Reflections on “Ethnographies and Health”

Judy Green

Simon Cohn’s introductory remarks cautioned against being enrolled into the common biomedical framing of ethnography in health as providing particular ‘methods’. As participants noted, in fields such as medicine where ‘methods’ become fetishised as procedural ways of providing authority for accounts, and policed through journal demands for ‘methods’ sections, this can be hard to resist, even if reframed as ‘methodology’. So how, he asked, can we preserve the idea of an ethnographic sensibility? Tiago Moreira’s (as always) engrossing keynote address set the tone for the two days in how to do this. Drawing on healthy ageing, he spoke of how to focus on practices of proliferation, on articulating diversity, and on being attuned to the ‘little stories’ that help us reveal the ‘multiverse’ of health. His questions – how is health made, how does practice come to count as healthy, and how we relate to different ‘healths’? – were taken up in wonderful and energising ways by the participants at this two day conference.

First, It was a real privilege to hear such a range of disciplinary, professional and theoretical perspectives being brought to bear in uncovering diverse ‘healths’. From Jana Declercq’s introduction to linguistic ethnography, to Ben Kasstan’s elegant masterclass in how to use historiographic material in ethnography in his analysis of how the ‘social body’ gets reproduced in practices that knit together the state and Orthodox Jewish maternity practices, the participants not only spoke to health practices, but also how we make them visible, and represent them, in ethical and respectful ways. Connections and resonances across papers multiplied across the two days, and these notes are not an attempt to summarise, but rather document some personal reflections.

One initially random connection was the number of ethnographers who were occupational therapists by training. Ursula Read’s paper on everyday care practices from her ethnography of people with psychosis in Ghana gave some hints as to why: the OT’s gaze is also directed at the mundane practices of self-care, using multiple technologies such as checklists and observation, and also suffused with questions about what mattes to people – ethnographers attend to these, but also attempt to ‘scale up’, in thinking through the relations between the social and individual body, and to do some reflexively, in critiquing the categories we import – such as autonomy, or dependence.

This critique of categories is not straightforward, as many presenters noted. Which normative concepts get disrupted, and which ones we ‘stick with’ is inevitably troubling. We cannot problematize everything, and in making a cut– to delineate a field, a case, a sample, or a boundary to the endless potential for following the threads – we inevitably reify some categories whilst fracturing others. Choosing to study people with a particular disease, or from a particular demographic group, inevitably risks reproducing those categories. Periklis Papoloukas, in a fascinating account of how LBGT people with MS navigate and represent the disruptions to their biographies was nice example which raised discussion of how these decisions about what to disrupt and what to leave in their black boxes are made. These cuts are theoretical – we can to some extent decide as we follow the threads what should be queered, and what not – but pragmatic considerations from the requirements of funders, journals, ethics review boards, and other parties also shape these decisions in more or less explicit ways.