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- Convenors:
-
Paul Kadetz
(Xi'an Jiaotong Liverpool University)
Barbara Gerke (University of Vienna)
- Discussant:
-
Elisabeth Hsu
(University of Oxford)
- Location:
- JUB-135
- Start time:
- 10 September, 2015 at
Time zone: Europe/London
- Session slots:
- 2
Short Abstract:
This panel examines the construction and application of the normative discourse of safety in global health and problematizes the assumptions of hegemony embedded therein. We are particularly interested in examining the interactions between global and local-level understandings of safety.
Long Abstract:
The biomedical concept of safety has served as a unifying principle and motivational force in the development of global health policies and governance. Although the biomedical discourse represents safety as a hegemonic concept, anthropological research problematizes such representations. This panel will examine the construction and application of the normative discourse of biomedical safety in global health and critique the assumptions of hegemony embedded therein. We are particularly interested in analysing the interactions between global and local-level understandings of safety. We seek to examine: how a single construction of safety became hegemonic, authoritative, and representative of global health expertise? How local health practitioners with local understandings of safety have responded to this hegemony? How safety is constructed in global health policy making? And if and how the discourse of global health safety is related to colonial discourses of safety? We also seek to better understand: the link between health, the state and global securitization. The relationships between trade, toxic commodities and the safety discourse of global institutions. And the problems identified in applying one system's methods of proving safe practices (such as randomized control trials) on different ordered systems of understanding. This panel aims to examine these and other areas of the discourse of safety through local ethnographies, discourse analyses, historiography and critical, constructivist, and interpretive medical anthropological studies.
Accepted papers:
Session 1Paper short abstract:
Through twenty-two months of field and archival research this paper examines how rituals of safety are mechanisms by which dominant social orders are protected and identifies how the enforcement of an etic system of safety onto any given group may, ultimately, compromise the safety of that group.
Paper long abstract:
In the normative global health discourse, safety is represented as a concept that is universal, inherently beneficent and ultimately irrefutable. Yet, research at local levels in the Philippines problematises these assumptions embedded in the biomedical construction of safety. This paper examines how the imposition of an etic construction of safety onto a group can affect the group's health and well-being. Twenty-two months of field research were carried out through interviews, focus groups, and participant observation within communities of four rural municipalities in the Philippines and with stakeholders at state and multilateral levels. Archival research and participant experience at the World Health Organization were employed to contextualise the global discourse of safety that, at least in part, can be traced back to the construction of biomedical expertise via the work of the Rockefeller Foundation in internationally establishing the hegemony of biomedicine in the early 20th century. The case study of the implementation of safe delivery in the rural Philippines through state insistence on in-facility birthing with "skilled birth attendants" and the cessation of training for traditional birth attendants provides an illustrative example of the need for more nuanced and complex understandings of safety within any given health context and problematises the assumptions of local universality embedded in the global health discourse. This research examines how rituals of safety are mechanisms by which dominant social orders are protected and identifies how the enforcement of an etic system of safety onto any given group may, ultimately, compromise the safety of that group.
Paper short abstract:
This paper critically evaluates core assumptions and practices in dominant approaches to Occupational Health and Safety (OHS) through an anthropological exploration of the everyday perceptions, experiences and practices related to OHS risks amongst Bolivian cooperative miners.
Paper long abstract:
It is generally agreed that knowledge on the causes and consequences of a particular risk influence the way people prepare for and respond to it. This rational-actor-paradigm logic is envisaged by dominant Occupational Health and Safety (OHS) approaches, according to which knowledge of what constitutes OHS risks together with an awareness of their consequences on workers will necessarily result in the establishment of appropriate and effective risk management strategies within workplaces. My 17 months of ethnographic fieldwork amongst Bolivian cooperative miners working in Potosí shows however a much more complex scenario, in which miners simultaneously face a number of physical, geological, socio-political and economic risks as they go about their work and lives which must be carefully weighed against each other. In this context of overlapping risks and uncertainties, OHS risk perceptions and behaviours are governed by a different rationality; they are the result of risk-trade-offs in which the miners carefully balance the overlapping risks and uncertainties that affect them and their relatives together with the degree of control and choice they have over all these. Miners are well aware of potential losses of taking OHS risks, but also of the gains of the decision. This paper presents an ethnographic account of the uncertainties, negotiations, relationships and conflicts that shape how Bolivian cooperative miners conceptualise OHS risks and occupational safety. In so doing, I highlight the neglected political-economic dimensions of dominant approaches to OHS, the resulting conflictive encounters between miners and OHS experts and the shortcomings of current OHS interventions.
Paper short abstract:
This paper explores how concepts of 'safety' circulate and become contested. Ethnography of occupational health and safety reveals a mismatch between technocratic, procedural constructions of safety in global policy and local Bangladeshi interpretations that are adversarial, economic, and embodied.
Paper long abstract:
This paper explores the construction and circulation of a concept of 'safety,' from policymakers in Europe to the shop floors of garment factories in Bangladesh. After the 2013 collapse of the Rana Plaza factory building in Dhaka (which resulted in the loss of more than 1,000 lives and injuries to thousands more), regimes of health and safety governance in the global garment industry have become narrowly focused on issues of building and equipment safety to the exclusion of more wide-ranging, embodied, and politically sensitive discussions of worker health. With a multi-sited ethnographic approach that traces the construction of occupational safety policy among European stakeholders (ILO in Geneva, Secretariat of the Accord on Fire and Building Safety in Amsterdam, multinational corporations headquartered in Europe, WHO, etc.) to its application in Bangladeshi factories, my research shows how global discourses and practices of worker 'safety' reflect a technocratic impulse to inspect, audit, repair, and recompense that are at odds with local Bangladeshi interpretations of 'safety' that are political, adversarial, economic, and embodied. My research contributes to our understanding of 'safety' as a biomedical concept by tracing its twin relationship to economic formulations of risk, and legal conceptions of liability within a local ethnographic context that contests these notions at every turn.
Paper short abstract:
The paper analyses the ways in which ideas and discourses on safety and potentiality that appear alongside biotechnical and biomedical aspects of assisted reproduction (ART), child’s identity, or concepts of family and kinship shape the contemporary debates on legal regulation of ART, and specify approaches to their interpretation by law.
Paper long abstract:
In 2002-2005 a team of researchers from seven European countries joined together under an international project 'The Public Understanding of Genetics: a cross-cultural and ethnographic study of the 'new genetics' and social identity' (QLG7-CT-2001-01668) funded by EC and headed by social anthropologists from the University of Manchester to investigate the ways in which different publics understand the 'new genetics' in the areas of family and kinship, race and ethnicity, governance and legislation, and food. Lithuanian researchers participating at the project focused on the local thinking on assisted reproductive technologies (ART) and genetics in relation to identities of ethnicity, family and kinship.
The paper intends to revisit the research in Lithuania after ten years, and to discuss the aspects of implementation of biotechnological innovations the ethnographic updating brings anew, and the ways in which they respond to previous findings. This time it sets the debate on the normative assessment of ART as the conceptual point of departure and as an empirical example. The paper analyses the ways in which ideas and discourses on safety and potentiality that appear alongside biotechnological and biomedical aspects of assisted reproduction, child's identity, concepts of family and kinship shape the contemporary debates on legal regulation of ART. It underlines that safety and potentiality appear here as contested sites and principles that however create a movement in specifying the legal thinking on ART in Lithuania.
Paper short abstract:
Based on my ethnographic research of Ayurveda in the Czech Republic I intend to interpret how is the safety of Ayurveda constructed in the dialogue of ayurvedic and local biomedically formed understanding of safety and to contribute to the discussion of the safety of traditional medicine use.
Paper long abstract:
Drawing upon results of my diploma thesis and current fieldwork I would like to discuss the issue of safety of Ayurveda as it is formed in the process of its introducing, practising and regulating in the Czech Republic.
Similarly to other European countries the Czech medical safety discourse is significantly shaped by the western scientific paradigm. This is manifested in legislation which defines the safe medical practices as those ones which follows scientifically proved methods and are mainly done by physicians, but also in the local general understanding of safety. At the same time the biomedical hegemony of safe medical practices is questioned by the diminishing trust in the biomedicine especially with regard to the limited efficiency of treatment of civilization diseases and to the emerging fear of possible dangerous use of chemical medicines. In this environment traditional medicine enjoys high popularity.
Partly as a consequence of limited import of traditional medicines to the Czech Republic till early nineties there are no practitioner associations or legislation directly regulating ayurvedic practice, only the legislation regulating ayurvedic medicines. This is connected with the absence of standardization of Ayurveda in this country and leads to constant negotiations of not just constitutive content, form and legal possibilities of ayurvedic practice but also of their safety. Therefore a variety of self-regulation practices emerges.
The aim is to examine practices through which is the safety of Ayurveda constructed in local environment and contribute to the discussion of safety of traditional medicines use in Euro-American regions.
Paper short abstract:
This paper presents ethnographic examples from India on the perceptions of safety among Tibetan and Ayurvedic doctors processing mercury for use in medicines. Perceptions of mercury’s toxicity and how safety concerns are negotiated in the wake of the global UN ban of mercury will be examined.
Paper long abstract:
When the global legally-binding treaty to ban mercury (the 'Minamata Convention', initiated and steered by the United Nations Environment Programme), was signed by over 120 nations in 2013, many Tibetan and Ayurvedic doctors in India were confronted with an alien (global) paradigm of toxicity based on the atomic nature of mercury (Hg) and had to re-think their own safety concepts. This paper presents ethnographic examples of how Tibetan and Ayurvedic doctors in northern India, who use processed mercury (largely as mercury-sulphide) in their medicines, have responded to this ban and the safety concerns it has raised. Through euro-american media coverage on heavy-metal toxicity of their medicines, Tibetan and Ayurvedic physicians and their institutions have also felt compelled to communicate and 'prove' the safety of their mercury-containing medicines according to these global standards. Practitioners interviewed felt threatened to continue practising their processing methods that have been considered 'safe' in their authoritative texts and clinical practice for centuries. I examine how the media coverage and the UN ban have changed their discourse of safety and if and how such changes have affected their research, safety management, and actual pharmacological practices. I argue that these events have led to a conflict between medical epistemologies resulting in a syncretic mix of resistance and acceptance. For example, resisting the safety doxa of the atomic mercury model has also reinforced the identities of medical practices being hailed as specifically 'Tibetan' or 'Ayurvedic.'
Paper short abstract:
Local actors encounter two evidence discourses in global health: the ranking of cultural commodities according to "terroir", and various yet common languages of science. This paper introduces collectors of Chinese medicinal substances, and how scientific data is collected about the same substances.
Paper long abstract:
The global discourse about healthy Chinese medicine-pharmaceuticals falls into at least two distinct domains: the ranking of cultural commodities according to "terroir", and various yet common languages of science. This paper is based on ethnographic fieldwork in China, and - from a science studies-vantage point - it investigates various data collectors in the contested yet multifarious field of Chinese pharma-medicine.
Lena Springer introduces collectors of Chinese medicinal substances in contemporary China, such as wildcrafters or highly specialised "pharma-workers", on the one hand. On the other hand, she demonstrates how scientific data is collected about the same substances. In some outstanding cases, the different kinds of collectors do collaborate closely: both locally and in global science. Thus she compares the two evidence discourses in global health and gives examples of how local actors encounter terroir and data, and shape them together.