Public co-lectures

We are happy to announce that colectures presented during the summer school will be public!
They will take place at Freie Universität Berlin (Habelschwerdter Allee 45 14195 Berlin) in Hörsaal (Lecture Hall) 1b.

SummerSchool_vign_1.jpg
Here is the program of the colectures:

  • Miriam Ticktin (New School for Social Research, New York) & Vinh-Kim Nguyen (U. de Montréal, Collège d'Études Mondiales, Paris, U. of Amsterdam)

Engaging care, citizenship and sovereignty: dialectics of theory and ethnography  [abstract]
Monday, July 22nd - 10am

Somatic modes of attention: embodying inequality and structural violence  [abstract]
Tuesday, July 23rd - 9am

Syndemics, insecurity and access to health care in Zimbabwe and Nepal  [abstract]
Thursday, July 25th - 9am

Ethical choices and challenges in the anthropology of health  [abstract]
Friday, July 26th - 9am

 

Abstracts of the lectures

Miriam Ticktin & Vinh-Kim Nguyen | Engaging care, citizenship and sovereignty: dialectics of theory and ethnography

Both of us have written books, drawn from our dissertation research, that are ethnographies of humanitarian responses to the HIV epidemic in Metropolitan France and French West Africa, respectively. While fieldwork was conducted in different sites by different ethnographers, the ethnographic object, conceived in transnational terms, was in effect a common one. The books that resulted develop theoretical arguments about care, citizenship and sovereignty drawing on their ethnographic foci. Theoretical convergences and divergences will be discussed in light of differing fieldwork experiences.
The aim of our co-presentation is to provide students with the opportunity to engage in an in-depth and interactive discussion of the dialectic between theory and ethnography. We will discuss the trajectory from research proposal formulation to fieldwork to writing-up, with a particular focus on the role of anthropological theories in conceptualising problems and accounting for field data. The second part of our discussion will examine how this earlier work has contributed to conceptualising our future research. Throughout, we will illuminate ongoing conceptual debates and empirical advances in the field of medical anthropology and science and technology studies.

See:

  • Nguyen V.K., 2010. Introduction. In: The Republic of Therapy: Triage and Sovereignty in West Africa's Time of AIDS. Durham, NC, Duke University Press.
  • Ticktin M., 2011. The Gendered Human of Humanitarianism: Medicalising and Politicising Sexual Violence. Gender & History, 23(2): 250–265.
  • Ticktin M., 2011. Introduction. In: Casualties of care. Immigration and the politics of humanitarianism in France. Berkeley, Los Angeles & London, University of California Press, 1-26.
  • Ticktin M., 2011. Biological involution? The production of diseased citizens (chapter 6). In: Casualties of care. Immigration and the politics of humanitarianism in France. Berkeley, Los Angeles & London, University of California Press, 192-219.

> top

Heide Castañeda & David Napier | Somatic modes of attention: embodying inequality and structural violence 

One major task of medical anthropology is to examine and understand how notions of embodied wellbeing (health) and not-wellbeing (illness) are socially articulated and individually lived. As such, medical anthropologists employ various strategies for assessing how somatic states are individually and subjectively experienced within the broader social and cultural frameworks in which health and illness unfold. The concept of subjectivity as employed in medical anthropology thus refers to the multifaceted and sometimes incoherent and contradictory ways that people experience and make sense of their suffering. Ethnographic approaches provide a tool for understanding how exclusion, subordination, and insecurity become embodied and are transformed into lived experience. The concept of somatic modes of attention — that is, the culturally elaborated ways of attending to and with one's body in its surroundings — allows for analysis of embodied inequalities and insecurities. Such frameworks not only make possible the codification (for better or worse) of otherwise inchoate forms of meaning; they also facilitate the creation of new illness categories that refine and clarify existing definitions of suffering and health. Because these defining processes are dynamic, examining new and emerging disorders can allow us to see not only how individuals navigate the boundaries between illness and health, but also between socio- and psychopathologies, feelings of inclusion and trust, and a person’s sense of exclusion and/or betrayal.
In her work on health and migration, Castañeda, for instance, discusses how migrants embody the inequalities and insecurities associated with illegality, and how their uncertain status can redefine subjective experiences. Under such conditions, various regulatory practices shape the formation of identities by invading people’s subjective experiences of well-being and suffering. Napier, by contrast, focuses on how contexts of care can affect perceptions of wellbeing by profoundly influencing a person’s sense of worth. In extreme cases of perceived betrayal, for instance, the narrating of illness states and vulnerabilities may be avoided by patients in clinical settings, or even become impossible for them to express. In such conditions understanding illness requires more than an assessment of biological and psychological states, and may well demand new skills that caregivers are unwilling to learn and adopt. Widening the disjunctions between patient needs and health care services allows inequalities to proliferate, leading to conditions of greater social suffering and to what medical anthropologists call “structural violence”. Here, structural inequalities generate a host of mutually reinforcing economic, political, cultural and psychodynamic insults that unfairly target the already vulnerable.

See:

  • Castañeda H, 2008. Paternity for Sale: Anxieties over “Demographic Theft” and Undocumented Migrant Reproduction in Germany. Medical Anthropology Quarterly, 22(4): 340–359.
  • Castañeda H,  2013. Structural vulnerability and access to medical care among migrant street-based male sex workers in Germany. Social Science & Medicine, 84(2013): 94-101.
  • Napier D., 2013. Betrayal and its Modern Consequences. Unpublished essay [not to be disseminated or replicated]
  • Napier D, 2009. Book review essay, M.-J. DelVecchio Good et al. (eds.), Postcolonial Disorders. Berkeley: University of California Press, 2008. Anthropological Quarterly, 82(2): 599–606.

> top

Lenore Manderson & Ian Harper | Syndemics, insecurity and access to health care in Zimbabwe and Nepal

In this presentation we will link issues of insecurity with questions related to health systems and people’s consequent access to health care. Using the theoretical ideas around “syndemics” – where clusters of issues and problems feed into each other, reinforcing health related problems – we will link a number of phenomena that mutually reinforce what we see as current issues facing health systems.
To do this, we will draw on long term research and observations from Nepal and Zimbabwe, and other research settings with which we are familiar, to illustrate how these phenomena are linked. For example, low intensity conflict (witnessed in both countries to varying degrees) can lead to the breakdown of social order, with multiple insecurities for political systems and individuals. This in turn shapes the form of services and access to these. Issues here include limited access for practical reasons (e.g. associated with physical risks of travelling in conflict zones), loss of civil liberties, internal migration and consequent rapid urbanisation. In addition, settings that are insecure typically have poorly resourced services, and disruptions to the flow of goods (such as pharmaceuticals) and services (e.g. disruptions to cold chains).  Health services are also undermined with the outflow of health professionals particularly to the countries of the global north, with resultant human resource disparities. These migration patterns can be fuelled by ethnic and regional differentials as well. With the concomitant rise of urbanisation and the insecurity and inadequacy of public systems, the rise in the private sector results in the proliferation of private hospitals, pharmacy outlets and related services. This stratification into public and private feeds disparities in access: those who can afford (or can’t, but sell land and assets to pay) can access tertiary services, and those who cannot remain dependent on underresourced and failing public services. In extreme cases, this can result in the vulnerable ill being left to the vagaries of “zones of abandonment”.
Given the current economic insecurities witnessed around the world, and highlighting the interconnectedness of these issues in Nepal and Zimbabwe, we will finish by posing a series of questions to stimulate discussion. In what ways might these examples be replicated in other countries? Is the idea of syndemics the best way to theorise these issues?

See:

  • Gwatirisa P. & Manderson L., 2012. “Living from Day to Day”: Food Insecurity, Complexity, and Coping in Mutare, Zimbabwe. Ecology of Food and Nutrition 51(2): 97-113.
  • Harper I, N Rawal & M Subedi, 2011. Disputing distribution: Ethics and pharmaceutical regulation in Nepal. Studies in Nepali History and Society,16(1): 1-39. [full text]

> top

Sylvie Fainzang & Peter Redfield | Ethical choices and challenges in the anthropology of health

To contribute to a shared reflection on the place of ethics in ethnographic research on health and suffering, our co-lecture will focus on charged contexts where moral expectations and ethical questions both come to the fore and defy easy resolution. 
Sylvie will raise two issues stemming from her research. The first relates to the connection between the ethical posture of a researcher and the construction of a research object. Taking the example of a study on lying in the doctor-patient relationship, she will explain her choice not to tackle the issue from an overtly ethical perspective, precisely in order to achieve an “epistemically ethical” approach to the subject. This implies not building the research around one's own values and judgments, but rather explicitly constructing the object in the most objective way possible so as to do justice to the values of the persons studied. The ethical stance for the anthropologist here consists of analyzing lying as one would any other social practice, without making an a priori moral assessment of this (so morally loaded) practice, even if his/her convictions lead him/her to deplore enduring medical paternalism and inadequate patient information. The second issue relates to the difficult choices facing an anthropologist when the fact of working on a specific subject may appear simultaneously a way to contribute to the greater good of the people or group studied, and a risk that might harm to them.  Sylvie will pose a series of questions based on a study she conducted regarding reproduction and sexuality in immigrant African families in France. For instance, what would be the ethical justification for choosing not to speak about excision or polygamy? Is it admissible to justify this silence in terms of a desire to avoid stigmatizing of the populations who practise it, even when such research might also contribute to criticizing situations of social domination? Does defending certain values to the benefit of one group sometimes entail compromising the larger collective to which it belongs? In such situations anthropologists find themselves having to arbitrate between rival interests, including their own.
Peter will respond to these issues with comparative examples drawn from work on the topic of medical humanitarianism. In a mirror reversal of doctor-patient lying, moral expectations prefigure humanitarian action as essentially good, based on motives of generosity and common humanity. As an object of study it thus raises parallel challenges of recognizing it a form of human practice, as well as the actual history of principles like neutrality that undergird it. Humanitarianism likewise poses a complex of critical choices about speech, silence and emphasis for the anthropologist. Given anthropology’s own legacy of broadly humanitarian convictions, the work of critique here entails a degree of implication and a need to arbitrate between interests, exposing the political edge of ethics. When facing troubling inequalities at the level of health and life, who and what determine which needs are most pressing? How best to raise such a question, particularly in a manner that recognizes actual practice and not simply a priori judgment?

See:

  • Redfield P., 2013. Action beyond optimism (chapter 9). In: Life in crisis. The ethical journey of doctors without borders. Berkeley, Los Angeles & London, University of California Press, 229-244.
  • Fainzang, S., 2010. Patient information between public space and anthropology: ethnography's contribution to the debate. Etnografica, 14(1): 97-114.
  • Fainzang S., 2007. Anthropology and Medicine: Empathy, Experience and Knowledge. in: E. van Dongen, R. Kutalek, eds., Facing Distress. Distance and proximity in times of illness, Wiener ethnomedizinische Reihe, 4: 1-20.

> top

Online user: 1 RSS Feed