In the context of neoliberalism and global austerity measures, health care institutions around the world confront numerous challenges in attempting to meet the needs of local populations. Examples from Africa (including, Ethiopia, Ghana, and Congo), Latin America (Peru, Mexico, Guatemala), Western Europe (France, Greece), and the United States illustrate how hospitals play a significant role in the social production of health and disease in the communities where they are. Many low-resource countries have experienced increasing privatization and dysfunction of public sector institutions such as hospitals, and growing withdrawal of funding for non-profit organizations. Underlying the chapters in The Work of Hospitals is a fundamental question: how do hospitals function lacking the medications, equipment and technologies, and personnel normally assumed to be necessary? This collection of ethnographies demonstrates how hospital administrators, clinicians, and other staff in hospitals around the world confront innumerable risks in their commitment to deliver health care, including civil unrest, widespread poverty, endemic and epidemic disease, and supply chain instability. Ultimately, The Work of Hospitals documents a vast gulf between the idealized mission of the hospital and the implementation of this mission in everyday practice. Hospitals thus become “contested space” between policy and practice.
Introduction
William C. Olsen and Carolyn Sargent
Part I Global Medicines in Local Cultures
1 Global Health Goals and Local Constraints in a Rural Peruvian Clinic
Morgan K. Hoke, Samya R. Stumo, and Thomas L. Leatherman
2 Science and Sanctity: Biomedicine and Christianity at an Ethiopian Hospital
Anita Hannig
3 The Cosmopolitan Hospital
Cheryl Mattingly
4 “Dangerous Disease”: Epilepsy in Asante
William C. Olsen
5 The Salience of the State in Biomedicine: Congo and Uganda Cases Compared
John M. Janzen
Part II Care Giving and Hospital Labor
6 Creating a Therapeutic Community: Lessons from Allada Hospital Benin
Mark Nichter, Ghislain Emmanuel Sopoh, and Roch Christian Johnson
7 Medical “Errands” among Women with Cervical Cancer in Guatemala
Anita Chary and Peter Rohloff
8 Routinized Caring or a “Call” to Nursing: Shifts in Hospital Nursing in Rukwa, Tanzania
Adrienne E. Strong
9 “We Work with What We Have, Not with What We Would Like to Have”: Hospital Care in Mexico
Vania Smith-Oka and Kayla J. Hurd
Part III Hospitals and the Patient
10 The Navigation of Public Hospitals by West African Immigrants with Cancer in Paris, France
Carolyn Sargent
11 Each Child Is Unique: The Responsible U.S. Parent’s Take on Hospital Care Gone Wrong
Elisa J. Sobo
12 Making Ethnographic Sense of Cesarean Rates in Greek Public Hospitals
Eugenia Georges
13 The Nightside of Medicine: Obstetric Suffering and Ethnographic Witnessing in a Pakistani Hospital
Emma Varley
Afterword
Claire Wendland
References
Notes on Contributors
Index
William C. Olsen is a lecturer in African anthropology in the African studies program at Georgetown University and a research librarian in the Georgetown University Library. He is the co-editor (with Walter van Beek) of Evil in Africa, and the co-editor (with Tom Csordas) for Engaging Evil: A Moral Anthropology.
Carolyn Sargent is professor of anthropology at Washington University in St. Louis, MO. She is co-editor (with Caroline Brettell) of Gender in Cross-Cultural Perspective, and co-editor (with Carole Browner) of Reproduction, Globalization, and the State.
