The hospital and the hospital:Infrastructure, human tissue, labour and the scientific production of relational value

How does science make a home for itself in a public hospital? This article explores how scientists working in ‘resource poor’ contexts of global health negotiate relationships with their hosts, in this case the doctors, nurses and patients who already inhabit a provincial-level hospital. Taking its lead from recent works on science, ethics and development, this article seeks to ‘provincialize the laboratory’ by focussing on the scientific tropics as a space of productive encounter and engagement. A view from the hospital reveals the tenuous process of ‘setting up’ a place for science, in a world that does not immediately recognize its value. The article examines the material exchanges of infrastructure, bodily tissues and labour that enable one young scientist to establish a scientific life for himself. The success of those transactions, it argues, ultimately derives from their objectification of scientific vulnerability and their enactment of relationships of mutual recognition. As opposed to asking how scientific knowledge is produced in the tropics, the view from the hospital challenges us to focus on the establishment of relationships between scientists and their hosts as a productive endeavour in its own right. </jats:p

When comparison comes first:Reflections on theory in medical anthropology

This think piece draws on experiences of fieldwork in a Papua New Guinean hospital to reflect on tensions between political engagement and ‘deep’ comparison in medical anthropology theory. The paper argues that, contrary to the assumptions implicit in recent critiques of ‘suffering slot’ anthropology, paying attention to the workings of power does not preclude ontological comparison. Through a comparison of the different kinds of visibility sought by patients and doctors in the public hospital, I argue that the question of power re-surfaces in relation to the mutually entangled infrastructures required to realise those different projects

Introduction:Diagnostics, medical testing, and value in medical anthropology

Introduction to the Special Issue on Diagnostics, Medical testing, and Valu

Patient pathways and diagnostic value in Sierra Leone

What is the value of a diagnostic test? Most obviously for primary healthcare settings, laboratory tests can inform clinical decision making about treatment and patient management. Their predominant value in this context is therefore medical. But what about when that healthcare setting is chronically under-resourced, healthcare workers (including laboratory workers) are underpaid, and government supply chains fail to deliver basic laboratory supplies? In this contribution to the Field Notes section, we describe a Community Health Centre (CHC) in Sierra Leone where such conditions have given rise to a quasi-private laboratory service within the public health facility. Through detailed ethnographic description of patients’ diagnostic pathways through the facility, we examine and assess the impact on patient care when the medical and economic value of diagnostic tests diverge

Food as pharma:marketing nutraceuticals to India’s rural poor

This commentary sketches out the politics of the expansion of affordable, fast-moving nutraceutical products into rural India, with a focus on fortified foods and beverages. It examines the relationships between industry, government and humanitarian organisations that are being forged alongside the development of markets for nutraceuticals; the production of evidence and the harnessing of science to support nutraceutical companies’ claims; the ways in which nutraceuticals are being marketed and distributed in rural areas; and the concepts of health and well-being that are being promulgated through those marketing campaigns. Lastly, it asks what kinds of impact fast-moving nutraceuticals are likely to have on the lives of India’s rural poor. It concludes by questioning how smooth a transition to nutraceutical consumption Big Food marketing strategies can really facilitate and how readily low-income families seeking to feed their families and safeguard health will actually adopt concepts of wellness and internalise micro-nutrient associated risks

Testing and trust: Public perceptions, expectations, and experiences of COVID-19 testing in Scotland

Final Report for 'Building Trust in a Pandemic: Public expectations, perceptions and experiences of Covid-19 testing in Scotland'COVID-19 testing is a cornerstone of long-term pandemic control. Public trust in testing is essential to the success of the government’s testing strategy. This rapid qualitative study investigated public understandings, expectations, and experiences of COVID-19 testing in Lothian, Scotland. The study explored how people understand the purpose and value of tests, their motivations to undergo testing and follow government guidelines, and the ways in which perceptions and experiences of testing affect trust in government and health services. The study aimed to contribute to social understandings of medical testing, and to provide rapid feedback to the government and institutions involved in the administration of COVID-19 testing to help improve the efficacy of testing programmes