Anthropology & Medicine最新文献

This paper examines the aspirations, imaginaries and utopias of designers of an AI-based mental health app in India. By looking at automated therapy as both technological fix and sociotechnical object, I ask, What can we learn from engaging with psy technologists' imaginaries and practices of health care futures? What are the assumptions they encode in the app? How does automated therapy reconfigure the geographies and temporalities of care? While automated therapy as instantiated by Wysa provides, I argue, a modest mental health intervention, the scalar aspirations of designers are anything but small. The paper proceeds in three steps. First, it turns to designers' imaginaries of what it means to care for current mental health needs in digitally saturated lifeworlds and how they inscribe them into the app. It identifies nonjudgmental listening, anonymity, acceptance, reframing, and agency as key ideas encoded in Wysa's sociotechnical algorithms, along with a congruence between entrepreneurial and encoded ethics of care. Second, it situates automated therapy within anthropological scholarship on 'little' technical devices in global health to argue that automated therapy devices such as Wysa articulate dreams for minimalist interventions with macro effects. Finally, it explores the new geographies and temporalities of care that automated therapy spurs, tracing the ways the app bridges various spatial and temporal gaps and obstacles of human therapy and upends common global health pathways. This paper contributes to recent scholarship on aspirations, dreams and utopias and on digitization and datafication in global health.

As projects seeking to provide digitized tools in health care and medicine are gaining ground at an accelerating pace, imaginations and incipient formations of digital health have acquired a new political urgency. These projects promise to revolutionize health care and medicine. However, efforts to institutionalize digital technologies in health are often fraught with difficulties that cause them to stall during implementation. We explore digital health technologies with respect to how they are aspired to, designed, used, and resisted. Our central argument is that the spread of digital health technologies has set in motion complex processes around the production, extraction, circulation, and economic valorization of data. These processes reconfigure multiple sets of relationships between people, between human bodies, and machines, and between actors in health care and the diverse institutional landscapes they inhabit. We explore these processes in three interrelated and geographically dispersed fields: (a) imaginaries of health and well-being; (b) new geographies of care; and (c) the datafication and (dis-)embodiment of health. This special issue brings into creative tension case studies from across geographical locations and thematic areas. Taken together, they draw attention to the question of how digital health technologies are situated in making and shaping the future of health care. By foregrounding anthropological perspectives, this Special Issue pushes the epistemological boundaries of the emerging scholarship on digital health technologies and global health. At the same time, it argues for a closer engagement of medical anthropologists and sociologists with processes of digitization in health.

This paper discusses the afterlives of MOS@N, a mobile health (mHealth) intervention which, between 2014 and 2018, monitored maternal and child health in the district of Nouna, in rural Burkina Faso. The paper documents the work of "godmothers," who were hired and equipped with mobile phones to keep track of pregnant women, and accompany them for medical consultations. As is the case with the majority of mHealth projects in Sub-Saharan Africa, MOS@N was a pilot. This paper examines some of the enduring effects of practices of testing and demoing which were designed as temporary. Indeed, three years after MOS@N was shut down, godmothers are still doing care work. This work is now carried mostly on a voluntary basis and implies the constant repair of decaying technology, which undermines some of the original purposes of MOS@N, and (re)produces gendered forms of social obligation. Ultimately, the paper explores the remnants of a settled intervention, and how they may help us challenge imaginations of global health futures.

Based on ethnographic research in northern Ghana, this article explores the complex logistics of blood and the ways in which the availability of blood has been transformed through the introduction of drones. We explore how drone services affect this ecosystem of supply and contribute to reshaping the practices of physicians, nurses, facility pharmacists and stock managers, as well as the expectations and experiences of patients and their families. Situated at the interface of medical anthropology, critical studies of infrastructure and anthropological studies of digital innovations in healthcare, our paper attends to the emerging anthropological research on medical logistics as a means of connecting people with medical resources. It demonstrates the fundamentally ambivalent nature of technological innovation: on the one hand, drones have fueled health workers' hopes and transformed access to blood. On the other hand, their introduction has also led to connectivity without stock. In line with STS scholarship, we highlight the important role of the physical properties of objects such as blood in shaping their circulation.

The potentials of digital health to improve health outcomes by empowering patients with more control over their health data have transformed into threats of criminalization in the post-Roe era, threats that are creating serious, and at times deadly, harms to patients and the providers that care for them. While patients' health data are increasingly used to criminalize healthcare, data activists, legislators, and lawyers are engaged in radical caretaking strategies to protect health data, patients, and abortion care providers.

By the time the results of an ethnography are published it almost inevitably becomes an audit of What Just Happened. The papers in this special issue reveal three insights that follow from this. An audit of the unenvisaged consequences of digital health interventions, an audit of envisaged consequences and an appreciation of the importance of context as the determinant of those consequences.

Governments across the world differently invoked citizen responsibility for responding to the risk of COVID-19 infection. Approaches which focused on changing social practices served to reinforce distinctions between 'sanitary' and 'unsanitary' citizenship. This paper examines citizens' responses to public health policy messaging, exploring as a case study the reception of UK Government messaging about responsible behaviour during the first two years of the COVID-19 pandemic. We examine the public responses to such messaging from narrative interviews with 43 people who became ill with COVID-19. These interviews were with people who identified as members of the minoritised religious and racialised groups, who were most heavily burdened by the impact of COVID-19. Interviewees challenged assumptions that they were 'irresponsible' for having caught COVID-19, and instead directed attention towards the ways in which pandemic guidance was unworkable. Some actively critiqued government messaging, questioning the problematic racialisation of pandemic messaging and challenging individual responsibilisation for the management of the pandemic. Through this analysis we demonstrate the active role of citizens in enacting, and at times resisting, health policy.