Border Crossing in Biomedicine

This week’s readings did a particularly good job of explaining the complications and revolutions around transnational medical pursuits.  While reading each article, I thought of a recent reading in my theory class by Thomas Barth on ethnic boundaries. Barth emphasizes that ethnic categorizations persist even when individuals move across “boundaries” (or geographically) and/or when one shares an identity with people in more than one ethnic group.  Ethnic boundaries then affect societal structure and organization; thus, they are sustained by inclusion and exclusion & even detachment and engagement practices. I thought about the structuring of ethnic boundaries and how they impact medical tourism or a “biotech pilgrimages”.

            I particularly thought about ethnic boundaries when reading Beth Kangas’ article on therapeutic itineraries in Yemen. She remarked that research studies that only take place in the originating country provide an incomplete and even erroneous view of the decisions and experience that people face while abroad.  Thus she did multi-sited fieldwork to build a robust ethnography that accounted for transnational border crossing or even  “ethnic boundary” crossing (Yemen to US, Yemen to Jordan).  Kangas did a great job explaining the macro and micro issues that affect therapeutic itineraries for Yeminis people. I found that her explanations of the financial and ethical challenges in seek medical care transnationally, echo Nancy Scheper-Hughes’ article on the global trafficking of human organs.

            Nancy Scheper-Hughes’ highlights the traffic of human organs (kidneys, corneas, liver tissues, heart valves, etc) around the world. Her article was valuable to me because it clearly demonstrated that human organ trafficking or sale is not unique to Asian countries but evident in Africa, Europe, and South America. The article took a very ethnocentric view but recognized that bio-ethical arguments against human organ trafficking are not universal but are often influenced by Euro-American notions of agreement and choice.  Nevertheless, the article highlights the fact that organs are just “commodity” to individuals in the trade and that the exchange (Mauss) of organs is influenced by social conditions (political economies, capitalism) and individual (and familial) reasons for living.

            I enjoyed Priscilla Song’s article on biotech pilgrimages. Similar to Song, I found the coined phrase more valuable than just “medical tourism”. Through ethnographic examples the article demonstrated deep sacrosanct & faith driven desire to seek medical advancement and treatment for individuals or their loved ones. Tourism suggest a leisurely or “fun” quest for enjoyment or discovery; whereas, through the narratives presented it was obvious that individuals were negotiating medical efficacy, spending hours of online research/readings on medical advancements and technology, spending their last dime and/or fundraising large sums of money to scour the globe for a cure or just a therapeutic treatment. The understanding of pilgrimage theory accurately shapes the political economies & illness experiences that influence transnational health quests.  I wonder how this research would be influenced by multi-sited work as Kangas suggested. It seems though that the use of social media forums (CareCure Community) is a way of doing “multi-sited” work to engage with patients in their site treatment and in their home country. I will be curious in our later sessions how to ethically and effectively use online chat rooms for ethnographic research in biomedicine.