Papers by Laura Montesi
Medicine Anthropology Theory
Diverse histories and traditions of critical epidemiology in Latin America provide an important, ... more Diverse histories and traditions of critical epidemiology in Latin America provide an important, although underutilised, alternative framework for engaging with the embodied health inequalities of the Anthropocene. Taking COVID-19 as ‘a paradigmatic example of an Anthropocene disease’ (O’Callaghan-Gordo and Antó 2020) and drawing on ethnographic research in Brazil and Mexico on vaccination campaigns among Indigenous Peoples, we review and analyse the scope and limits of Latin American critical epidemiology in addressing Anthropocene health. While there are intersecting and parallel dynamics between diverse national and regional histories of epidemiology, we argue that the relatively differential focus on political economy, political ecology, and colonialism/coloniality in Latin American critical epidemiology, alongside the attention to non-western disease experiences and understandings, constitute a counterpoint to biomedical and specific ‘Euro-American’ epidemiological approaches. ...
Documento de trabajo, 2021
Books by Laura Montesi
Managing Chronicity in Unequal States, 2021
Chronicity, care packages and a 'good life' 28 Lisa Ballesteros 2. (Un)Deservingness and disregar... more Chronicity, care packages and a 'good life' 28 Lisa Ballesteros 2. (Un)Deservingness and disregard: Chronicity, hospice and possibilities for care on the American periphery 49 Devin Flaherty 3. Publicly privatised: Relative care support and the neoliberal reform in Finland 70 Erika Takahashi 4. The 'hassle' of 'good' care in dementia: Negotiating relatedness in the navigation of bureaucratic systems of support 91 Lilian Kennedy 5. Assemblages of care around albinism: Kin-based networks and (in)dependence in contemporary Tanzania 112 Giorgio Brocco 6. Alcoholism and evangelical healing in Indigenous Mexico: Chronicity and care at the margins of the state 132 Chiara Bresciani ContEnts vi 7. When 'care' leads to 'chronicity': Exploring the changing contours of care of homeless people living on the streets in India Sudarshan R. Kottai and Shubha Ranganathan 8. 'My body is my laboratory': Care experiments among persons who use drugs in Downtown Montreal
By portraying the circumstances of people living with chronic conditions in radically different c... more By portraying the circumstances of people living with chronic conditions in radically different contexts, from Alzheimer’s patients in the UK to homeless people with psychiatric disorders in India, Managing Chronicity in Unequal States offers glimpses of what dealing with medically complex conditions in stratified societies means. While in some places the state regulates and intrudes on the most intimate aspects of chronic living, in others it is utterly and criminally absent. Either way, it is a present/absent actor that deeply conditions people’s opportunities and strategies of care.
This book explores how individuals, groups and communities navigate uncertain and unequal healthcare systems, in which inherent moral judgements on human worth have long-lasting effects on people’s wellbeing. This is key reading for anyone wishing to deconstruct the issues at stake when analysing how care and chronicity are entangled with multiple institutional, economic, and other circumstantial factors. How people access the available informal and formal resources as well as how they react to official diagnoses and decisions are important facets of the management of chronicity.
In the arena of care, people with chronic conditions find themselves negotiating restrictions and handling issues of power and (inter)dependency in relationships of inequality and proximity. This is particularly relevant in current times, when care has given in to the lure of the market, and the possibility of living a long and fulfilling life has been drastically reduced, transformed into a ‘reward’ for the few who have been deemed worthy of it.
Informe de políticas policy brief. Biogobernanzas frente a la pandemia de COVID-19: Necesidades, recursos y estrategias en comunidades indígenas del estado de Oaxaca. Documento de trabajo., 2021
Este informe se preparó en el marco del Programa de apoyo para proyectos de investigación científ... more Este informe se preparó en el marco del Programa de apoyo para proyectos de investigación científica, desarrollo tecnológico e innovación en salud ante la contingencia por COVID-19 financiado por el Consejo Nacional de Ciencia y Tecnología (CONACyT). Su objetivo es brindar evidencia científica a los tomadores de decisiones de los tres niveles de gobierno para que puedan desarrollar políticas que
favorezcan la gobernanza comunitaria en los contextos indígenas del país ante escenarios de riesgo como la pandemia de COVID-19. El informe será de interés para todas aquellas personas que están involucradas en el fortalecimiento de las respuestas de prevención y mitigación del daño en contextos de emergencia sanitaria desde una óptica participativa y comunitaria. El documento propone recomendaciones de política pública en los ámbitos de salud, educación e información que tendrán que ser sucesivamente adaptadas a cada contexto, conscientes de que las comunidades indígenas presentan características y composiciones plurales y específicas.
Articles by Laura Montesi
EntreDiversidades. Revista de Ciencias Sociales y Humanidades, 2022
En México, la diabetes mellitus, junto con otros desórdenes metabólicos, sigue incrementándose a ... more En México, la diabetes mellitus, junto con otros desórdenes metabólicos, sigue incrementándose a pesar del despliegue de diversas estrategias de salud pública. Este artículo cuestiona las bases epistemológicas de estas estrategias y plantea la necesidad de un cambio de paradigma, alcanzable a través del intercambio entre conocimientos científicos y legos. Con base en ocho años de investigación etnográfica en un pueblo indígena de México, se describe cómo interpretaciones ‘otras’ de la diabetes —usualmente subalternizadas o ignoradas— presentan valiosos aportes epistémicos que resuenan con recientes avances científicos de tipo biosocial, que critican la autonomía del individuo y la separación cuerpo-mente y cuerpo-ambiente. Este diálogo, aunque permeado por tensiones, puede tener consecuencias trascendentales para el conocimiento y la acción ante la diabetes mellitus.
Beyond race and ethnicity: How an ethnography of diabetes can contribute to a socially complex approach to hyperglycemia, human suffering, and care
Background: Diabetes mellitus has recently assumed the form of a public health epidemic and novel... more Background: Diabetes mellitus has recently assumed the form of a public health epidemic and novel "epidemic of signification" (Treichler, 1987). Indigenous peoples have been the objects of biomedical discourses that emphasize ethnoracial differences and genetics as etiological factors associated to type 2 diabetes. In response to the racialization of diabetes, anthropologists have reframed "the meaning of diabetes as a socio-political pathology" (Scheper-Hughes, 2006, p.xviii) and the body as the locus where social history inscribes itself. This paper contributes to this anthropological project by putting forward critical phenomenology as a theoretical and methodological orientation. Methods: This is a theory-based paper. Core anthropological literature on diabetes from the 1960s to present was reviewed as well as phenomenological philosophy texts. Results: An ethnographic exploration of the local enactments of care and ways of managing and conceptualizing diabet...
Teaching Anthropology, 2021
What are the physical experiences of fieldwork really like? This article invites anthropologists ... more What are the physical experiences of fieldwork really like? This article invites anthropologists engaged in teaching to transform the way research methods are currently taught to include frank and thoughtful conversations on how bodies, in their mundane physicality, are implicated in fieldwork. While the (mindful) body that actively and purposefully engages with the reality under investigation has gained centrality in anthropological discussions about “being there”, the body that things happen to has been ignored or marginalised. We contend that an exploration of the body that falls ill, feels uncomfortable, or simply does not match with an idealised image of the skilled and productive fieldworker (often male and able-bodied) has practical, pedagogical, political, and analytical merits. By recounting some of our own private anecdotes of challenges encountered in fieldwork, we emphasise the centrality of our physical experiences to our ethnographic approach. Discussing the glamourles...
Medicine Anthropology Theory
Introduction to the special issue 'Embodied Inequalities of the Anthropocene', guest edit... more Introduction to the special issue 'Embodied Inequalities of the Anthropocene', guest edited by Jennie Gamlin, Laura Montesi, Sahra Gibbon, Paola Sesia, Jean Segata, and Ceres Victora.
región y sociedad
Objetivo: examinar, mediante una perspectiva fenomenológica, las percepciones, las valoraciones y... more Objetivo: examinar, mediante una perspectiva fenomenológica, las percepciones, las valoraciones y las experiencias de las personas indígenas del contexto rural en situación de vulnerabilidad estructural durante la pandemia de COVID-19. Metodología: se realizaron entrevistas a siete indígenas residentes en contextos rurales del estado de Oaxaca. Resultados: las personas entrevistadas presentaron condiciones de vulnerabilidad que influyeron en su experiencia de la pandemia, con expresiones de miedo, desconfianza, incredulidad o resignación. Enfatizaron los costos sociales y económicos, pero también manifestaron elementos de protección y resiliencia relacionados con su modo de vida. Limitaciones: el estudio no tiene ambiciones de representatividad; constituye un acercamiento exploratorio que se beneficiaría con una ampliación y profundización. Valor: contribuye a retratar la manera en que en el medio rural indígena se experimentó la pandemia de COVID-19. Conclusiones: las característic...
Health Care Delays and Social Suffering Among Indigenous People with Diabetic Foot Complications in Mexico
Medical anthropology, Jun 12, 2024
InterDisciplina, 2025
En un contexto epidemiológico marcado por las crecientes tasas de desórdenes metabólicos y preocu... more En un contexto epidemiológico marcado por las crecientes tasas de desórdenes metabólicos y preocupaciones en torno a la dieta, se ha generado una “polifonía discursiva” relacionada con las prescripciones alimentarias reproducidas por diversos sujetos. Esta multiplicidad de discursos, muchas veces contradictorios, contribuye a generar resignificaciones en la población sobre las prescripciones propuestas traducidas en prácticas alimentarias de refracción. El concepto “energía”—manejado en el etiquetado de alimentos, en los discursos biomédicos sobre el metabolismo, y en los entendimientos legos de la población en torno a la fuerza y la salud— constituye una pieza clave en esta polifonía discursiva. Con ejemplos etnográficos desde Oaxaca, en el sur de México, analizamos las distintas connotaciones para el concepto “energía” en relación con los alimentos y la salud, tomando como ejemplo el caso del maíz y las restricciones dietéticas en personas con diabetes que se autoidentifican indígenas. Mostramos cómo calorías, energía y fuerza generan discrepancias y asonancias en los diversos sujetos discursivos, y cómo todo ello se acompaña de inquietudes y ambivalencias emocionales.
EntreDiversidades, 2022
En México, la diabetes mellitus, junto con otros desórdenes metabólicos, sigue incrementándose a ... more En México, la diabetes mellitus, junto con otros desórdenes metabólicos, sigue incrementándose a pesar del despliegue de diversas estrategias de salud pública. Este artículo cuestiona las bases epistemológicas de estas estrategias y plantea la necesidad de un cambio de paradigma, alcanzable a través del intercambio entre conocimientos científicos y legos. Con base
en ocho años de investigación etnográfica en un pueblo indígena de México, se describe cómo interpretaciones ‘otras’ de la diabetes —usualmente subalternizadas o ignoradas— presentan valiosos aportes epistémicos que resuenan con recientes avances científicos de tipo biosocial, que critican la autonomía del individuo y la separación cuerpo-mente y cuerpo-ambiente. Este diálogo, aunque permeado por tensiones, puede tener consecuencias trascendentales para el conocimiento y la acción ante la diabetes mellitus.
Teaching Anthropology, 2021
What are the physical experiences of fieldwork really like? This article invites anthropologists ... more What are the physical experiences of fieldwork really like? This article invites anthropologists engaged in teaching to transform the way research methods are currently taught to include frank and thoughtful conversations on how bodies, in their mundane physicality, are implicated in fieldwork. While the (mindful) body that actively and purposefully engages with the reality under investigation has gained centrality in anthropological discussions about "being there", the body that things happen to has been ignored or marginalised. We contend that an exploration of the body that falls ill, feels uncomfortable, or simply does not match with an idealised image of the skilled and productive fieldworker (often male and able-bodied) has practical, pedagogical, political, and analytical merits. By recounting some of our own private anecdotes of challenges encountered in fieldwork, we emphasise the centrality of our physical experiences to our ethnographic approach. Discussing the glamourless, bodily aspects of fieldwork is crucial to preparing ourselves and our students for fieldwork, to combating ableism in anthropology, and to downplaying anxiety over narrow standard goals of "good" fieldwork. We also argue that theoretical considerations of the messy and unpleasant physical experiences that fieldwork involves can bring further insight into how research is (un)done.
Anthropology & Medicine, 2020
Based on seven months of ethnographic fieldwork in two urban health centres in Oaxaca City, Mexic... more Based on seven months of ethnographic fieldwork in two urban health centres in Oaxaca City, Mexico, this paper analyses the ways in which underprivileged middle-aged and older female patients experience and transform grupos de ayuda mutua (GAMs), or mutual-aid groups, a public health programme aimed at improving chronic patients’ adherence to their biomedical treatments. GAMs work as ‘technologies of the self’ within the context of the Mexican neoliberal regime and patients are urged to be self-responsible. GAM members regard such urging favourably and act according to their broader understandings of life, which they see as a lucha (struggle) that requires cuidarse (a polysemic verb alluding to self-care for self-preservation) and hard work in a structurally unequal place characterised by precarity and social unrest. This seemingly rugged individualism is converted into microlevel collaboration through culturally distinctive Oaxacan practices of mutual help. By exploring the playful ways these women participate in GAMs, this paper shows how biomedical settings can be repurposed as spaces of socialisation and wellbeing for older women living in vulnerable
conditions.
Revista Pueblos y fronteras digital, 2017
Este artículo presenta los resultados de una investigación etnográfica de corte fenomenológico (2... more Este artículo presenta los resultados de una investigación etnográfica de corte fenomenológico (2013/2014), que exploró las representaciones socioculturales de la diabetes y las experiencias de vida de los afligidos en una comunidad ikojts en Oaxaca. El estudio sugiere que para muchos miembros de ese grupo la diabetes es una expresión de la vulnerabilidad, síntoma y metáfora de cambios sufridos por ellos recientemente. Se describe cómo la diabetes permite a los afligidos articular la experiencia de la vulnerabilidad en múltiples niveles y se invita a incluir la etnicidad en el entendimiento de las epidemiologías desiguales del país, evitando nuevas formas de esencialización racial y cultural.
“Como Si Nada”: Enduring Violence and Diabetes among Rural Women in Southern Mexico
Medical Anthropology
Rural women in Southern Mexico link their diabetes to distressful life experiences rooted in ordi... more Rural women in Southern Mexico link their diabetes to distressful life experiences rooted in ordinary violence. While much has been written on the use that diabetes sufferers make of their morbid condition as an idiom of distress, I investigate the personal and social effects that such an idiom has on women. As I illustrate, diabetes reflects an ambivalence that helps women to speak about the unspeakable and, at the same time, reinforces their ideas of culpability, namely that they are to blame for both the gendered violence that they endure and the diabetes from which they suffer.
Diabetes, alcohol abuse, and inequality in southern Mexico: A synergistic interaction
Medicine Anthropology Theory | An open-access journal in the anthropology of health, illness, and medicine, Apr 27, 2018
Concern about how their diet has changed is central to how the Ikojts, a Mexican indigenous peopl... more Concern about how their diet has changed is central to how the Ikojts, a Mexican indigenous people, explain their deteriorating health conditions and the rise of diabetes in particular. However, medical advice on “healthy” eating is largely disregarded and, sometimes, even defiantly challenged. Through an examination of food memories and of the food (dis)encounters that the diabetic diet provokes, I cast light on this seemingly ironic contradiction. Based on one year of fieldwork, this
article argues that a healthy diet is a shared discursive social practice that enables the articulation of (sometimes radically) different understandings of food and health. The analysis of people’s ambivalent attitudes to healthy eating in times of diabetes reveals that, for the Ikojts,
diabetes includes but also transcends healthy eating as a form of individual responsibility. Indeed, diabetes is symptomatic of larger societal issues originating from a rapidly changing context.
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Papers by Laura Montesi
Books by Laura Montesi
This book explores how individuals, groups and communities navigate uncertain and unequal healthcare systems, in which inherent moral judgements on human worth have long-lasting effects on people’s wellbeing. This is key reading for anyone wishing to deconstruct the issues at stake when analysing how care and chronicity are entangled with multiple institutional, economic, and other circumstantial factors. How people access the available informal and formal resources as well as how they react to official diagnoses and decisions are important facets of the management of chronicity.
In the arena of care, people with chronic conditions find themselves negotiating restrictions and handling issues of power and (inter)dependency in relationships of inequality and proximity. This is particularly relevant in current times, when care has given in to the lure of the market, and the possibility of living a long and fulfilling life has been drastically reduced, transformed into a ‘reward’ for the few who have been deemed worthy of it.
favorezcan la gobernanza comunitaria en los contextos indígenas del país ante escenarios de riesgo como la pandemia de COVID-19. El informe será de interés para todas aquellas personas que están involucradas en el fortalecimiento de las respuestas de prevención y mitigación del daño en contextos de emergencia sanitaria desde una óptica participativa y comunitaria. El documento propone recomendaciones de política pública en los ámbitos de salud, educación e información que tendrán que ser sucesivamente adaptadas a cada contexto, conscientes de que las comunidades indígenas presentan características y composiciones plurales y específicas.
Articles by Laura Montesi
en ocho años de investigación etnográfica en un pueblo indígena de México, se describe cómo interpretaciones ‘otras’ de la diabetes —usualmente subalternizadas o ignoradas— presentan valiosos aportes epistémicos que resuenan con recientes avances científicos de tipo biosocial, que critican la autonomía del individuo y la separación cuerpo-mente y cuerpo-ambiente. Este diálogo, aunque permeado por tensiones, puede tener consecuencias trascendentales para el conocimiento y la acción ante la diabetes mellitus.
conditions.
article argues that a healthy diet is a shared discursive social practice that enables the articulation of (sometimes radically) different understandings of food and health. The analysis of people’s ambivalent attitudes to healthy eating in times of diabetes reveals that, for the Ikojts,
diabetes includes but also transcends healthy eating as a form of individual responsibility. Indeed, diabetes is symptomatic of larger societal issues originating from a rapidly changing context.