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Paper short abstract

This paper examines female community health workers in Eastern DR Congo as frontline infrastructures of chronic care. It explores how care is negotiated amid conflict, political neglect, and global health regimes in a context of chronic crisis.

Paper long abstract

This paper examines the moral and material entanglements of female Community Health Workers (CHWs) in South Kivu, Eastern DR Congo, a region shaped by protracted armed conflict, political neglect, and fragmented health infrastructures. Drawing on ethnographic fieldwork, it approaches care not only as a response to illness but as a chronically sustained practice within polarised and unstable health systems.

In contexts where state healthcare provision is limited and humanitarian interventions are intermittent, CHWs often function as key infrastructures of long-term and chronic care, mediating between global health regimes, local moral expectations, and everyday survival. While officially positioned as volunteers, they assume enduring responsibilities for maternal health, malaria prevention, and community surveillance, navigating affective relations marked by trust, fear, frustration, and moral obligation.

Engaging critical perspectives on care, chronicity, and moral economies (Fassin 2007; Fraser 2016), and building on the concept of chronic crisis (Vigh 2008), the paper argues that care itself becomes a site where sociopolitical polarisation is lived and negotiated. CHWs inhabit the fractures between humanitarian ideals and material scarcity, between notions of citizenship and abandonment, and between institutional mandates and community demands.

By foregrounding the everyday labour of CHWs, the paper contributes to anthropological debates on how chronic care trajectories are reconfigured in polarised settings of the Global South, highlighting both the limits of care and the solidaristic practices that emerge amid enduring instability.