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The Making and Unmaking of Health in Precarious Times

Session VII-17, 2022 Annual Meeting

On Saturday, December 3 at 8:30 am

Panel Description
This panel explores the emergence of new ways of talking about health and illness in a number of institutional contexts in the Middle East. Being ill and seeking health in contemporary times take place in socio-economic contexts marked by widespread unemployment, military repression, environmental degradation, economic crisis and the ever-present possibility or actuality of war and displacement which has produced a wide sense of precariousness and fear of the present and future. These disasters take place at the same time as the COVID-19 pandemic which has brought new efforts to keep health in line and to control the spread of the pandemic while at the same time neglecting other health care issues, such as severe chronic diseases like cancer and diabetes, and the health of certain populations like refugees and adolescents. Indeed, the pandemic has brought to the fore widespread interest in preventive medicine and containment measures which has made space for the emergence of new markets, professions, labor issues and practices while at the same time erasing other concerns. Building on a literature that writes about crisis and decline as chronic and endemic rather than episodic or aberrant, the panel explores disasters as the context, thereby opening new possibilities for social analyses of health and disease. These precarious contexts have reshaped the social and cultural conceptions of health and illness, as well as the health and social care practices and policies in the region. Based on case studies from Turkey, Palestine, Jordan and Egypt, this panel proposes to investigate health at the level of policies, infrastructures and everyday life. The panelists use different kinds of methods for social analysis, including interviews, surveys, participant-observation and ethnographic fieldwork. Thus, the purpose of the panel is to investigate the ways the precarious contexts have unraveled notions of health at the level of policies, infrastructure and relationships and have produced new forms of care and new experiences of illness and wellbeing.
Disciplines
Anthropology
Medicine/Health
Participants
Presentations
  • While the covid-19 pandemic has centered attention on uncertainty, which is currently being experienced in more profound ways on a global scale, uncertainty has been a common feature of life in the oPt. Uncertainty in the oPt impacts various life dimensions and is marked by chronicity, and is shaped by ongoing settler-colonialism. However, in the social science and health literatures, uncertainty is oftentimes conceptualized as a more acute or temporary phenomenon, whether experienced during the course of illness or acute shocks. Uncertainty is less often conceptualized as structural or intrinsically chronic, but rather as a passing event or temporary experience. This shortcoming in the conceptualization of uncertainty itself calls into question the relevance of salient concepts to contexts where uncertainty is chronic and widespread, including the Palestinian context. Our research, beginning in September 2019, set out to explore people’s conceptualizations and lived experiences of uncertainty in the oPt. Building on over a year-and-a-half of research, which included over seventy in-depth interviews, we explore conceptions and Palestinians’ experiences of uncertainty throughout the West Bank before and during the covid-19 pandemic. We seek to understand how new uncertainties produced by the pandemic are experienced and understood within a context of chronic uncertainty. Do people understand this experience as being distinctive? How do past experiences with chronic uncertainties inform modalities of dealing with uncertainties in the present pandemic moment? We find that experiences of uncertainty are multilayered, stemming from the political context and permeating through various dimensions of life, including economic uncertainty, safety and security, and aspects of social life. We find that class, place, gender, and age (or life phase) shape people’s experiences of uncertainty, especially in more marginalized communities, where uncertainty is simultaneously chronic and acute. The pandemic added new forms of the ‘unknown’ as some interlocutors put it, which also interacted with preexisting uncertainties, especially in the Jordan Valley communities facing the threat of de jure annexation alongside the pandemic. Our interlocutors navigated uncertainty in various ways, at times constricting the physical and social spaces they interact with in order to reduce their exposures to acute uncertainties, often linked to the potential for mobility. They create alternatives and amidst the uncertainty and chaos of the everyday find ways and create new possibilities.
  • Over the past two years, COVID-19 has produced major social, economic, and political changes around the globe. From major restrictions on socialization and travel to unemployment and economic hardships largely generated by lockdowns and curfews, COVID transformed how we relate to each other and the world around us. At the same time, the virus itself and its social meanings have changed over time in marked ways. This paper seeks to understand how ordinary people in Egypt and Jordan have viewed and managed the virus, often in ways that are very similar. In both countries, during the first part of the pandemic, for someone to “yicoren” (an Arabic verb that means to become inflicted with the Corona virus) was greatly stigmatized and negatively viewed to the degree that families had to hide the illness of their loved ones. Even when someone died of COVID, the news was carefully covered up and the family pretended that the person died of some other cause. Most recently, people have become more open about the illness and clearly communicated when a death happened due to COVID. Drawing on ethnographic research in Jordan and Egypt, the “Ethics of Care” approach, new feminist materialism, and Mary Douglas’ concepts of purity and danger, this paper explores the fear, disgust, and shame that initially were attached to COVID and how and why feelings and views changed over time. The narratives of illness and the tragic stories I heard in both countries have generated many questions: What was the impact of lockdowns, curfews, and physical distancing on the daily life of communities where relationality is central to daily life? Why there was such a strong stigma initially attached to the virus, and how did people manage that stigma? Who was burdened with caring (both physically and socially) for the ill? Equally important, who did the caring for the deceased? Who washed, carried, and buried the body? Why did views of the virus change? How did people’s reactions to the virus relate to state policies and global discourses?
  • Since the official declaration of the start of COVID-19 pandemic in Turkey in March 2020, the Syrian refugees’ already precarious situation in Turkey worsened. Discrimination and stigmatization against them as “virus-spreaders” increased considerably. Many of them lost jobs during the economic crisis, which is partly caused by the quarantine measures. Because of the inadequacies in the COVID-19 statistics, how many Syrian refugees, out of a registered 3.5 million, got the virus is still unknown. However, it is known that many of them had the virus, living in crowded, dilapidated houses in the major cities, like Istanbul and Izmir. Moreover, the non-governmental organizations (NGOs), which many Syrians benefit from for their health, educational and legal needs, either scaled down their face-to-face services or functioned totally online for several months when the pandemic peaked. Based on a survey filled by 850 Syrian refugees in Turkey, and netnographic research, which includes the Syrians’ comments and questions on the web page of the survey and other similar web pages, this talk explores how the pandemic and measures against it affected everyday social interactions, health and illness conceptions and health-seeking behaviors of Syrians in Turkey. Since the state provided masks in the early months of the pandemic in accord with the citizenship ID number, and organized vaccinations , many Syrians had trouble reaching these services. The talk will also cover how Syrian refugees formed new informal networks of solidarities online and cooperated with the formal NGOs and Turkish municipalities in order to solve their problems brought by the pandemic and quarantine measures.
  • The COVID-19 pandemic has shed light to the magnitude of environmental degradation and also demonstrated how environmental, animal and human health is inextricably linked, which is at the core of the One Health approach. Ambient air pollution is one of the main determinants of environmental health and is associated with a range of adverse short- and long- term health outcomes ranging from pulmonary diseases to neurological disorders. It is the fourth leading risk factor globally in terms of mortality. Current studies even suggest that damage caused by air pollution is greater than smoking globally. Air pollution also plays a role in the severity of the COVID-19 infection and the transmissibility of the virus. To date, myriad of studies has identified particulate matter (PM) as the main driver of air pollution and indicator of health effects. Recently several studies suggest that a 20% increase in the PM concentration is associated with almost twofold increase in the number of patients with Covid-19. This talk aims at estimating the effects of air pollution on health outcomes and avoidable mortality attributable to long-term exposure to air-pollution in Turkey. Special focus would be on Istanbul, the city of 20 million. The talk also discusses how One Health approach is needed urgently in controlling and preventing future pandemics and proposes that this approach advances understanding social and structural determinants that magnifies the effects of Covid-19 among vulnerable populations. Moreover, the talk urges policy makers to develop a holistic, integrated and dynamic early warning systems based on the One Health framework to control infectious diseases.