Marshallese mothers face the highest rates of adverse maternal and child health outcomes compared to other ethnic groups in Hawai'i. Previous studies used interviews with healthcare providers to understand these disparat...Marshallese mothers face the highest rates of adverse maternal and child health outcomes compared to other ethnic groups in Hawai'i. Previous studies used interviews with healthcare providers to understand these disparate outcomes; however, the voices of Marshallese women are relatively absent. This project explores the bwebwenato (Marshallese mode of storytelling) of first-generation Marshallese mothers who navigated discrimination before, during, and after pregnancy in Hawai'i. Using collaborative methodology, we co-produced research that centers the bwebwenato of Marshallese women. In addition to the intersections of power and race in healthcare settings, Marshallese mothers chose to highlight the discrimination they faced growing up in Hawai'i. Through these stories, they profess their ability to navigate their cultural traditions and beliefs within and against a local racial hierarchy that places Micronesians at the bottom. Bwebwenato as a method has the potential to transform research into a more acceptable form for groups experiencing discrimination and patient-provider interactions into more equitable exchanges.
Med Anthropol Q
· 2025 Dec · PMID 40418723
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Drawing on the experiences of mothers raising children with Down syndrome in Amman, Jordan, this article approaches disability stigma as a phenomenon that attached to meaningful relations of kinship and community. These...Drawing on the experiences of mothers raising children with Down syndrome in Amman, Jordan, this article approaches disability stigma as a phenomenon that attached to meaningful relations of kinship and community. These same relations, however, enabled mothers, children, spouses, relatives, and other disability advocates to (re)claim Down syndrome as normal. In doing so, they challenged extant narratives that treated embodied difference as a relational risk in need of containment. "Normal" possesses disciplinary and oppressive capacities, but it can also become an effective tool. Claiming "normal" helped some families situate Down syndrome as an unexceptional way of being in the world and a valuable mode of being in relations with others.
Med Anthropol Q
· 2025 Dec · PMID 40393045
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Despite a growing body of literature linking environmental toxins and endometriosis, environmental issues make only occasional appearances in public, patient, and specialist conversations about endometriosis. These conve...Despite a growing body of literature linking environmental toxins and endometriosis, environmental issues make only occasional appearances in public, patient, and specialist conversations about endometriosis. These conversations may hover at the edges of public discourse, but do not gain traction. Based on ethnographic work in the United Kingdom, this article develops the concept of "slippery" knowledge as that which evades action. Ignorance of environmental or ecological etiologies is less a dearth of information than a dearth of possibilities for action. This article elaborates two ways of conceiving of environmental or ecological disease: the exposure model predicated on harmful external factors "getting in" to damage individuals or communities and the embodied ecologies model, which posits inevitable and ongoing mutual imbrication among living and non-living entities. Knowledge regarding endometriosis is "slippery" in both models. Whether knowledge seems actionable or not is inextricable from deep-seated power dynamics related to colonialism, gender, and race, which perpetuate ways of knowing (and acting) on endometriosis that are troubling and troublingly durable.
In the aftermath of the Supreme Court's 2022 decision to overturn the federal right to abortion, much public and political debate has surrounded gestating and in vitro embryos' "personhood." In this paper, I draw on 15 m...In the aftermath of the Supreme Court's 2022 decision to overturn the federal right to abortion, much public and political debate has surrounded gestating and in vitro embryos' "personhood." In this paper, I draw on 15 months of participant observation in biomedical spaces of infertility to reveal how embryos can be enacted as not only unborn children but as many different kinds of entities. I examine how embryos become "multiple" as in vitro fertilization (IVF) professionals inseminate, monitor, and transfer them into patients' bodies: enacting them as makeable, contingent, recordable, animatable, predictable, introducible, praisable, and appraisable entities. Providing a new perspective into the varied ontologies of in vitro embryos, this paper has far-reaching implications for the anthropological study and politics of reproductive medicine and politics today.
Global health regimes have reversed the role of traditional birth attendants (TBAs) from partners in the fight against maternal and child mortality to barriers to indicator-driven care. In rural Tanzania, widespread fear...Global health regimes have reversed the role of traditional birth attendants (TBAs) from partners in the fight against maternal and child mortality to barriers to indicator-driven care. In rural Tanzania, widespread fear of government surveillance and punishment for non-compliant individuals and organizations that climaxed during the presidency of the late John Magufuli (2015-2021) put increased pressure on TBAs. To negotiate tensions, TBAs adopted the position that they only escort women to health facilities for birth. We argue that TBAs' insistence on this only both occludes and protects their multiple caring roles and responsibilities in a context of harsher home birth penalties, yet limited efforts to improve systemic shortages in the rural health system. TBAs' performance of "we only escort women" operates both as the sedimentation of policies, a way to resist them, and means to hold space for TBAs in the wake of ambiguous global and national health policies.
Med Anthropol Q
· 2024 Dec · PMID 39804993
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Despite the transformative contributions of Black feminist thought, medical anthropology often fails to recognize or center the works of Black feminist thinkers. We argue that Black feminist theory is critical for a stud...Despite the transformative contributions of Black feminist thought, medical anthropology often fails to recognize or center the works of Black feminist thinkers. We argue that Black feminist theory is critical for a study and praxis of new approaches to healing, health, medicine, illness, disability, and care. We can't continue to simply recognize that current systems are failing us; Black feminist theory moves us past recognition toward transformative liberation. This special issue emerges from works and conversations leading up to, during, and after the first Black Feminist Health Science Studies Collaboratory, held virtually in May 2021. Through the Collaboratory, we propose a new form of coming together around the sharing of knowledge and practice based in Black feminist thought and Black feminist healing arts. The collection of works that follow demonstrates and provides practical means toward a more liberatory practice of medical anthropology.
Med Anthropol Q
· 2025 Jun · PMID 39741122
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Attending closely to the lived experiences of people moving in and out of Medicaid-funded institutions, I argue that "the streets" are critical to understanding healthcare in US urban poverty. Exploring the relationship...Attending closely to the lived experiences of people moving in and out of Medicaid-funded institutions, I argue that "the streets" are critical to understanding healthcare in US urban poverty. Exploring the relationship between "the streets" and Medicaid-funded institutions, this essay asks: How does the relationship between "the streets"-and in the words of my research interlocutors-"life on the other side" shape life in Medicaid-funded institutions in the Northeast US city? How do the social and symbolic conditions of this relationship-conditions structured by anti-Blackness-formulate the human in urban poverty? By joining Medicaid-funded institutions together as a broader health-governing network, I demonstrate how these institutions become boundary spaces that reveal the socially and symbolically interdependent worlds of "the streets" and life off them. Ultimately, this essay argues that "the streets" contain the social and symbolic conditions that dehumanize the poor through the logics of anti-Blackness, thus defining the terms of humanization that Medicaid-funded institutions afford.
Med Anthropol Q
· 2024 Dec · PMID 39740243
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This article examines how Eritrea's realization of Millennium Development Goal 5 (the reduction of maternal mortality) reveals the complex workings of medical sovereignty in sub-Saharan Africa. Through the case study of...This article examines how Eritrea's realization of Millennium Development Goal 5 (the reduction of maternal mortality) reveals the complex workings of medical sovereignty in sub-Saharan Africa. Through the case study of Eritrea, I demonstrate how postcolonial African countries might approach structuring their healthcare systems to navigate-and challenge-the neoliberal contours of global health humanitarianism. By analyzing both Eritrea's colonial history and the liberation-era history of medicine alongside contemporary healthcare policymaking, I trace how racial and gender dynamics shape the reduction of maternal mortality and the pursuit of medical sovereignty more broadly. To engage in this pursuit, African states must negotiate the tensions between autonomous healthcare development and the political constraints of global health humanitarianism.
Med Anthropol Q
· 2025 Dec · PMID 39731703
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This article explores how acuteness is experienced by people with endometriosis in Finland. Drawing on in-depth interviews as well as anonymous written endometriosis stories, we trace instances when the sense of chronici...This article explores how acuteness is experienced by people with endometriosis in Finland. Drawing on in-depth interviews as well as anonymous written endometriosis stories, we trace instances when the sense of chronicity and cyclicality of endometriosis is disrupted by a possibility of risk to life. These instances include when endometriosis tissue grows in unanticipated and aggressive ways, when medical interventions lead to unexpected complications or medications raise concerns about a gradually developing risk, and when endometriosis diagnosis becomes a catch-all category that could mask the onset of a life-threatening condition. Our analysis of illness experiences suggests that, while risk to life is an unlikely outcome in chronic conditions such as endometriosis, concerns about risk shape how the chronicity and cyclicality of endometriosis are felt and managed in everyday life.
Med Anthropol Q
· 2025 Jun · PMID 39700043
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In this article, we examine the clinical encounters of people diagnosed with a severe mental illness (SMI). Drawing on more than 1-year of ethnographic research and interviews in Indonesia, we show that instances of mora...In this article, we examine the clinical encounters of people diagnosed with a severe mental illness (SMI). Drawing on more than 1-year of ethnographic research and interviews in Indonesia, we show that instances of moral self-reflection occurring in the process of acquiring and appropriating clinical insight emerge at the intersection of heterogeneous discursive regimes. When biomedical notions of health and illness dominate these discourses, they reimagine pre-existing notions about spirituality and religion. Furthermore, consenting to psychiatric notions of health and illness can create common ground and a sense of shared experience, leading to grassroots movements for the empowerment of the mentally ill, self-help groups, and other support structures. At the same time, these processes can increase uncertainty and be generative of a culture of blame, as individuals are caught in overlapping and at times contradictory moral systems that each have the potential to strip patients of their moral status.
Med Anthropol Q
· 2025 Jun · PMID 39699933
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Based on 28 months of ethnographic research in Deanuleahki-a river valley in Sápmi, the transborder Indigenous Sámi homeland-this article traces my interlocutors' striving to reclaim and repair ecological and kin relatio...Based on 28 months of ethnographic research in Deanuleahki-a river valley in Sápmi, the transborder Indigenous Sámi homeland-this article traces my interlocutors' striving to reclaim and repair ecological and kin relations through the everyday praxis of care. I trace this striving through the unmaking and remaking of local relations of care amidst encroachment by post-Second World War Nordic welfare states and regimes of environmental stewardship. I propose a dual conceptualization of ecosocial injury and resurgent care to account for, on the one hand, care's alienation from its social and ecological contexts; and, on the other, the intimate everyday labor of revivifying relations of kinship and belonging, and conditions of material livability, within local ecologies. This defiant and desirous politics of care carves out an opening to attend ethnographically and theoretically to both dislocation and repair in spaces of Indigenous resurgence. In conceptualizing such a politics of care, the article brings into conversation key literatures in medical anthropology and in the interdisciplinary scholarship on care and Indigenous resurgence.
Med Anthropol Q
· 2025 Dec · PMID 39688940
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Achieving a target of zero-zero disease, zero disability, and zero discrimination-has become the dominant focus of campaigns to control or eliminate diseases, from HIV/AIDS to malaria to leprosy. Given the historical fai...Achieving a target of zero-zero disease, zero disability, and zero discrimination-has become the dominant focus of campaigns to control or eliminate diseases, from HIV/AIDS to malaria to leprosy. Given the historical failure of most eradication programs over the last century, such teleological imaginings of disease-free futures might seem overly utopian. But even if it were possible to eradicate such diseases in their entirety, would this be universally welcomed, even by those most affected by them? In this article, I compare the narratives of national and international bodies concerned with eliminating leprosy, in particular, with the more ambivalent narratives of those affected by the disease in India, the country where the disease is most prevalent. For the latter, the promise of elimination not only seems unrealistic, but represents a potential loss of identity. Imagining disease trajectories in less linear terms, I argue, might also nuance understanding of them.
Med Anthropol Q
· 2025 Jun · PMID 39620965
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In Turkey's occupational health system, doctors must use the International Labor Organization's (ILO) standards to classify the chest radiographs of workers at risk of lung diseases caused by dust exposure. Yet these sta...In Turkey's occupational health system, doctors must use the International Labor Organization's (ILO) standards to classify the chest radiographs of workers at risk of lung diseases caused by dust exposure. Yet these standards do not provide a uniformity of care within the tripartite structure of the occupational health system, which divides disease surveillance, disease diagnosis, and worker compensation into distinct silos. This division often produces ambiguity and unpredictable outcomes for occupational disease claims. The traffic of diagnostic decisions among workplaces and medico-legal institutions-what I refer to as diagnostic ecologies-shapes medical knowledge. The tripartite organization of the occupational health system in Turkey makes the evaluation of chest radiographs a space where professional expertise and professional ethics are constantly negotiated. A focus on diagnostic ecologies illustrates how disease ontology is distributed across the occupational health system's components.
Med Anthropol Q
· 2025 Jun · PMID 39612345
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Selective abortion of female fetuses is a widespread, illegal, and profoundly consequential form of family planning in contemporary India. In Gujarat state, public health campaigns against the practice rely on narratives...Selective abortion of female fetuses is a widespread, illegal, and profoundly consequential form of family planning in contemporary India. In Gujarat state, public health campaigns against the practice rely on narratives exhibiting the hallmarks of melodrama: good-evil binaries, stock characters, emotional provocations, simplistic diagnoses, and inevitable triumphs. As biopolitical truths, such narratives resonate ethically and emotionally for people. By individualizing blame, obscuring structure, circumscribing discourse, and legitimizing authority, such narratives also exert many classic biopolitical effects. But they do not necessarily transform subjectivity or behavior, as biopower is often assumed to. Anti-sex selection messaging illustrates how moralistic, sentimentalized interventions against potentially harmful practices can provoke strong responses without changing actions. In highlighting resonance as a relevant biopolitical limit, the not-quite-paradoxes of Gujarati public health narratives-encapsulation without accuracy, regulation without discipline, authority without efficacy, participation without transformation-suggest one approach for analyzing the governance of life without falling into determinism.
Med Anthropol Q
· 2025 Mar · PMID 39612308
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Since the 1990s, preimplantation tests within in vitro fertilization have promised to enhance the selection of embryos for uterine implantation. However, alongside ethical controversies, these diagnostic techniques often...Since the 1990s, preimplantation tests within in vitro fertilization have promised to enhance the selection of embryos for uterine implantation. However, alongside ethical controversies, these diagnostic techniques often identify a high rate of mosaic embryos-those containing a mix of cells deemed normal and abnormal-creating one of the largest technical challenges related to the testing. These cases raise dilemmas for professionals in assisted reproduction and, more intensely, create challenges for individuals whose embryos are identified as mosaic. This article examines the experiences of a woman who decides to implant a mosaic embryo, focusing on her strategies for managing technical uncertainties and evaluating the embryo's potential. It highlights the essential role that online forums play in this process and examines how users utilize these platforms to gain insights and navigate the complex decisions involved with new biomedical technologies.
Med Anthropol Q
· 2025 Mar · PMID 39431408
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Following the recommendation of the WHO in the mid-2000s, the Ugandan government banned traditional birth attendants (TBAs) and encouraged all women to give birth in biomedical clinics. Yet in rural Luuka district, about...Following the recommendation of the WHO in the mid-2000s, the Ugandan government banned traditional birth attendants (TBAs) and encouraged all women to give birth in biomedical clinics. Yet in rural Luuka district, about half of women still give birth at home or with the assistance of lay providers. This article examines women's healthcare behavior to better understand decisions that are characterized as irrational by officials, in particular women's choices to delay care, move between providers, and defer health decisions to others. Building on anthropological interest in the relationality of care, this article explores how women compel the care of others, especially under conditions of healthcare scarcity and in contexts outside clinical settings. A focus on the gendered nature of kin-based care provides insight into how acts often characterized as irrational can be modes of action for women in ways that exceed a policy focus on healthcare choice and autonomy.
Med Anthropol Q
· 2025 Mar · PMID 39427339
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Pain can be a pervasive feature of cancer, particularly in regions such as India, where the disease is rarely detected in its early stages. Yet over recent decades, morphine, a "gold standard" pain medicine, has been rar...Pain can be a pervasive feature of cancer, particularly in regions such as India, where the disease is rarely detected in its early stages. Yet over recent decades, morphine, a "gold standard" pain medicine, has been rarely used in India. This article draws on anthropological discussions of clinical disclosure in Indian cancer care to complicate assertions that this is because pain is missed or ignored by healthcare workers. Instead, in a context where the disclosing of prognoses is partial and indirect, I argue that morphine has gained a communicative function. Typically withheld until the "end of life", the drug has come to be read as a death sentence. It has become an analgesic and a prognosis. It is an object that talks in situations where direct communication is often avoided.
Med Anthropol Q
· 2025 Mar · PMID 39190643
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Biomedicine is organized around interventions. Despite growing concern about overtreatment in healthcare systems, not intervening can still raise questions about potential negligence and the quality of care. Based on eth...Biomedicine is organized around interventions. Despite growing concern about overtreatment in healthcare systems, not intervening can still raise questions about potential negligence and the quality of care. Based on ethnographic fieldwork with palliative care teams in England, we explore the work palliative care specialists do to reduce and sometimes halt interventions for patients at the end-of-life, in a general medical environment that is largely interventionist. We describe how judgments about what is an action or not aren't based on obvious or agreed criteria, but ultimately according to what different actors feel constitutes the best form of care. In other words, the underlying values that shape ideas of care determine how action and inaction are nominated, and not the other way around.