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- Convenors:
-
Eva Jörgensen
(University of Iceland)
Muriel Lamarque (Sheffield Hallam University)
Send message to Convenors
- Format:
- Panel
- Stream:
- Health and Medicine
- Location:
- B2.22
- Sessions:
- Friday 9 June, -, -
Time zone: Europe/Prague
Short Abstract:
This panel aims to explore liminal healthcare actions of marginalised groups and the way people seek care within alternative therapeutic spaces to counteract standing inequalities in times of uncertainty.
Long Abstract:
The drawing of borders between regions, groups, and people has increased in recent years as a result of crises in public health. The marginalization of some people over others remains the basic rule dictated by the logic of political economic value as it is applied to bodies.
In an environment of growing limits and uncertainty, health is one of the categories where vulnerability becomes critical, affecting people's ability to obtain, enjoy, and sustain basic levels of well-being. At various stages of life, barriers based on economic, legal, ethnic, racialized, and gender-related factors, among others, limit equal access to healthcare, health rights, safety, and impact risk navigation.
Nevertheless, despite such disadvantaged situations, people and communities constantly look for methods to traverse the periphery, relying on informal coping strategies and various forms of socio-cultural capital to address marginalization. How do groups deal with the obstacles placed in their way of receiving institutional or mainstream healthcare? How do they advocate for themselves? What alternative therapeutic approaches are people using to improve their sense of health and well-being? How do people describe and express their physical and social pain?
Especially from a lay standpoint, this panel seeks papers that explore alternative spaces within the context of health. The following are some suggested topics: Embodied experiences of liminality, alternative therapeutic settings as tools for navigating health inequalities, performative activities as health interventions, or lived experiences during times of medical uncertainty. Other submissions that address liminal spaces of healthcare are also welcome.
Accepted papers:
Session 1 Friday 9 June, 2023, -Talieh Mirsalehi (Lund University)
Paper short abstract:
The Covid-19 pandemic has been a time of uncertainty, not least when it comes to concerns over preservation of the body and access to healthcare services. This paper focuses on liminality of migration, embodied experiences of self care, and facing the prolonged and emerging uncertainties.
Paper long abstract:
Health inequalities are a known phenomenon in different countries. Sweden is not an exception. The outbreak of the Covid-19 pandemic has exposed and exacerbated a range of already-existing health inequalities that especially impact vulnerable groups, including those categorized as foreign-born and migrant. When the first wave of the pandemic hit Sweden in March 2020, some migrated groups who resided in segregated areas were hit hard. Investigating the cause of these marginalized groups’ overrepresentation in mortality and morbidity statistics, socioeconomic factors, poor health, low health literacy, and lack of access to health authorities' guidelines are considered as potential contributing factors to the situation. What is less explored, however, is the impacted groups’ lived experiences of a migratory life during the pandemic. In Sweden, seeking care independently and taking a great deal of responsibility for one's health is a central health paradigm. This socioculturally shaped view, nevertheless, can be interpreted, internalized, and acted upon differently based on one’s former experiences of dealing with similar situations in similar contexts. This can lead to the emergence of old and new coping strategies among different groups. This paper explores a group of asylum seekers’ embodied experiences of dealing with situations that arise before and during migration and the pandemic. It is to investigate how participants in this study perceive their vulnerabilities, what approaches they take to secure their health in the face of a pandemic, and in what way they express their bodily (un)readiness to face uncertainties of the pandemic and their liminal migratory lives.
Muriel Lamarque (Sheffield Hallam University)
Paper short abstract:
The following work reflects on different forms and expressions of popular and traditional medicine that arise in contexts of international displacement, especially to compensate for the absence of equitable healthcare. It is based on the health experiences of Latin American migrants in Spain.
Paper long abstract:
Managing and controlling international migration is undoubtedly one of the main concerns within the international agenda, especially in terms of civil and political rights. Regarding health, governmental response to large population flows —especially in the Global North— still represents great limitations, failing (accidentally or deliberately) to provide adequate, egalitarian, and affordable care to those people who do not qualify within the legal/normative schemes of citizenship.
Faced with this scenery of structural inequality and administrative abandonment, migrant populations resort to numerous self-managed practices, community assistance networks and informal structures (both local and transnational) to share/distribute medical goods and knowledge, hoping to solve or palliate their health problems. The following work aims to analyse different forms and expressions of popular medicine that arise in contexts of international displacement, especially to compensate for the absence of equitable healthcare. Based on cultural principles of cooperation and reciprocity, the importance of such initiatives is not only pragmatic in terms of their ability to resolve ailments but also represents a source of consolation and mutual support, re-establishing the feeling of social and civic belonging.
The material and reflections here presented derive from ethnographic research on the health/disease/care-neglect processes of Latin American people living in Spain, focusing particularly on the continuity of traditional healing practices and the health identities forged around the concepts of inheritance, memory, and resistance.
Elin Wallner (Umeå University)
Paper short abstract:
This paper aims to explore lived experiences of inaccessible or missing medical knowledge related to reproductive, sexual and hormonal conditions mainly affecting women. This, in relation to patients’ efforts to navigate, negotiate and give meaning to their illness and healthcare experiences.
Paper long abstract:
In 2020, a Swedish social media movement was initiated with the hashtag: #alltserfintut (Wigen, 2020). It translates to “everything looks fine” and represents a sentence heard from healthcare providers when seeking treatment for pregnancy or birth induced injuries. Through #alltserfintut, individuals share experiences of dismissal and not accessing care, express dissatisfaction, seek support, information and alternative ways to deal with their situation. Similar experiences and digital communities can be found regarding other conditions and illnesses related to reproductive, sexual and hormonal health, mainly affecting women. Oriented from and in relation to such contexts, this working paper analyses material collected through ethnographic in-depth interviews with individuals suffering from severe perineal trauma, endometriosis and vulvodynia.
When patients contact healthcare services they are seeking medical treatment, but they also seek knowledge in order to make sense of their experiences. This paper focuses on the latter aspect. The research participants express uncertainty coming from a lack of knowledge about their conditions, which makes it hard for them to understand and communicate what they are going through – both in terms of being denied a diagnosis, and in terms of a general lack of knowledge about these gendered medical issues. Here, I aim to explore lived experiences of inaccessible or missing medical knowledge, in relation to the patients’ efforts to navigate, negotiate and give meaning to their illness and healthcare experiences. This is analysed from a phenomenological perspective, and in relation to the concept epistemic injustice, and especially the aspect ‘hermeneutical injustice’ (Fricker, 2007).
Iwa Kolodziejska (Institute of Ethnology and Cultural Anthropology, University of Warsaw) Iwona Kaliszewska (University of Warsaw) Evgeniia Zakharova (University of Warsaw)
Paper short abstract:
In authoritarian Chechnya uncertainties in medical landscape concern not only people seeking healthcare but also people providing alternative therapies. We look at informal coping tactics of alternative healers in response to Covid-19.
Paper long abstract:
Being an unofficial complementary or alternative medicine healer in Chechnya, republic in the North Caucasus, is a risky endeavor. Official healers are institutionalized in Islamic Medical Center – a state funded medical center where people are cured according to Islamic medicine. A non-mainstream, noninstutionalized healer may overnight become an enemy of the state. With state-promoted tradition of collective responsibility he/she endangers not only himself or herself but also his or her family. Non-official healers, however, despite all odds, operate in Chechnya. We look at the ways in which they are traversing the periphery.
What are healers’ everyday tactics of navigating between the hegemonies of state apparatus and biomedicine? How, in a place where the state tries to regulate the most intimate spheres of life and impose its own vision of proper healing, alternative healers respond to Covid-19?
Basing on fieldwork in summer and autumn 2021 we will take a closer look on how grey zone healers waver in the Chechen medical landscape, how they narrate themselves and what strategies they used to avoid risks. We will show that for healers in Chechnya, adapted to unfavorable conditions, Sars-Cov-2 was just another obstacle to deal with along other obstacles posed by an authoritarian state to local non-official healers. These healers build an additional alternative healing setting for those who look for other than institutionalized healing in Chechnya.
Sarah Wishloff (McGill University)
Paper short abstract:
This paper explores the care-seeking practices of persons experiencing chronic mental health crises and the intervention efforts of co-responding mental health-police officer teams. I ask what therapeutic possibilities are generated and what marginalizing logics are reified by crisis intervention.
Paper long abstract:
A series of high-profile police shootings involving persons with mental illness has forced many Canadians to grapple with the dual public health crises of mental health and racialized police violence (Shoush et al. 2020). The Ontario Mental Health Act provides police with the unique authority to apprehend a person suffering from mental disorder for transport to a healthcare facility where they are legally required to receive a physician’s examination and subsequent psychiatric assessment. In a context where year-long wait times for psychiatric consultation and a lack of community-based infrastructure mire the possibility of treatment in uncertainty, calling the police becomes a care-seeking behaviour for marginalized groups experiencing mental health crises who cannot access healthcare otherwise. However, this disproportionate police contact perpetuates the criminalization of mental illness, sustaining the violence and precarity that punctuate life on the margins.
This paper examines the efforts of Mobile Crisis Intervention Teams (MCITs)—first-responder units that pair mental health clinicians with crisis-trained police officers—to transform the moment of police encounter into an alternative therapeutic space. Based on ethnographic fieldwork in the form of ride-alongs and interviews with two MCITs in Southern Ontario, I found that the performance of crisis is a strategy enacted by the chronically mentally ill to trouble the seeming certainty of continued marginalization. I argue that the liminal space of crisis intervention serves as an opening to imagine an “otherwise” (Povinelli 2014) that subverts the reality of health inequalities while simultaneously reifying the forms of violence that give rise to them.
Eva Jörgensen (University of Iceland)
Paper short abstract:
The Icelandic government’s policy to left school primary healthcare largely inaccessible to students. Interviews with school nurses show ongoing issues faced with healthcare and the tactics used to battle increased pressures on the mainstream healthcare system as a result of the pandemic.
Paper long abstract:
One of the Sustainable Development Goals for health that aims to ensure equitable access to healthcare is primary healthcare. Schools serve as vital health institutions for adolescents, providing access to healthcare in their immediate surroundings in addition to serving as educational institutions. The Covid-19 pandemic brought unprecedented times of government public health interventions, often than not resulting in school closures, disruption of daily routines, intended to keep people safe and reduce the spread of the virus. Whilst multiple countries decided to close school operations, the Icelandic government’s primary aim was to keep educational institutions open, especially on the primary and secondary levels, which required imposed restrictions on services and activities. However, the need for healthcare staff at the forefront of the COVID-19 emergency response led to severe disruptions in primary health-related support students receive through the programme due to the nurses' absence during 2020 and 2021 as well as the additional pressures brought on by later variants.
The presentation is a part of a larger doctoral project examining the impact of the COVID-19 pandemic on adolescents in Iceland. Here, I will present themes from interviews conducted with school nurses in various parts of Iceland between November 2020 and June 2022. Major themes will be discussed, namely struggles with providing routine health care for students during governmental restrictions and the strategies used to provide healthcare support to minors during precarious times as the mainstream mental healthcare system becomes more pressured and waiting lists lengthen.
Kristofer Hansson (Malmö University)
Paper short abstract:
This paper explores how people with disabilities encounter and manage limitations and uncertainty within the Swedish healthcare sector by analyzing individual experiences of disability, encounters with health-care professionals, and the material culture within healthcare.
Paper long abstract:
This paper explores how people with disabilities encounter and manage limits and uncertainty within the Swedish healthcare sector. Previous research has pointed out that individuals with different forms of disability often meet health-care professionals that lack knowledge about their specific conditions. These limitations have also been defined as a form of medical paternalism, where the professional's knowledge is emphasized over the patient’s knowledge. Within disability research, this displacement has been categorized as a medical model in contrast to a social model where the patient's body is not the focus, but rather the context in which the individual lives. This is a theoretical model that can be viewed through cultural analytical lenses to explore liminal healthcare practices. This paper addresses these questions based on interviews done with people who have lived with disabilities and their experiences of seeking care in the healthcare sector. What kind of embodied experiences of liminality do they have in relation to healthcare? How do they navigate health inequalities in relation to liminal spaces of healthcare? In what ways does this create uncertainties in everyday life for people living with disabilities? One of the findings in the interviews is that it is not only the professionals’ lack of knowledge that generates inequalities, but also the material infrastructure in, for example, the hospitals. Therefore, in this paper it will be suggested that the medical model from disability research should also be elaborated with cultural analytical perspective on material culture.
Atwa Jaber (The Geneva Graduate Institute (IHEID)) Shilan Masrour (Geneva Graduate Institute (IHEID)) Shirin Heidari (Geneva Graduate Institute) Ryan Whitacre (Graduate Institute (IHEID))
Paper short abstract:
This paper discusses the challenges refugees faced in their migration journey, and how that journey continued to be structured by bureaucratic hurdles and conditions of liminality in their everyday lives, with a focus on healthcare related challenges that refugees face in their liminal spaces.
Paper long abstract:
In Switzerland, the migrant experience is characterised by a series of discrepancies between expectations and reality, which deepen the condition of liminality. Refugees and asylum-seekers travel to the Canton of Geneva with high expectations of legal protection, safe accommodation, financial stability, free education, and state-sponsored health care. However, once they enter the Canton, they face a set of challenges that limit their ability to work, access care, or even secure legal protections.
Between August 2021 and October 2022, we conducted participant observation in refugee residences and non-governmental organisations that provide services for refugees and asylum-seekers; focus groups (2); and in-depth interviews (35) with refugees and asylum-seekers of various origins, mainly Syria, Afghanistan, and Iran.
This paper discusses the challenges refugees faced in their migration journey, and how that journey continued to be structured by bureaucratic hurdles and conditions of liminality in their everyday lives, with a focus on healthcare related challenges that refugees face in their liminal spaces, as they are neither in their home country nor are they fully integrated into the new country’s society. As our data demonstrates, refugees expressed a deep sense of marginalisation, driven by a set of structural challenges that limit their present possibilities and hopes for the future. To overcome mental health challenges, the paper discusses how refugees use drugs as a tool to overcome issues of loneliness, isolation, and living on the margins.