“Where are all the anthropologists?” The question came from public health worker Douglas Hamilton on the first day of the Princeton-Fung Global Forum on Ebola, held in November 2015 in Dublin, Ireland. There, the place of anthropology in the recent outbreak was touched on by the first speaker, and swiftly become one of, if not the, recurring themes of the conference. The question was addressed not to me, but to the panelists on stage — not an anthropologist among them, not that day — but as a graduate student working on issues of health in West and Central Africa, I could not help but take the question for my own. So in response, I suggest that anthropology was simultaneously everywhere and nowhere in this context, a state of affairs that goes beyond this outbreak in calling for anthropologists to conduct both research and better public relations, and in calling into question the forms public anthropology can and should take.
From the moment Peter Piot, the co-discoverer of Ebola, gave his opening remarks, the question of anthropology-in-Ebola took hold of the Forum and its diverse attendees. “We have to listen far better,” Piot argued, “to what people think before we start putting in place measures… [involving social scientists in Ebola] helped a lot. Although I had some big discussions! Some anthropologists said, ‘Okay, I need to spend two years in that village to understand what people think’ [a statement that drew laughs from the audience].” He continued: “We don’t have the time for that… we needed more kind of social marketing people, people who can do a snapshot and understand it rapidly, what’s going on.” While I doubt that Piot’s setting of the stage in this way was truly mocking or malicious — I may have snickered too, and it is certainly not lost on me that it’s taken in sum several months for me to submit this piece, revise it and usher it to publication — the stage was nevertheless set, and so the questioning continued. In response to Hamilton’s query, the panelists hastened to engage anthropology, almost in a defensive manner. The CDC’s Rebecca Levine emphasized that “anthropologists were not completely lacking” or absent in Ebola, but rather “were tremendously useful” during her stints in the field. On a similar if slyer note, MSF Ireland’s Gabriel Fitzpatrick stated that “anthropology is one of the key answers… but I would say, one of the few times I have worked with an anthropologist, it takes a while to get a report back [cue audience laughter].” On the next panel, NPR’s Brooke Gladstone asked “Why do we even need one [an anthropologist]?”, arguing that West Africans were perfectly capable of speaking for themselves across cultures, especially since “these people aren’t in some hidden enclave in the Kalahari or in the North Pole.” For her part, Margaret Chan, the Director-General of the WHO, indirectly tipped her hat to anthropology, noting that “when technical interventions go against culture, culture will always win.” Such themes carried over to the second day of the Forum as well: “I apologize: I’m not an anthropologist,” noted the Wellcome Trust’s Jeremy Farrar in his opening remarks, “so I’m not starting the day well [more laughter!]… [but] anthropologists have got more engaged. [Pause] Thank you [said wryly; even more laughter!].” Who knew a conference on Ebola could be so humorous? By the time the three anthropologist-panelists (Princeton’s João Biehl and Carolyn Rouse, and Berkeley’s Raphael Frankfurter) took the stage on the second day — along with their comrade-in-arms, Princeton’s Angus Deaton, who declared that “I’ve been sort of anointed as an economist, [so] then I can do what economists don’t want me to do, which is behave like an anthropologist” — anthropology-in-Ebola felt both underdone and overdone.
And this, I think, is an important point. Thus, rather than straightforwardly recounting the remarks of these anthropologist-panelists or the overall contributions of anthropologists regarding Ebola (important as such recounting is), I want to outline the existence of a particular second version of anthropology at play here. At the risk of reading too much into the numerous anthropology jokes that circulated throughout the Forum — though reading too much into phenomena is evidently anthropologists’ forte! — I suggest that they speak to a more profound, if subtle, discomfort on the part of non-anthropologists as to what they perceived as the mismatch between anthropological knowledge and anthropology as a form of practice. In other words, few of the non-anthropologists at this Forum denied that knowledge about the various sociocultural landscapes in and across Sierra Leone, Guinea, and Liberia was or would have been pertinent in the context of Ebola, but they did question the temporality and methodology associated with anthropological ways of “collecting” this knowledge. What struck them as funny and odd was thus not what they viewed as the self-evident utility of sociocultural knowledge, but rather, the notion that it could take anthropologists years to grapple with something that is, after all, so self-evidently useful. They appreciated our skills, but rolled their eyes at how we (whoever “we” are; the “real” anthropologists? The “academic” anthropologists? Not exactly a homogenous group) chose and choose to employ them.
What I suspect these non-anthropological actors at the Forum would have preferred to see from anthropology during the recent outbreak amounts to what Didier Fassin (2010) terms “‘cultural keys’”: quick and concise ethnographic soundbites that enable the architects and executioners of medical interventions to “interpre[t] ‘resistance in the population’” (40). The ideology underlying such keys Fassin (2001) dubs “culturalism”: the supposition that “the pertinent explanation [of an issue] can be found among those who are the object of the action, not those who instigate it… by overdetermining the role of cultural factors, it sweeps aside any socioeconomic or sociopolitical explanations of the phenomena examined” (306). This “tendency to attribute health problems to cultural practices,” elaborates Dominque Behague (2014), is “politically convenient as it relieves governments, institutions, and politicians of their responsibilities, while it also identifies a clear target… the local population.” Anthropologists, particularly those working within the academy, have tended to shun the spread of cultural keys and culturalism, often rightly so: my own previous fieldwork on HIV/AIDS in Cameroon reinforced for me that shallow understandings of complex phenomena serve no one well. Nevertheless, our deliberate restraint in this regard has inadvertently led to the rise of this particular second version of anthropology: what I call the “good-enough anthropologist.”
This concept of the “good-enough” comes from psychoanalysis, in particular from the work of Erik Erikson (1950) on “good-enough holding” and of Donald Winnicott (1960) on “good-enough mothering.” Stripped to their conceptual bones, such terms refer to the ways in which the basic, ordinary, competent nurturance of an infant is generally sufficient to ensure that the child develops “normally” as this is defined along psychoanalytic lines. In anthropology, the “good-enough” manifests most prominently in the work of Nancy Scheper-Hughes (1992) on motherhood in Brazil, in which she acknowledges its psychoanalytic roots but finds them somewhat too optimistic (360). More useful for my purposes, however, is her application of this concept to anthropology itself. “Weary [of] postmodernist critiques [and mindful that] the anthropologist is an instrument of cultural translation that is necessarily flawed and biased,” Scheper-Hughes calls for “good-enough ethnography [in which] we struggle to do the best we can with the limited resources we have at hand — our ability to listen and observe carefully, empathetically, and compassionately” (1992: 28). In all of these contexts, the “good-enough” is itself good.
My use of the “good-enough” is not so positive. By the “good-enough anthropologist,” I here refer to the subtle assumption of many of the non-anthropological actors at the Forum that as long as they acknowledged at least some of the sociocultural aspects of Ebola in some form, they were, if not necessarily “real” anthropologists, then good-enough anthropologists for the purposes of confronting this outbreak. In other words, “real” anthropologists would not or could not give cultural keys for unlocking Ebola, so non-anthropological actors transformed themselves into good-enough anthropologists in the process of seeking those keys on their own. And so cultural keys and culturalism were present at the Forum, despite anthropologists’ refusal to engage them. Among the more glaring examples: Chan labeled one of the main drivers of this disease as “centuries-old cultural beliefs and traditions… cultural beliefs and practices of the community proved to be one of the most difficult barriers to address.” Farrar lamented that “the risk is not in the technology, not in the data; the risk is that the population don’t see the benefits” of medical interventions, an issue that was important in this epidemic and would be even more so in future ones. Moreover, I simply lost track of the number of times handwashing and the color of body bags were brought up in a generic West African context. Ultimately, IRC’s Emmanuel d’Harcourt unwittingly said it best: Ebola has shown a need, he argued, for “people who get it. It’s anthropologists, but it’s also people who think like anthropologists.”
In this light, my answer to Hamilton would be that anthropology was, and continues to be, simultaneously everywhere and nowhere in this context — everywhere in the form of the good-enough anthropologist, and nowhere in the form of the “real” anthropologist’s rejection of cultural keys and culturalism. One might argue that this emergence of the good-enough anthropologist is, to a certain extent, progress — that it at least suggests an increasing acknowledgment of, and increasing seriousness concerning, the validity of the sociocultural in the realm of the biomedical (as if the two can be separated). There may be some truth to this. Yet while the good-enough anthropologist may be a form of public anthropology, it is not a public anthropology of anthropology’s making. This makes it both disconcerting and intriguing, a “public afterlife of [an] ethnography” (Fassin 2015) that calls into question just who, precisely, can be an ethnographer. As such, it suggests that anthropologists ought to expand our academic practice to encompass both research and better public relations: non-anthropological actors become good-enough anthropologists when we ourselves are not good enough at self-promotion, at clearly defining and communicating what it is we do, how we do it, and why we do it this way.
The issue of what constitutes “good anthropology” is, of course, controversial within anthropology: this is part of the issue, albeit an inevitable one. Moreover, while good-enough anthropology easily veers into culturalism, I can also admittedly see where it has the potential to foster a more democratic anthropology (though this is not the direction it has largely taken thus far), raising and/or reopening key questions similar to the one above. Who controls public anthropology, if anyone? What can or should “real” anthropologists do when faced with a public anthropology they may find dismaying? Is public anthropology an anthropology with a public presence, an anthropology practiced by publics, or both? Do attempts to trace such public afterlives aid the democratization of anthropology, or do they border on a way for scholars to reassert authority over the works they write? These are questions whose value lies more in discussion than in simple answers. Nevertheless, I know at least some core tenets of “good anthropology” when I see them. A willingness to take seriously the voices, views, and criticisms of our interlocutors, and to acknowledge that research — all research, not just anthropology — is constructed on and by deeply entrenched relations of power. An acknowledgement that “cross-cultural translation” (another Forum buzzword) amounts to far more than the simple substitution of a phrase in one language for a phrase in another. An ability to be comfortable (and comfort is not laziness) with partial conclusions, epistemological uncertainty, and the terrifying-yet-liberating idea that “everything is more complicated than you thought” (Appiah 2008: 198). More than this — an ability to dissect “the illusory sense that there is firmness and stability in the intrinsically messy social world of people, health, and disease” (Adams 2013: 84), even as we strive to respect and depict the ways in which those with whom we work often seek this very firmness and stability in their lives and on their own terms.
So: if the Fung Forum suggests that anthropology is everywhere-nowhere, where to go from here? The notion of an extended fieldwork stint in the midst of a swift-moving outbreak may seem laughable — and in situations like these, anthropology ought to accordingly adjust the temporal structure of its work as much as professionally possible — but it is no cause for overthrowing anthropology in favor of culturalism and its keys. At the risk of sounding too opportunistic, Ebola’s wake could and should be a period not merely for anthropological scholarship in this regard, but for better communication of the value of this work to diverse audiences, and for better making a virtue out of epistemological complexity. It is also worth pursuing further the above intersections and implications of academic democratization, good-enough anthropology, and public anthropology. I realize, of course, that such communication is only as interesting as its listeners want it to be; that this task itself is undeniably complex; and that I myself am only beginning to undertake it in my current research on mental health in Cameroon and Senegal. Nevertheless, this task is also increasingly necessary — because the good-enough anthropologist is on the rise, and for the time being, that is not good enough at all.
Elizabeth Durham is an incoming second-year PhD student in anthropology at Princeton University. She works on the localizations of “global mental health” in Cameroon and Senegal, and has researched HIV/AIDS in the former country as a 2012-2013 Fulbright Student Research Grantee.
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Behague, Dominque. 2014. Thoughts on Ebola. The Center for Medicine, Health, and Society, Vanderbilt University. Available from: http://www.vanderbilt.edu/mhs/2014/12/thoughts-on-ebola/.
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