In the Journals

In the Journals, October 2020, Part I

Annual Review of Anthropology

Beyond the Household: Caribbean Families and Biocultural Models of Alloparenting
Robin G. Nelson

Alloparental or extramaternal care is an integral aspect of human childrearing. This behavior has been explored both as an extension of the primary mother–infant dyad that evolved to meet the demands of altricial offspring and as an economic exchange of energy and resources. Much of this research centers on foraging or small-scale communities and positions the household as the central unit through which to explore negotiations of care. In this review, I use evidence from Black Caribbean communities living in industrialized countries to challenge the broad applicability of the analytical model of the bounded household and to question whether our current articulations of theory and empirical assessments of extramaternal care are well suited to investigations of these behaviors in the vast majority of contemporary human populations. Alloparental practices in the Caribbean reflect dynamic responses to maternal migration and the local influence of global labor markets. The children who remain at home experience variability in the care received from their surrogate parents. The dynamic aspect of the care practices enacted by these transnational families reveals the behavioral flexibility that has been integral to human survival.

Socio-Ecological Challenges as Modulators of Women’s Reproductive Trajectories
Pablo A. Nepomnaschy, Amanda Rowlands, Ana Paula Prescivalli Costa, and Katrina G. Salvante

Amenorrhea, anovulatory cycles, miscarriages, and other reproductive outcomes are often seen as pathological. Life history theory, in contrast, treats those outcomes as adaptations that helped women optimize the timing of reproductive ventures across our evolutionary history. Women’s bodies adjust their reproductive strategies in response to socio-ecological conditions, a process mediated by the hypothalamic-pituitary-adrenal axis (HPAA). Here, we review the links between socio-ecological conditions, HPAA activity, and the pace of women’s reproductive transitions such as puberty, age at first birth, interbirth interval, and perimenopause. We also discuss the HPAA’s role as a modulator of reproductive function: It not only suppresses it but may also prime women’s bodies for future reproductive ventures. We conclude by reviewing challenges and opportunities within our subfield, including the need for transdisciplinary teams to develop longitudinal studies to improve our understanding of women’s reproductive trajectories and outcomes from the moment they are conceived.

The Impact of Ancient Genome Studies in Archaeology
Omer Gokcumen and Michael Frachetti

The study of ancient genomes has burgeoned at an incredible rate in the last decade. The result is a shift in archaeological narratives, bringing with it a fierce debate on the place of genetics in anthropological research. Archaeogenomics has challenged and scrutinized fundamental themes of anthropological research, including human origins, movement of ancient and modern populations, the role of social organization in shaping material culture, and the relationship between culture, language, and ancestry. Moreover, the discussion has inevitably invoked new debates on indigenous rights, ownership of ancient materials, inclusion in the scientific process, and even the meaning of what it is to be a human. We argue that the broad and seemingly daunting ethical, methodological, and theoretical challenges posed by archaeogenomics, in fact, represent the very cutting edge of social science research. Here, we provide a general review of the field by introducing the contemporary discussion points and summarizing methodological and ethical concerns, while highlighting the exciting possibilities of ancient genome studies in archaeology from an anthropological perspective.

NAGPRA at 30: The Effects of Repatriation
Stephen E. Nash and Chip Colwell

On November 16, 1990, US President George H.W. Bush signed into law the Native American Graves Protection and Repatriation Act (NAGPRA). This federal legislation marked the culmination of decades of debate among scientists, curators, and Native American leaders and activists over the control of ancestral human remains and sacred, funerary, and communally owned objects. Anthropologists have now investigated myriad aspects of NAGPRA, from its underlying philosophical arguments; to its legislative history, its legal ramifications and political effects, and the methods of its implementation; to how it has remade American museums, archaeologists, tribes, and federally funded repositories; and to how it has ushered in a new (even if imperfect) period of collaboration and partnership. This article reviews the last 50 years of scholarship on repatriation, with a particular focus on NAGPRA’s last 30 years.

Living in a Toxic World
Alex M. Nading

While the proliferation of industrial toxic substances over the past century has had drastic environmental and bodily effects, conventional methods of measuring and mitigating those effects continue to produce uncertainty. The project of living in a toxic world entails ethical, technical, and aesthetic efforts to understand toxicity as a contingent encounter among beings, systems, and things, rather than as a fundamental characteristic of particular substances. Anthropologists do not just observe such encounters; they live and work within them. This review examines recent anthropological research on toxicity, proposing that responses to toxic disaster and occupational exposure, as well as acts of familial, state, or corporate care, are all modes of “toxic worlding.” The review concludes with a summary of recent research in collaborative and engaged anthropology, suggesting that such approaches are essential not so much for purifying or detoxifying the world as for making it otherwise.

Deaf Anthropology
Michele Friedner and Annelies Kusters

Deaf anthropology is a field that exists in conversation with but is not reducible to the interdisciplinary field of deaf studies. Deaf anthropology is predicated upon a commitment to understanding deafnesses across time and space while holding on to “deaf” as a category that does something socially, politically, morally, and methodologically. In doing so, deaf anthropology moves beyond compartmentalizing the body, the senses, and disciplinary boundaries. We analyze the close relationship between anthropology writ large and deaf studies: Deaf studies scholars have found analytics and categories from anthropology, such as the concept of culture, to be productive in analyzing deaf peoples’ experiences and the sociocultural meanings of deafness. As we note, however, scholarship on deaf peoples’ experiences is increasingly variegated. This review is arranged into four overlapping sections titled Socialities and Similitudes; Mobilities, Spaces, and Networks; Modalities and the Sensorium; and Technologies and Futures.

Typologies, Typifications, and Types
Stephanie Sadre-Orafai

This article positions types at the center of anthropological knowledge production, considering them both from the abstract, analytical perspective of expert typologies and from the tacit, phenomenological perspective of everyday practices of typification. Proposing what an “anthropology of types,” broadly construed and across these two scales, might look like, I examine the histories and uses of types and typological thinking in anthropology, highlighting the empirical, analytical, methodological, ethical, and political questions they have raised. I then describe the phenomenological foundations of typification, how sociocultural and linguistic anthropologists have approached it, and the accompanying challenges related to translation and representation. Finally, I review ethnographies of expert practices of type production, tracing the circuit of typification–typology–type and back again to show how forms of expertise institutionalize lay knowledge in ways that further solidify the misrecognition of types as natural, and examine visual and arts-based interventions that draw attention to these processes.

The Aftermath of Mass Violence: A Negative Methodology
Yael Navaro

Recent anthropological works on the aftermath of mass violence can be studied as having generated a negative methodology. New work has addressed the gaps, voids, and hollows of knowledge production in and about sites of mass atrocity and is developing novel research practices within these schisms. While considering the (im)possibility of research as the condition of possibility (as well as the question) for anthropological (and historical) work on the long durée of mass violence, this review highlights some adverse ethnographic methods that have emerged (and have been conceptualized) in the interstices. A critical positionality vis-à-vis anthropology’s positive outlook for evidentiary presences in the field has moved scholars of mass atrocity and its aftermath toward methods that would tarry in and through the negative.

Critical Public Health

Premature evaluation? Some cautionary thoughts on global pandemics and scholarly publishing (open access)
Kirsten Bell and Judith Green

In the space of two short months, the coronavirus pandemic has transformed the social, economic, and political landscape across the globe. For many, our research plans and projects have been one of the casualties of the virus, but we are also increasingly being assured that the virus is not just an impediment but an opportunity. Inboxes are daily flooded with requests to contribute to special issues or blogs on the coronavirus, and research funders have been fast to develop funding calls for research on the pandemic. Thus, among the many uncertainties of the COVID-19 pandemic, one clear outcome has been an incitement to publish.

The rise of molecular HIV surveillance: implications on consent and criminalization
Alexander McClelland, Adrian Guta and Marilou Gagnon

Public health experts in the US and Canada are increasingly mobilizing molecular-based surveillance techniques in seeking to identify and control HIV. Both countries are also leading in the world to criminalize HIV exposure, transmission and non-disclosure, as well as having pervasive ongoing criminalization regimes toward drug use, sex work and migration. Molecular surveillance aims to rapidly identify ‘risk network’ clusters of people normally out of reach to public health (e.g. drug taking sexual networks of gay men, rural people living in poverty), in the near real-time, where transmissions are taking place, and to then intervene with enhanced public health approaches. This commentary critically interrogates the seemingly benign new technology that is being presented by leading public health authorities evacuated of social and political context. We outline a series of concerns facing people living with HIV related to molecular surveillance as it intersects with consent and criminalization.

More than a buzzword: how intersectionality can advance social inequalities in health research
Josée Lapalme, Rebecca Haines-Saah and Katherine L. Frohlich

Intersectionality is increasingly adopted in research to understand the complex ways that social inequalities shape health. Intersectional research thus explores how multiple forms of oppression intersect and shape how marginalised social groups experience health issues. Yet intersectionality research has often neglected to focus on the upstream structural factors that (re)produce social inequalities in health. In this paper, we argue that intersectionality can further advance social inequality in health research when it is used to understand more than just the multiplicity of socially marginalised groups’ experiences and identities, but also how interlocking social structures and power relations perpetuate social inequalities in health. We suggest that analysing policy with an intersectional lens is a key entry point to empirically explicate the underlying mechanisms that permit social inequalities in health to persist. To illustrate our argument, we use the example of how an intersectional perspective can be adopted to better understand the role of tobacco control policies in contributing to social inequalities in smoking.

Journal of the History of Medicine and Allied Sciences

Medicine and Colonial Patent Law in India: A Study of Patent Medicines and the Indian Patents and Designs Act, 1911 in Early- Twentieth-Century India
Subhadeep Chowdhury

This paper investigates the history of drugs sold as “patent medicines” in India in the early twentieth century. The paper investigates their legitimacy as patenting of medicines was forbidden by the Indian Patents and Designs Act, 1911 (IPDA). The paper argues that the instrument of letters patents functioning as the prerogative of the Crown that gave monopolistic rights to grantees to sell any compound without having to disclose its constituents was the reason behind this seemingly conflicting historical relationship between the law and the market. Colonial law-making left sufficient space within the ambit of the IPDA for letters patents to have their ill effects. The colonial state made attempts to address this as a public health issue by incorporating concerns related to this class of medicines within regulations addressed to the drugs market in the 1930s. The currency of patent medicines in the market was further added to by Indian indigenous entrepreneurs fueled by cultural nationalism of Swadeshi ideology in Bengal in the early twentieth century. However, even such indigenous responses or attempts at hybridization of manufacturing and selling practices related to patent medicines were mostly informed by upper-caste/ upper-class interests and not so much by those of consumers of these medicines.

The Case Against the Doctors: Gender, Authority, and Critical Science Writing in the 1960s
Kelly O’Donnell

In the 1960s, widespread popular-cultural deference to the authority of science and medicine in the United States began to wane as a generation of journalists and activists reevaluated and criticized researchers and physicians. This article uses the career of feminist journalist Barbara Seaman to show the role that the emerging genre of critical science writing played in this broader cultural shift. First writing from her position as a mother, then as the wife of a physician, and finally as a credentialed science writer, Seaman advanced through distinct categories of journalistic authority throughout the 1960s. An investigation of Seaman’s early years in the profession also vividly demonstrates the roles that gender and professional expertise played in both constricting and permitting new forms of critique during this era.

Medical Anthropology

Beyond the Linguistic/Medical Anthropology Divide: Retooling Anthropology to Face COVID-19 (open access)
Charles L. Briggs

Differing analytics and ethnographic practices impede conversations between linguistic and medical anthropologists. Here I juxtapose articles in this special issue that use diverse ethnographic sites to rethink anthropological concepts of health, disease, care, the body, language, and communication in the light of the 2020 COVID-19 pandemic. I track how anthropologists and their interlocutors envision relations between ideologies, embedded modeling (or metacommunication), and ordinary pragmatics, particularly by projecting their actual or ideal consonance versus exploring how sounds, bodies, technologies, and practices emerge from disjunctures. Comparing H1N1 in 2009 and COVID-19 prompts reflection on why anthropologists must transcend this foundational divide to tackle pandemic complexities.

How Communicative Approaches Enrich the Study of Care (open access)
Lynnette Arnold and Steven P. Black

A comprehensive approach to care requires analysis of the role of communication in care encounters, an endeavor that is situated at the intersection of medical and linguistic anthropology. While work across these subfields is not new (see Kuipers 1989; Wilce 2009), recent scholarship signals an increasingly organized effort to synthesize theoretical paradigms at this intersection (e.g. Briggs and Faudree 2016; Carr 2011; Harvey 2013; Parkin 2013; Shohet 2007; Teas Gill and Roberts 2012). The communicative approach to care advanced in this special issue contributes to this synthesis. In this introductory essay, we offer insights into care that emerge from attention to language as a form of social action, action which simultaneously produces and is produced by global and local inequities. Our communicative approach contributes novel perspectives on topics of concern to medical anthropology, including structural violence and care, the temporality of care, and the ontology of care.

“Making Medicine” with Salvia divinorum: Competing Approaches and Their Implications
Paja Faudree

The psychoactive plant Salvia divinorum has long been used medicinally by Indigenous people from southern Mexico, the only place where it is endemic, and is now studied by pharmaceutical researchers. I analyze competing ways the two groups “make medicine” with salvia, attending simultaneously to material/embodied and semiotic/linguistic dimensions of those practices. I introduce two concepts – stripping and enrobing – to show that differences in how the groups interact with salvia have ethical and political consequences. Those repercussions matter because salvia is but one of many plants important to marginalized groups whose ties to them are threatened by international medical interests.

Global Health Education and Mediatization of Care in Costa Rica
Steven P. Black and Gabriela Alvarado

Costa Rica has become a destination for global health education courses, while funding for global health has increased dramatically over the past thirty years. An examination of one Costa Rican group’s efforts to market humanitarian discourses, focusing on website design, provides a window into the workings of global health education and details the sometimes-uncomfortable position of non-US health professionals in educational programming. This contributes to theorizations of the intersection of mediatization and care, and suggests links between the legitimation of global health as a discipline, on the one hand, and the reproduction of inequities, on the other.

Time Discipline and Health/Communicative Labor in Pediatric Primary Care
Jennifer R. Guzmán

In rural Southern Chile, native Mapuche families receive care mostly from non-indigenous clinicians. Parents and doctors alike orient to the importance of timely medical care, but clinical and communication norms also result in misunderstandings and tension. Parents find it hard to communicate about structural obstacles, and valued practices of care in families may conflict with normative expectations for timely presentation. Parents’ disclosures about the duration of their children’s illnesses can expose them to clinical censure, which in turn reinforces pernicious negative stereotypes about this racialized and marginalized community.

Cross-border Communication and the Enregisterment of Collective Frameworks for Care
Lynnette Arnold

Communication plays an important role in the non-copresent care that is increasingly prevalent today. Drawing on long-term research with transnational Salvadoran families, I explore how one multigenerational kin network managed a health crisis: a family member had been diagnosed with a new form of chronic kidney disease that is epidemic in rural Central American communities. The family used cross-border communication to simultaneously enact care and consolidate a particular register of care. I suggest that everyday communication is a powerful force that works both within and beyond immediate care work encounters in ways that have far-reaching consequences for ethical and moral life.

Care in Interaction: Aging, Personhood, and Meaningful Decline
Anna I. Corwin

Care, as it is instantiated through interaction, can both perform and shape cultural and moral understandings of what it means to be a person in the world. American Catholic nuns have been found to age more “successfully” than their peers. However, in contrast to the successful aging paradigm, an analysis of care interactions from research conducted in a Franciscan Catholic convent in the Midwestern United States reveals that the nuns practice an ideal of meaningful decline. I explore how linguistic analysis of care interactions evidence ideologies of personhood and aging, and how a model of meaningful decline (the notion that valuable personhood endures beyond productivity) is instantiated through interaction.

Medicine Anthropology Theory (Open Access)

After illness, under diagnosis: Negotiating uncertainty and enacting care
Lenore Manderson

A vast portion of the world’s population live with ill health following acute infection or disease and its emergency management. This reflects the increased capacity of technological innovations and pharmaceuticals to interrupt decline or complications, even when cure is unlikely. The authors in this Special Section illustrate how, in different localities, people live with risk for themselves or their offspring; with non-communicable, degenerative, autoimmune, and congenital conditions; with the after-effects of diagnostic procedures and surgical interventions; and with continued treatment and surveillance. We attend to the value of conceptualising this as ‘living under’ diagnosis or description. We illustrate how diagnostic labels overdetermine subsequent embodied states of being, structuring interactions and social relations with family, friends, and health professionals. Living under diagnosis, we argue, impacts on self-care, care for and by others, everyday lives, and anticipations of the future.

Bhabha in the clinic: Hybridity, difference, and decolonizing health
Carolyn Smith-Morris

Before professional diagnosis, the determination of whether one is ‘ill’ or ‘well’ rests within the patient. These moments, when sufferers (re)cognize their own bodily and phenomenological experience as abnormal or different, are critical to the positioning of healer and patient. So too are moments when diagnosed patients, struggling with a treatment regime, compromise and adjust to embrace, if only partially, disparate ideas of health. In this article, I apply Homi Bhabha’s framework of hybridity and difference to think about the perception of illness, self-diagnosis, and power in healing relationships. I consider how sufferers enact hybrid positions between their bodily perceptions and their professional diagnoses. To illustrate the utility of Bhabha’s colonial critique for health care, I examine narratives by patients with diabetes-related vision loss about: (1) first realizations that something was wrong, what Bhabha might call the ‘intervention of difference’; (2) expressed differences between self-knowledge and biomedical knowledge, corresponding to Bhabha’s ‘partial embrace’ of the colonial ideal; and (3) the self-colonizing epistemological work that compliant patients do as they re-orient their pre-diagnostic self to a post-diagnostic habitus of self-monitoring, timed medications, and other treatments. I conclude with a discussion of how Bhabha’s colonial hybridity supports a more productively contentious medical anthropology that envisions and pursues decolonized health care.

Diagnosing hikikomori: Social withdrawal in contemporary Japan
Rae V. Sakakibara and Ellen B. Rubinstein

Hikikomori (‘social withdrawal’) appeared in Japan at the end of the twentieth century, inciting public panic about a generation of Japanese youth who shun social contact and fail to engage in the age-appropriate activities of young adulthood. Widely cited as a ‘condition’ rather than a psychiatric symptom or disorder, hikikomori has functioned variously as a diagnosis of individuals, families, and society at large. Taking the polysemous (and controversial) nature of hikikomori as a starting point, we draw on fourteen months of ethnographic research to explore how families negotiate a diagnosis of hikikomori in everyday life. Our focus on families opens up fruitful questions about the moral economies of life under diagnosis, not simply for the diagnosed individual, but also for those who assume responsibility for that individual’s health and wellbeing.

The stakes of (not) knowing: Motherhood, disability, and prenatal diagnostics in Jordan
Christine Sargent

This article draws on the concept of subjunctivity to explore how conditions of uncertainty, experimentation, and refusal shape the lives of women raising children with Down syndrome in Amman, Jordan. The connections that women forge – as mothers of children with Down syndrome – enable them to imagine new possibilities for their families and their futures across boundaries of class and circumstance. Prenatal diagnosis, however, invites possibilities of a different kind, challenging established models for divine creation, human agency, and moral accountability. As women reflect on what they would have done if they had known about their child’s Down syndrome in utero, they reason themselves to different conclusions. Yet their interest in the question itself reveals how, even in its absence, prenatal diagnosis circulates as a technology of subjunctivity, conjuring multiple possible pasts, presents, and futures.

Collaborative intimacies: How research pigs in Danish organ transplantation facilitate medical training, moral reflection, and social networking
Anja M. B. Jensen and Mette Nordahl Svendsen

Pigs and pig organs are frequently used prior to human trials in experimental transplant research into how to optimise human transplantation. But what exactly happens when transplant professionals perform experimental research on pigs? Similarly, what happens when a pig is on the surgical table? Based on ethnographic fieldwork in Danish transplant research laboratories, we investigate how pig experiments facilitate ‘collaborative intimacies’ among medical professionals. Collaborative intimacies are used here as an empirical and theoretical framework for conceptualising and re-imagining the social relationships between species and the medical disciplines that emerge in laboratory work. Collaborative intimacies in the lab provide medical training and facilitate moral reflection and social networking among transplant professionals. As such, we argue that research utilising animal models is not only about technological progress and ethical dilemmas; rather, collaborative intimacies make us understand how intimate relations among medical professionals in translational research unfold and how such relations matter for professional and technological futures.

Promises and perils of Guan: Mental healthcare and the rise of biopolitical paternalism in contemporary China
Zhiying Ma

This article examines families’ involvement in the care and management of people with serious mental illnesses in China, and focuses on how that involvement is shaped by changing psychiatric institutions and law. Drawing on 32 months of fieldwork, I show that familial involvement is primarily characterised by guan [管], which can mean ‘care’ and/or ‘control’, and which commonly invokes a particular cultural ideal of parenting. Tracing how the language and practice of guan circulate between different realms, I argue that a ‘biopolitical paternalism’ has emerged in contemporary China. It reduces patients to carriers and manifestations of biomedical/security risk and legitimises the state’s policy of population management as a form of paternalistic intervention, while displacing certain paternalistic responsibilities, such as hospitalisation and ensuring medication compliance, onto patients’ families. This biopolitical paternalism produces vulnerabilities and unease within families and aggravates health disparities between patients. The analytic of biopolitical paternalism has conceptual efficacy and practical implications beyond mental health.

Unsettling disciplinary frontiers: An opportunity to address inequities in genetic medicine?
Emily Hammad Mrig

Recent advances in genetic research provide anthropologists with an opportunity to reconsider the meaning and importance of interdisciplinary research. This piece suggests that interdisciplinary thinking can help to redevelop health policies aimed at improving access to new genetic technology and addressing many health care inequities. Drawing from research on access to genetic testing among women with a breast cancer diagnosis in the United States, I explore how patient perspectives can be used to redefine how policy makers interpret the utility of genetic medicine. Individuals undergoing genetic testing describe how genetic knowledge is translated into salient change in their lives, a view rarely recognized in conventional evaluations of genetic medicine. This work also recognizes how the ‘potentialities’ of genetic medicine both fuel the engine of ongoing genetic research and motivate individuals to imagine possible future actions to improve health. This reflection is meant to provoke debate and contribute to discussion about how health policies can be designed to improve inequities in access to genetic medicine.

Living with transplant: Never quite beyond illness
Laura L. Heinemann

Organ transplantation is often held to epitomize the power and promise of biomedicine. Yet life after transplant does not so clearly mark an ‘after’ to illness, and instead requires close monitoring and treating for organ rejection, graft failure, or the side effects of medication regimens. Such medical domains are counterbalanced, in turn, by relations of kinship, friendship, home and work life. In this Position Piece, I call for attention to the interconnected tensions among these domains, focusing on one illustrative case example: that of Janet, a three-time kidney recipient. By detailing Janet’s lifelong imbrication of daily life with vulnerability and biomedical intervention, I delineate the mismatch between popular imaginings of transplant as ‘cure’ and the realities of living a life that is never quite beyond illness.

Post-cure
Narelle Warren and Courtney Addison

The curative imaginary is a powerful driver of hope and investment in medicine, often displacing attention and resources given to other illness-related fields of practice. Whereas cure implies an end to the sick role and the possibility of an absolute state of health, in practice those fields that are touted as having high curative potential grapple with the ongoing nature and incompleteness of post-cure care. By capturing the public imagination and channelling research and funding in particular directions, the motif of cure risks drawing resources away from other, less seductive forms of treatment, and towards the technological at the expense of the social. Drawing on our research into precision medicine and deep brain stimulation, we track how cure operates as a concept in these fields, and compare this to how medical practitioners actually care for patients. We argue that a critical engagement with post-cure possibilities offers an opportunity to challenge and rethink what constitutes good medical care, as well as the social, political, and economic underpinnings of medical innovation.

Leprosy, impurity, and stigma in Vietnam
Le Hoang Ngoc Yen

This Position Piece examines the nature of Vietnamese folk constructions of leprosy through Mary Douglas’s (1969) and Victor Turner’s (1967) works. Investigating Vietnamese explanations for the origins of leprosy and its channels of transmissions, symptoms, and consequences, I argue that these accounts are rooted in narratives of transition, transgression, the crossing of boundaries, and categorical confusion of various kinds. I argue that these deeply embedded perceptions of leprosy help to explain the existence of persistent stigma against leprosy in Vietnam, despite highly effective drug treatments and extensive state awareness programmes.

Naming and framing ecological distress
Susan Wardell

We are living in a time of massive anthropogenic ecological and climatic shifts. Awareness of these changes and their effects on human lives is increasing, with recognised impacts on mental health. At present, a variety of different terms exist to describe ecological change-related distress. They range from the philosophical to the clinical, and are already beginning to form part of professional practice, as well as popular discourse, with prescriptive implications. In this piece, I explore some of the different names and frames for ecological distress by drawing on a sample of 30 online articles, blogs, and videos, and bringing these into dialogue with scholarly literature. My purpose is to open up a conversation about how medical anthropologists might attend to the meaning-making processes that surround ecological distress and (individual, institutional, and political) responses to it.  

‘We come in as “the nothing”’: Researching non-intervention in palliative care
Erica Borgstrom, Simon Cohn and Annelieke Driessen

In our ethnographic study of palliative care in a UK medical setting, we concerned ourselves with instances when medical staff chose not do something, which we came to call ‘noninterventions’. Such instances raised an obvious question: how does one study something that is not happening? In this Position Piece, we outline three ways in which we have tried to engage with this methodological question, from the initial grant application process to the point we are at now: first, a somewhat positivist approach, which allowed us to delineate the phenomenon of our study; second, a following technique, adopted to understand noninterventions as and when they are conceived by our informants; and third, an approach that tries to trace enactments of ‘not doing’ by mapping the range of different practices and, in so doing, elucidates how ‘not doing’ invariably occurs alongside other forms of doing. We describe what these approaches have taught us so far and reflect on the limits of each. We do so in the hope of providing others with starting points for studying nothings, ‘not doings’, and absences.

PTSD or lack of love? For radical interdisciplinarity in global trafficking aftercare
Runa Lazzarino

In this Position Piece, I critically reflect upon some epistemological and political issues of interventions and intervention-oriented research in post-trafficking mental health care. I discuss three loci of friction within the framework of a critical global mental health approach to trafficking aftercare: ethnography, biomedical studies, and post-trafficking care. I address these loci through three case studies: two drawn from my own ethnographic fieldwork and one from a recent systematic review of biomedical studies on post-trafficking mental health. My discussion focuses on the limits of such activities when conducted as isolated interventions and highlights the need for radical interdisciplinary and participatory approaches.

Revelation or confirmation? The ‘fake probe’ in global health
Patricia Kingori and Rachel Douglas Jones

Fakes have become a matter of concern across global health. Commissioning inquiry into presumed fake practices in global health requires both a pre-existing sense of what would constitute real provision and a suspicion that it is not being offered. In this Position Piece, we analyse the research methods being used to identify and reveal other—presumed—fakes in global health provision. We put forward the concept of the ‘second-order fake’—the fake that is used to reveal a fake—to draw attention to the methodological politics at stake in the use of the fake. By reviewing historical cases of the creation of methods of deception, we analyse the assumptions they bring into global health from other disciplines. We foreground the promises of revelation that are embedded in probes that rely on fakes to uncover fakes. We suggest that despite the growing prevalence of methods which themselves deploy fakes to find fakes, these techniques bring us no closer to understanding the lived ambiguities of everyday practices of fakery.

From social distancing to social containment: Reimagining sociality for the coronavirus pandemic
Nicholas Long

This essay develops an anthropological critique of ‘social distancing’. While the 2020 coronavirus pandemic requires us to reconfigure established forms of sociality, distancing regimes such as ‘lockdowns’ can profoundly disrupt the provision of care and support, creating practical difficulties and existential suffering. I advocate instead for strategies of ‘social containment’, outlining several of the containment arrangements people in England have developed to reconcile relational obligations with public health imperatives during the pandemic. I end by addressing some of the steps anthropologists must take when translating such ideas into policy.

Beyond the military metaphor: Comparing antimicrobial resistance and the COVID-19 pandemic in the United Kingdom
Iona Francesca Walker

Military metaphors shape the limits and possibilities for conceptualising and responding to complex challenges of contagion. Although they are effective at communicating risk and urgency and at mobilising resources, military metaphors collapse diverse interests and communities into ‘fronts’, obscure alternative responses, and promote human exceptionalism. In this article, I draw from criticisms of the use of military metaphor in scientific and policy descriptions of antimicrobial resistance (AMR) over the past sixty years on order to compare with and explore the use of military metaphors in descriptions of the COVID-19 pandemic. As AMR research has recognised the importance of symbiotic human–microbe relationships and new areas of interdisciplinary collaboration in recent years, a corresponding decline in the use of military metaphor in scientific discourse has begun to emerge. I ask how the legacy of the military metaphor in AMR research can offer lessons regarding or alternatives to the martial language currently saturating responses to the COVID-19 pandemic in the UK.

Bat portraits in times of pandemic
Michèle Cros

In this Photo Essay, photographs are combined with drawings collected in Burkina Faso in the years following the 2014–2016 Ebola outbreak. Portraits of bats are shown. The blacklisting of these animals following the recommendations of health authorities collides with local realities, where it is not possible to talk about bats in a ‘general’ sense. The same is true today in the period of COVID-19, when chiropterans are once again in the etiological hot seat: bats are behind the pandemic, according to Ridley’s shock phrase (2020). In Burkina Faso’s Lobi country, between the red and black fruit-eaters (which have always been eaten) and the small insectivores (which have never been eaten as such, but are very useful to animist healers), there is a chasm of representation that is unveiled by these images. 



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