El comercio infame: capitalismo milenarista, valores humanos y justicia global en el tráfico de órganos

This article documents the growth of “transplant tourism” and the global traffic in human bodies, desires, and needs. Organ transplantation today takes place in a transnational space with surgeons, patients, donors, sellers and brokers following new paths of capital and technology. In general, organs flow from South to North, from third to first world, and from poorer to richer bodies, and from black and brown to whites and from females to males. The “scarcity” of organs and tissues combined with the scarcity of patients of sufficient means to pay for these expensive operations, has spawned a lucrative business driven by the market calculus of supply and demand. The spread of new medical technologies and the new needs, scarcities, and commodities –for instance, fresh organs and tissues– that they inspire raises urgent public issues concerning: the reordering of relations between bodies and the state in late modernity; the appearance of “fluid” and divisible bodies that disrupt early modern notions of the indivisible and autonomous body-self; the emergence of new forms of barter and social exchange that breach the conventional dichotomy between gifts and commodities and between kin and strangers; the interplay of magic and science; and the power of rumours and urban legends to challenge the official medical and transplant “narratives” on the meanings of life, death, and sacrifice.Este artículo documenta el crecimiento del “turismo de transplante” y el tráfico global de cuerpos, deseos y necesidades humanas. El transplante de órganos tiene lugar hoy en día en un espacio transnacional en el que circulan cirujanos, pacientes, donantes, vendedores e intermediarios que siguen los nuevos caminos del capital y de la tecnología. En general, los órganos fluyen de sur a norte, del tercer al primer mundo, de los cuerpos más pobres a los más ricos, de negros y cobrizos a blancos, y de mujeres a hombres. La “escasez” de cuerpos y tejidos, en combinación con la escasez de pacientes con medios suficientes para pagar estas costosas intervenciones, han hecho surgir un lucrativo negocio impulsado por el cálculo de oferta y demanda de mercado. La extensión de nuevas tecnologías médicas y las nuevas necesidades, escasez y mercancías –por ejemplo, órganos y tejidos frescos– que inspiran, hacen surgir debates públicos de carácter urgente, relacionados con: la reordenación de las relaciones entre los cuerpos y el Estado en la modernidad tardía; la aparición de cuerpos “fluidos” y divisibles que ponen en cuestión nociones de la primera modernidad acerca de lo indivisible del cuerpo –self–; la aparición de nuevas formas de trueque e intercambio social que rompen la dicotomía convencional entre dones y mercancías y entre parientes y extraños; el juego mutuo entre magia y ciencia; y el poder de los rumores y leyendas urbanas de plantear un reto a las “narrativas” oficiales médicas y de transplantes acerca de los significados de la vida, de la muerte y del sacrificio

Is It Ethical for Patients with Renal Disease to Purchase Kidneys from the World's Poor?

Background to the debate: In many countries, the number of patients waiting for a kidney transplant is increasing. But there is a widespread and serious shortage of kidneys for transplantation, a shortage that can lead to suffering and death. One approach to tackling the shortage is for a patient with renal disease to buy a kidney from a living donor, who is often in a developing country, a sale that could—in theory at least—help to lift the donor out of poverty. Such kidney sales are almost universally illegal. Proponents of kidney sales argue that since the practice is widespread, it would be safer to formally regulate it, and that society should respect people's autonomous control over their bodies. Critics express concern about the potential for exploitation and coercion of the poor, and about the psychological and physical after-effects on the donors of this illegal kidney trade

Violence and affective states in contemporary Latin America

This special issue brings together scholars interested in the analysis of the social, cultural and affective dimensions of violence. The contributions explore the connections between situated experiences of violence and shifting affective states, relations, sensations and contingencies in contemporary Latin America. The articles consider how violence might constitute a nexus for the production of subjectivities and forms of identification, relationality and community, alterity and belonging, in a range of Latin American contexts including Argentina, Brazil, Guatemala, Mexico and in the Mexican diaspora in Spain

Postcolonial Transplants: Cinema, Diaspora and the Body Politic

This essay examines depictions of migrant workers in French and British postcolonial cinema as transplanted interlopers, 'exotic' or transgendered bodies that are perceived as a threat to the integrity of the body politic

Repealing Ireland's Eighth Amendment: abortion rights and democracy today

In 2018, the Irish public voted to repeal the Eighth Amendment to the Irish Constitution, which since 1983 banned abortion in the country. While this was a watershed moment in Irish history, it was not unconnected to wider discussions now taking place around the world concerning gender, reproductive rights, the future of religion, Church–State relationships, democracy and social movements. With this Forum, we want to prompt some anthropological interpretations of Ireland's repeal of the Eighth Amendment as a matter concerning not only reproductive rights, but also questions of life and death, faith and shame, women and men, state power and individual liberty, and more. We also ask what this event might mean (if anything) for other societies dealing with similar issues

"Now he walks and walks, as if he didn't have a home where he could eat": food, healing, and hunger in Quechua narratives of madness

In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers

Fanon's Letter Between Psychiatry and Anticolonial Commitment

The name of Frantz Fanon has become a symbol of anticolonial militancy and the struggles of national emancipation against colonial rule. However, Fanon was also a psychiatrist, who never abandoned clinical practice even after resigning from his post in colonized Algeria in 1956. The coexistence, in Fanon, of medicine and political involvement represents one of the most productive and contradictory aspects of his life and work. Fanon was highly critical of colonial ethnopsychiatry, but never abandoned his commitment to improving the condition of psychiatric patients. After his escape from Algeria, he wrote extensively for El Moudjahid, the journal of the anticolonial resistance, but also practised in the hospital of Charles Nicolle in Tunis. In this essay I propose a new assessment of the relation between psychiatry and politics by addressing Fanon's influence on Franco Basaglia, leader of the anti-institutional movement in Italian psychiatry in the 1960s and 1970s. Basaglia was deeply inspired by the example of Fanon and the contradictions he had to confront. Rereading Fanon through the mirror of Italian anti-institutional psychiatry will define a new understanding of Fanon as committed intellectual. Indeed, this may suggest a new perspective on the function of intellectuals in contexts signed by the aftermath of colonial history, drawing on the example of two psychiatrists who never ceased to inhabit the borderline between the clinical and the critical, medicine and militancy, the necessity of cure and the exigency of freedom

A Tale of Two Cities: The Exploration of the Trieste Public Psychiatry Model in San Francisco

According to the World Health Organization (WHO), the “Trieste model” of public psychiatry is one of the most progressive in the world. It was in Trieste, Italy, in the 1970s that the radical psychiatrist, Franco Basaglia, implemented his vision of anti-institutional, democratic psychiatry. The Trieste model put the suffering person—not his or her disorders—at the center of the health care system. The model, revolutionary in its time, began with the “negation” and “destruction” of the traditional mental asylum (‘manicomio’). A novel community mental health system replaced the mental institution. To achieve this, the Trieste model promoted the social inclusion and full citizenship of users of mental health services. Trieste has been a collaborating center of the WHO for four decades with a goal of disseminating its practices across the world. This paper illustrates a recent attempt to determine whether the Trieste model could be translated to the city of San Francisco, California. This process revealed a number of obstacles to such a translation. Our hope is that a review of Basaglia’s ideas, along with a discussion of the obstacles to their implementation, will facilitate efforts to foster the social integration of persons with mental disorders across the world

Hiding or hospitalising? On dilemmas of pregnancy management in East Cameroon

Current international debates and policies on safe motherhood mainly propose biomedical interventions to reduce the risks during pregnancy and delivery. Yet, the conceptualisations of risk that underlie this framework may not correspond with local perceptions of reproductive dangers; consequently, hospital services may remain underutilised. Inspired by a growing body of anthropological literature exploring local fertility-related fears, and drawing on 15 months of fieldwork, this paper describes ideas about risky reproduction and practices of pregnancy protection in a Cameroonian village. It shows that social and supernatural threats to fertility are deemed more significant than the physical threats of fertility stressed at the (inter)national level. To protect their pregnancies from those social and supernatural influences, however, women take very physical measures. It is in this respect that biomedical interventions, physical in their very nature, do connect to local methods of pregnancy management. Furthermore, some pregnant women purposefully deploy hospital care in an attempt to reduce relational uncertainties. Explicit attention to the intersections of the social and the physical, and of the supernatural and the biomedical, furthers anthropological knowledge on fertility management and offers a starting point for more culturally sensitive safe motherhood interventions