Wednesday, December 31, 2014

Veena Das' "Affliction: Health, Disease, Poverty"

Veena Das is Krieger-Eisenhower Professor of Anthropology at Johns Hopkins University.

She applied the “Page 99 Test” to her new book, Affliction: Health, Disease, Poverty, and reported the following:
From page 99:
Swapan was deteriorating. One night his mother discovered that he had begun to defecate in the room. She stood outside in the street and loudly lamented for all to hear: “Let the neighborhood now come and see. Does he belong to a house? Is it my fault?” The powerful combination of symbols of pollution and the woman’s voice as lament, forced open a public space in which her plight had to be received… Ironically, in this case it was not the mother crying out for revenge because the enemy had harmed her child but because the child is the enemy. Once earlier relating her story to me, Swapan’s mother had said to me, “I pray to god-oh god, lift him up to yourself-can anyone imagine such words, wrenched out of a mother, words asking for the death of the same son to whom she had given shelter in the womb, borne him in pain? He has made his mother into a dayan [female monster].”
This page describes the unfolding of a case of mental illness in a young man living in a slum in Delhi (India). The center of gravity in this discussion is not on the clinic and on the exclusion of the mad in asylums, but on the network of relations (human and nonhuman) within which madness is encountered, acquires shape and is lived. The book asks who is the subject of illness? It proposes that illness might be seen not as located in the body of the individual but in the family circumstances, medical markets, state provisioning , and singular lives, as it (the illness) moves between times of normalization and times of critical pathology. Given the incoherences that illness produces in these relations the book goes on to ask, How should we understand the ontology of disease and of cure?

The scene of health care among the urban poor in India is of a proliferation of practitioners from different streams of medicine, of the neglect of patients in public hospitals and clinics and of medical markets within which the poor diagnostic skills, aggressive marketing of pharmaceuticals, and a combination of high rhetoric of policy makers with complete indifference to the actual plight of patients, has led to a crisis in the quality of care that the poor receive. Paying close attention to how practitioners imagine their craft – and the knotting of the complex worlds of patients and healers, the book asks how new norms of living are continuously generated within this scene of illness and care. At once a tender and intimate account of the conditions in which small events of illness might morph into major catastrophes for the poor and a stringent criticism of self-congratulatory discourses of global health, the book seeks to unsettle the ease with which scholars and policy makers pronounce on the characteristics of health care for the poor from a comfortable distance. A closer look based on immersion in these lives, leads us away from either a nostalgic rendering of the poor or a paternalistic viewpoint from above that assumes that the expert knows best. The stance of the poor in face of such everyday crises might be best described as that of “ordinary realism” in which the anthropologist too participates as she navigates these complex worlds.
Learn more about Affliction at the Fordham University Press website.

--Marshal Zeringue