the formal health and social care systems failed them.

Paper long abstract

This paper examines how informal family caregivers of people living with dementia adapt to the challenges they face, particularly in acquiring the knowledge and skills needed throughout their caregiving journey. It reconstructs how carers develop practical and valid expertise despite beginning with very limited understanding, and interprets these processes in the context of unmet needs stemming from inadequate or inaccessible formal health and social care in Hungary.

The analysis draws on data collected between 2019 and 2022, including in‑depth semi‑structured interviews with 22 informal caregivers. Participant observation at Alzheimer Café events – typically organised by social services to support those affected by dementia – provided further insight into the adequacy of available support. Additionally, online communication and content from Alzheimer Cafés on Facebook were examined, with particular attention to the period when in‑person events were suspended during the pandemic.

Findings reveal a substantial and policy‑relevant presence of ‘care poverty’ in Hungary. Caregivers frequently described negligent formal care, limited knowledge sharing, and a lack of recognition as partners in consultations. Observational and content‑analysis data echoed these concerns, showing that Alzheimer Café support was inconsistent.

Caregivers emphasised that meaningful assessment and information from the point of diagnosis would have been crucial, yet formal support repeatedly failed to meet their evolving needs. As a result, carers developed their own expertise through experience, trial and error, and alternative information sources. They also reflected on what constitutes ‘valid knowledge’, discussing expertise, expert identity, and the value of peer support grounded in shared experiential understanding.

Paper short abstract

This article explores how institutional care navigates moralities of care in rural Shanxi, China. By improvising moral performances beyond healthcare, primary hospitals mitigate tensions between moral requirements and unmet care needs to maintain family intimacy and uphold social welfare provision.

Paper long abstract

In China, anti-cancer treatment resources are so polarised between urban and rural areas that it leads to massive intra-national therapeutic mobility to major cities. Primary hospitals surrounding rural areas, such as county-level hospitals and county-level traditional Chinese medicine hospitals, could only provide fundamental anti-cancer treatments. Following the logic of cure, receiving local treatment becomes a last resort during clinical decision-making processes, while following the logic of access, most studies associate the utilisation of local primary hospitals with limited family care resources and financial constraints. However, the complexity of healthcare modes that primary hospitals employ is largely overlooked in both logics.

Instead, I suggest we might better understand primary hospitals as significant care infrastructures embedded in local social contexts. Based on ethnographic research in the oncology ward of a county-level hospital in Shanxi province, China, this study reconfigures what care means to institutional health providers beyond healthcare. Inspired by Julie Livingston’s framework of improvising medicine, I develop the notion of ‘improvising morality’ to describe the autonomy of doctors in a primary hospital where they actively navigate the morality of care from both family and social perspectives. Through a balance of constraint and capacity, the improvising moral performances of doctors mitigate tensions between unmet care needs and moral requirements to maintain family intimacy and uphold social welfare provision.

Paper short abstract

This paper analyses the judicialization related to high-cost drugs in Chile, focusing on the case of Spinal Muscular Atrophy (SMA), where legal action against the State becomes essential for halting disease progression within a context marked by profound inequalities and unmet care needs.

Paper long abstract

This article analyses the experience of judicialization over high-cost drugs in Chile, focusing on the case of Spinal Muscular Atrophy (SMA). People with this condition, and their families, file a judicial recourse against the State based on the right to life, in order to be granted the possibility of halting the progression of the disease. Legal action against the State by those who rely on public health coverage reveals unmet care needs and deep inequalities in access to treatments, within a context of care poverty given by differences in socioeconomic status, where the right to health is not guaranteed.

Based on ethnographic research, we observe how litigation takes shape as an alternative infrastructure of care, sustained by networks that bring together people with SMA, their families, health professionals, lawyers, and civil society. These actors are part of a network; a connective history of legal and bureaucratic learning that seeks and negotiates access to care and the right to life. The findings are organized into three main themes: the process of obtaining and producing documents that demonstrate the need for the drugs; the formation of a connective network that integrates the embodied experience of illness; and the extension of litigation as an open-ended process.

We discuss the ways in which people with SMA appear before the State through legal representation, and how the need to resort to judicialization reveals structural uncertainties of care resulting from the absence of public policies that guarantee access to and provision of these treatments.

Paper short abstract

We, a research project on ageing well in the German-Polish border region, explore unmet care needs that emerge when citizens engage with digital public services that are meant to foster care-giving and caring communities.

Paper long abstract

How are care needs met in the German-Polish border region? How do older people, (older) individual and institutional caregivers struggle with missing ressources in demographically challenged rural communities? In our presentation we discuss these questions by referring to a transfer research project funded by the German Ministry of Research, Technology and Space. By using practice-based research approaches and co-creative methods we try to open up the discourse about unmet care needs. Our focus is on public care service technologies that are meant to foster care-giving and caring communities. We explore instances of citizens’ engagement with such digital public services as settings where care needs are discussed. We are especially interested in how digital technology becomes a medium for sharing observations and opinions of care needs, care poverty and care inequality, and thus, for the articulation of locally salient social and economic divisions with and through expectations and experiences of care. In the process, we examine how the provision and use of digital public infrastructure unsettles taken-for granted roles of the states, the family and the private sector in preventing and addressing care poverty and care inequality. Along with these substantial questions, we are interested in the methodological challenges and opportunities of rendering care poverty and inequality accessible through a combination of ethnographic and participatory methods.

Paper short abstract

Drawing on ethnography with CKDu patients in rural Andhra Pradesh, this paper shows how care poverty is lived, with people shifting between caregiver and care-receiver roles, and women bearing disproportionate physical, emotional, and economic burdens across households and communities.

Paper long abstract

Care poverty is not only about the absence of services but about how people experience and navigate unmet care in daily life. In this paper, I examine care poverty ethnographically, drawing on long-term fieldwork with people living with Chronic Kidney Disease of Unknown Aetiology (CKDu) in the Uddanam region of Andhra Pradesh. I focus on how chronic illness, social expectations, and fragile healthcare infrastructures intersect to shape who receives care, who provides it, and how it is negotiated within households and communities.

CKDu’s unknown aetiology and insidious onset mean the disease is often detected only at advanced stages, producing persistent uncertainty and repeated engagements with biomedical institutions that rarely yield clear answers. In prolonged engagements, illness and diagnosis blur, and care emerges not as a discrete service but as continuous, relational labour, echoing Alex Nading’s work on chronicity and embodiment.

Through in-depth conversations, repeated encounters, and participant observation, I trace how unmet care needs are woven into everyday rhythms: journeys to distant hospitals, patching together medicines, recalibrating work and rest, and tending to bodies that refuse linear progression. Care is emergent, negotiated, and embedded in moral worlds, resonating with ethnographies of care (Buch, Mol, Ticktin).

Rather than treating caregiver and care-receiver, formal and informal care, or objective and subjective needs as fixed, this paper shows how people move fluidly between these positions as they ‘get by’ with CKDu, with caregiving falling primarily on women, whose exhaustion, strain, and precarity are continually negotiated across households and social networks.

Paper short abstract

Drawing on ethnographic research across Istanbul’s Little Syria neighborhoods, this paper argues that improvised practices of “ordinary care” enable Syrian refugees to build stable and dignified lives despite living in legal and economic precarity in the aftermath of war and displacement.

Paper long abstract

The majority of the 2.5 million Syrian nationals residing in Turkey are classified under the ambiguous legal category of “Temporary Protection” even after fifteen years. While this status provides Syrians with legal residence and a set of basic rights including free healthcare at public hospitals and access to education, it doesn’t give them the right to shelter or formal employment, making livelihood difficult in an expensive metropolis like Istanbul. Given this context of care deficit, my paper examines the everyday lives of working-class refugees and argues that “ordinary care” is a crucial means by which they build sustainable and dignified lives despite living in legal and economic precarity in the aftermath of displacement. Ordinary care, as I theorize here, is an improvised form of life-making which includes practices of reciprocity and neighborliness, as well as the ethical relations and affective ties that are forged in the process. Compared to organized political protests by which refugees make the news, ordinary care is more subtle and easily overlooked because it unfolds in the intimacy of domestic, everyday spaces such as the family homes, the neighborhood, and local organizations. It is informal, improvised, and tacit in contrast to top-down forms of governmental and humanitarian care provided to refugees. Based on long-term ethnographic research in the “Little Syria” neighborhoods of Istanbul, my paper reveals the concrete ways in which ordinary care—as resource, relations, and affect—is given and received as Syrian refugees strive to create stable lives despite growing anti-refugee sentiment across Turkey.

Paper short abstract

Menopause is rarely addressed beyond reproduction. Drawing on narratives of Indigenous Bhil women in Maharashtra, this study explores ageing, cultural silence, and unmet policy needs, showing how women’s health becomes marginal once fertility ends.

Paper long abstract

Menopause marks a significant transition in women’s lives, yet remains largely invisible within health systems that prioritize reproduction over ageing. The present qualitative study among indigenous Bhil women in Maharashtra, India, examines how menopause is experienced, interpreted, and managed in contexts shaped by social marginalization, limited healthcare access, and cultural silence.

The in-depth interviews (n=42) with premenopausal and postmenopausal Bhil women, explores local understandings of menopause, bodily change, and ageing. Findings reveal that menopause is rarely recognized as a distinct physiological phase; instead, it is understood through idioms of ageing, declining strength, spiritual disturbance, or moral change. Symptoms such as body pain, fatigue, sleep disturbances, and emotional shifts are normalized as part of growing older or attributed to a lifetime of physical labour, rather than menopause itself. The absence of open discussion and formal health guidance means that indigenous women often enter this phase unprepared, learning about menopause through embodied experience or observation of older women.

The paper argues that menopause exposes a critical polarization in women’s health between reproductive and post-reproductive life stages. Once fertility ends, women’s bodies increasingly fall outside the scope of formal healthcare, increasing reliance on traditional healers, family support, and personal endurance. At the same time, menopause create new possibilities, relief from menstruation and pregnancy anxiety, shifts in domestic and social roles, and increased participation in community life.

The narratives within this paper calls for rethinking women’s health beyond reproduction highlighting the need for anthropological engagement with ageing, care, and silence in a polarized world.

Paper short abstract

The presentation explores care poverty in urban Ethiopian households, intertwining the care needs of migrant domestic workers and their female employers in a context marked by a severe lack of care services, mediated by local practices that combine protection with power asymmetries.

Paper long abstract

This paper offers an ethnographic reflection on care poverty based on the experiences of Ethiopian domestic workers and the urban middle-class households that employ them. On the one hand, young migrant domestic workers experience multiple forms of unmet care needs, including the absence of support networks in their villages of origin, the lack of formal legal protections in domestic work, and experiences of marginalization and mistreatment within employers’ households. On the other hand, many middle-class female employers face the difficulty of reconciling paid work outside the home with childcare, eldercare, and household management. This burden is often intensified by limited social support networks, by the frequent absence of husbands, and by a broader context marked by the scarcity and inaccessibility of care services.

Within this framework, the local practice of "adera" (አደራ)—a form of entrustment rooted in extended community networks—assigns host families a role of protection and care toward domestic workers, framed as “vulnerable village girls.” These responsibilities fall primarily on female employers, who are regarded as the “custodians” of the domestic space. This moral grammar produces ambivalent outcomes: while it may offer support and orientation, it simultaneously tends to normalize power asymmetries, dependency, and silence.

The analysis shows how solitude, interdependencies, responsibilities, and unmet care needs intertwine in the everyday experiences of domestic workers and their female employers, revealing the gendered dynamics of the household and the multiple configurations of care poverty in contexts marked by profound socio-structural care deficits.

Paper short abstract

On outreach nights, policy goals like ending extreme poverty by 2030 feel unreal. Moving through a world of scarce beds and untreated illness, volunteers working in Spain with the homeless patch unmet needs with improvisation. But they complain: “no one cares”, as care inequalities become visible.

Paper long abstract

Policy documents often speak of a more efficient use of resources and even promise the eradication of extreme poverty (2020, 2030…), but it never happens. For the homeless, those deadlines dissolve into lack of resources and care. They lack medical attention, mental health support, safe shelter, and care. The most troublesome need is scarcity of accommodation. Drawing on participant observation as a volunteer with the Spanish Red Cross, I approach care poverty and care inequalities at the margins of homelessness outreach work.

Though the elder, the hospitalised, or the children are the usual subjects of the ethnographies of care, the homeless, stuck in “zones of abandonment”, with unmet need, and wounds inflicted by “structural violence”, end up meeting early death.

Outreach encounters involve people with untreated conditions like cancers, cirrhosis, tuberculosis, infected wounds at risk of gangrene, mental illnesses, addictions, loneliness. Volunteers record needs and refer the homeless to support services that do not materialise.

Volunteers struggle with unmet need and frequently initiate care without request, improvising support with personal resources when formal routes fail. These practices generate friction with professional social workers, whose institutional priorities and eligibility rules require rationing and the reordering of needs. Volunteers often complain of abandonment, lack of resources, and lack of interest on the part of institutions and their social workers.

“No one cares”, they say. These encounters at the margins of homelessness outreach, as a site of care, make care poverty visible.