As part of the annual meetings of the American Anthropological Association that have been reconstituted as 'Raising Our Voices' - a series of virtual events - I joined a roundtable discussion entitled "Anthropological Insights for Rapid Mobilization During COVID-19 and Other Health Emergencies", organized by Kristin Hedges (Grand Valley State University) and Michael Ennis-McMillan.
Held in November 6, 2020 (November 7, 6 AM! in Manila), The panel featured people working in medical anthropology and global health: Claudia Ordonez (Emory University), Jorge Benavides-Rawson (George Washington University), James Pfeiffer (University of Washington, Mark Nichter (University of Arizona), Monica Schoch-Spana (Johns Hopkins), and Robert Hahn (Centers for Disease Control), and touched on topics like systemic racism, health disparities, trust, biocommunicability, medical populism, and health care workers.
Here is the transcript of my prepared remarks for the roundtable discussion, offering my thoughts about what's happening in the Philippines:
Cut off from physical fieldwork, the pandemic has pushed me, like many anthropologists in the Philippines, to embrace methods that allow me to do research at home - or within my own community. Foremost of this of course is monitoring what people are thinking and experiencing during the pandemic; how they negotiate rules like mask wearing and distancing, how social and health inequities impact people’s experiences, and how local concepts of immunity and contagion are influencing the way people imagine the virus.
Speaking of the virus, I’ve also been reflecting on the pandemic from a multi-species perspective not just in terms of microbes but non-human animals and house plants that people are embracing to an astounding extent here. I have also been looking at the ways political leaders from Rodrigo Duterte to Donald Trump respond to the pandemic in various - often noxious - ways.
What we are seeing the Philippines, and what I have also been virtually observing, around the world are the familiar patterns or styles with which political leaders - from the local to national level - respond to the pandemic - in what we term ‘ medical populism’. Foremost of this is the resort to spectacle and simplification, whether it is Brazil’s Bolsonaro denying the magnitude of the pandemic to Donald Trump touting cures like chloroquine - or dramatically taking off his mask after going home to the White House. As the pandemic drags on, we see leaders shifting to vaccine messianism, vaccine nationalism, or the promise of forthcoming vaccines to end the pandemic. This embrace of simple solutions naturally pit leaders against public health experts, so we see tension, even as we also see how science is invoked for political ends.
Another component of medical populism is the forging of divisions between the people and dangerous or infectious others. Especially during the early phase of the pandemic, it was heavily linked to China and leaders were happy to perpetuate this racialization of the virus. Donald. Trump’s antagonism towards the WHO is another example, and all over the world we see leaders turning against critics, media, and other groups, some even using the “fog of COVID-19” to gain more political power. This brings us to the discursive use of pandemics as “states of exception” that justify exceptional measures, allowing for the suspension of human rights.
The anthropological dimension to all of this of course is how people respond to this political responses, and how medical populism resonates with them. There is much we do not understand and one challenge is how we can engage with our communities in ways that transcend physical and social distance. Here in the Philippines we are beginning to see a sense of conspiracy among rural communities who think that the virus is a ploy by hospitals and politicians to make money. There’s also a sense from within poor communities that they are more resistant to the virus given that they’re already exposed to all kinds of bacteria. These are evolving views and I will end for now by emphasizing the evolving nature of the pandemic which requires our constant vigilance and engagement.
On October 28, 2020, I joined Harm Reduction International in the online launch of the 7th edition of the The Global State of Harm Reduction - a biannual report that provides an independent analysis of harm reduction developments in the world.
In the online launch, I shared key updates about harm reduction and drug policy currents in Asia, as the author of the Asia chapter the GSHR 2020. Ganna Dovbakh and Jorgelina di Loro gave similar updates from Eurasia and Latin America, respectively, while Naomi Burke-Shyne, Executive Director of Harm Reduction International, offered an introduction and synthesis. Colleen Daniels, Deputy Director of HRI, moderated.
The report is available online. Aside from regular updates, it features a chapter that reviews the impacts of COVID-19 on harm reduction services worldwide. The 2020 report is also more explicit in highlighting the interconnectedness of harm reduction and illnesses like hepatitis C and tuberculosis. Key themes in the Asia chapter include the continuation of drug wars and punitive drug regimes, the rise of methamphetamine and NPS (hence, the need for harm reduction services for people who use those drugs), as well as the impacts of drug policies on women.
At the 16th World Congress on Public Health 2020 held virtually from October 13-16, 2020, I presented preliminary findings of ongoing research on the 'multiplicity' of hypertension, using patient's experiential knowledge as starting point. The organized session featured the work of the RESPOND study, which is a collaboration between the London School of Hygiene and Tropical Medicine, University of the Philippines Manila, and partner universities in Malaysia.
In this particular sub-study, which builds on already-published work on local conceptions of hypertension, we draw in particular from science and technology studies, particular the scholarship of Annemarie Mol (2002), who goes further and demanding that we acknowledge the multiplicity within one condition. Using atherosclerosis as illustrative example, she presented the illness not as one entity but as many, it is made to cohere through various practices - of measuring, sensing, narrating, and visualizing. How would hypertension look like if we construct it from patient practices - not as a lens through which we view the patient? And which form hypertension would take if we also account for how patient experiences and practices are intertwined with the practices of clinicians or healthcare researchers in the making of hypertension?
The panel chaired by Martin McKee and Dina Balabanova also featured presentations from RESPOND collaborators include Jhaki Mendoza, Benjamin Palafox, Maureen Seguin, and Marysol Balane. You can find out more about our research group in RESPOND's Twitter account.
