Panel 21 – Health and bodies in emergencies and uncertain times

Conveners: Claudia Merli (Department of Cultural Anthropology and Ethnology, Uppsala University) and Mats Målqvist (International Maternal and Child Health (IMCH), Uppsala University Hospital)

Abstract: Clashing definitions of health and perspectives on bodies often meet during times of uncertainty and emergency. In the Anthropocene era the fragility and vulnerability of individuals, groups and environments can be magnified and often extended in conjunction to health and humanitarian interventions that can turn into new forms of governance. Local epistemologies of the relation between individual, community and environment may be silenced or marginalised vis-à-vis hegemonic categorisations that approach ‘nature’ and ‘society’ as domains that are or need to be kept separated. This panel invites contributions that critically assess and debate health and bodies from a wide range of perspectives, including medical anthropology, anthropology of health, global health, public health, medicine, forensic anthropology, science and technology studies, and others. Topics for papers in this panel can address:

  • Epidemics and pandemics
  • Chronic health crises
  • Neglected Tropical Diseases
  • Treatment of human remains in epidemics
  • Disaster Victim Identification and forensic identification
  • Community engagement in times of crisis
  • Psychosocial support among displaced populations
  • Natural hazards and health

Long Abstract: The operative and accepted definition of health by international organisations is the one proposed by the WHO, in which ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (Preamble WHO 1948 and 1978 Alma Ata). It affirms an all-encompassing ideal state of well-being as a stable, positive and whole attainment. Critical approaches to the study of health and health interventions, especially in the global south, privilege the examination of local material and social conditions as well as global political and economic dynamics, problematizing this universal definition of health not only because idealistic, but also as often associated with often short-term action-driven approaches that can lead to unintended or undesirable consequences (see Hanna and Kleinman 2013; Kim et al. 2013). Critical perspectives on health put forward instead a definition that emphasises individuals as well as populations’ control and access to material and non-material resources, including healthcare, in specific socio-cultural contexts (Baer, Singer, and Susser 2003), and take into consideration in the design of health interventions that work long-term those structural barriers that limit or prevent this access (Kim et al. 2013).

In the Anthropocene we witness the progressive ecological fragility of different ecological and urban contexts (cities, mountains, etc.) and vulnerability of individuals, households, and populations (Baer and Singer 2009). At the same time we are called to challenge the vulnerability paradigm that has informed much of contemporary response to disasters (Gaillard 2018). A critical approach to global warming and climate change takes into account also the health consequences produced in fragile environments, which can rapidly transform from a locally delimited health crisis into a global health scare.

Epidemics are increasingly framed as humanitarian emergencies or catastrophes, opening up to new forms of intervention and domination in sudden calamities and chronic states of uncertainty, by NGOs and other humanitarian organisations operating from different moral frameworks (for example utilitarianism, liberal cosmopolitanism, capabilities approach, etc.) (see Nguyen 2009; Redfield 2010; Suri et al. 2013). We want to explore how these interventions operate from an uncritical definition of the body developed within the Western biomedical epistemology, which does not take into consideration the theoretical articulation between the individual body, the social body, and the body politic (cf. Scheper-Hughes and Lock 1987).

One of the aspects characterising the aftermath of environmental crises as well as health epidemics concerns the treatment and potential dehumanization of dead bodies and human remains. A biomedical approach to death as a state detached from human life may cause severe conflict to contextual nursing practices and cultural perceptions of life and afterlife (Richards 2016). This approach often gains prerogative in crisis situations, e.g. Ebola outbreaks or in the aftermath of environmental disasters.

We invite colleagues to critically reflect on how an uncritical biomedical approach reproduces a perspective on ‘nature’ and ‘society’ as untroubled versus troubling separate domains in the context of health interventions during uncertain times.

References:

Baer, Hans, and Merrill Singer. 2016. Global warming and the political ecology of health: Emerging crises and systemic solutions. London: Routledge.

Baer, Hans A., Merrill Singer, and Ida Susser. 2003. Medical anthropology and the world system. Greenwood Publishing Group.

Gaillard, J.C. 2018. Disaster studies inside out. Disasters doi:10.1111/disa.12323

Hanna, Bridget, and Arthur Kleinman. 2013. “Unpacking Global Health: Theory and critique.” In P. Famer, J. Y. Kim, A. Kleinman and M. Basilico (eds), Reimagining Global Health, pp. 15-32. Berkeley: University of California Press.

Kim, Jim Yong, Michael Porter, Joseph Rhatigan, Rebecca Weintraub, Matthew Basilico, and Paul Farmer. 2013. “Scaling up effective delivery models worldwide.” In P. Famer, J. Y. Kim, A. Kleinman and M. Basilico (eds), Reimagining Global Health, pp. 184-211. Berkeley: University of California Press.

Nguyen, Vinh-Kim. 2009. Government-by-exception: Enrolment and experimentality in mass HIV treatment programmes in Africa.Social Theory & Health, 7(3): 196–217.

Redfield, Peter. 2010. “The verge of crisis: Doctors without Borders in Uganda.” In. D. Fassin and M. Pandolfi (eds), Contemporary states of emergency: The politics of military and humanitarian interventions, pp. 173–195. New York: Zone Books.

Richards, Paul. 2016. Ebola: How a people’s science helped end an epidemic. Chicago: ZED Books.

Scheper-Hughes, Nancy, and Margaret Lock. 1987. The mindful body: A prolegomenon to future work in Medical Anthropology. Medical Anthropology Quarterly(1): 6–41.

Suri, Arjun, Jonathan Weigel, Luke Messac, Marguerite T. Basilico, Matthew Basilico, Bridget Hanna, Salmaan Keshavjee, and Arthur Kleinman. 2013. “Values and Global Health.” In P. Famer, J. Y Kim, A. Kleinman and M. Basilico (eds), Reimagining Global Health, pp. 245-286. Berkeley: University of California Press.

WHO (World Health Organization). 1948. Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June­─22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force on 7 April 1948.