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- Convenor:
-
Samuel Taylor-Alexander
(Monash University)
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- Format:
- Panels
- Location:
- Ligertwood 214 Piper Alderman Room
- Sessions:
- Thursday 14 December, -, -
Time zone: Australia/Adelaide
Short Abstract:
This panel asks scholars to examine healthcare regimes in Asia, NZ and the Pacific. It will address statecraft in relation to health, migration, family, and belonging, and provides an opportunity to reflect on how medical anthropology has influenced how we understand the state and state practices.
Long Abstract:
This panel invites scholars to examine healthcare regimes in Asia, NZ and the Pacific, considering the conference aim of extending anthropological understandings of the state. Inspired by and honouring the work of Pr. Julie Park, the panel will address statecraft in relation to (1) health (2) migratory processes, (3) family, and (4) belonging, to unpack statecraft as a geographically situated practice driven by experts concerned with the security of territories and populations. Said differently, it draws attention to the connections between people, places, and practices that become the focus of political attention and give way to new healthcare regimes and processes of socialization and subject formation in NZ and the Pacific. In doing so, the panel further provides an opportunity to reflect on the development of medical anthropology in NZ and the Pacific, and how this has influenced our understanding of the state and state practices in the region.
Accepted papers:
Session 1 Wednesday 13 December, 2017, -Paper short abstract:
The recognition of Pacific peoples in New Zealand as having legitimate rights to state health care occurred from the 1980s onwards. Using records of health research statistics and grants, I examine the complex relationships between Pacific and Maori health, Pacific states and the New Zealand state.
Paper long abstract:
Health research often reflects prevailing ideas but can also act as a vanguard for new perspectives on the part of the state. The period from 1950 to 1990 was a pivotal for the recognition of Pacific peoples as a population with a legitimate claim to state-sponsored health care in New Zealand. This process of recognition involved ideas of biological and cultural relatedness with Maori as well as the economic facts of labour migration. In this paper, I argue that over this period New Zealand-based Pacific health research moved from encountering ÍšPacific Islanders as the other to acceptance of Pacific peoplesÍ› active engagement in New Zealand: their health citizenship. This change is shown through analysis of demographic and health statistics and the grants awarded by the Medical Research Council of New Zealand. I examine the complex relationships between Pacific and New Zealand Maori health, Pacific states and the New Zealand state, and the intermittent recognition of transnationalism. Pacific peoplesÍ› active health citizenship from the 1980s onwards was a beachhead into a broader ranging mutual engagement with the state. In this process, however, the transnational nature of Pacific lives was ignored.
Paper short abstract:
Based on research conducted as part of an anthropology field school, this paper explores the health maintenance practices of people living in rural Malaysia and emphasises the contribution of traditional therapies - particularly Chinese medicine and Malay healing - to people's concepts of wellbeing. Co-authored by the Health Mapping Group
Paper long abstract:
The Malaysian health system is premised on aspirational mission statements which set forth a series of goals to facilitate positive changes in health and wellbeing for the population. This includes provision of universal health care and preventive health. However, significant gaps remain between aspiration and realisation, and many people are unable to access preventive care due to issues related to hidden costs, availability of particular services, or because of cultural preferences for healthcare. In this paper, based on a 2017 anthropology field school, we explore the factors that underlie people healthcare choices. For our participants, ideas of keeping healthy (health maintenance) were important and, although such services were theoretically offered via public health services, this was not the case in practice. Instead, community members expressed an explicit preference for traditional healers - most commonly Chinese traditional medical practitioners or bomohs (Malay healers)- because of the wholistic provision of care. In this paper, we explore these reasons and question the relationship between health and the state in ensuring the best outcome for the community.
Paper short abstract:
As taxpayers, New Zealand citizens who become patients are credited with moral capital which can be paid forward as they engage with the healthcare system. We examine the ways in which moral capital was paid forward within the moral economy of a community long-term conditions management team.
Paper long abstract:
This New Zealand study used ethnography to explore the activities of communities of clinical practice (CoCP) in a community based long-term conditions management program within a large primary healthcare clinic. CoCP are the informal vehicles by which patient care was delivered within the program. Here, we describe the CoCP as a micro level moral economy within which values such as trust, respect, authenticity, reciprocity and obligation circulate as a kind of moral capital. As taxpayers, citizens who become patients are credited with moral capital because the public health system is funded by taxes. This moral capital can be paid forward; accrued, banked, redeemed, exchanged and forfeited by patients and their healthcare professionals during the course of a patient's journey. The concept of moral capital offers another route into the 'black box' of clinical work by providing an alternative theoretic for explaining the relational aspects of patient care.
Paper short abstract:
This paper explores oral health self care practices for 45 people living in Dunedin, New Zealand on lower and fixed incomes. The resulting empirically derived model of oral health is highlighted against the mutilating policies of the State towards citizens with little disposable income.
Paper long abstract:
This paper explores oral health self care practices for 45 people living in Dunedin, New Zealand on lower and fixed incomes. The empirically derived model of oral health that the participants responses created was an aspirational ideal whose achievement was blocked by the mutilating policies of the State towards citizens with little disposable income. Participants were well aware of this. My analysis explores the entanglements of agency, technologies and policies within the mouths of citizens by drawing on Julie Park's studies of biotechnologies and well being, and her contributions to the idea of sensuous citizenship.
Paper short abstract:
This paper examines New Zealand child oral health policy in juxtaposition with the experiences of real Northland families, and how through policy, neoliberal ideals create the concept of a 'good' citizen/parent in how they adhere to 'correct' oral health behaviours.
Paper long abstract:
This paper examines how child oral health policy creates the concept of a 'good' parent or mother through the ideals of the state, juxtaposed with the realities of everyday family life in Northland, New Zealand. Research was undertaken examining oral health policy and supporting documents from the year 2000 onwards, alongside interviewing a small group of Mothers with young children in the Northland region as part of a masters research project. This research bought to light how language in child oral health policy separates who is a 'good' citizen/parent/mother through how well they adhere to the advice of the state in caring for their children's oral health. This explicitly reflects the government's neoliberal ideals of individual responsibility in this time period - attempting to position New Zealand as a developed and neoliberal country. In Northland, which has high levels of deprivation, a large Maori population and little industry, child oral health policy is therefore ill-equipped to meet the needs of the child population, which is reflected in the poor outcomes of child oral health in Northland. In talking to mothers these ideals prescribed through current policy are almost never followed by parents due to their pedantic nature and barriers such as cost, travel and general life stress. Therefore in this practice there is a lack of belonging - those who are not white, rich and live in a city are ignored by policies, and funding, as well as being deemed 'bad' parents, despite their circumstances.
Paper short abstract:
Encounters with representatives of states in the course of anthropological health research, and research-based insights into mutual contingencies between states and persons, provide the substance for this personal account of changing state practices in Aotearoa New Zealand and some Pacific nations.
Paper long abstract:
Encounters with representatives of states in the course of anthropological health research, and research-based insights into mutual contingencies between states and persons, provide the substance for this personal account of changing state practices in Aotearoa New Zealand and some Pacific nations. I draw on my own research and that of research group colleagues and of my PhD students to provide brief research stories which contribute to insights about states and about how states and persons are intertwined. My time-frame is from the 1980s to the present. Early insights from my PhD research about internal struggles even within that single branch of the state concerned with health; and my first PhD student, Sally Abel's, conclusion based on research on the New Zealand Nurses Amendment Act (1990) in the context of ongoing health reforms, that no one was in charge, have informed my thinking about states as often contradictory, chameleon-like and diffuse networks. Nonetheless, and pace the conference theme statement, tentacles of the state can be seen to be 'set against' citizens and communities, as our later research into living with haemophilia and the political ecology of TB, demonstrated. I see this as one facet of mutual contingency, rather than an 'older' view. I conclude with an instance of a positive outcome for members of a biosocial group as a result of a state that they had shifted, and some hopes for other, similar, outcomes.