how Kenyan Muslim activists experience and make sense of the networked assemblages of police power that transform urban spaces into “gray zones” that fall within the ambiguous spectrum between war and peace. As US-trained Kenyan police employ military tactics of tracking and targeting potential terror suspects in quotidian urban spaces, they rely on “pop-up” interventions such as abductions, house raids, and makeshift checkpoints—flexible maneuvers designed to match the amorphousness of the so-called enemy. I introduce the term citizen-suspect to shed light on actually existing citizenship in the urban gray zone. Citizen-suspects contend not simply with the fear and paranoia that come with subjection to surveillance and suspicion but with the knowledge that is needed to navigate the shape-shifting geographies of transnational policing.
Adopting a Root: Documenting Ecological and Cultural Signatures of Plant Translocations in Northwestern North America Nancy J. Turner, Chelsey Geralda Armstrong, Dana LepofskyIn recent years, there has been an increasing recognition of the role humans play in the structure, composition, and function of ecosystems. Ethnoecological documentation of traditional management systems of Indigenous Peoples in northwestern North America has contributed significantly to this rethinking. A less well-recognized but foundational part of traditional management of this region is the practice of transplanting plants and plant propagules to expand the range and accessibility of culturally valued plants. In part, the lack of recognition of such translocations has to do with difficulties in identifying evidence of such actions from the past. Here, we summarize various lines of evidence, including that from ethnographic and ethnohistoric records, languages, oral traditions, phytogeography, and archaeology, to document the widespread and long-standing extent of plant translocation practices among Indigenous Peoples of northwestern North America. Furthermore, we demonstrate how such practices have helped shape contemporary native plant communities throughout the region. Recognizing these past contributions to current ecological contexts honors Indigenous heritage and Indigenous Peoples’ long-term relationships with their biological worlds.
Genetic syncretism: Latin American forensics and global indigenous organizing Lindsay A. Smith, Vivette García‐DeisterIn the 1970s, Latin America became a global laboratory for military interventions, the cultivation of terror, and ideological and economic transformation. In response, family groups and young scientists forged a new activist forensics focused on human rights, victim-centered justice, and state accountability, inaugurating new forms of forensic practice. We examine how this new form of forensic practice centered in forensic genetics has led to a critical engagement with Indigeneity both within and outside the lab. Drawing on ethnographic fieldwork with human rights activists and forensic scientists in Argentina, Guatemala and Mexico, this paper examines the relationship between forensic genetics, Indigenous organizing, and human rights practice. We offer the concept of ‘genetic syncretism’ to attend to spaces where multiple and competing beliefs about genetics, justice, and Indigenous identity are worked out through (1) coming together in care, (2) incorporation, and (3) ritual. Helping to unpack the uneasy and incomplete alliance of Indigenous interests and forensic genetic practice in Latin American, genetic syncretism offers a theoretical lens that is attentive to how differentials of power embedded in colonial logics and scientific practice are brokered through the coming together of seemingly incompatible beliefs and practices.
Using Telecare to Treat Opioid Use Disorder: An Ethnographic Study in New York During COVID-19 Christopher P. CaulfieldThis paper presents an in-person and digital ethnography of people in New York State who use drugs and seek treatment for opioid use disorder (OUD) using phone or video connection to receive healthcare (telecare) including interviews prior to and during the COVID-19 pandemic. This article leverages a Feminist and Science and Technology Studies (STS) approach to elucidate how the framing of the opioid crisis shapes the interconnections that are discernable, providing a heuristic to understand the increased rates of deaths due to drug overdose during the pandemic. The narratives of people seeking treatment are analyzed through the theoretical lenses of Nelly Oudshoorn’s concept of the technogeography of care, Nancy Campbell’s concept of technologies of suspicion, and Nancy Fraser’s analysis of the US juridical-administrative-therapeutic in/justice system. This paper traces and problematizes how telecare contributes to redefining the experience of familiar places, such as home, into spaces of both care and surveillance, and how the technology of telecare presents both affordances and foreclosures to accessing care as people struggle to conform with its requirements in order to receive care. Key findings are, (1) the significance of hugs and tactile connection that is sorely missed by people using telecare for group therapy, (2) the critical importance of proximity to in-person services even while using telecare, (3) the resistance strategies of telecare users to surveillance mechanisms, and (4) the continued stigmatization of drug use and treatment acts as a key barrier to people who are striving to produce the identity of a patient who is clinically stable for take-home medication.
Ephemeral Infrastructures of Drug Smuggling Mobilities Javier Guerrero C., Craig MartinThe study of drug smuggling has often taken an organizational perspective whereby the structures of how smuggling is constituted predominate. Building on a growing body of scholarship addressing the networked complexities of drug smuggling this article considers the importance of distinct infrastructural arrangements. Its primary focus is on the materiality of drug smuggling infrastructures, and how the social, spatial and temporal qualities of these configurations overlap with licit mobility infrastructures, including intersections of visibility/invisibility, stability, and permanence. The core conceptual premise, drawn from Science and Technology Studies, is that drug smuggling mobilities are formed of ephemeral infrastructures that exhibit temporary, short-lived stability and permanence through the subversion of licit infrastructural configurations. Drawing on material from El Dorado Airport, Colombia, the paper examines the everyday artefacts which constitute these ephemeral infrastructures.
The ‘noncommunicable disease space’: ethnographies of conferences, advocacy and outrage (free access) Clare HerrickNoncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavioural and environmental risk factors. These are, in turn, represented by multiple constituencies and communities of expertise and interest. This fractured landscape is evidenced by and magnified through an abject lack of conferences devoted to the category of NCDs. One of the very few is the NCD Alliance Forum, most recently held in February 2020 in Sharjah, United Arab Emirates. With the first Forum held in 2015 and another in 2017, these events offer powerful insight into the key actors, advocacy strategies, debates and aspirations of those working in the ‘NCD space’. Using the Forum as its object of research and analysis, this paper critically reflects on two persistent questions facing NCD advocates. First, how might NCDs be more like infectious diseases in cultivating a sense of urgency and action? Second, is NCD advocacy a ‘movement’ or a ‘community’ of loosely connected actors? Set against the emerging COVID-19 outbreak, which at the time of the Forum was limited to China and a handful of other countries, the Forum offered a unique opportunity to reflect upon the significant challenges facing NCD advocates across global north and south. COVID-19 only highlights how rising rates of NCDs have made global populations vulnerable to emerging infectious diseases. Yet, as the paper concludes, with the COVID-19 pandemic continuing to rage, the future of NCD advocacy and funding looks ever more fragile even as evidence of its need continues to grow.
Time away is time out: narratives of intentional reimprisonment amongst inmates living with HIV in a US setting Landon B. Kuester & Mark C. FreestoneThere is a growing effort from a range of professionals and institutions to develop comprehensive integrated prison-to-community healthcare, discharge planning, and community re-entry support for inmates living with HIV. This paper draws from ethnographic data to explore the ‘lived experience’ of HIV-positive inmates in a US State prison system offering an integrated case management support programme. In the US, incarceration is critical for connecting socially marginalised people and those with health needs to certain rights and resources. We present the ways in which imprisonment enables a claims-making process against the state by allowing this group access to resources and rights connected to imprisonment, healthcare, and associated social welfare support. Offenders identified incentives underpinning their expressed desire or ‘intention’ to return to prison over time. Our findings suggest that this group of inmates has increased opportunity to access material, medical, and welfare resources when compared to the general inmate population and those outside the prison system. Multiple gaps remain in this group’s sense of security in the community, ability to cope with the stress of everyday life, sustained support with substance dependency and, most importantly, consistent access to medical and welfare resources that enable them to live independently. Ironically, for many inmates living with HIV, incarceration offers a better chance of accessing public health services than living in the community.
Evaluating translation of HIV-related legal protections into practice: a qualitative assessment among HIV-positive gay, bisexual, and other men who have sex with men in Manila, Philippines Alexander C. Adia, Connie J. Lee, Arjee J. Restar, Bianca C. Obiakor, Ma Irene Quilantang, Kristen Underhill, Jennifer Nazareno & Don OperarioLegal protections for people living with HIV (PLHIV) are important for protecting human rights, yet little research has examined how laws translate into awareness and understanding for key populations. The Philippines has recently revised their legal protections for PLHIV in response to its growing HIV epidemic, where HIV-positive gay, bisexual and other men who have sex with men bear the majority of cases. We present findings from interviews with 21 HIV-positive gay, bisexual and other men who have sex with men in Manila, Philippines regarding awareness, understanding, and needs regarding HIV-specific legal protections at the time just before new revisions to the omnibus HIV law were passed. Overall, there was no standardized way participants became aware of legal protections; few became aware through healthcare providers, while most learned through online resources, social media, and advocacy organizations. However, even after learning about HIV-specific legal protections, many found the law too complex to understand or did not understand how to use such protections. This led participants to preemptively take action to avoid HIV-related discrimination, even if they were protected by law. Participants demonstrated a strong desire for interventions and policies to improve legal awareness and understanding for PLHIV, government officials, and private businesses. This research demonstrates the value of increasing awareness and understanding in policy-specific interventions designed to improve quality of life for PLHIV. Interventions centered around legal protections are currently underdeveloped, providing a strong opportunity to integrate such interventions in existing practice or as stand-alone tools to decrease perceived stigmatization.
Snacking practices in school: othering and deviance in a health-normative context Hilje van der Horst, Stefan Wahlen & Mirte ReimerinkMany public health interventions encourage healthy behaviours by strengthening health norms within schools or workplaces. Such health norms and health-normative contexts can also produce social hierarchies and forms of othering, including unhealthy ‘deviant’ behaviours. This article aims to better articulate how deviance is produced in a health normative school context. We approach the interplay between a health-oriented environment and deviance from a practice theoretical perspective, emphasising four different facets of this perspective. This paper is based on a case study in a school that has a strong orientation towards healthy eating, drawing on observations, focus group discussions with children, interviews and a survey (forty students, aged 10–11). We analyse how strong norms on healthy behaviour depend on the meticulous guarding of boundaries with deviant behaviours as well as, in some cases, associated ‘others’. The article thereby promotes a practice theoretical approach on deviance emphasising the mundane character of healthy eating in school. We contribute to the debate on deviance and norms as to better understand healthy eating practices by distinguishing four different facets of a practice theoretical approach: 1) practice as distinct entity 2) the performance of practice 3) practices in a nexus of multiple practices and 4) individuals as nodal points of practices. The results assist in critically reflecting on assumptions upon which many public health interventions are built as well as contributing to an understanding of normativity and deviance in mundane practices such as snacking in school.
The social meaning of steps: user reception of a mobile health intervention on physical activity (open access) Bastien Presset, Jan-Niklas Kramer, Tobias Kowatsch & Fabien OhlIn recent years, mobile health (mHealth) technologies have received increasing attention from industry and researchers. Such technologies have been the focus of both criticism and high expectations. In this paper, we analyze the integration of mHealth tools in everyday life. Insights into the actual use of such tools have empirical importance and could contribute to our theoretical understanding of mHealth technologies. Our research is based on 23 interviews with the participants of a smartphone-based mobile health intervention aimed at increasing physical activity. We followed the principles of grounded theory during data collection and our analysis is framed by the domestication approach. Our results reveal that the intervention design can result in the participants feeling ill-represented by the reductive nature of the data they generate. The results also reveal the inadequacy between biomedical standards and the social contexts of use. In addition, we describe how middle-class users perceive step-counting through the prism of a moralizing ethos of self-responsibility. Our research has practical implications for the developers and participants of mHealth interventions and theoretical implications regarding mHealth as a societal practice. We also suggest that mHealth-related public policies may fail to reach certain population groups, namely those who do not share the values that surround those technologies and their uses.
Depression, Deprivation, and Dysbiosis: Polyiatrogenesis in Multiple Chronic Illnesses (open access) Stefan EcksBiomedicine tends to treat “mental” illnesses as if they could be isolated from multiple social and somatic problems. Yet mental suffering is inseparable from complex somatosocial relations. Clinical fieldwork in a deprived area of the UK shows that nearly all the people treated for “depression” are chronically multimorbid, both in their bodies and in their social relations. Mental suffering is co-produced by poverty, trauma, and excessive medication use. Patients’ guts are as imbalanced as their moods. Single vertical treatments make them worse rather than better. In the UK, patients in poorer neighbourhoods do not “lack access” to healthcare. If anything, they suffer from taking too many medications with too little integration. I conceptualize the bad effects of excessive interventions in patients with multiple chronic problems as polyiatrogenesis.
Leaning into Perplexity: A Case of a Patient Who Did Not Want Treatment But Also Did Not Want to Leave Hirshbein, L., Im, D. & Ayubbi, I.K.This article presents the case of a young, second generation American Muslim man who was admitted involuntarily to an adult psychiatric inpatient unit. The patient’s clinical picture was unclear—the treatment team was unsure if he demonstrated signs and symptoms of bipolar disorder or if a personality disorder (antisocial or narcissistic) better explained his presentation. His clinical picture after a couple of weeks of hospitalization was not sufficiently acute that he needed to remain in the hospital, but he refused to leave because he wanted documentation that he had no mental illness. This article considers the patient’s history, the nuances of psychiatric diagnosis, the issues involving psychiatry and the law that arose in this case, and the collaboration of the psychiatric providers with the Chaplain Imam at the hospital. The case illustrates a collision between the limitations of science and the expectations of the patient and his family within our broader social, cultural, and professional contexts.
“We Need Other Human Beings in Order to be Human”: Examining the Indigenous Philosophy of Umunthu and Strengthening Mental Health Interventions (open access) Jerome Wright & Janaka JayawickraThis paper examines how cultural, historical and contemporary perspectives of mental health continue to inform ways of understanding and responding to mental distress even under the biomedical gaze of the Movement for Global Mental Health (MGMH). Based on experiences in Malawi, the authors explore three prominent interventions (practical support, counselling and support groups) employed by village health workers within a mental health task-shifting initiative and reveal how the ancient philosophy of Umunthu with its values of interconnectedness, inclusion and inter-relationships informs and shapes the direction of these interventions. Practical support is marshalled through traditional village structures, counselling provides advice and an encouragement to hope, and support groups provide a place for emotional exchange and a forum for the enactment of values, reflection and reinforcement of Umunthu. What are pronounced as biomedical psychosocial interventions are in fact the delivery of culturally embedded therapeutic approaches. Historical and socio-political evidence is offered to explain the dominance of biomedical perspectives and the HSAs’ responses and a call is made for a transformation of MGMH to embrace rich philosophies such as Umunthu and enact respectful, inclusive and democratic values to enlist collaborations between equals to develop relevant and effective knowledge and local responses to mental distress.
Synchronization and Syncopation: Conceptualizing Autism Through Rhythm Fie Lund Lindegaard ChristensenIn this article, I argue that rhythm is a key concept in understanding autism. The article builds on fieldwork conducted amongst autistic children at two specialized institutions in Denmark, as well as interviews with parents of autistic children, some of whom were also autistic themselves. The paper draws on Lefebvre’s theory of ‘rhythmanalysis’ and treats rhythm as a ‘way of being’. Viewing autism as a rhythm by using locutions expressed by my interlocutors, such as staccato, schematic, robotic, desynchronized, not tuning in and dissonant, illustrates the many ways to perceive social interaction as rhythmic. I add to this the concept of syncopation, to describe some of the most common features associated with autism, pointing to a non-pathological way of being irregular or offbeat. This ‘non-pathologizing language’ communicates both the challenges and contributions of social interactions between autistic people and their friends and family members.
Reanimating the Body: Comics Creation as an Embodiment of Life with Cancer McMullin, J., Rushing, S., Sueyoshi, M. & Salman, J.Cancer is regarded as a disease that redefines an individual’s life and relationships. The medicalization and reclamation of the individual’s sense of body, self, and social life have been long examined by psychiatry and anthropology alike. We argue that creating comics is a form of artistic narrative that affirms and proclaims the existence of a past and future possibilities for individuals diagnosed with cancer. Despite the interconnections among lived experience and meaning making, little attention has been paid to the potential therapeutic effects of comics creation. Individuals diagnosed with cancer were recruited for ten weekly comics making workshops. Data include qualitative interviews and workshop observations. Six women who were diagnosed with cancer consented to participate. Meaning making themes included (1) slowing down to process their experiences, (2) expressing frustration with medical encounters, and (3) reflecting on traumatic relationships. The process of redefining their cancer experience connects the sufferer’s individual and social context. We find that the physical act of ‘making’ comics works to create meaning and an embodied expression of meaning. Creating comics, for our participants, offered multiple entry points and perspectives for redefining their stories that provided new insights and paths to explore their medical traumas and reanimating their bodies.
Making Fast-Track Surgery Transportable: Sino-Danish Travel Work Signe Lindgård Andersen
This article examines the concrete travel work that enables the global transport of Fast-Track Surgery (FTS), a set of evidence-based, standardized protocols and guidelines for perioperative recovery. Having ethnographically followed FTS training for medical staff from provincial hospitals in China’s Gansu province at a local hospital in Denmark, I show how FTS is made transportable through interactions between Chinese and Danish healthcare professionals in a series of workshops, meetings and educational activities. I argue that the transportability of a health-promoting infrastructure like FTS is neither a matter of technology transfer nor of evidence as such. Rather, it requires a specific kind of travel work in the form of traveling comparisons as a constant two-way dynamic between hospital settings in Denmark and China.
Becoming Role Models: Pedagogies of Soft Skills and Affordances of Person-Making in Contemporary (open access) China Gil HiziThis article looks at the market-driven globalization of pedagogies of interpersonal “soft” skills by depicting these practices’ microdynamics and phenomenological attributes. My case study is located in urban China, where expertise and practices of soft skills have recently become accessible to people of different social backgrounds. Drawing on participant observations in relevant workshops in a second-tier city, I describe interactive dynamics where participants express themselves in new ways and, in turn, envision possibilities for changing their personalities and social standing. This process characterizes a globally expansive apparatus, which in China takes the particular form of role-modeling interactions where participants transition from learners to “exemplars.” “Self-improvement” through these pedagogies tends to emerge as moments of perceived affordances for self-transformation, activated through the synergy of seemingly accessible bodily capacities and the configuration of valuable “skills.”
What Does the Situation Say? Theorizing Multiple Understandings of Climate Change (open access) Michael SchneggOur ways of knowing the weather are transforming. Climate change modifies weather patterns, and the globalization of scientific knowledge promotes new ways of making the weather intelligible. Following both transformations, I explore how Damara pastoralists (ǂNūkhoen) in Namibia entertain various Indigenous, religious, political, and scientific explanations for the most distressing weather-related phenomenon they experience—the lack of rain. Integrating qualitative and quantitative data, my ethnography reveals how people combine knowledge from multiple, even contradictory, registers to explain one situation, and use a different combination of sources to explain another. To understand this, I develop a phenomenological framework that shows how being-in-the-world creates a phenomenon situationally. If phenomena differ depending on how we enact the world, it is unsurprising that these phenomena would then entail different explanations. With this, I theorize why people make sense of climate change in multiple ways, and why they move between them.
Forensic psychotherapy and tele-psychiatry Jessica YakeleyThe Portman Clinic, part of the Tavistock and Portman NHS Foundation Trust, is a forensic psychotherapy out-patient clinic offering psychoanalytically-informed assessments and treatment to children, adolescent and adults who present with violence, antisocial personality disorder, criminality and/or problematic sexual behaviours. Treatment offered is usually weekly individual therapy or group therapy or, in the case of children and adolescents, child psychotherapy and work with their parents and carers. Therapy is aimed at identifying, exploring and understanding the conscious and unconscious affects, anxieties and conflicts which give rise to their behaviours and which often stem from childhood abuse, neglect or loss, with a view to a reduction in their problematic behaviours and improvement in their relationships with others and themselves. In psychoanalytic psychotherapy the therapist pays particular attention to the therapeutic relationship, or transference, in which the patient’s experiences of the therapist are unconsciously influenced by their early experiences with significant others in childhood and adolescence. Awareness of the therapist’s countertransference – the thoughts and feelings that the therapist has towards the patient which represent the unconscious communications of the patient – can help understand the his1 psychopathology and the risk that he poses, and inform therapeutic interventions and interpretations. Exploration and understanding of the transference and countertransference dynamics in the relationship between patient and therapist provides insight into the unconscious fantasies and conflicts which motivate and sustain the patients’ relationships with others.
Since the start of the pandemic, as with other psychological therapy services, therapy for patients2 at the Portman Clinic has shifted from being delivered in person to being delivered remotely, either by the use of the telephone, or by Zoom, from the therapist’s home. This change in the therapeutic frame has had a significant impact on both clinicians and patients, and some of the particular ways in which the patients have experienced and used this remote contact has presented new opportunities in understanding and treating this particular patient population whose emotional and interpersonal difficulties are expressed via destructive bodily actions and behaviours.
Anticipating an unwanted future: euthanasia and dementia in the Netherlands (open access) Natashe Lemos DekkerThis ethnographic exploration of anticipation draws on fieldwork among people with dementia and their families in the Netherlands. I examine how requests for euthanasia by people with dementia offer insight into the work of anticipation, revealing it to be a temporal orientation through which the future is made tangible. Imagining a future with dementia may prompt some people to request euthanasia, but timing such measures is extremely difficult and often results in deferral. Contributing to an emerging anthropology of time, I argue that anticipation is a process of establishing, collapsing, and renegotiating the temporal distance between present and future, bringing the future into the present while also, and simultaneously, keeping the future at bay as a continuous ‘not yet’.
Echolocation among the blind: an argument for an ontogenetic turn (full access) Greg DowneyProponents of the ontological turn typically advance a highly conceptual understanding of variation in ontology. In contrast, this article argues theoretically that cultural canalizations of embodied ontogenetic processes — especially the development of local neurologies — underwrite distinct lived worlds. This theoretical argument for a corporeal basis of world-making draws on the case of vision-impaired individuals who actively echolocate, or perceive space using sound. Neurological evidence shows that echolocators’ sensory practices over developmental time produce specialized brain adaptations to behaviour. Human echolocation thus demonstrates how enculturation effaces the distinction between biology and culture in a behavioural-developmental spiral with implications for our understanding of human being.
Listening after the animals: sound and pastoral care in the zoo Tom Rice, Alexander Badman-King, Samantha Hurn, Paul Rose, Adam ReedIn anthropology and across the humanities and social sciences, zoos have tended to be theorized as places of spectacle. Scholars often focus on the ways in which these institutions enable the viewing of other-than-human animals by human publics. This article, however, uses sound-focused ethnographic fieldwork to engage with two UK zoos and to describe a particular mode of cross-species listening which is enacted by zookeepers. The concepts of pastoral care and control discussed by Foucault and applied to the zoo context by Braverman are productively reworked and reorientated in order to understand this form of listening. The article also demonstrates the interconnectedness of keeper, visitor, and animal sound worlds, in the process generating an original perspective that complements and enriches conventional zoo studies.
Medicine Anthropology Theory (Open Access)
Special issue ‘Medical Testing, Diagnosis and Value’, edited by Alice Street and Ann H. Kelly. The entire issue is fascinating, and a separate post will be dedicated to it.