Amulets as Infrastructure

This article explores the use of amulets on children’s bodies, drawing on empirical examples from Mugum in western Nepal and theoretical insights from anthropology of personhood, kinship and infrastructure. Taking four-year old Tashi and his family in Mugum as a starting point, we show how the status of toddlers and small children is “extraordinary”; they are physically fragile, emotionally uncontrolled, and weakly connected, and in need of special protection. In the complex transition to ordinary personhood, amulets serve as one of many “technologies of protection” for children (Garrett 2013, 189). We suggest that amulets act as a stable infrastructure that enables a hope for children to live ordinary lives, and argue that the significance of these means of protection intersects closely with notions of marginality. Note: To have Tibetan script correctly displayed, please download the PDF file and open it in a desktop application.&nbsp

Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: In 2011 Norway granted undocumented women the right to antenatal care and to give birth at a hospital but did not include them in the general practitioner and reimbursement schemes. As a response to limited access to health care, Non-Governmental Organizations (NGO) have been running health clinics for undocumented migrants in Norway’s two largest cities. To further facilitate universal health coverage, there is a need to investigate how pregnant undocumented women use NGO clinics and how this afects their maternal health. We therefore investigated the care received, occurrence of pregnancy-related complications and pregnancy outcomes in women receiving antenatal care at these clinics. Methods: In this historic cohort study we included pregnant women aged 18–49 attending urban NGO clinics from 2009 to 2020 and retrieved their medical records from referral hospitals. We compared women based on region of origin using log-binominal regression to estimate relative risk of adverse pregnancy outcomes. Results: We identifed 582 pregnancies in 500 women during the study period. About half (46.5%) the women sought antenatal care after gestational week 12, and 25.7% after week 22. The women had median 1 (IQR 1–3) antenatal visit at the NGO clinics, which referred 77.7% of the women to public health care. A total of 28.4% of women were referred for induced abortion. In 205 retrieved deliveries in medical records, there was a 45.9% risk for any adverse pregnancy outcome. The risk of stillbirth was 1.0%, preterm birth 10.3%, and emergency caesarean section 19.3%. Conclusion: Pregnant undocumented women who use NGO clinics receive substandard antenatal care and have a high risk of adverse pregnancy outcomes despite low occurrence of comorbidities. To achieve universal health coverage, increased attention should be given to the structural vulnerabilities of undocumented women and to ensure that adequate antenatal care is accessible for them.publishedVersio

Commoners and nobles : the persistence of hereditary social divisions in Lhasa under communist rules

Commoners and Nobles is a study of hereditary social division in Lhasa under Communist rule. The main question I pose in this thesis is: How and why are the social categories of pre-Communist Lhasa persistent and made relevant in the daily life despite five decades of Chinese rule and the comprehensive socio-economic restructuring of Tibetan society? I suggest a focus on family background (rig / kyesa) as an organizing principle of pre-Communist Tibetan societies, and in particular the position of the former lay elite - the noble families. In daily life in contemporary Lhasa, Tibetans from different family backgrounds socialize extensively. However, family background is made relevant in certain contexts. This thesis analyses how family background is made relevant with regard to marriage practices and choice of marriage partner, to local notions of cultural knowledge, and to norms of respect and humbleness. My analysis is two-folded. On the one hand commoners define nobles as local experts on Tibetan culture and ideals of 'good Tibetan persons'. On the other the act of humble behaviour towards nobles is based not only on religious principles, but is also a strategy for presenting oneself as a good person. The first main point concerns how kyesa (and particularly nobles) relates to knowledge of Tibet, and what Tibetans define as 'Tibetan culture' (böba rigshung). I will argue that this knowledge, defined locally as knowledge of Tibetan culture (böba rigshung), is desired yet inaccessible within the official educational system of society. Cultural knowledge - knowledge of Tibetan history and religion, and language traditions (festivals) - is identified with noble families and their ancestors. This, I suggest, may be understood in terms of the nobles' ability to control social memory by documenting the past. By analysing both the ambiguous relation between the former Tibetan nobility and the Chinese government, and local perceptions of the transmission of knowledge, I explore how cultural knowledge remains within the noble families. The second point concerns what motivates commoners to reproduce the social distinctions of kyesa, through respectful behaviour (yarab chözang) towards nobles. I argue that the persistence of hereditary social divisions must be seen not only in relation to the distribution of cultural knowledge, but also in terms of notions of what constitutes a 'good person' and morality in the context of a political conflict. I suggest that respectful behaviour towards nobles is based in religious principles of karma and compassion, but is also a strategy for presenting oneself as a 'good person', that is a person who is 'Tibetan at heart' (sem böba yin), as opposed to 'Red at heart' (sem marpo yin)

In search of trust and efficacy

This article describes how Tibetan medicine, traditionally an ethnomedicine indigenous to Tibetan areas, travels across cultural boundaries in a multiethnic region, presenting empirical findings from Rebgong (Ch. Tongren) in Qinghai province, People’s Republic of China. Focusing on Muslim Hui and Han Chinese citizens, we describe how these patients smoothly engage with Tibetan medicine. This, we argue, is enabled by a strong sense of trust in distinguished Tibetan doctors, or ‘lineage doctors’, and their privately produced Tibetan medicines, and by shared understandings of the patient role. Contemporary medical pluralism in Rebgong invites us to revisit classic themes in medical anthropology as it brings the study of ethnomedicine into the context of a reconfigured instrumentalized public health system and ethnic relations, in which trust is a rare and treasured quality

Bidrar Liverpool Care Pathway til en større åpenhet rundt døden?

NORSK: Hvordan et menneske går ut av livet, er vel så viktig som hvordan det kom inn i livet. Å hjelpe pasienten til en fredfull død har alltid vært dypt forankret i sykepleien. Det snakkes lite i korridorene på Radiumhospitalet om døden blant helsepersonell, og fra helsepersonell til pasient og pårørende. Det er fremdeles et stort fokus på kreftrelatert behandling på Radiumhospitalet, og dessverre mindre fokus på omsorg for døende pasienter. Liverpool Care Pathway (LCP) er et internasjonalt anerkjent verktøy for å kvalitetssikre omsorgen til døende og deres pårørende. Målet er å oppnå hospice standard på terminalpleien i andre deler av helsetjenesten. Vår erfaring fra sykehus indikerer at det er mye som gjenstår i dette feltet, når vi ikke engang åpner opp for samtaler omkring døden

Documenting the undocumented - The use of maternal health care and pregnancy outcomes in undocumented migrant women in Norway.

Research on undocumented (including pregnant) migrants in Norway have mostly been ethnographic (qualitative) studies, or small cross-sectional studies from the voluntary clinics. The situation in other Scandinavian countries is similar, and undocumented migrants’ use of health care services has until recently been a neglected area of research. The aim of the proposed study is to explore longitudinally the utilization of primary health care services at voluntary clinics and emergency clinics by undocumented pregnant women in Oslo and Bergen. In addition, we would like to compare pregnancy outcomes and perinatal health outcomes in undocumented migrants and their children to foreign and Norwegian born residents registered in the Medical Birth Registry