Books by Janina Kehr
Le développement rapide des sciences de la vie et de la biomédecine, mais aussi les approches plu... more Le développement rapide des sciences de la vie et de la biomédecine, mais aussi les approches plus classiques de la santé publique et l'épidémiologie influent considérablement sur la définition des maladies, les soins, et, au-delà, sur notre vie quotidienne. Plus généralement, les questions liées à la vie et au vivant sont aujourd'hui au coeur des préoccupations individuelles et collectives. Fruit d'une collaboration entre des équipes de recherche française et allemande, cet ouvrage analyse, en s'appuyant sur des enquêtes ethnographiques et sociologiques, la vie non plus seulement en tant que concept scientifique et philosophique, mais aussi comme expérience vécue d'êtres humains situés dans des configurations sociales et politiques.
Journal Issues by Janina Kehr
Transfigurations of Health and the Moral Economy of Medicine
Zeitschrift für Ethnologie, 2018
This special issue explores the deep entanglements between medicine, law, politics, morality and ... more This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experiences and forms of treatment and care in varying locations and contexts of Egypt, Tanzania, Brazil, India, and Italy. By introducing the concept of “transfiguration” we highlight the highly ambiguous, ever-evolving, and increasingly transnational character of these processes in the vastly contested and power-ridden fields of medicine and well-being. Furthermore, we argue that a moral economy approach can figure as a lens to disentangle and disaggregate these different fields’ values and practices analytically and to account for the need to reflect systematically on people’s continuous struggles for a “good life” in the context of profit-driven and often highly exclusionary economies. Against this background, the contributions to this special issue ask through a shared theoretical concern how medicine, illness experience and medical knowledge production coalesce in our shared times of “excessive” economies in relation to subjectivities, materialities and values. In conclusion, we ask which ethical and political demands arise for anthropologists as novel, strongly politicized and morally loaded fields of research open up; and how we can respond to the challenges of doing research in the capital-intensive fields of medicine and health and act accordingly in our investigations and writings.
La récente épidémie de maladie à virus Ebola en Afrique de l'Ouest a constitué un moment paroxyst... more La récente épidémie de maladie à virus Ebola en Afrique de l'Ouest a constitué un moment paroxystique dans la visibilité mondiale de l'effondrement des hôpitaux en Afrique. Abandonnés par les soignants au plus fort de la crise, certains hôpitaux comme le Redemption Hospital de Monrovia ont fermé. Des corps sans vie ont été oubliés devant des portes closes pendant que la prise en charge s'opérait dans les centres de traitement de Médecins Sans Frontières. À Paris, à la suite des attaques terroristes du 13 novembre 2015, les hôpitaux publics ont été célébrés pour leur réponse extraordinaire déployant dans la nuit une véritable "médecine de guerre", une "mobilisation exemplaire" grâce au courage des soignants et l'efficacité du plan blanc. Le caractère exceptionnel de ces événements suscite la sidération et la peur, mais aussi la célébration d'une image victorieuse de la biomédecine hospitalière occidentale — capable de technicité, d'efficacité et de solidarité tandis que cette même médecine hospitalière montre son impuissance et sa dangerosité en Afrique de l'Ouest. Au-delà de ces exemples extrêmes, le fonctionnement quotidien des hôpitaux face à des crises et changements majeurs – économiques aussi bien que sanitaires – fait l'objet de fortes critiques, en Afrique comme en Europe. En Afrique subsaharienne, les hôpitaux publics subissent de longue date un ensemble de contraintes matérielles, financières et morales considérables, résultant en des soins coûteux et de piètre qualité. En Europe, les politiques d'austérité récentes s'ajoutent au « New Public Management » et transforment la pratique médicale dans les espaces cliniques. En somme, comme piliers des systèmes de santé contemporains, les hôpitaux sont contestés pour l'imperfection de leurs capacités de soin et sont soumis à des évaluations permanentes en même temps qu'ils sont héroïsés comme symboles phares du progrès médical et de la prolongation des vies. Ainsi, de Yaoundé à Boston et de Madrid à Delhi, les hôpitaux incarnent des tensions entre excès – de modernité, de médicaments, de technologies diagnostiques, de mesure – et rareté – soulignée par l'austérité, l'audit, et le contrôle. Ces tensions et nouveaux défis appellent à revisiter l'institution hospitalière dans le monde, comme objet anthropologique et comme site emblématique à travers lequel se cristallisent les enjeux liés à l'économie politique et morale de la santé publique contemporaine.
Papers by Janina Kehr
Towards an epistemology of co-infection
Tuberculosis and HIV co-infection came to figure as one of the major global health problems at th... more Tuberculosis and HIV co-infection came to figure as one of the major global health problems at the beginning of the twenty-first century, with multiple attempts to tackle this intricate issue on epidemiological, clinical, and public health levels. In this article, we propose thinking beyond the practical problems caused by co-infections in order to explore medicine’s epistemological attachment to the idea of single diseases, using TB/HIV as an analytical lever. We retrace how TB/HIV co-infection has been problematised in public health discourses since the 1990s, particularly in WHO reports and international public health journals, and show that it has been mainly discussed as a complex biosocial phenomenon in need of more resources. The epistemological interrogation of the concept of co-infection itself – as an entangled object of two or more diseases with different histories and social, political, and scientific identities – is largely missing. To elaborate on this gap, we look at ...
L'hôpital: Vers une nouvelle anthropologie des espaces cliniques
L’hopital est devenu depuis une vingtaine d’annees un terrain privilegie des chercheurs en anthro... more L’hopital est devenu depuis une vingtaine d’annees un terrain privilegie des chercheurs en anthropologie de la sante. Mais qu’est-ce qu’un hopital ? Est-ce seulement une realisation architecturale qui permet l’exercice de la medecine contemporaine ? Espace a la fois permeable et delimite, ordonne et ouvert, imprevisible et opaque, medical et non-medical, l’hopital moderne est sujet a des changements technologiques et economiques rapides. Il contient aussi les traces de la medecine d’autrefois et evoque des souvenirs et des emotions pour celles et ceux qui y ont sejourne, travaille ou soutenu des proches. Ce dossier aborde l’objet « hopital » en reliant le lieu hospitalier aux pratiques – medicales, infirmieres, bureaucratiques et comptables – exercees en son sein. Ensemble, les contributions incitent a etudier l’hopital non seulement comme terrain ethnographique mais aussi comme lieu anthropologique, pour aborder la maniere dont chaque hopital existe dans sa singularite – pour les p...
Against Sick States: Ebola Protests in Austerity Spain
A few months ago, the independent Spanish online newspaper El Diario published a cartoon entitled... more A few months ago, the independent Spanish online newspaper El Diario published a cartoon entitled “Ebola in Madrid”. It showed a health worker, camouflaged in a green protection suit, wearing a white head shield and goggles, leaning over a patient almost completely hidden under the sheets of the hospital bed. The huge hospital room is deserted and empty, …
Rezension zu: Stefan Sperling: Reasons of Conscience: The Bioethics Debate in Germany
American Anthropologist, 2014
Georgians love their lives, too
On the Otherwise in Anthropology and Medicine
Sind wir je postmigrantisch gewesen? Ein Aufruf zur Debatte
‘It’s also the system’
Understanding Tuberculosis and Its Control
BioSocieties
The "more-than-human" has become an indispensable perspective in science and technology studies a... more The "more-than-human" has become an indispensable perspective in science and technology studies and in the social study of the life sciences more widely. In general, the more-than-human indicates that being, doing, living and relating is shaped not only by human but also by non-human worlds, materials and entities-be they animals, technologies, microbes or elements. This perspective takes multiple forms. Some scholars are influenced by studies on Actor Network Theory and, more recently, on "modes of existence" (Latour 2012) in the Anthropocene. Others are influenced by work on ontologies of practice (Mol 2002), in which science and medicine are conceived as coming to existence by means of coordination and relation between humans, technologies and knowledges (Berg and Mol 1998; Mol 2002). Others emphasize new materialist approaches (Haraway 2016), particularly in feminist science studies, which aim to register "life in capitalist ruins" (Tsing 2015) where cross-species relations with critters and plants come to centre stage. Still others locate themselves within scholarship on "matters of care" (Puig de la Bellacasa 2017) and "ecologies of support" (Duclos and Criado 2020) that pushes feminist questions on the reproduction of life into ecological and more-than-human terrains. Finally, some look to ethnographic studies in indigenous spaces in the Amazon and Australia, which aim to provincialize modern Euro-American "life/non-life" distinctions (Povinelli 2016) and nature-culture dichotomies (Descola 2013), not least through the study of human-animal relations.
Zeitschrift für Ethnologie, 2018
This special issue explores the deep entanglements between medicine, law, politics, morality and ... more This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experiences and forms of treatment and care in the varying locations of Egypt, Tanzania, Brazil and India. By introducing the concept of 'transfi guration', we highlight the highly ambiguous, ever-evolving and increasingly transnational character of these processes in the vastly contested and power-ridden fi elds of medicine and wellbeing. We also argue that a moral economy approach can fi gure as a lens to disentangle and disaggregate these diff erent fi elds' values and practices analytically and to account for the need to refl ect systematically on people's struggles for a 'good life' in the context of profi t-driven and often highly exclusionary economies and their impacts on health care systems. Against this background, the contributions to this special issue ask, through a shared theoretical concern, how medicine, illness experience and medical knowledge production coalesce under the condition of 'excessive' economies in relation to subjectivities, materialities and values. In conclusion, we ask which ethical and political demands arise for anthropologists as novel, strongly politicised and morally loaded fi elds of research open up; and how we can respond to the challenges of doing research in the capital-intensive fi elds of medicine and health and act accordingly in our investigations and writings.
Mouvements, 2019
Soigner par temps d’austérité… Partant de son enquête sur les mobilisations et pratiques alternat... more Soigner par temps d’austérité… Partant de son enquête sur les mobilisations et pratiques alternatives qui ont émergé depuis 2012 en Espagne à la suite de la crise économique et de la mise en oeuvre des politiques d’austérité, Janina Kehr discute deux registres de réponse : celui de la Marea Blanca, qui ancre sa défense d’un système de santé publique dans des actions régionales et nationales hautement symboliques, la lutte contre les privatisations et un activisme de professionnel.les ; et celui des Comunidades activas en salud, qui privilégie des expérimentations locales pour permettre aux plus démuni.es de parler de leurs expériences du soin et de se plaindre. Pour elle, les deux formes de contestation sont légitimes et complémentaires. Les plaintes et revendications locales sont nécessaires pour « que cela aille mieux », pour faire émerger d’autres formes de médecine et de prise en charge, un impératif que la nécessité de défendre le service public ne doit pas faire passer au second plan.
Medical Anthropology. Cross-Cultural Studies in Health and Illness, 2018
In France, the treatment of migrant patients is haunted, but not overdetermined, by colonial prac... more In France, the treatment of migrant patients is haunted, but not overdetermined, by colonial practices of cultural essentialism and othering. Taking tuberculosis care in a public hospital as an example, I show how colonial hauntings surface in racialized patient–physician encounters and diagnostic practices. Colonial hauntings exist on two levels of awareness: on the level of the articulated, where physicians critique contemporary and historical politics toward immigrants, and on the level of the unarticulated, where, physicians − as they search to practice a caring medicine − unconsciously reproduce colonial forms of knowing and treating migrant patients as racialized others.
Anthropologie et Santé, 2018
In the past 20 years, the hospital has become a privileged field site for medical anthropologis... more In the past 20 years, the hospital has become a privileged field site for medical anthropologists. But what is a hospital? Is it only an architectural formation that allows for the practice of contemporary biomedicine? A space permeable and clearly delimited, structured and open, unpredictable and opaque, medical and non-medical, the modern hospital constantly undergoes rapid technological and economic change. It harbours the traces of past medicines and produces memories and emotions for those who have resided, worked there or supported close ones undergoing treatment and care. This special issue approaches the research object « hospital » by linking specific hospital places to the professional practices exercised in its realms, be they medical, nursing, bureaucratic or managerial. Taken together, the contributions incite to study hospitals not only as ethnographic field sites, but also as singular anthropological locations, in order to understand how each hospital exists in its particularity – for patients, professionals and families – and how it arranges medicine and care. In the degree that we detach our ethnographic view from the problems specific to hospital medicine, it becomes possible to apprehend the productions and proprieties of hospitals as such.
Understanding Tuberculosis and its Control, Helen Macdonald and Ian Harper (ed.), 2019
This chapter engages ethnographically with the ways TB control is practiced and problematized in ... more This chapter engages ethnographically with the ways TB control is practiced and problematized in France. TB control is part of a larger state apparatus, where republican dilemmas and paradoxes, characteristic of French politics, as well as pragmatic arrangements, characteristic of public health, occur: differing treatments despite an ideal of equality; and the conditioning of preventive actions by an inegalitarian social and political system with conflicting priorities of inclusion and exclusion. With this chapter, I contribute to understanding the social, political and medical stakes and dilemmas of tuberculosis control in a low-burden country, in which tuberculosis exists primarily as an immigrant’s disease.
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Books by Janina Kehr
Journal Issues by Janina Kehr
Papers by Janina Kehr