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- Convenors:
-
Magdalena Góralska
(University of Warsaw)
Mirko Pasquini (University of Gothenburg)
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- Format:
- Panel+Roundtable
- Stream:
- Health and Medicine
- Location:
- B2.22
- Sessions:
- Thursday 8 June, -, -
Time zone: Europe/Prague
Short Abstract:
When, why, and in what social and material conditions does medical or healthcare collapse occur? This panel invites papers that critically reflect on conditions of healthcare or medical crisis, uncertainty, and collapse.
Long Abstract:
While the pandemic has exposed the many serious shortcomings and inadequacies of contemporary healthcare systems, the ensuing economic decline has put a serious strain on their functioning and accessibility, sometimes pushing them to the verge of collapse. The last three years have brought attention to the precarity and fragility of contemporary healthcare and medical systems, though calls for their post-pandemic reimagining or reform have arguably been sparse.
Within the broader rubric of uncertainty, drawing on the entire spectrum of systematic malfunctions, this panel invites papers that speak about cases of medical precarity, including instances of systemic malfunction, policy mismanagement, and political abuse that lead malfunctioning systems to collapse. When, why, and in what social and material conditions does medical or healthcare collapse occur? By what metrics or standards do people define and measure medical or healthcare collapse? Alternatively, how do healthcare and medicine co-exist, or even thrive, under conditions of systematic malfunction? In what ways might Western biomedicine contribute to medical precarity, including some patients and some diseases at the expense of others?
We welcome papers taking on topics such as, for example:
- pandemic and post-pandemic healthcare malfunctions,
- cost-driven healthcare inaccessibility,
- war-time healthcare,
- inequality by design: medical exclusion of certain groups or health issues,
- various stages of systemic healthcare malfunction,
- healthcare or medical collapse in all its forms.
Accepted papers:
Session 1 Thursday 8 June, 2023, -Paper short abstract:
This paper wants to explore the malfunctions and critical conditions of the community healthcare system in the city of Bologna (IT), focusing on the fieldwork experience in one marginalized area of the city and on the consequences of its lack of general practitioners (GPs).
Paper long abstract:
Based on the data collected during a multi-method action-research project aimed at mapping and tackling health inequalities in the city of Bologna (2017- ongoing), this paper would like to explore the current collapse of the community healthcare system, enhanced by the pandemic. In particular, we would like to focus on how the healthcare system reproduces inequalities through the placements of the proximity health services, implementing the exclusion of the already oppressed groups. Specifically, the main concern revolves around the distribution of general practitioners (GPs) in some disadvantaged areas of the city of Bologna, focusing on a specific one where we have a longer term fieldwork experience (Pescarola).
Due to the legal form of recruitment of GPs by the Italian National Health System, the latter cannot allocate GPs to a specific area. This generates a gap in how GPs are distributed throughout the city, with a relative lack of GPs in the most disadvantaged areas. It also generates barriers in accessing primary care services, leading to an overload of the emergency room system, already stretched due to lack of staff. The result is a mechanism that systematically enhances social and health inequities, often leaving people to overlook their health needs. Moreover, this system also tends to undermine the relationships between citizens and public institutions, increasing a sense of neglect and mistrust among the inhabitants. In the end, this paper would also like to show the possibility of some experimental devices and tools that can affect the distribution of GPs.
Paper short abstract:
Infodemic defines a storm of information, overwhelming – just like the COVID-19 virus – healthcare structures and their fragmented organisation. Looking at the Italian primary care, the paper articulates the unfolding of the infodemic crisis as a motor of long-term healthcare system transformation.
Paper long abstract:
Infodemic, as too much information including false or misleading information, has been widely documented by journalists and commentators. Yet, infodemic long-term effects over health care organisations remain understudied. In places like Italy, the COVID-19 infodemic prospered over the massive introduction of telemedicine, that expanded exponentially in the face of lockdowns and other drastic measures of social distancing.
During my fieldwork in 2021-2022, many General Practitioners (GPs) told me they bought new phones for work. They opened new WhatsApp, Face-Book and Instagram profiles. Social platforms have become a primary source of contact with patients and discussion with colleagues. GPs created new emails accounts and hired communication professionals to filter phone calls. But the ever-increasing number of requests for care still created an overburden of calls, emails and text messages. Such a tempest of information, whose management is widely improvised, ended up creating a backlash of mistrust. GPs are accused by multiple parties of having failed their gatekeeping role while practicing care by distance during the first and second wave of the COVID-19, with disastrous repercussion for patients’ health and hospital overcrowding rates.
This paper explores the infodemic in the Italian primary care, asking: how do technologies of communication create, inflate or delimit opportunities for infodemic to emerge in healthcare? And how does mistrust, generated by the infodemic, changes the possibility for trustworthy, equal relationships of care by distance? Addressing such questions, the paper illustrates the unfolding of the infodemic crisis as a motor of long-term healthcare system transformation.
Paper short abstract:
This paper discusses the pandemic and post-pandemic healthcare malfunctions in the Helsinki metropolitan area, Finland. The malfunctions have become a full scale crisis during the autumn of 2022. The presentation gives preliminary results from a research project based on photovoice method.
Paper long abstract:
The focus of the research is on employees performing vital COVID-19 related jobs: providing individual care to vulnerable clients in both organisational and home settings. We examine how diverse people (in Finland, Canada, Scotland/UK and South Africa) who work/have worked in formal and informal care address challenges by collaboratively examining their ideas to ease risks and develop opportunities to deliver and receive care. Specifically, we will analyse how care workers in precarious positions (women, LGBTI2SQ people, and migrant status or minority ethnic people) are experiencing COVID-19 crises in their work, and how they see a post-pandemic future.
Despite the relative success of the measures against COVID-19 in Finland, many long-term effects of the pandemic are visible. Waiting times in the public health care were already very long and this situation was worsened by the pandemic. During the worst months of the pandemic, emergency laws were applied enabling, for instance, the employer to decide unilaterally about the holidays of their employees. Employers and employees have repeatedly discussed salaries and compensation with care workers, often with the employees left unsatisfied. In 2022, the nurses’ unions have organised large strikes and there are fears that many care workers are overworked and plan to change occupation or retire early.
In the project, care personnel with foreign background take photos of their working life and, if they wish, make an exhibition of their photos. Group and individual interviews are conducted in different stages of the project.
Paper short abstract:
The paper explores the relationship between medical policies and practices and pregnancy within the framework of a reproductive healthcare system in Zagreb, Croatia. The emphasis is placed on personal experiences of being pregnant and giving birth during the pandemic and post-pandemic times.
Paper long abstract:
Reproductive health policies and practices in Croatia arise as a relevant research topic during times of crisis such as the COVID-19 pandemic, earthquakes, or changes in law policies. The author uses the public healthcare system in Zagreb and personal narratives to provide insight into the urban context of the pandemic and post-pandemic experiences of pregnancy and childbirth. This paper examines changes or restrictions that were put in place within the reproductive healthcare system as a response to the COVID-19 pandemic and how those policies and practices affected the experience of pregnancy. By analyzing the relationship between policies and approaches in the biomedical discourse and through personal narratives based on the lived experiences of pregnant women who gave birth and those who tried to conceive via medically assisted reproductive technologies during the strict lockdown in 2020, the author wants to see what kind of impact introduced epidemiological measures had on the provision and quality of health services related to women’s reproductive health. Furthermore, the author wants to investigate, if there is any evidence of a post-pandemic change in reproductive healthcare practices that arose from lessons learned during the pandemic. It is important to urge the discussion about women’s reproductive healthcare rights and how the Croatian public healthcare system deals with challenges related to social, economic, or public health issues within demanding times to be better prepared to ensure quality healthcare despite the possible crisis in the future.
Paper short abstract:
The talk focusses on the decades-long failure of the medical system with regard to the diagnosis and therapy of the disease ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). Through ethnographic analysis of patients experiences, medical (non-)knowledge regimes are critically examined.
Paper long abstract:
My contribution takes a look at the decades-long failure of the international and here specifically German medical system with regard to the diagnosis and therapy of the disease ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). Although this systemic autoimmune disease has been recognized by the WHO since 1969, it is largely ignored by medical theory and practice, with devastating consequences for the more than 250,000 people affected in Germany alone. In the course of the Covid-19 pandemic, the disease came to public attention, because ME/CFS is primarily caused by viruses and conjectured to be part of the post-Covid syndrome. The post-Covid syndrome is estimated to affect one in ten people who were exposed to the Corona virus, and has become a serious problem for the medical system, which lacks both trained medical staff and suitable treatment methods. My presentation will focus on the experiences of patients whose medical histories are related to viral infections, but began years or decades before Covid-19. On the one hand, they provide a harrowing insight into the paths of suffering and the lack of medical treatment options, and on the other hand, they show medical sociological tendencies to psychologize physical causes. Gender-related aspects play a particularly striking role here–predominantly young female patients report stigmatization and not being taken seriously, which perpetuates culturally handed-down role stereotypes of nervous-hysterical female patients. At the same time, medical non-knowledge regimes and power relations in the field of neurology are critically examined, which have contributed to the systematic denial of ME/CFS.