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- Convenors:
-
Sandra Calkins
(University of Twente)
Emily Yates-Doerr (Oregon State University)
- Discussant:
-
Simon Cohn
(London School of Hygiene Tropical Medicine)
- Location:
- JUB-G22
- Start time:
- 9 September, 2015 at
Time zone: Europe/London
- Session slots:
- 1
Short Abstract:
This panel examines how inequalities come to matter, unpacking the evidentiary practices in global health that mark some concerns as worthy of attention and aid. It asks how anthropologists can intervene in spaces where critical health decisions are made to shape these knowledge practices.
Long Abstract:
There is a shared commitment between the fields of global health and medical anthropology that inequalities in health must be eliminated. But how to do so, and what inequality may be are unsettled questions. This panel explores how inequalities come to matter, unpacking the evidentiary practices in global health that mark some concerns as worthy of attention and aid. It asks how anthropologists can intervene in spaces of global health, humanitarianism, development cooperation, and other sites where decision-making is infused with a sense of urgency. Whereas global health practitioners tend to assume the universal applicability of their methods and evidences, medical anthropologists often study how differences materialize in specific therapeutic assemblages. Instead of only pointing out differences and incommensurabilities in global health, how can we use our methods and their strengths to build better worlds?
We invite theoretical and empirical papers that examine:
1) What evidentiary practices are used to qualify health inequalities, compare them, set priorities and propose solutions?
2) How might medical anthropologists interfere in global health decision-making to make a difference? What criteria and normativities mark our knowledge claims?
3) How can we study the un/making of differences in global health in times of urgency without hiding behind standard critical stances? How does this relate to hopes for better futures?
Accepted papers:
Session 1Fredrik Nyman (Jönköping University)
Paper short abstract:
This paper examines how Swedish public health policies have developed over the years with emphasis on regulations with impact on social minorities, such as gay men. It asks what the anthropologist can do to affect knowledge production where white heterosexual hygiene is often left undisputed.
Paper long abstract:
Although Sweden never experienced an 'actual' AIDS epidemic, the response to HIV has been one of the toughest in Europe. With over 40 people brought to court, and coercive isolation still in use, Sweden is the leading country when it comes to prosecuting people living with HIV. Several motions of the most extreme nature were put forward, such as tattooing HIV-positive people in the axilla or confining them to separate 'camps'. The most inhuman suggestions did not go through. Still, Swedish AIDS politics were characterised by certain political coercion. Gay bathhouses were banned in 1987, resulting in gay men losing their most prominent arena for social gathering. One year later, the Diseases Act was revised to authorize compulsory care of people suspected of violating the health regulations.
Decades later, certain groups and spaces are still being marked as particularly 'risky'. Gay men are still banned from donating blood, unless they agree to abstain from having sex for 12 months. Africa is still treated as the source of disease. Not only because of the situation with HIV, but also because of the recent outburst of Ebola in West Africa. This paper sets out to examine what researchers like Catherine Waldby (1996) noted: why have some groups become the targets of AIDS education, while white heterosexual (men) are exempted? With Swedish AIDS politics and strategies as objects of investigation, it asks what the anthropologist can do to affect knowledge production where white (male) heterosexual hygiene is 'prioritized' and left undisputed.
Sandra Calkins (University of Twente)
Paper short abstract:
I explore how gender inequalities come to matter as distinct bodily states in recent nutrition interventions in Uganda. I ask whether attention to instabilities of evidences linking the problem and its purported solution could help to move beyond some common critiques of global health.
Paper long abstract:
In 2010 Ugandan guidelines on maternal nutrition established the importance of addressing gender inequality in society by improving the nutritional status of women. While gender inequality there is framed as a social problem, global health interventions typically are rooted in an understanding of biological sex difference. Drawing on recent fieldwork in Uganda, I examine nutritional interventions and surveys, seeking to measure, treat, and monitor micro-nutrient malnutrition. Gender inequality there is enacted as deficiency of some substances (folic acid, iron etc.). Nutritional interventions do not merely reflect distinctions drawn in everyday life concerning sex/gender but shape and naturalize "biological" differences by drawing a range metaphysical distinctions between bodies--bodies in need of different substances and female bodies before, between, or in the midst of pregnancy--with quantifiable micro-nutrient needs. These translations posit global health as the arena to work out social inequalities. I join others in questioning these assumptions while trying to move beyond a mere critical dismantling of practices in global health. I ask whether and how a stronger focus on mundane processes of biomedical evidence making could help to find other, possibly more hopeful affinities.
Emily Yates-Doerr (Oregon State University)
Paper short abstract:
Through an analysis of an obesity prevention initiative in Guatemala, the paper suggests that the 'social determinants of health' framework risks remaking conditions of inequality by targeting a narrowly defined, determinant form of health.
Paper long abstract:
The prominent global health framework of 'social determinants of health' focuses on addressing 'the problem of inequality' by shifting attention away from individual and toward environmental conditions of disease. Through analysis of an obesity prevention initiative in Guatemala, the paper suggests that despite this shift, the social determinants framework risks remaking conditions of inequality that it purports to oppose by prioritizing - and targeting - a narrowly defined form of health. The paper illustrates how this framework might benefit from the methods of praxiography. Whereas 'social determinants' enacts health as the outcome of a diverse social and environmental assemblage, praxiography - the writing of practices - recognizes the malleability and fluidity of the 'object' of health. I close by advocating for the importance of descriptive politics - that is, politics that make space for indeterminacy - rather than the prescriptive politics deployed in the field of global health's framing of 'the social' as 'determinant.'