ASA2016: Footprints and futures: the time of anthropology

(P51)
Mobilities of wellbeing
Location Science Site/Maths CM105
Date and Start Time 05 July, 2016 at 09:00
Sessions 2

Convenor

  • Jonathan Skinner (University of Roehampton) email

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Short Abstract

What new mobilities of wellbeing are emerging in this post-9/11, postmodern, neoliberal era of travel? This panel seeks to explore the future of movement for leisure and medical necessity, for wellbeing in its many dimensions.

Long Abstract

What new mobilities of wellbeing are emerging in this post-9/11, postmodern, neoliberal era of travel? What is the future of movement for leisure and medical necessity, for wellbeing in its many dimensions? Medical tourists, wellbeing migrants, other travellers and niche tourists, are taking their leave in exceptional conditions of technological and terrorific change. What is the traffic to and from these places and how are conditions of precarity, instability, sickness, evacuation and terror negotiated? This panel seeks to consider the variety of mobilities of wellbeing. We especially welcome submissions relating to topics such as: medical tourism and health tourism, suffering and travel, migration and wellbeing, disease mobilities.

This panel is closed to new paper proposals.

Papers

(Im)mobile patients: negotiating care in medicoscapes of Nigerian physicians and their families

Author: Judith Schühle (FU Berlin)  email

Short Abstract

This paper seeks to explore how (im)mobilities of objects, patients, care givers and health professionals are negotiated within transnational therapy networks constituted of migrated Nigerian physicians and their family members back home who are embedded in a local culture of medical mobility and tourism.

Long Abstract

This paper looks at the role that Nigerian trained physicians who have migrated abroad play in the health care seeking behavior, wellbeing and disease management of their families back in Nigeria. Within "medicoscapes" (Wolf and Hörbst 2003, 2014) that connect diverse biomedical landscapes and cultural expectations of wellbeing and care, migrated physicians actively weave safety nets from abroad that try to bridge the gap between the healthcare system they work in and the health care system their family members are treated in.

As members of "transnational therapy networks" (Krause 2008) they decide when to move a patient-relative to "enclaves of abundance" (Sullivan 2011) that is state of the art hospitals within Nigeria or abroad or when to bring objects, care givers and health professionals to an immobile patient.

The paper analyzes the (im)mobility of patients against the backdrop of a history of medical tourism in Nigeria, and how this shapes a therapy network's expectations on mobility. In Nigeria, being a mobile patient or a medical tourist can be as much a necessity as a social prestige: Politicians and celebrities are known as medical tourists, regularly flying out of the country for medical check ups and routine procedures. For complex procedures, patients fly to countries such as India, Saudi Arabia, the UK or the US.

It will thus be shown that the decision to move or not move a patient depends not only on biomedical reasoning, but also on different cultures of (mobile) care, both in Nigeria and in the country to which the physicians migrated to.

Mitochondrial medicine as an emerging site of transnational scientific knowledge and patient mobility

Author: Jacquelyne Luce (Mount Holyoke College)  email

Short Abstract

Mitochondrial disease is increasingly visible due to discussions of mitochondrial donation technologies. Based on fieldwork with mitochondrial disease patients and clinician-researchers, this paper explores mitochondrial medicine as a site of transnational scientific knowledge and patient mobility.

Long Abstract

Mitochondrial disease is becoming increasingly visible as a result of discussions surrounding emerging "mitochondrial donation" technologies. Mitochondrial donation is represented as an assisted reproduction technology by some, and as gene therapy by others. My research, involving fieldwork in the US and Germany, and narratives that are very much developed in relation to developments in the UK, is situated at a critical point of social and technological transformation. The UK, the US and Germany are very differently situated in relation to the global and transnational flows of knowledge, 'patients', and practitioners concerning emerging medical technologies. Regulations to permit mitochondrial donations in humans were introduced in the UK in March 2015. In February 2016, the National Academies of Sciences, Engineering, and Medicine endorsed the use of 'mitochondrial donation' on the condition that until further evidence is available only male embryos are transferred to the uterus of an intended parent. In Germany, a site of significant restrictions concerning reproductive technologies and embryo research, mitochondrial donation is, for my interviewees, not even foreseeable in any sense of the near future within the boundaries of the nation. How do we even think about the local contexts of governing medical technologies in an era of increasing medical and scientific mobility? In what ways does the development and regulation (permission or prohibition) of a technology, shape on-going research trajectories or influence patient understandings of mitochondrial disease and the transnational articulation of shared goals in support of developments in research and care?

HIV-trajectories: struggles of marginalized people from Central and Eastern Europe living with HIV/AIDS in Berlin to gain access to health care and social welfare

Author: Pawel Lewicki (Europa-Universität Viadrina Frankfurt (Oder))  email

Short Abstract

Marginalized and migrating people living with HIV/AIDS from Central and Eastern Europe in Berlin manage different elements of their subjectivity in order to access health and “good life”. I show how these practices reveal imperial dynamics in health and social/labor policies of the German state.

Long Abstract

Since decades Berlin enjoys a reputation of particularly liberal and tolerant space, not least for all kinds of gender and sexual identities. Such reputation, apart from attracting white middle-class homosexuals from Western Europe and North America seeking sex, appeals to marginalized sexual and gender minorities from all over the world, and - due to proximity - particularly to those from Central and Eastern Europe (CEE) and from the new member states (NMS) of the EU. Based on ethnographic research on trajectories of marginalized people living with HIV/AIDS (PLWHA) from CEE and the NMS who seek help at an anti-HIV organization in Berlin, I show an (European) imperial dynamic (Stoler 2011) that becomes visible both in everyday struggles over access to health and social welfare of marginalized PLWHA and in their imaginations about living in "the West". I focus on interplay of race, class, gender, sexuality and health/legal status in order to show different strategies and tactics of subjectification beyond national and EU borders. These managements of identities should enable survival and "livable life" in conditions of marginalization and precarity beyond national and EU borders. They reveal not only different and overlapping forms of "normalization" and discrimination of migrants in different locations, but also various coalitions and subversions against the reproduction of global, (post-)imperial inequalities inscribed in health and social/labor policies in the EU and in CEE countries.

Wellness tourism: marketing counter culture?

Author: Rebecca Buchanan (School of Oriental and African Studies)  email

Short Abstract

A content analysis comparing the online marketing of lifestyle resorts to spiritual retreats to illustrate the counter cultural potential of spiritual retreats through a Foucauldian technology of the self as a resistance to neoliberalism.

Long Abstract

This paper compares the online marketing of two types of wellness tourism: lifestyle resorts and spiritual retreats. Drawing on case studies from the UK and Spain, the paper examines the neoliberal context within which the destination provider organisations create demand for their products.

Through content analysis of website images and text I find evidence of a transformative Foucauldian 'technology of the self' on offer for the spiritual retreat visitors. I argue that - as part of these spiritual retreats - the individual follows a personalised wellbeing 'journey' that equips them with the skills needed to live outside of the intrusion of bureaucratic societal institutions upon their lives. I also note the existence of a new-age Orientalism in the commodification of the complementary and alternative medical therapies practised there. This process of self-care is positioned as 'counter cultural' to commoditised and consumerist values, however paradoxically the restrictive price of the holiday product ensures that this form of self-care remains a luxury.

My work lends empirical weight to the potential of alternative medicine as a resistance tool to neoliberalism and recent inter disciplinary attempts to theorise the implications of transformational tourism for wellbeing.

Working towards well-being: negotiating well-being in the interactions between services and Roma migrants in Leeds

Author: Marketa Dolezalova (University of Manchester)  email

Short Abstract

Following increase in the number of Roma migrants in Leeds in the last decade a number of services and projects aimed at Roma were established. This paper considers how understandings of well-being are negotiated between services and Roma and the impact of services on well-being of Roma migrants.

Long Abstract

This paper draws on ethnographic fieldwork among Czech and Slovak Roma migrants in Leeds and discusses search for a sense of well-being in the dialectics between the material and the intangible. The migration of Roma from Central and Eastern European countries to the UK is part of a wider migration trend in recent decades. Roma are considered to be among the most marginalised groups in Europe. For many Roma, migration to Leeds offers improved financial situation leading to increased material well-being and the possibility of escaping the stigma and discrimination experienced by Roma in many areas of their lives in former Czechoslovakia. Increased mobility of Roma across borders has been accompanied by increased international awareness and attention to the situation of Roma in Central and Eastern Europe. The new visibility of Roma as a group that experiences discrimination and marginalisation has led to the emergence of policies, actors and projects aimed at issues such overcoming poverty, unemployment, or poor health among Roma, and thus towards improving the well-being of Roma. Following the enlargement of the EU, Leeds has received a few thousand of Roma migrants and several services for Roma were established as well as short-term projects aimed at Roma. This paper looks at the mobility of individual Roma and the mobility of funds, concepts, and public and third sector workers, and considers the impact of these services and projects on the well-being of Roma migrants.

Suicide tourism: precautions, pitfalls and difficult niches

Author: Jonathan Skinner (University of Roehampton)  email

Short Abstract

This is a critical analysis of the relatively new expression or compound ‘suicide tourism’ using news media followed by case studies.

Long Abstract

This is a critical analysis of the relatively new expression or compound 'suicide tourism'. It is a category or label in the press, both academic and media, and so warrants critical discourse examination. It links the terminal practice of suicide taken by the few to a leisure pursuit enjoyed by the many. Both involve the individual and are culturally-embedded activities. First this paper looks at the coinage of this expression before examining it in relation to the two respective domains - leisure and death, largely from an anthropological perspective but also including medical legal legislation. The paper then goes on to present case study material from striking natural sites as well as clinical medical locations: Beachy Head and Dignitas, Zurich, in particular, are contrasting locations where death—by-suicide is controversially 'enacted'. There is need for a comment on anthropological ethics and the positioning and involvement of the researcher in such research.

Crossroads of wellbeing: divergent paths in migrants' journeys in Brazil

Author: Simone Toji  email

Short Abstract

In following the lives of two migrant women in the city of São Paulo, two different processes of claiming wellbeing are elicited, disturbing notions such as ethnicity, freedom, rights and citizenship, and overlapping senses of wellbeing as necessity, fantasy and/or utopia.

Long Abstract

The city of São Paulo, in Brazil, embodies the density of more than 11 million people living together. In its precarities, disjunctions and immensity, people are able to lead very divergent lives from each other. In following the lives of two migrant women, one born in China and the other, in Bolivia, two different journeys in search of wellbeing were enacted.

One of them believed in wellbeing as access to public services of a European welfare state model, which she could not have in her country of origin, China, or in Brazil. In order to reach what she herself called the 'good life', she regarded nationality as a matter of bureaucratic procedures that were possible to be manipulated in the name of an envisaged future in a country of historic welfare standard, considering Brazil a provisional platform for it.

On the other hand, the other migrant trajectory advocated wellbeing as the right of migrant women to have access to good quality public services in Brazil, organising this claim within the social movements' realm in São Paulo, and requiring changes in public service. However, in order to make herself a public figure in the local politics, she resorted to a constrained notion of ethnic identity.

In looking closely to both cases, this paper intends to raise considerations on disturbed notions of ethnicity, freedom, rights and citizenship, and on overlapping senses of wellbeing as necessity, fantasy and/or utopia.

Migration, mobility and healthcare in south africa: exploring the impact of migration and patient mobility on the South African public healthcare system.

Author: Rebecca Walker (University of Witwatersrand)  email

Short Abstract

This paper considers the impact of patient mobility on the South African public healthcare system. It draws on recent research documenting the experiences of both migrant and non-migrant healthcare users and staff in rural, urban and peri-urban primary healthcare clinics across South Africa.

Long Abstract

Drawing from research carried out in six primary healthcare clinics in three regions of South Africa this paper considers the impact of internal and cross-border migration and patient mobility on the South African public healthcare system. In a context of widespread anti-foreigner sentiments and prevailing perceptions of non-South Africans "over-burdening" an already compromised public healthcare system, research focused on the role of patient mobility in relation to healthcare. A total of 228 surveys were completed with migrant and non-migrant healthcare users on their experiences of accessing public health care. Additionally, 77 in-depth interviews were conducted with healthcare providers to explore their perceptions of the impact of migration on their ability to provide quality care. Preliminary analysis shows that increasing mobility within the South African public health care system includes high levels of internal movement of people to access healthcare from a clinic of their choice - rather than from their nearest clinic. Meanwhile cross-border migrants were generally found to move for other reasons such as employment opportunities. The findings also highlight the complexities of different types of movement as impacting the public healthcare clinics.This paper therefore will discuss how these findings contest and complicate the popular belief that cross-border migrants travel purely to access (and abuse) free primary healthcare in South Africa. Moreover it will consider the importance of documenting and exploring these forms of mobility as a way of ensuring that the South African public healthcare system is responsive to the movement and well-being of all people.

This panel is closed to new paper proposals.