Paper short abstract:

I will use scientists’ responses to a recent anthropological paper on the ‘unknowing’ of inequality in the conduct of transnational medical research in Africa to reflect about the relationship between scientific knowledge about the world, scientists’ being in that world, and anthropologists’ commentary upon both (while inhabiting the same world).

Paper long abstract:

Not-knowing - be it as simple ignorance or nihilist ignoration, calculated concealment or public secret, scientific suspension of knowledge or blind stupidity - interests anthropologists not only as absence of their main object, knowledge, but increasingly also in its own right, as productive of sociality. What is not known can make or undo associations, and direct and orient action. And the relationship between known and unknown is charged with power. Knowledge can legitimise authority and be monopolised by it; even greater is the power of the one who can make unknown, against evidence and experience to the contrary. While such 'unknowing' can undo the transformative effects of knowledge of the world, this process can not necessarily be inverted: countering (known) unknowns with knowledge - 'speaking truth to power' - will not simply reverse power relations or change worlds. Effective critique would have to do something other than saying things as they are.

This paper will reflect about unknowing and the possibility and purpose critique based on some observations of how the experience of inequality and injustice are (known and) unknown in the knowledge-seeking order of a major transnational medical research site in Africa. Sharing impetus and experiences of other anthropologists on this panel (which was conceived out of such shared concerns), I focus less on the intentional control of knowledge and its publication by powerful institutions or individuals, guided by particular interests (which remains an important issue), but wonder why and how certain dimensions of being in the world are excluded from scientists' effective knowledge.

Paper short abstract:

Based on empirical analyses of the central role played by bêtise in contemporary global health, I will discuss what are the formal and theoretical difficulties to enunciate and criticize stupidity (understood as the arrogance and absurdity inherent to the exercise of reason itself) in anthropological terms and in anthropological studies.

Paper long abstract:

From Flaubert to Barthes, the most successful literary attempts at telling the truth of modernity have included a systematic critique of human stupidity (understood as the arrogance and absurdity inherent to rationality itself), which notably exposed the infinite manifestations of 19th and 20th century scientific and political bêtise. By contrast anthropologists have largely ignored stupidity as an object of inquiry and critique; they have preferred to reveal other truths about the institutions of modern governance (the oppressive potential of their rationalities, for example).

In this paper I will discuss what are the formal and theoretical difficulties to enunciate and criticize stupidity in anthropological terms and in anthropological studies. I will present my own (largely failed) attempts at analysing the central role played by arrogantly absurd reasoning (a definition of bêtise) in contemporary global health and at finding a language to expose it (which avoids the meta-language of irony). I will finally suggest possibilities, inspired by popular comedies, art and everyday language, for an anthropology of stupidity, one which would include the stupidity of anthropological truth-tellings themselves.

Paper short abstract:

This paper will address the predicament of telling truth about truth-tellers, of following fearless speech, and of speaking without a certain claim on action.

Paper long abstract:

This paper will address meta-parrhesia: the predicament of telling truth about truth-tellers, of following fearless speech, and of speaking without a certain claim on action. The classic critical approach of unveiling falters in the face of figures who are, as Didier Fassin puts it, untouchable by virtue of their relation to moral value and furthermore articulate in their self-representation. Using the example of Médecins Sans Frontières, an organization that has defined itself through a potent combination of dramatic action and blunt rhetoric, I examine the problem of discussing things known but unresolved.

Paper short abstract:

Over a short period, the Bill and Melinda Gates Foundation has become the largest private player in global health funding and governance, spending more annually on healthcare in developing regions than the World Health Organization (WHO), and providing 10 per cent of the WHO's overall budget. The Gates Foundation's growing influence is raising concerns about the foundation's transparency, accountability, grant disbursement decisions, and investment in corporations seen as exacerbating global health problems. Drawing on interviews with those inside the Gates Foundation and outside, this talk explores the relationship between philanthropic power and expert ignorance.

Paper long abstract:

In particular, I explore the ways that those most concerned with the Gates Foundation's dominance over decision-making are typically the same individuals least likely to voice concerns publicly, leading to hierarchies of silence where the most valuable knowledge is that which is rarely articulated. The Gates Foundation exemplifies the methodological difficulty of accessing the "truth" of organizations which tend to generate more strategic silence about their operations the more their own knowledge-base and scale of influence expands. This case illuminates an obvious and yet underappreciated truism: the more an organization knows, the less we're entitled to know about it, particularly when those with the most expertise about an institution are the least likely to speak 'truth to power.'

Paper short abstract:

This paper reflects on conflicts that have emerged whilst undertaking anthropological research alongside colleagues seeking to control the spread of tropical diseases in East Africa. It highlights the challenges of 'speaking truth to power' noting the benefits & counter-productive consequences.

Paper long abstract:

This paper reflects on conflicts that have emerged in the course of doing anthropological research alongside colleagues seeking to control the spread of neglected tropical diseases in East Africa. Drawing upon fieldwork undertaken at numerous locations in Uganda and Tanzania since 2005, the paper analyses responses to our research on three tropical diseases: schistosomiasis, lymphatic filariasis and soil-transmitted helminths. This research suggests that current strategies to distribute drugs free of charge to adults and children living in endemic areas is less effective than that indicated in the biomedical literature and, at several sites, has failed. The process of researching and writing up field research has elicited a range of responses from parasitologists, epidemiologists, vector biologists and public health specialists involved in the implementation and/or monitoring of the control programmes. This has included attempts to restrict access to field sites, to contain the dissemination of findings, to re-do local studies in such a way as to suggest that drug coverage is higher than it is, to hold back information suggesting rates of re-infection are high in the aftermath of treatment, the exertion of moral pressure to set aside information that may threaten funding and livelihoods, and misrepresentation of our research in refereed medical journals in an effort to discredit it. The paper highlights the challenges of 'speaking truth to power' in a context where control programmes are primarily funded by international organisations such as the Gates Foundation, USAID, and the UK DfID, and it notes the benefits of doing so as well as the counter-productive consequences.

Paper short abstract:

This paper explores contested anthropological insights into rumours linked to medical research that were encountered as part of applied anthropological study in western Kenya.

Paper long abstract:

This paper explores the contested interpretations of "blood stealing" accusations linked to medical research and the responses of biomedical research scientists to anthropological insights into these rumours. During an applied anthropological study carried out alongside a clinical trial of a preventive malaria intervention for infants in western Kenya, researchers were faced with numerous reports of "blood stealing". In light of their potential significance for future roll-out of the intervention, these rumours - the term often used by respondents - were further explored. Although the stories of "blood stealing" were seemingly not linked to the intervention per se, we deemed their persistance in this highly researched setting to be worthy of further analysis. With the input from other members of the social science team I drafted an article in which the rumours were described, discussed with reference to the reported key rumour spreaders, the nature of medical research, the potential instrumental uses of rumours, and placed in context. The article was however met with concerted opposition from senior members of the local branch of the collaborating biomedical research institution. Criticisms were levelled at the objectives, methods, intepretation and presentation of the findings. Perhaps most tellingly, by recounting respondents' descriptions of rumours, I was accused of giving an "unbalanced" account and of presenting the community as, in the words of one malariologist, "primitive". The nature of the opposition suggested either a basic misunderstanding of the nature of anthropology or a calculated attempt at undermining the research.

Paper short abstract:

Based on more than 20 years of collaboration with medical researchers, the paper reflects on the kinds of expectations that powerful medical research institutions have when they engage anthropologists, and what it is about the results that anthropologists present to them that either makes them enthusiastic, excites feelings of anger and betrayal, or leaves them cold. It also examines the kind of truths that anthropologists present to their medical collaborators and about these collaborations and reflects on the ways in which these truths are constructed.

Paper short abstract:

Reflection on work at the interface of Global institutions and Government in the context of South Asia, and its impact on the control of tuberculosis.

Paper long abstract:

In this paper I reflect on the relationship between practice and academia in the arena of the control of tuberculosis. The control of TB involves complex assemblages of institutions - global, governmental, and local - ones that shift as international and national priorities, polices and resources change. Drawing on over twenty years experience, I meditate on the changing face of policy and practice focusing in particular on the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and the WHO, and their relations with national TB programmes in the context of South Asia. At times anthropological truths and ideas are heard, and at other times they are ignored. Why this might be so is discussed. As such the ideas presented speak more broadly about the relation between anthropology and organisations.

In particular, the paper will analyse how this health programme represents a particular and increasingly dominant form of development practice, one where an increasing focus on financial accountability and its effects lies at the centre of an evolving programme. The movement between, on the one hand working in tuberculosis control, and on the other medical anthropological reflection allows particular insights and analysis.

Paper short abstract:

What is the anthropologist’s response when some of his most natural allies outside academia – independent journalists – turn against his interpretations? This paper describes their attempts to counter fieldwork-based knowledge and discusses the complexities of anthropological engagement in a situation where the anthropologist has little alternative but to confront the linguistic, social and political distinctions certain gatekeepers in the study country would like to keep intact.

Paper long abstract:

What is the anthropologist's response when some of his most natural allies outside academia - independent journalists - turn against his interpretations? Analysis of news journalism in the Malawi Broadcasting Corporation (MBC), the country's only public broadcaster, has long been driven by a certainty about its biased and bigoted nature. Such has been the certainty among activists and independent journalists that their analysis has appeared to require little first-hand observation of journalistic practices and actual programme formats. By contrast, an anthropological study recently uncovered through ethnographic fieldwork that one of the MBC's most popular programmes sustains a vibrant arena for moral debate. Broadcast in Chichewa, Malawi's most widely spoken language, Nkhani Zam'maboma gives every evening an outlet for listeners' own news, many of which are stories about folly and misconduct among figures of authority. The study, while explicit about the undeniable bias of the MBC's main news bulletin, has been greeted with scepticism by some Malawian journalists. This paper describes their attempts to counter fieldwork-based knowledge and discusses the complexities of anthropological engagement in a situation where the anthropologist has little alternative but to confront the linguistic, social and political distinctions certain gatekeepers in the study country would like to keep intact.

Paper short abstract:

This paper explores epistemological issues relating to 'truth' as an attribute of anthropological knowledge, based on fieldwork on same-sex sexual lives and life-worlds in West Bengal, India.

Paper long abstract:

This paper explores the experiences of people of same-sex sexuality living in regional towns in West Bengal, India. The paper is especially concerned with ways in which a sense of sexual subjectivity may not be relevant or cognizable to people in this context. People who took part in the research often refuted, or demurred at, any sense of sexual identity or subjectivity in favour of more indeterminate and indirect means of conceiving and practicing intimate relationships with people of the same sex. As such, such relationships, or connections, where typically characterized by evasiveness and indeterminacy, a way of 'being-in-the-world' that was at odds with the encroachment of public health HIV prevention interventions into this area, that sought to determine, describe and enumerate same-sex sexualities, and especially male-to-male sexual subjects. As an anthropologist, working in this context, one was predominantly aware that gathering 'facts' about sexual lives and life-worlds was intrinsically partial or inadequate as an ethnographic approach, since the characteristic feature of research participants lives was that they were characterized by an ambivalent relationship to fact or truth. This engendered broader questions about 'the facts of life.' In what ways are lives in general lived or narrated fictitiously? Are lives most meaningfully described outside of any paradigmatic claim to truth? Conceiving sexual life-worlds in these terms becomes especially complex when advocating 'up' from ethnographic work, seeking to influence broader policy and programming paradigms, for example. Such concerns are explored in this paper via my own experiences of working within national level HIV

prevention planning in India and also through reflections on the experiences of sexual health outreach workers and sexual rights advocate in West Bengal.

Paper short abstract:

I argue that presently procedures to authorize controversial, politically relevant knowledge are changing. The emergence of non-governmental organizations that certify and rate things of all sorts is indicative of this change. This has in impact on what social critique can be.

Paper long abstract:

Many of us have invested a lot of intellectual energy to establish anthropology as a post-structuralist, post-foundational discipline. The only realm where we are normally prepared to offer knowledge with a normal scientific claim of validity is with reference to processes where others make sense and create realities for, instance by numeric representations. Or even a step further: instead of writing the critique of this or that social reality it appears more challenging to examine the making of critique.

In certain contexts the will to "speak truth to power", i.e. to articulate critique and expect to be heard, seems to require one more additional step beyond the analysis of other peoples' sense making. This step is about making a substantial claim with reference to a state of affairs that gets across as being objective and sometimes imperative for action.

A pertinent case is an anthropologist's knowledge about what she considers to be an ethically intolerable state of affairs that is publicly not recognized as such. For instance me reporting about what goes on in South Kordofan (Sudan) since June 2011.

However, all knowledge to be processed juridically and politically needs to be authorized beforehand by certain procedures. I argue that presently the procedures to authorize controversial, politically relevant knowledge are changing in a certain direction. The emergence of non-governmental organizations that certify and rate things of all sorts is indicative of this change. This, again, has in impact on what social critique can be.

Paper short abstract:

The outputs of anthropological research are less stable than they used to be. Post-fieldwork negotiations of ethnographic accounts are increasingly part of the research experience. This paper explores some experiences and implications of anthropology’s essentially relational epistemology.

Paper long abstract:

Anthropologists it seems often have peculiar difficulty communicating the results of their research to those with whom they have collaborated. It is increasingly common for PhD researchers among other to find when they return the insights of their ethnographic analysis to the institutions that they have studied, be they NGOs, activist networks, or other institutional actors, that they receive a hostile response. This is not because the researchers have made what are recognised as factual errors or because their analyses are insufficiently rigorous, but because the framing is alien, the epistemology unfamiliar. The ethnographic account is seen to have missed the point, focussed on irrelevant matters, or undermined stated goals with its focus on relationships. The anthropological account is not regarded as inconsequential, but as excessively consequential, yet unrestrained by the discursive conventions that it has studied. The issues here are both epistemological and ethical and arise from the inescapably relational nature of anthropological knowledge.