Pain always begs a response, yet biomedical providers everywhere struggle with how to know and respond to pain. Based on collaborative ethnographic work in a Tanzanian hospital, we explore healthcare workers' sociocultural perceptions of pain and pain care practices to show how pain is recognized and distinguished in the busy clinical setting. Influenced by the socially productive nature and potential of fakes, we present the category of feki pain as a way healthcare workers negotiated care within a context of biomedical scarcity and sociocultural values that make it difficult to express and recognize pain of all kinds. The category of feki pain highlights both the difficulty that pain presents to low-resource healthcare systems and the possibility to recognize and respond to the structural nature of women's pain.
In Ecuador's Amazon, Indigenous communities affected by leishmaniasis often modify their diets as part of their health-seeking practices. Drawing on qualitative research with sixty-eight participants from seven Indigenous groups, this study explores how and why patients' diets shift in pursuit of healing from leishmaniasis. Participants understand therapeutic diets holistically, including food recommendations, preparation methods, and social behaviors believed to influence disease progression. Across groups, dietary logics of therapeutic efficacy often reflect analogical reasoning, a form of relational ontology in which the qualities of foods are believed to act upon the body through correspondence rather than causality in the disease's symptoms. Therapeutic dieting operates not only as a health-seeking practice but also politically, as a mechanism of moral and social regulation within the space of (self-)care. This study invites medical practitioners working in Amazonian contexts to engage with non-physiological logics of healing efficacy to enhance culturally responsive care and patient well-being.
This article examines the ethical and cultural logics shaping living donor kidney transplantation in Japan, where donation is restricted to kin and deceased donation remains rare. Drawing on ethnographic fieldwork in a Tokyo-area hospital, it analyzes how Japan's kin-based transplantation regime contrasts with the utilitarian model dominant in the United States, where donor pools are expanded through non-kin and anonymous exchange. I argue that Japan's restriction to family donors reflects an ethic of care rooted in family-based welfare and intergenerational reciprocity. At the same time, the desire to prevent the exploitation of non-kin transfers the burden of giving onto family, in particular aging parents, spouses, and women, stretching traditional kinship obligations. It also privileges "social matching" over biological compatibility.
Antibiotic use surged during COVID-19 despite it being a viral illness, heightening global concerns about antimicrobial resistance (AMR). In Türkiye - where antibiotic consumption and AMR were already high - this paradox exposed longstanding tensions between policy and practice. Türkiye has adopted World Health Organization guidelines promoting the "rational" (akılcı) use of antibiotics, yet everyday healthcare encounters reveal how these reforms are translated, negotiated and reinterpreted. Drawing on fieldwork in Istanbul, this article shows how local expectations of antibiotics as symbols of care and professional competence shape prescription and use. Rather than aligning practice with policy, stewardship reforms are absorbed into existing moral and relational norms, reinforcing rather than transforming existing dynamics of care. Global stewardship attempts, as they filter through local systems, understandings and situated priorities, are vernacularized in ways that diverge from their original intentions - redistributing accountability without addressing the structural conditions that shape antibiotic use.
In settler colonial contexts, health interventions are often sites for contesting authority, belonging, and protection. On Lingít Aaní, colonial responses to infectious disease illustrate how vaccination and public health practices produced racial hierarchies and secured white futurity by exposing Tlingit people to biomedical extraction, risk, and surveillance. I conceptualize this dynamic as inoculating whiteness, a situated analytic for understanding how immunological interventions shielded settler bodies from biological and political threat while exposing Indigenous bodies to experimentation, surveillance, and managed vulnerability. Drawing on ethnographic and archival research on colonial public health based in Sheet'ká, this article examines how inoculating whiteness operated during COVID-19 before tracing its genealogy through smallpox vaccination under Russian colonialism and BCG experimentation and tuberculosis sanatoria under U.S. governance. It argues public health has been instrumental to settler colonial governance and racialization and highlights Tlingit practices of collective care that articulate alternative frameworks for health and sovereignty.
Using gender as an analytic, I parse out how the historical gendered, classed, and racialized roots of the 12 Step Program remain present in its therapeutic model, even in global contexts beyond its original formulation. These foundations continue to shape therapeutic logics and experience within the Program, in positive and negative ways. I outline several key experiential points of friction with the 12 Step Program for women in one residential drug rehabilitation center in the United States-México border zone, demonstrating the gender of this therapeutic model's framework. Clarifying the Program's gender of care helps make sense of why so many women find this therapeutic model inadequate, without discounting the very real support 12 Step Programs have provided to both women and men around the world. Attention to these frictions with structures (in this case a therapeutic model) illuminates the implicit frameworks that organize our world and direct our attention to developing novel frameworks/institutions.
This paper analyzes two disparate experiences of buprenorphine, a medication for opioid addiction, in California. Within the context of the U.S. War on Drugs and after decades of criminalization, buprenorphine represents a shift toward outpatient medical treatment of opioid addiction, but it has been unequally distributed and experienced across geographic settings and populations. Drawing on my interlocutor's description of buprenorphine's "hold," I interrogate how buprenorphine's symbolic and pharmacological power to embrace, restrain, and otherwise "hold" people arises through its social context. "Holding" is a patient-driven epistemology, working metaphorically and neurochemically, illustrating raced, classed, and gendered positionalities that simultaneously express and constrain forms of agency and resistance in ideological struggles over the meanings of care in addiction treatment. Buprenorphine's "hold," or lack thereof, can be read as a neurochemical embodiment of state violence, revealing intensities of carceral forms of "care" and possibilities for transforming addiction treatment meanings.
Using ethnographic vignettes from my doctoral research, this article contextualizes and analyses Britain's Black maternal health crisis- a crisis of reproductive racism- through a Black feminist lens. The inequities Black mothers face has a strong Black (and) feminist history of being analyzed in relation to the politics of anti-Black racism and misogynoir as they are upheld and sanctioned by the State and the maternity services. This article, therefore, positions Black feminist consciousness as the overarching ethical and analytical framework that contemporary researchers must (re)turn to when studying reproductive racism in Britain. In light of this argument, I draw attention to the Black feminist articulations of racism, uneven reproduction, and reproductive necropolitics (introducing the idea of "necropolitical mythopoeia"), arguing that they are robust analytical tools that can kickstart the epistemological (r)evolution that is desperately needed in the British research landscape.
Documented migrant workers from Indonesia recruited for work in Malaysia need to undergo tuberculosis screenings before being issued work permits and visas. Centered on the production, circulation, and interpretation of chest X-ray images, these screenings are shaped in concrete, practical ways by the demands of border control regulations requiring them. By focusing on how these screenings are practiced in Indonesian clinics, I argue that migrant tuberculosis screenings in the Indonesia-Malaysia migration corridor enact a distinct form of tuberculosis, co-determined by its relation to border control-what I call border tuberculosis. The notion of border tuberculosis draws attention to how biomedical practices and standards are adjusted in ways that lend themselves to the selective and productive function of the border. Thus, the article shows that these biomedical screenings are not disinterested instances of data gathering, but constitutive and productive elements of the particular mode of governing borders they are embedded in.
In this article, I examine how institutionalized older adults in Peru articulate suffering through the idiom of la nada-"nothingness"-and how this shapes desires for euthanasia. Moving from close ethnography of bodies in space and time to structural and ethical discourses on euthanasia, I argue that calls for euthanasia arise not only from biomedical suffering or terminal illness, but also from socially produced experiences of relational erosion, confinement, and moral invisibility. Residents' refrain-"no tengo nada"-signals not only material lack but the collapse of reciprocal ties, autonomy, and recognition. Euthanasia thus becomes a moral claim that life cannot be defined by biological survival, absent dignity and belonging. The article challenges narrow bioethical frameworks and shows how end-of-life suffering is constituted through structural abandonment and social death, reframing the wish for euthanasia as a protest against life reduced to mere endurance without dignity.
Dolores St. is an alley in Marikina City, the Philippines, where a small-scale pagawaan (shoemaking workshop) continues to stand among residential buildings and provides informal employment to its neighbors. Here, the shoemakers and other residents have a complex relationship with shoemaking, an industry embedded in their community for over a century. They are sanay (habituated) to toxic industrial glue. This paper offers perspectives into peoples' understanding and experiences of harm and health through participant observation, interviews, and focus group discussions, revealing how being sanay to the pandikit (industrial glue) is embodied and is an active process through how shoemakers sense, know, and act in response to living with chemicals.
Drawing on clinical fieldwork in NHS general practice in East London, I consider the relationship between time, chronic illness, and therapeutic endeavor. Over the course of three treatment narratives, I attempt to show the negative labor that I claim is implied when clinical time is used to watch and wait as somebody is "wearing out" from chronic conditions. This may be the only form of care available to clinicians in situations where medicine is limited in what it can do to intervene. It emerges in response to illnesses that must be allowed to run their course and recurring symptoms that must somehow be tolerated, tarried with, or "waited out." The aim of the paper is to try to engage the grey area between medical intervention and non-intervention, where time in the clinic is offered in the service of helping people to wear out on their own terms.
HIV research often assumes that disclosure during research is both necessary and desirable for participants. This article challenges that assumption by proposing hermeneutic reflexivity as a practice-based mode of enquiry that does not depend on full disclosure of HIV experiences or coherent illness narratives, but rather on co-creation. Drawing on a multimodal ethnographic project with people living with HIV in Chile, we explore how silence, ambiguity and speculation can become central to image-making and sense-making. Hermeneutic reflexivity foregrounds aesthetic sensitivity, mutual questioning and shared authorship in co-creating collaborative mise-en-scène, fostering an ethnographic context in which forms of expression emerge that would not have surfaced through conventional narrative or testimonial methods. Grounded in phenomenological approaches to situated knowledge, this method reduces the risk of re-traumatization while fostering narrative agency, offering an ethical alternative for participatory health research in contexts where full disclosure may be risky for participants.
Using ethnographic vignettes from my doctoral research, this article contextualizes and analyses Britain's Black maternal health crisis- a crisis of reproductive racism- through a Black feminist lens. The inequities Black mothers face has a strong Black (and) feminist history of being analyzed in relation to the politics of anti-Black racism and misogynoir as they are upheld and sanctioned by the State and the maternity services. This article, therefore, positions Black feminist consciousness as the overarching ethical and analytical framework that contemporary researchers must (re)turn to when studying reproductive racism in Britain. In light of this argument, I draw attention to the Black feminist articulations of racism, uneven reproduction, and reproductive necropolitics (introducing the idea of "necropolitical mythopoeia"), arguing that they are robust analytical tools that can kickstart the epistemological (r)evolution that is desperately needed in the British research landscape.
