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Paper short abstract

This paper examines medical deserts in rural Serbia as a slow process of infrastructural erosion. As care and public transport withdraw toward urban centers, women’s reproductive healthcare becomes fragmented, improvised, and increasingly reliant on informal support.

Paper long abstract

“Medical deserts” refer to regions where healthcare services are technically accessible but, in practice, remain insufficient or inaccessible. Clinics, staff, pharmacies, and transport connections thin out, and care becomes harder to reach, less continuous, and more uncertain. This paper approaches medical deserts in rural Serbia as a slow, cumulative process of infrastructural erosion. We trace how village-based care and mobility links withdraw toward larger health centers, shifting women’s reproductive healthcare into a terrain of improvisation and informality.

Based on multimodal ethnography in villages in Northern Banat and Zaječar catchment, the analysis follows women across space and time through narrative accounts, participatory micro-mapping of routes to care, and traces of everyday logistics. We show how “universal” entitlements diverge from lived access, as irregular transport and long waiting times turn routine care into all-day undertakings, deter prevention, and, through disrespectful or non-consented encounters, erode trust and recalibrate women’s expectations of care.

Conceptually, we argue that medical deserts are spatially, organizationally, and socially produced, and that they operate as infrastructural polarizations between center and periphery, formal systems and informal “patchwork” support, institutional legibility and women’s narrative evidence. We demonstrate that these deserts are not empty, but provisionally sustained by fragile counter-infrastructures of kin, neighbors, and trusted clinicians, even as responsibility for continuity and safety is increasingly redistributed onto households.

Reading these dynamics through necropolitical optics, we suggest that decisions about availability, continuity, and quality of care shape differential exposure to risk, pain, and abandonment, while also generating everyday tactics of endurance and solidarity.