On "health reform"

A quick slippage can be traced from the 2008 US Presidential Election campaigns to now in the discourse on the allopathic healthcare system. At some point, any mention of the need for an "overhaul" became replaced by monotonous details of "reform." The metaphor of "revolution," on the other hand, barely got any play.

Soon after Obama's election, Gallup and other polls demonstrated that people were beginning to feel more comfortable about their ability to afford healthcare. The sense of corporal insecurity and dread of being abandoned in their senility was diminished by the simple fact that politicians were "finally taking healthcare reform seriously," meaning little more than that they were finally talking about it.

For some reason, interviewers and acquaintances think that I should have something particularly enlightening to say on the current debate. The people who are closest to me know that I am too intellectually pessimistic to respond with anything more than grumbles. Moreover, the people who are closest to me know that what is being touted as "reform," or even as "the public option," will do little to make easier our "bloody" struggles to ameliorate the gruesome realities faced by the indigent sick.

But my grumbling is just another shade of gray in the monochromatic swirl that is the debate on healthcare "reform."

A different, more radical pessimism is required, and for that purpose I will borrow from a friend:
"It's preposterous to think that someone should get paid to provide medical care -- 'Wait, you saved my life so you want me to pay you money???'"

Yeah, seriously: fuck you!

Perplexing insistence...

Please take a moment to look at the newest issue, "Killer Apps," page 30-32: The Atrium.

The 5 Laws of Infectious Disease

As per Dr. William Muller, Children's Memorial Hospital, Chicago, IL:

1. The average of two standards of care is not a third standard of care.
2. Vaccines are not a religion.
3. Always ask: where and how?
4. Antibiotics are not anti-pyretics.
5. Never pull out the big guns without an exit strategy.

A terrible commerce: Bourdieu, capital accumulation, and growth failure among indigenous children in rural Guatemala

Presented September 2009 at Society for Medical Anthropology annual conference, Yale University.

This paper was one of 5 in a panel organized by Bridget Hanna and me: "Global Health and Social Theory: Practice, Pedagogy and Unintended Consequences ." Arthur Kleinman agreed to serve as the discussant! The ensuing conversation was also enriched by the contributions of Peter J. Brown, whose idea of "macroparasites" (Cultural Anthropology 2(1):155-71) was the original inspiration for my expansion of Bourdieu's typology.

...

Since I began collaborating in community health interventions in Guatemala in 2007, I have felt so utterly demoralized at times that I think I’ve hit rock bottom. Struggling against the baleful synergies between disease and structural violence, as a medical student and wannabe anthropologist among the indigenous, rural poor in the Kaqchikel highlands, I have been faced with the abominable tasks of explaining and making sense of the unnecessary suffering and irredeemable deaths of patients, friends, and colleagues. If, as Paul Farmer writes, engagement with the indigent sick makes for a “vital practice,” shaping my imagined life-work in exciting ways, it has been in learning to write ethnography and think with social theory that I have found some solace. Even if we failed to identify any pragmatic contribution to be made by social theory to the clinical practice of social medicine, for me, at least, the practices of reading and writing—hobbies or not--have become central to my sense of who I am. Experiences, memories and vignettes about people and places compel me to go back to the communities I have grown to care about, but compulsions like this can be ignored until they become cold. It is in the application of social theory, implicit but nonetheless palpable in the vignette I will present shortly, that I have found new spaces to imagine solutions and renewed the desire to make meaning, permitting to keep going as often as I can.

Matyox chiwe.

Thank you:

http://www.globalgiving.com/projects/diabetesmaya/

Many Maya patients and families struggling against poverty, racism and diabetes have found solace through Wuqu' Kawoq's ongoing solidarity.

Much thanks to those who have already given!

These are uncertain times for everyone. Please help, as you are able, to ameliorate the insecurities that plague Wuqu' Kawoq's patients.

~Shom

where is the financial crisis now

here?

Tib'ana achike yixtikir. Do what you can.

Please see link.

At the risk of ethnocentrism...

It is a horrible experience to talk to your friend in Kaqchikel about his mother's fatal stroke and recognize his description as decorticate, then decerebrate, posturing.  

I know this speaks more to my linguistic incapability and to some latent Orientalism in me.  But still, it really was horrible.

My familiar friend, speaking in familiar words--and suddenly, I see the pathophysiology of a herniating brain.  

I did not explain to him what had happened to his mother's brain.  

I suppose it did not matter, either way.

WWKD (What Would Karl Do?) - stamina, starts and fits

From The Eighteenth Brumaire of Louis Bonaparte:

"Bourgeois revolutions, like those of the eighteenth century, storm more swiftly from success to success; their dramatic effects outdo each other; men and things seem set in sparkling brilliants; ecstasy is the everyday spirit: but they are short lived; soon they have attained their zenith, and a long depression lays hold of society before it learns soberly to assimilate the results of its storm and stress period. Proletarian revolutions, on the other hand, like those of the nineteenth century, criticise themselves constantly, interrupt themselves continually in their own course, come back to the apparently accomplished in order to begin it afresh, deride with unmerciful thoroughness the inadequacies, weaknesses and paltrinesses of their first attempts, seem to throw down their adversary only in order that he may draw new strength from the earth and rise again more gigantic before them, recoil ever and anon from the indefinite prodigiousness of their own aims, until the situation has been created which makes all turning back impossible, and the conditions themselves cry out:

Hic Rhodus, hic salta!
Hier ist die Rose, hier tanze!
[Here is Rhodes, leap here!
Here the rose, dance here!]

Never talk politics and religion...

Fourth year medical students are warned at my school to avoid the topics of politics and religion when applying for residency programs. We are taught in the preceding years that this applies to clinical encounters with patients and to professionalism in medicine.

The fundamentally flawed assumption in all this is that the practice and discourse of medicine are scientific and therefore fundamentally non-political.

This is, of course, entirely untrue. The provision of allopathic medical care at wealthy academic medical centers is absolutely political, based on access to the accruing benefits of power and violence that permit capital accumulation.

I wish I could say, however, that the political practices of biomedicine are limited to such insidious phenomena. In that case, one could say that at least physicians, nurses and everyone else is just doing their best. Any instances of collusion in regnant economies of inequality and harvests of violence are unfortunate and unintended. If politics is implicated in medicine, it must be working behind the backs of those teams of sleep-deprived people in white coats who congregate every morning before most other people are awake.

Fine. If that is so, then why is it acceptable on the in-patient wards to complain about Medicare physician payment cuts, and about Obama's "socialist" healthcare plan?

If it is so damn hard to pay taxes out of a six-digit physician's salary, then why not complain about the "hard-earned tax dollars" that go to the military budget every year without fail? That is, ~$500 billion per year, depending on how you do the math. Comparing this figure to Obama's stimulus package CBO and to the healthcare budget, we are faced with the gut-wrenching realization that people (who happen to be physicians) can be bitterly opposed to "government-sponsored" healthcare while having little problem with government-perpetrated violence.

Physicians can be as self-serving and reactionary as anyone else who benefits from the way things are. Unfortunately, the contemporary industries of medical education and healthcare provision reward these qualities.

Lest this sound like an angry rant, I should say that I am deeply, deeply saddened by all of this. I have had the luxury of persisting, albeit in little ways, in those brands of radical idealism that call for lived and pragmatic solidarity with the poorest and most marginalized.

And it is horribly, devastatingly disappointing to witness such countervailing ideologies and ways of being-in-the-world in people with whom I share something so presumably sacrosanct as the mandate to alleviate suffering.

So now I tried to bring it up...

During moments of downtime, I introduced the topic of high neonatal and infant mortality in communities in Guatemala where I have friends and patients.

The most I've gotten as a response? "Yeah, that makes sense. I mean its not like some places in Africa..."

What?

In the Neurosurgical Intensive Care Unit

the anthropologist in me (or is it just the same old suspicious world-systemist in me?) is making comparisons between the energy that is quite readily and appropriately expended on prolonging the life of critically ill and injured in chicago (electricity and materials for manufacturing and operating the mechanical ventilators) vs. the energy that is so violently taken away from indigenous children in rural guatemala (food scarcity, absence of government-run sewage treatment+disposal --> diarrhea, all of which manifests as chronic malnutrition).

here, suffering patients warrant fancy machines.

in socorro, suffering children get contaminated wells, juan's 5-foot-deep holes on the footpaths (for sanitation...eventually...labor paid in kCal's by adult male beneficiaries...); energy sapped by malnutrition enteropathy and bellies pregnant with worms; jun ti way rik'in jub'a ri atzan; fewer and smaller red blood cells and inches off children's linear growth potential.

i imagine accusations, eg from critical care docs, that this comparison amounts to a rationalization of euthanasia. but that is a provocatively empty, reflex reaction. i'm trying to be provocative, sure, but simply to call for even more care for more sick people.

...

sadly, it feels dicey when i broach this topic with my teammates in the ICU. if only they knew: i'd be overjoyed if they did what they do everyday in the ICU for a patient in guatemala.

Dilemmas in a polytherapeutic context

Is it worth it to try improving (or preventing) the provision of care by providers whose competence is questionable?  How harmful does an intervention need to be before you step in and try to stop it?  

Doesn't the fact that people are going to those other providers mean that your services are not fulfilling the full range of a community's needs?

Fight crisis with crisis

Some help on a recent post from Walter Benjamin:

"The tradition of the oppressed teaches us that the 'state of emergency' in which we live is not the exception but the rule.  We must attain to a conception of history that is in keeping with this insight.  Then we shall clearly recognize that it is our task to bring about a real state of emergency, and this will improve our position in the struggle against Fascism.  One reason why Fascism has a chance is that in the name of progress its opponents treat it as a historical norm." ~quoted in Taussig, "Terror as usual" (1989)

Horse Ivermectin

"If you don't speak the language, you're just practicing veterinary medicine."  ~ Arthur Kleinman

What if you speak the language while calculating the appropriate does of equine-strength Ivermectin for all the members of the family?

On activism

Prompt: Activism, applied research and theory have had an interesting and in no way similar relationship to each other in the scholars we have looked at in this semester. There is no consensus on what activism or applied research might be, nor even what counts as theory or explanation. Consider these questions in the work of the following scholars: Moore, Scott and Das. How have they resolved these pulls or pressures, if they have? If you anticipate similar pressures in your own career, what if anything have learned from them?

...

“Why does one engage in doing something that in reality never comes, and never can come, to an end? … in order to be able to orient our practical activities to the expectations that scientific experiences places at our disposal.” ~Max Weber, “On Science as Vocation”

In his exposition on science as vocation, Max Weber insisted on a practical segregation between the commitment to rigorous sociological critique and what he considered an equally compelling obligation—active participation in political process. Nonetheless, as evidenced by the quotation above, Weber’s exploration of the relationship between his “scientific” and “practical” (that is, “political”) activities acknowledges and affirms many contemporary anthropologists’ sense of indeterminacy as they navigate between the falsely dichotomized realms of “applied anthropology” and “theory.” The lives and work of Sally Falk Moore, Joan Scott and Veena Das are unique examples of how academics have struggled and, in some sense, made peace with this tension. Before delving into their particular decisions, however, I found it helpful to briefly consider two essays to help orient myself to to broader disciplinary conversations on this issue: Scheper-Hughes’ call for “a militant anthropology,” and Rylko-Bauer et al’s more recent attempt to “reclaim applied anthropology.”

Scheper-Hughes’ 1995 strident essay, “The Primacy of the Ethical: Propositions for a Militant Anthropology,” decried anthropology’s secular soteriology of the anthropologist as “fearless spectator,” that is, “a passive act which positions the anthropologist above and outside human events as ‘neutral’ and ‘objective’ (i.e., uncommitted) seeing I/eye.” (419) Drawing on the Levinasian notion of the primacy of the ethical, a pre-epistemological, pre-linguistic encountering of the Other, and on Carol Gilligan’s ethics of care, Scheper-Hughes calls instead for anthropology as “witnessing…in the active voice,” positioning the anthropologist “inside human events as a responsive, reflexive, and morally committed being, one who will ‘take sides’ and make judgments.” (419) Scheper-Hughes claims that anthropology’s “theoretical abstractions and rhetorical figures of speech” are an example of humans’ “uncanny ability to hold terror and misery at arm’s length.” (417) Scheper-Hughes imagines the next generation of “barefoot anthropologists” who position themselves as “negative workers,” that is, who work persistently against the grain of hegemony, however that is to be defined. (420) In contrast, Rylko-Bauer et al (2008) adopt a much less polemical tone, tracing a history of what they define as “applied anthropology.” Pointing to historical examples like Sol Tax’s “action anthropology” and Cornell’s Vicos, Peru project, they insist on the possibility of pursuing “the ‘mutually instrumental’ goals of advancing knowledge and of being politically and ethically effective.” (185)

Of note, Rylko-Bauer et al, as does Scheper-Hughes in a later reflection on the aforementioned essay, indicate the work of Paul Farmer as exemplary of the agenda they hope to advance. Interestingly, Rylko-Bauer et al, in their “history of the present” in contemporary anthropology, arrive at Farmer’s work as the culmination of an “applied” current that diverged from a more theoretically driven current in the early 1940s-50s. (181-182) This genealogy ignores Farmer’s claim that his dissertation and resultant ethnography, AIDS and Accusation (1993), was in fact an attempt to respond to George Marcus and Michael Fischer (1986), who called for increased attention to history and political economy within interpretive or symbolic analyses. While improving on Scheper-Hughes’ haphazard and inconsistent gestures to more rigorous reflection (e.g., referring to anthropology’s subjects as, “hungry populations of the Third World that generously provide us with our livelihoods”), Rylko-Bauer’s history and subsequent proposal, thus, contain unsubtle blindspots, including a trivialization of the “handmaiden era,” which Feuchtwang (1973) identifed as the “colonial formation of British social anthropology”; not to mention the erasure of the origins and trajectory of the Manchester School, whose members were quite attentive to global political-economic processes; and of the simultaneously occurring work of Boas and Dubois—much of which was unequivocally “applied,” insomuch as its explicit objective was to disturb and change unjust discourses, practices and policies, but also in that both Boas (Boas 1974, 1940; Stocking 1968) and Dubois (Baker, 1998: 108-126) flexibly modified the methods, theories and sites of their investigations and interventions according to the contingencies of the historical moment. Both Scheper-Hughes and the exponents of “applied anthropology” considered here, on the other hand, have a pre-determined vision of the proper priorities and imperatives of anthropology, which causes them each to elaborate a simulacrum of process and indeterminacy (through personal experience of fieldwork, and disciplinary history, respectively) within teleological arguments, essentially closing off the possibility of interrogating the ongoing processes of working out their own positions in worlds that, upon close inspection, continue to be as indeterminate as ever. I find that Sally Falk Moore, Joan Scott and Veena Das, like Weber, more fully acknowledge indeterminacy in the relationship between their scholarly existences in academic worlds and their social existences in political worlds—and the un-givenness of each, independently, as well—and we have much to learn from them as we strive to struggle along and work through these tensions ourselves.

In her memoir, “Part of the Story,” Moore describes the contingency of her decision to go into anthropology in the first place. Indeed, trained first as a lawyer, it was an ethical response to her involvement in the Nuremberg trial that resulted in her decision to study anthropology at all. Furthermore, she refers to heated debates between visiting African students while she was at USC, and the heterogeneity of post-colonial African societies that it signified, as the inciting experience that led to her notion of the “semi-autonomous social field,” which she mobilized with supporting ethnographic evidence (1973, 1992) in a powerful critique of the ignorance in post-colonial African states’ statutory law of the fields of “customary law” that governed many communities.

In “Certainties Undone” (1999), Moore makes quite explicit her approval of ethnographic work that does “depart from an earlier, narrower anthropology” to mount indictments of the global political economy. Interestingly, in our class discussion with her, Moore’s criticism of Bornemann’s book took on a much more strident tone than the aforementioned published review. She railed against the weak linkages in Bornemann’s argumentation, paying particular attention to the absence of “evidence” for his broadest claims. Coombe, on the other hand, had compiled essays from contributors who were more explicit in acknowledging the limits of their “competence” as anthropologists, foregoing grand and potentially unsubstantiated claims, in favor of gesturing towards the larger processes in which the ethnographically described cases were embedded.
Her exhortation to our class to think about “the concrete,” resonates with her trenchant attack of the Comaroffs’ sweepingly lyrical piece on post-colonial violence in South Africa (1999). While I suspect much of this difference of opinion derives from their distinct modes of writing, and while her rejoinder reflects a shared attitude of concern with the Comaroffs regarding the people and societies they describe, we must recall that Moore used her training as both a lawyer and anthropologist during significant periods of her career to correcting the work of aid and development entities. It would behoove us to note her substantial experience in effecting change through observation and critique. Regardless of how we feel personally about her Manchester school-inspired prose and about the potentially ethnocentric, universalizing notion of “the concrete,” her exhortations serve as a warning to anthropologists who wish their knowledge-production to enable and assist the poor and otherwise marginalized: we must consider the criteria that define evidence and the modes of argumentation that are acceptable to powerful entities and individuals whose action(s)—or inaction(s)—can have dire consequences in the lives of our interlocutors in the field.

Like Moore, Joan Scott acknowledges the contingency of her engagement with history. In “Finding Critical History,” Scott does not describe her academic work as a natural evolution out of her committment to political engagement and activism: “Becoming a historian was not a consolation for politics, but a companion to it. Though not an inevitable one” (3). Nonetheless, as she explains viz. her engagement with social history as a young historian, her knowledge-production was intimately intertwined with her political engagements: simultaneous with her participation in the vibrant campus activist movements of the time, she and her peers “were rewriting some of the meanings of politics in these studies, with an eye to legitimating the movements of social protest that were taking shape around us.” (11)

At the same time, with her deconstructivist turn in her academic work, a similar turn seems to have occurred in her understanding of herself as historian, academic and social actor. In fact, here she might object that the notion of, “herself,” and the multiple aspects of “herself” that I identify, are mere discursive constructs: “I was not the origin of the gender concept, even among historians, but my paper was a site where several lines of thought converged. ‘Joan Scott’ is not, from this perspective, a person, but a place holder, a representative for a collective endeavor of which I (Joan Scott) was only a part.” (2) Nonetheless, despite the sincerity and modesty of her words, her distinction between the discursive “Joan Scott” who wrote “Gender: a useful category of historical analysis,” and the I (Joan Scott) reflecting on a career, does not somehow evacuate Joan Scott—without quotation marks—of a sense of political and intellectual agency. She may have been only “a part” of a collective endeavor, but she was a part of it, nonetheless, and an active part, at that.

Moreover, as reflected in the very effort to trace her intellectual trajectory, deconstructionism does not result in a refusal to describe her existence as that of a coherent, continuous subject through time. She does, of course, apply her Foucauldian scalpel to the notions of race (2007) and experience, but, while Scheper-Hughes, Rylko-Bauer (2008) and others might want to push Scott over the edge of “the postmodern chasm,” they (and we) would be remiss in not recognizing the imaginative thought—and thoughtful strategy—that her approach enables. In the conclusion to Scott’s interrogation of “experience” (1991), we could easily substitute “anthropology” for “history,” and “anthropologist” for “historian,” when she writes: “Experience is, in this approach, not the origin of our explanation, but that which we want to explain. This kind of approach does not undercut politics by denying the existence of subjects; it instead interrogates the processes of their creation and, in so doing, refigures history and the role of the historian and opens new ways for thinking about change.” (797) Indeed, it was the turn from social history to deconstructionism that opened up the space for productive experimentation with ideas—a theoretical opportunism of sorts—that has permitted Scott’s versatile movement between political-economic, post-structural and, most recently, psychoanalytic frameworks according to the exigencies of her work at the given moment.

Again, “militant,” “applied” and even “processualist” anthropologists might counter that academia’s theorizing into existence of “new ways for thinking about change” does not necessarily translate into solidary intervention that makes concrete changes in situations marked by material poverty and physical violence. In responding to the criticism that academics engage in purposeful purposelessness, Scott replies: “Critique is not criticism, nor the proposal of alternatives. … The point of critique is to make visible those blind spots in order to open a system to change. Not to replace what is with a fully formulated, ideal plan, but to open the possibility for thinking, and so acting, differently.” Scheper-Hughes’ problem with “post-modernism,” which Scott finds so productive, is uncertainty. Scott is not threatened by uncertainty; rather, she accepts it and chooses to see contingency and indeterminacy as the conditions of change. Indeed, this is precisely what Parité and The Politics of the Veil are about—the productive use of destabilization of categories to attempt to make change.

Nonetheless, the vehemence of Scheper-Hughes’ attack on “post-modernism” and Scott’s defensiveness—evidenced in the last quotation by her reliance on a somewhat Kantian subject who can change actions according to changing thought—make me suspect that something more personal is at stake. Scheper-Hughes, horrified by the deconstruction of race and ethnicity in South African university classrooms while those same categories mark who dies and who lives in the bantustans, relegates academic discourse, at least in South Africa, to an almost violent irrelevance (417); Scott, on the other hand, sees teaching (in a classroom, no doubt) as a form of activism: “the transmission of knowledge for a purpose beyond itself, a purpose animated by caring relationships and politics (shaping the way kids thought about the world in order to make it a better place) (2). Indeed, just as Scott was able to do at various points in her career, teaching students, shaping their thinking and helping them to form charismatic communities of resistance is social action, and, at universities where today’s undergraduates will be tomorrow’s deciders, a particularly effective one at that.

We can extend Scott’s line of thinking by taking a cue from her own theoretical orientations: to what do “application,” “activism” and “theory” refer, anyway? “Application” describes even the most self-contemplating “anthropology”—the anthropologist observes and writes, or otherwise produces, maintains and applies knowledge, if not in order to fulfill some very deep and individual yearning, then to pay the bills and get funding for the next adventure. Scott has already shown us, above, that “activism” is discursively deployed and can be discursively reinterpreted. What is left of “theory,” then, if anything? Can “theory,” “explanation,” and “knowledge,” do things?

Here, I find useful the idea of “nextness” that Das (2007; 78) extrapolates from Cavell in describing another dichotomy, the relation between norm-setting legislation and transgression. Noting that Foucault reverses but nonetheless maintains that basic dichotomy in Discipline and Punish, Das proposes in its stead a “nextness”:
Thus, instead of imprisoning metaphors to capture the relations between outward criteria and inner states, one may think of these as lining each other, of having a relation in which they are next to each other but joined in the way in which legislation and transgression are joined. (78)

Cast in terms of “nextness,” the relationship between theory and application or activism takes on new meaning. Indeed, this nextness is similar to the notion Das describes of “abstract questions,” or theory, as a shadow: “concrete relations that we establish in living with others are like shadows of the more abstract questions—that is, we learn about the nature of the world in the process of such living.” (4) What if relation of theory, explanation, the act of writing, to application and activism is not a simple dichotomy? What if, in the case of anthropology, the practices of reading and writing, and the application of knowledge towards social action, are thought of rather as lining each other, next to each other but joined? In a sense, Das is suggesting that when the limits of either action or writing are transgressed, we must resort to the other.

When Das describes “witnessing” as exemplified by her interlocutors’ folding in of poisonous knowledge in the descent in the everyday, made manifest in reinhabiting the world through a gesture of mourning (78), she is also describing her own anthropological practices of “witnessing.” Indeed, Das parallels the gesture of mourning with Wittgenstein’s gesture of waiting when his spade, as indicative of a pen, is turned: “For me the love of anthropology has turned out to be an affair in which when I reach bedrock I do not break thorugh the resistance of the other, but in this gesture of waiting I allow the knowledge of the other to mark me.” (17) Writing, and theory, are the anthropologist’s descent into the everyday, the way that Das folds in the poisonous knowledge of others’ pain and suffering into her everyday lifeworld.

The metaphor of the eye, also, is a useful corrective to Scheper-Hughes’ simplistic reduction of the anthropologist to the observing I/eye. If, as interpreters of Wittgenstein posit, “the relation of the subject to the world is like that of the eye to the visual field—the eye is not itself in the visual field that it defines,” Das writes: “…the experience of being a subject is the experience of a limit. … It is Wittgenstein’s thought that the subject is the condition of experience.” (4) Simply because the observing I/eye does not behave according to Scheper-Hughes’ particular brand of anthropological militancy, the anthropologist is not reduced to a disembodied, impassionate camera. Das asks us if there might be an alternative, that is: “to not simply articulate loss through a dramatic gesture of defiance but to inhabit the world, or inhabit it again, in a gesture of mourning? It is in this context that one may identify the eye not as the organ that sees but the organ that weeps.” (62) The observing I/eye is the same I/eye that weeps. Incidentally, the I/eye is also the one that reads—just as the myth of the dispassionate observer is over-turned, the possibility that reading theory and ethnography can expand empathic vision means that the production of written texts is hardly without positive social impact.

Thus, in distinguishing her mode of anthropology from Scheper-Hughes’, Das poses an alternative “public role for anthropology” that integrates theory and practice. She writes: “To hold these [disparate] types of words together and to sense the connection of these lives has been my anthopological kind of devotion to the world.” (221) This anthropological devotion is intertwined with her social action and activism—indeed, her way of doing anthropology responds to the exigencies of her activism in a way that “militant anthropology” denies.

Anthropological practice is reading and writing, but also being-in-the-world and engaging in social action. In concluding this essay by thinking with Das, I hope to have shown that this dichotomy is a false one. Alongside what I have learnt from the works considered here and others about the relationship between theory, activism and application, I have, as Das puts it, found myself holding their words together with the wisdom—however mere, as all eleven might protest, or not—that I have been privy to in accompanying the members of “my” cohort through this year. And it is from these experiences of reading, writing, and being together that I have learned that anthropology, for many of us, is little more than an anti-heroic attempt to exist, think and act more meaningfully, more socially, and more fully, whatever form this takes in each individuated life-work.

Citations:

Baker, Lee. From Savage to Negro.
Boas, Franz. Race, Language and Culture.
Boas, Franz. "On alternating sounds."

Comaroff, J and J Comaroff.  "Occult economies and the violence of abstraction."  

Das, Veena. Life and Words.
Farmer, Paul. AIDS and Accusation.

Marcus, George and Michael Fischer.  Anthropology as Cultural Critique.

Moore, Sally Falk. As noted in text.
Rylko-Bauer, et al. "Reclaiming applied anthropology."

Scheper-Hughes, Nancy. As noted in text.
Scott, Joan Wallach. The Politics of the Veil. Parité. And otherwise as noted in text.

Stocking, George. "Franz Boas and the culture concept in historical perspective."  In: Race, Culture and Evolution.

Weber, Max. From Max Weber. 

"financial crisis"

the current "financial crisis" can only be understood as such from a particular positionality.

from other positions, financial crises happen every few coffee seasons, every few births.

the current situation, then, represents but an acute exacerbation of a financial system based on everyday crises.

naysay

too many people, too often respond to a sense of urgency with words of false comfort and feigned wisdom.

even if i am young, that's not the only reason to feel impatient about unnecessary suffering.

even if i am idealistic, that's not the only reason to aim for the highest standards of care for the indigent sick.

The Problem

“Solito.” “Alone,” in Spanish diminutive. Speaking from his perspective as a father, health promoter and rural peasant from an indigenous hamlet in Guatemala, a friend describes a pathetic, oppressive feeling of abandonment.

He’s just recounted the entirely preventable death of a neighbor’s malnourished child during a rotavirus outbreak. Child malnutrition is rampant among impoverished Guatemalan indigenes. The national prevalence of chronic malnutrition is the highest in the hemisphere. In the poorest communities where I work, chronic malnutrition under 5-years-old exceeds 60%; infant mortality estimates reach 120 per 1,000 births, about 4 times the already appalling national rate.

The terrible irony is that my colleague’s community of 300-500 households serves as the target of no less than 6 “development” entities that address healthcare, poverty and food security. We foreigners are a common sight here, towering over everyone else. Thus, the persistence of hunger and needless deaths begs the question: how does “development” affect the “target population”?

In part, we hope to help by providing access to Pierre Bourdieu’s, “cultural capital,” which in turn can mobilize economic Capital for “development” and “autonomy.” But can knowledge be turned to power, if childhood malnutrition influences academic attainment and physical labor capacity? Extrapolating on Bourdieu, of what use is cultural capital to people who are sapped of biological capital through illness and death? What do “individual liberties” and “community autonomy” mean here? Does blatantly unnecessary suffering affect “development” discourse and practice?

Regarding the suffering of others also might affect us in a more personal sense. For example, how deeply and durably is the “development” worker (and medical student) affected by the experience of examining a jaundiced, tachypneic newborn and telling the parents—who are friends and collaborators—that their baby is septic and could die?

Thus, two challenges emerge. First, what interventions would make children survive and grow? I believe that profound structural change is required: titles to arable land, potable water systems, food security and a full range of medical interventions commensurate to the severity, prevalence and distribution of disease. To achieve these things, those with more power must be convinced to mobilize it. Here, the second challenge becomes rate-limiting: is it possible to affect the ethical response of “development” workers to such situations?

Here, Sally Falk Moore’s methodological focus on articulating social fields permits a salutary, albeit ambitious, parsimony. The challenges presented above reflect two interpenetrating social fields, inhabited by “us” (“development” workers) and “them” (“the community,” “the poor,” or “the Maya”). Our two challenges fuse into one: faced with the disheartening and enraging stubborness of the material world, how might we muster an equal and opposite stubborness in struggling to embody and implement hopeful imaginaries of humane social realities? Can we operationalize and institutionalize the radical forms of pragmatic solidarity that seem eminently appropriate? By using our understanding of these social fields and their points of articulation, we can release the potential energy in the intersubjective spaces inhabited by development workers and community members, thereby engendering collaborative and transformative social movements.

A challenge for us

A baby died in Quixayá three days ago.

V thought it was rota, as there is an outbreak right now. Diarrhea and vomiting for 2-3 days, so he said they needed to go to the clinic ASAP.

But the mother is a patoja and doesn't have a esposo, she doesn't have any support. She said, thank you for your advice, but I don't have pasaje. So V out of sincerity of his heart gave her pasaje from his own wallet.

The patoja took the baby right away, but it was too late.

Rute' Gerardo - Patricia Cuj Xet'

Ruchaq' Gerardo rub'i Erick, xutaq chwe jun rutzil chi nuwach iwir chaq'a roma kite' ri ka'i. Kite' la yawa', la ixoq xkam pa noviembre kan, roma ri k'atan chi rij, xtzoqpin, xtzoqpin sib'elaj ronojel q'ij, xkikot, xkikot enter ruchakul ronojel aq'a.

Erick xa xura'ij xuya' jun rutzil chi nuwach richin ri Q'ij Kichin ri Taq Achib'ila' (Día de la Amistad). Xutaq jun rufoto chwe. Pan enero xiq'ax akuchi k'o wi ke la Campo Santo pa San Lucas chin xinya' wutzil chire, chin xinya' kan jun k'otzij richin. Wakamin ninna yirutz'u', man wetaman ta aj akuchi wi, pero ke ri ninna.

Y ninb'ij chwe chi nutz'u nuwach, ntze'en oku' najin nub'an chwach qa xel el pa Ruwach Ulew, taq najin yiq'ax rik'in, jantape nkanaj pa jay, nuxlan pa ch'at. Yojtzijon b'a chik pa ruwi' ruk'aslem, y najin ninb'ij chire chi k'o chi nwa b'a chik, y niqatz'u jub'ey chik rik'in Gerardo ri taq raq'om, achike aq'om najin nuqum wakamin, achike aq'om utz chi ruwach, achike aq'om man kan ta utz wakamin, achike man k'atzinel ta, yojtzijon chik.

Ninna chi yirutz'u y retaman chi itzel xinna roma rukamik, roma man xqato' ta chanin b'a chik, retaman chi sib'elaj sib'elaj yib'ison, yirutz'u y retaman. Man wetaman ta achike roma, pero ninna chi nutz'u ri ya pa nuwach, nuk'oxaj chi najin yinoq' wakamin. Ninya' jujun tzij chire, yitzijon b'a pa chab'al, nink'utuj chi nuku' numak, y ninmatyoxij chin xutaq la wuj chwe.

Y ninb'ij chwe chi ntze'en chik, jeb'el ntze'en, junam oku' xtze'en ojer. Ninb'ij chi man nrajo ta chi tan itzel ninna, pero kowin ninb'ij ke ri? Man wetaman ta, pero ninb'ij chi man nrajo ta xa yib'ison roma ri xb'a el pa Ruwach Ulew. Man wetaman ta akuchi k'o wi wakamin, pero ninna rutzil wichin.

Matyox chawe, nana. Ninmey awach sib'elaj. Ninyab'ej chi utz ab'anon, ki' ak'u'x, utz nanna achakul, awanim, mas tranquilo yawar ri taq aq'a wakamin. Utz kib'anon konojel awach'alal, ri Neitan xuchop jujun taq tzij pa chab'al yan, ri ka'i ne'y ixtani jeb'el, jeb'el xintz'u.

Yiq'ax awik'in jub'ey chik chanin. Tachajij awi', nan.

Matyox chawe, matyox, matyox. Ke ri k'a.

Jun nimaläj ixöq, nimaläj iyom.

Tatz'u.