Medical Anthropology Quarterly[JOURNAL]
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200 papers
Discounted Deaths: The Eruption of COVID-19 in the Geriatric System of the Community of Madrid.
Rubio-Mengual I, Villar Baile Á
Med Anthropol Q · 2022 Dec · PMID 36095984 · Full text
In this article, we explore a new category of analysis that we have called "discounted deaths," with which we seek to examine forms of dying occurring outside the scope of the triple meaning of the term "to count"-i.e.,...
In this article, we explore a new category of analysis that we have called "discounted deaths," with which we seek to examine forms of dying occurring outside the scope of the triple meaning of the term "to count"-i.e., deaths that did not count, deaths that were not counted, and deaths for which there was no account. To do this, we look at the empirical case of elderly people who died in Madrid's nursing homes during the first wave of the pandemic, between March and May 2020. Compared to other affected groups, theirs were deaths that were deemed tolerable. People who died in nursing homes were first excluded from the assistance mechanisms available under the health emergency and then buried in solitude, away from their loved ones, who were not made aware of their situation until they were in their final moments. [coronavirus, death, account, old age, Madrid].
Compassion or Corruption? Temporalities of Care and Nationhood in Papua New Guinean Nursing Education.
Andersen BA
Med Anthropol Q · 2023 Mar · PMID 36027572 · Publisher ↗
Nurse educators in Papua New Guinea (PNG) must prepare students for often demoralizing working conditions. This article analyzes classroom and practical lessons in a PNG Highlands nursing college. A variety of pedagogica...
Nurse educators in Papua New Guinea (PNG) must prepare students for often demoralizing working conditions. This article analyzes classroom and practical lessons in a PNG Highlands nursing college. A variety of pedagogical practices, including role plays and other simulation technologies, were used to socialize students to imagine patients' relatives while making clinical decisions, and to contemplate their own relatives and ancestors in reflecting on their moral commitments to health care. Such practices generate a mode of medical citizenship shaped by a regime of biocommunicability in which Christianity and education are thought to transform one's capacity to detach from the emotional appeals of kin. These pedagogies link the individual subjectivities of health workers to a persistent, though fragile, vision of the nation in which transgenerational, urban-rural kinship is a synecdoche for nationhood (and its deferral), despite professional counternarratives that cast these kinship ties as a slippery slope toward "corruption." [medical citizenship, temporalities of care, nursing simulation, nationhood, Papua New Guinea].
Dirty Work in Medicine: Understanding U.S. Physicians' Agency in Contested Medical Practices.
Buchbinder M
Med Anthropol Q · 2022 Dec · PMID 35986924 · Publisher ↗
Physicians who participate in abortion and medically assisted death in the United States work at the margins of institutionalized medicine. What motivates them to engage in such "dirty work"? This article uses ethnograph...
Physicians who participate in abortion and medically assisted death in the United States work at the margins of institutionalized medicine. What motivates them to engage in such "dirty work"? This article uses ethnographic materials from two recent projects to analyze physicians' roles as gatekeepers to contested medical services. Abortion and medically assisted death share many similarities: They are both deeply stigmatized practices that are heavily restricted in many U.S. jurisdictions, and which many physicians are reluctant to participate in for moral, religious, or professional reasons. They both also confer medicine with the power to govern life and death decisions through the apparatus of state law. However, state laws operate quite differently on physicians in these two cases, with different outcomes. This comparative analysis demonstrates how dirty work in medicine enrolls the agency and subjectivity of physicians in distinctive ways that may be eclipsed by totalizing biopolitical frameworks. [abortion, medical aid in dying, physicians, agency, biopolitics, United States].
Shouldering Death: Moral Tensions, Ambiguity, and the Unintended Ramifications of State-sanctioned Second-trimester Selective Abortion in Denmark.
Heinsen LL
Med Anthropol Q · 2022 Dec · PMID 35819201 · Full text
This article is based on an ethnographic study of pregnant couples' embodied, emotional, and moral experiences of second-trimester selective abortion in Denmark. Drawing on 16 selective abortion stories, I unpack the int...
This article is based on an ethnographic study of pregnant couples' embodied, emotional, and moral experiences of second-trimester selective abortion in Denmark. Drawing on 16 selective abortion stories, I unpack the intense, often highly accelerated, days that follow from the moment a fetal aberration is detected to the moment of fetal disposal or burial. I show that although prenatal screening and diagnostics have come to occupy a routinized part of pregnancy in Denmark, when women and their partners opt for termination, they are faced with a series of bodily events and actions they are entirely unprepared for while at the same time feeling essentially alone in grappling with the moral confusion that ensues. I argue that despite widespread medico-legal sanctioning and social endorsement of selective abortion, the specificities of how such terminations are done in Denmark in ambiguous, and conflicted, ways situate women and their partners in a series of moral tensions around how to relate to the abortion, the dead fetus, their grief, and their entitlement to such mourning. By chronicling the core struggles that the process of termination catalyzes, I point to the social and moral ramifications of the embodied practices and medico-legal choreographing of selective abortion in Denmark. [selective abortion, moral tensions, embodied practices, responsibility, death].
Mobility Imaginaries of Humanitarian Intervention: Gender, Migration, and Violence along Mexico's Southern Border.
Wurtz HM
Med Anthropol Q · 2022 Dec · PMID 35751851 · Publisher ↗
Thousands of Central American women have been displaced from their countries of origin by violence. While the violence committed against them is often portrayed as isolated acts of aggression, women's suffering is also p...
Thousands of Central American women have been displaced from their countries of origin by violence. While the violence committed against them is often portrayed as isolated acts of aggression, women's suffering is also produced and perpetuated by humanitarian interventions that immobilize women in dangerous transit zones. Interventions are then justified by institutional logics that juxtapose women's vulnerability against the threat of their own mobility. This article draws on 14 months of ethnographic fieldwork along the southern Mexico border among migrant women who sought out humanitarian assistance following violent encounters. Central to my argument is the concept of mobility imaginaries, or widely shared social assumptions about how mobility should and can be accessed, by whom, and under what circumstances. Through this framework, I show how gendered mobility biases that underlie institutional logics compound other forms of institutional inequality, which often serves to reproduce, rather than mitigate, root causes of gender-based vulnerability.
Homage to Ebola Fighters: Black Labor and Humanitarian Media Campaigns.
Gomez-Temesio V
Med Anthropol Q · 2022 Sep · PMID 35635804 · Full text
During the Ebola outbreak that hit Guinea in 2014, most of the people employed at the Wonkifong Ebola treatment unit were from Africa or Cuba. Despite the recruitment of black personnel, the unit exposes how the humanita...
During the Ebola outbreak that hit Guinea in 2014, most of the people employed at the Wonkifong Ebola treatment unit were from Africa or Cuba. Despite the recruitment of black personnel, the unit exposes how the humanitarian infrastructure exploited Guinean workers as if their lives were less vulnerable than those of the foreign personnel. The Africanization of aid reveals a post-colonial segregation at the intersection of race, class, and locality. The article follows Guinean workers in the quarantine unit, as well as their enrolment in media campaigns. Their experience illuminates a triage at the core of Global Health according to which not only were local workers treated as expendable lives, but their stories were silenced. Yet how did Guinean workers inhabit this anti-black world? The article unfolds the journey of workers during the outbreak and three years later, exploring the strategies they used to produce their own narratives through personal archives. [humanitarian aid, humanitarian media campaigns, race, Ebola, archives].
Death in an Ordinary Time: Reflections from Rwanda.
Sadruddin AFA
Med Anthropol Q · 2022 Jun · PMID 35556257 · Publisher ↗
Meanings and processes of death in Rwanda have changed dramatically in the 25 years following imvururu, the Kinyarwandan term for "interruptions" that signifies the numerous episodes of violence between the late 1950s an...
Meanings and processes of death in Rwanda have changed dramatically in the 25 years following imvururu, the Kinyarwandan term for "interruptions" that signifies the numerous episodes of violence between the late 1950s and mid-1990s. Reflecting on experiences of elderly Rwandans who witnessed imvururu in adulthood, this article traces how death is perceived and practiced in old age, a phase of the life course that is marked with relative political calm. Although traces of imvururu permeate the present, these ordinary times-ibihe bisanzwe-afford opportunities for the elderly to alter their notions of death as an event by making it a personal process, reviving valued preparation practices from the past and creating new ones with the young. This peopled account invites alternative ways of thinking about time and recognizing death's role in infusing meaning back into life in contexts where accounts of the everyday remain frozen in an apocalyptic imaginary. [aging, death, ordinary, temporality, Rwanda].
"I Do Not Have to Hurt My Body Anymore": Reproductive Chronicity and Sterilization as Ambivalent Care in Rural North India.
Lukšaitė E
Med Anthropol Q · 2022 Sep · PMID 35524762 · Full text
Drawing on 18 months of ethnographic fieldwork in rural Rajasthan, India, I examine women's narratives of chronic reproductive suffering and the practices they employed to relieve it. Cumulative effects of adverse and or...
Drawing on 18 months of ethnographic fieldwork in rural Rajasthan, India, I examine women's narratives of chronic reproductive suffering and the practices they employed to relieve it. Cumulative effects of adverse and ordinary reproductive events and exhaustion from caregiving were often seen as reproductive suffering, while sterilization emerged as an act of care toward women's ever-weakening bodies. Sterilization has been an integral part of the often coercive, incentive- and target-driven population control program in India. Rural women, however, described sterilization not as a form of violence but as an act of care, despite its ambivalence. In the context of reproductive chronicity-a persistent reproductive suffering recurring alongside reproductive events, available care options, relations within which these options are located, and structural conditions that shape women's lives-care and suffering are intimately and ambiguously intertwined.
Kamzori: Aging, Care, and Alienation in the Post-pastoral Himalaya.
Simpson N
Med Anthropol Q · 2022 Sep · PMID 35485448 · Full text
As the Gaddi community of Himalayan India transition from agro-pastoralism to waged labor, configurations of kinship and care have shifted. Such shifts have introduced relational tensions, especially between elderly wome...
As the Gaddi community of Himalayan India transition from agro-pastoralism to waged labor, configurations of kinship and care have shifted. Such shifts have introduced relational tensions, especially between elderly women, who have labored in the house and fields, expecting care in old age, and younger generations, who experience their own pressures of class aspiration. This article examines how the myriad tensions of the post-pastoral economy are experienced in the bodies of elderly women. It presents insights on kamzori, bodily weakness that is experienced by women who feel that their contribution of labor and care is unreciprocated by their kin or wider milieu. It recuperates alienation as a concept that captures distressed social relations. Alienation might be used by anthropologists studying aging, care, and debility to envisage the body in scalar relation to people, things and places, and illness or distress as disruption of such relations. [weakness, aging, care, gender, alienation].
Visiting Hours: Spacetimes of Human-Animal Interaction in South African Elder Care.
Golomski C
Med Anthropol Q · 2022 Jun · PMID 35338789 · Publisher ↗
This article examines human-animal interaction in elder care by focusing on an old age home in postapartheid South Africa. Residents admire and desire to be near animals, but staff mostly prohibit pets and service animal...
This article examines human-animal interaction in elder care by focusing on an old age home in postapartheid South Africa. Residents admire and desire to be near animals, but staff mostly prohibit pets and service animals due to regulations about hygiene and frailty. Instead, people make meaningful relationships with media representations of animals and wilder animals in the home's yard. This article uses the clinical timescale of visiting hours to interpret these alternative human-animal interactions and their temporal incongruities-to show how people make sense of differences they perceive between their own and animals' mortality and longevity, and how animals enable remembering and articulations of aging selfhood and social relations across the life course. A reinterpretation of visiting hours reveals the making of self-other distinctions in late life and temporal aspects of medical institutionalism that shape multispecies relations.
Debilitated Lifeworlds: Women's Narratives of Forced Sterilization as Delinking from Reproductive Rights.
Chaparro-Buitrago J
Med Anthropol Q · 2022 Sep · PMID 35274360 · Full text
Peasant women in Cajamarca, Peru, who were sterilized by the Peruvian government in the 1990s, narrate their experiences of reproductive abuse using Andean medical principles of debilidad and fuerza (debility and strengt...
Peasant women in Cajamarca, Peru, who were sterilized by the Peruvian government in the 1990s, narrate their experiences of reproductive abuse using Andean medical principles of debilidad and fuerza (debility and strength) (Tapias 2006). In their narratives, many describe a generalized sense of loss of strength resulting from the procedure. This contrasts with the reproductive rights framework's emphasis on infertility as the main harm. In this article, I ponder the dissonance between these two frameworks and propose the concept of debilitated lifeworlds as decolonial feminist delinking (Mignolo 2007) from human fertility-centric narratives. This concept is methodologically significant as a decolonial attunement to local motifs to talk about abuse and for weaving a constellation of embodied, emotional, social, and family harms. This article contributes to the emerging field of "decolonial reproductive studies" (Smietana et al. 2018: 117).
Recursive Debility: Symptoms, Patient Activism, and the Incomplete Medicalization of ME/CFS.
Rogers EL
Med Anthropol Q · 2022 Sep · PMID 35262958 · Publisher ↗
This article examines the contestation of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Lacking consistent diagnostic definitions, agreed-on biological indicators, or approved treatments, ME/CFS is an inco...
This article examines the contestation of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Lacking consistent diagnostic definitions, agreed-on biological indicators, or approved treatments, ME/CFS is an incompletely medicalized condition. It is defined by intractable and debilitating exhaustion after any form of exertion. Through an ethnographic exploration of an American ME/CFS patient activist group, I develop the concept of "recursive debility." Symptoms form the very basis for disease activist groupings in the absence of biomarkers, but they also present a significant barrier to traditional forms of activism. Ironically, then, debilitation blocks the means through which debilitation might end. Patients contest systems of knowledge but always in bodies that experience exhaustion without end. This article presents a disability studies intervention in suggesting that the recursivity of debility demonstrates the profound interdependence of the bodily aspects of impairment and the sociopolitical aspects of disability. [ME/CFS, chronic illness, medicalization, symptoms, debility].
Anachronic: Viral Socialities and Project Time among HIV Support Groups in Barbados.
Murray DAB
Med Anthropol Q · 2022 Sep · PMID 35262224 · Full text
From 2005 to 2015, up to five support groups for people living with HIV (PLHIV) operated in Barbados. However, by early 2020, all but one had disappeared. What caused the demise of these groups and why? What does this de...
From 2005 to 2015, up to five support groups for people living with HIV (PLHIV) operated in Barbados. However, by early 2020, all but one had disappeared. What caused the demise of these groups and why? What does this demise tell us about the HIV response in Barbados, and more particularly, everyday life for PLHIV? More generally, what does it tell us about "viral socialities" (ties formed between groups of people as they confront the lived effects of infection and discrimination attributable to HIV) and the effects of "project time" (a time frame delimited through the priorities of global HIV/AIDS agencies) on these socialities? Through ethnographic and archival research methods, this article reveals how multiple, unstable project times create and transform viral socialities of Barbadian PLHIV with anachronic effects for some-i.e., a sense of alienation or being "out of time" in relation to the priorities of the global HIV response.
Policy Statement: Mental Well-being among Anthropologists at Universities: A Call for System Transformation.
Fletcher EH, Backe EL, Brykalski T … +7 more , Fitzpatrick A, González M, Ginzburg SL, Meeker R, Riendeau RP, Thies-Sauder M, Reyes-Foster BM
Med Anthropol Q · 2022 Mar · PMID 35257413 · Publisher ↗
The Anthropology of Mental Health Interest Group affirms that the state of mental health in Academic Anthropology needs serious attention and transformation. We respond to structural inequities in academia that exacerbat...
The Anthropology of Mental Health Interest Group affirms that the state of mental health in Academic Anthropology needs serious attention and transformation. We respond to structural inequities in academia that exacerbate mental distress among graduate students and other anthropologists who experience oppression, by putting forward a policy statement with recommendations to create more equitable learning and working environments.
Interembodiment, Inheritance, and Intergenerational Health.
Bunkley EN
Med Anthropol Q · 2022 Jun · PMID 35156227 · Publisher ↗
This article introduces the concept of interembodiment, animated bodily entanglements between people, to illustrate the shared sense of illness that transgresses discrete biological bodies. Drawing on 15 months of ethnog...
This article introduces the concept of interembodiment, animated bodily entanglements between people, to illustrate the shared sense of illness that transgresses discrete biological bodies. Drawing on 15 months of ethnographic research in Senegal, West Africa, this article expands common understandings of inheritance and intergenerational health by exploring how women caring for others with metabolic disorders come to interembody the afflicted's symptoms, regardless of their own diagnostic status. These experiences trouble the clear distinction between communicability and noncommunicability and disrupt Western understandings of unshared biologies. Through the concept of interembodiment, we can see how noncommunicable diseases come to be communicated. Interembodiment helps explain aspects of intergenerational health between mothers and daughters and allows for broader understandings that encompass multiple biologies. Shifting the focus of health and illness from the individual to multiple interembodied biologies allows for a more nuanced understanding of disease and disease transmission, which could enable global health and public health programs to better address noncommunicable diseases around the world.
Thinking about Social Determinants of Health through the Relationality of Work and Drug Use.
Parsons MA
Med Anthropol Q · 2022 Jun · PMID 35107184 · Publisher ↗
Public health often frames drug use and addiction as destructive and antithetical to productive citizenship, particularly formal employment. Anthropologists show how drug use emerges in specific institutional, social, an...
Public health often frames drug use and addiction as destructive and antithetical to productive citizenship, particularly formal employment. Anthropologists show how drug use emerges in specific institutional, social, and political economic contexts. This attention to context suggests that the relationship between drug use and work may not be as stable as epidemiology models it. There is a multiplicity to the relationality of work and drug use. These results are based on in-depth interviews conducted in 2018 and 2019 with 16 individuals undergoing addiction treatment at a residential facility in northern Arizona. In some cases, drug and alcohol use led to losing work. In other cases, drug and alcohol use made work more possible. The entanglements between work and drug use fluctuated through time. Social determinants of health are relationally brought into being, part of larger assemblages, and dynamic.
Military Dogs and Their Soldier Companions: The More-than-human Biopolitics of Leishmaniasis in Conflict-torn Colombia.
Pinto-García L
Med Anthropol Q · 2022 Jun · PMID 35107182 · Full text
Cutaneous leishmaniasis is a vector-borne disease that produces growing skin ulcers. In Colombia, the transmitting phlebotomine sandfly is native to the same jungles that have been the primary theater of war. Although co...
Cutaneous leishmaniasis is a vector-borne disease that produces growing skin ulcers. In Colombia, the transmitting phlebotomine sandfly is native to the same jungles that have been the primary theater of war. Although combatants are the most affected by leishmaniasis, military landmine detection dogs are also significantly impacted. This article draws on ethnographic field research with human and canine members of the Colombian military. While their leishmaniasis ulcers constitute a shared expression of violence that makes evident the closeness of the human-dog bond, differences in their state-provided health care reveal the production of shifting species hierarchies. I argue that war scrambles both human-dog affective relationships and biopolitically configured interspecies hierarchies in ways that produce suffering, not just for humans and dogs separately, but also for the bonds they forge together. Building peace through health care demands repairing the ways in which armed violence has rendered the bonds between humans and nonhumans pathological.
Death and Dying in Carceral America: The Prison Hospice as an Inverted Space of Exception.
Sharp LA
Med Anthropol Q · 2022 Jun · PMID 35098581 · Publisher ↗
In America's prisons, long-term incarceration carries fears that one could die in prison alone and abandoned. Death by incarceration looms as inescapable for myriad inmates who are terminally ill or "graying" in prison....
In America's prisons, long-term incarceration carries fears that one could die in prison alone and abandoned. Death by incarceration looms as inescapable for myriad inmates who are terminally ill or "graying" in prison. These realities inform this study of a prison-based hospice program staffed by male inmate volunteers in a mixed medium/maximum security facility. Of special concern are the experiences of the men who sit by the bedside of others who are dying. I begin with the assumption that prisons loom as states of exception, epitomized by the realities of substandard prison medicine, the devaluation of care as anathema to prison survival, and the persistent neglect of the ill and aging. The ethos and practices associated with inmate-driven end-of-life care demarcate an inverted space of non-judgmental praxis that simultaneously envelopes the dying man while also instigating self-reflection, change, and self-care among inmate hospice volunteers.
The Politics of Trauma: Gender, Futurity, and Violence Prevention in South Africa.
Pentecost M
Med Anthropol Q · 2021 Dec · PMID 35066933 · Publisher ↗
In this article, I consider the framing of trauma as an epigenetic exposure that warrants intergenerational interventions. I draw on ethnographic research conducted in Khayelitsha, Cape Town, South Africa in 2014-15 to i...
In this article, I consider the framing of trauma as an epigenetic exposure that warrants intergenerational interventions. I draw on ethnographic research conducted in Khayelitsha, Cape Town, South Africa in 2014-15 to illustrate how violence prevention in this context is increasingly framed in epigenetic terms. I show that, in contrast to the anticipatory logic of a programmatic focus on maternal investment as a means to arrest intergenerational cycles of violence, violence produces different infrastructures of anticipation and effects on intergenerational relations. I argue against the speculative conflation of trauma and intergenerational epigenetics, to resist a newly biologized view of the bodily manifestations of apartheid history-in itself a re-inscription of damage, and a form of violence. Drawing on Murphy's concept of distributed reproduction (2017b), I argue for collectivized forms of intervention that aim for accountability and social justice.
"Passing Down Pollution": (Inter)generational Toxicology and (Epi)genetic Environmental Health.
Lamoreaux J
Med Anthropol Q · 2021 Dec · PMID 35066932 · Publisher ↗
Concern about the harmful health effects of industrial pollution is increasingly taking on an intergenerational dimension. In environmental health sciences such as toxicology, this has resulted in emphasizing the influen...
Concern about the harmful health effects of industrial pollution is increasingly taking on an intergenerational dimension. In environmental health sciences such as toxicology, this has resulted in emphasizing the influence of toxic chemicals, substances, and situations across generations. Toxic relationalities are now being explored through research on gene-environment interaction, including toxicogenomics and epigenetic research through animal experiments and birth cohort studies. Based on fieldwork conducted among reproductive and developmental toxicologists working in Nanjing, China, this article shows how toxicological research both expresses and produces renewed anxieties about "passing down pollution." These toxicological accounts of intergenerational harm problematically work through overly simplistic renderings of reproduction and biological relatedness. But they also have the potential to catalyze creative understandings of toxic relationalities and responsibilities at a moment when making kin is increasingly seen as key to securing livable futures. [toxicology, environment, epigenetics, kinship, China].
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