The Politics of Governance and Urban Marginality: A Camp Studies Perspective

ABSTRACT

Designed to provide temporary shelter to the displaced, in protracted refugee situations camps become places of long-term residency and undergo processes of urban change. The complex realities of protracted encampment challenge the dichotomy between the city (as a norm) and the camp (as an exception) that underpins dominant theoretical models of refugee camps. Instead, the theoretical lens of urban margins allows us to circumvent this binary and analyse the camps from the perspective of their relation to the city and the state. Rather than a specific location, this article approaches urban marginality as a condition produced by unequal power relations behind the enforcement of a particular urban order. Based on two years of ethnographic fieldwork, it draws on the case of Palestinian refugee camps in the West Bank. Unlike the majority of studies on Palestinian camps that focus either on top-down politics of exclusion or political agency of camp residents, the article examines how different actors, interests and modes of exercising power (both formal and informal) intersect in camp space and produce, as well as resist and subvert, the condition of urban marginality.     

Doing the City from the Margins: Critical Perspectives on Urban Marginality*

ABSTRACT

This special issue focuses on urban marginality in diverse contexts across the world (Africa, Latin America, Arab States and Europe) and proposes anthropological perspectives on contemporary urbanity that take into account the complexity of the social positions of those city dwellers that are on the margins. Three aspects of urban margins come to the fore. First, urbanites respond to increasing marginalisation through the production of alternative meanings and narratives about the city. While grand, powerful narratives may present cities as ‘divided’, ‘dual’ or ‘conflicted’, urban dwellers may carve out symbolic space through discourses of the non-spectacular and non-political, emerging out of lived space. Second, the cuts and frictions constituting urban margins do not only limit urban dwellers capacities, but can also provide spaces of agentic possibilities. As it is well known, the absence of state control can be turned by versatile urbanites into opportunities of the ‘informal’ economy. Third, urban dwellers engage in manifold practices that connect and entangle their marginalised position with spaces of power and resources. Through their practices urban margins become a relation to, not a disconnection from the ‘centre’. In this special issue we understand ‘urban margins’ not as essence or entities, but as forms of relations between urban dwellers shaped by processes of political, economic, spatial and social marginalisation. Seen in this way, urban margins constitute a perspective on the urban: a lens to entice comparisons of urban agency in the world of cities [Robinson, J. 2011. “Cities in a World of Cities: The Comparative Gesture.” International Journal of Urban and Regional Research 35 (1): 1–23. doi:10.1111/j.1468-2427.2010.00982.x]].     

Everyday Encounters in the Shopping Mall: (Un)Making Boundaries in the Divided Cities of Johannesburg and Mostar

ABSTRACT

The many studies that see shopping malls as places of power, control and exclusion have often neglected the potential of malls as places of encounters. Drawing on ethnographic data from the divided cities of Johannesburg in South Africa and Mostar in Bosnia–Herzegovina, we examine the ways in which urban dwellers who enter the mall from a marginalised position – poor black urban dwellers at a regional, middle class and white-dominated mall in Johannesburg and Bosniak city dwellers at a mall located in the Croat part of Mostar – use the mall, what kind of relations they build to others and how they rework boundaries of race, class, religion and ethnicity at the mall. Rather than being spaces that strengthen and reproduce centre–margins relations, urban dwellers appropriate them as places where these relations become reworked.     

Surinamese Maroons as reggae artistes: music,marginality and urban space

This article examines how marginalized Maroon youth in Paramaribo, the capital of the Caribbean nation of Suriname, employ musical strategies in combating ethno-racial stigmatization and improving their socio-economic position. Traditionally, Maroons, after escaping the plantations during slavery, have lived in semi-isolation in Suriname's dense rainforest. In recent decades, they have become increasingly urbanized, to the discontent of many in Paramaribo, who view Maroons as backward, violent criminals. Drawing on ethnographic fieldwork and popular culture analysis, the article discusses how young Maroons use reggae and dancehall to create and recreate physical and social spaces of their own within the city and outside the forest. They protest local conditions and inequity by drawing on regional images of marginality that have been shaped by Rastafari musicians in Jamaica. Simultaneously, they use this Caribbean frame to imagine Black Atlantic unity. Connecting to global soundscapes, young Maroons strategically use music to combat their urban marginality.     

Photography and Urban Marginality

In recent years several monographs have appeared in Italy, though even more abroad, as a report of ethnographic research into the everyday life practices of marginal urban social groups; all fall under a disciplinary subfield the author calls “Anthropology of urban marginality.” The authors of these works have increasingly been using technologies other than written representation, as for instance the medium of photography. There is a question at the core of this article which could be summed as, Why and how can this medium aid in a better understanding of the phenomena being investigated?     

Conditions of life in the city: medicine and gendered relations in Maputo,Mozambique

How do material conditions, urban life strategies, and postcolonial medical infrastructures shape the practices of care available to patients and families in Maputo? How do global health interventions articulate with urban economies, colonial legacies, and gendered relations? Under what conditions is health made available in Mozambique's capital? This article explores these questions through the experiences of one young woman as she moves through clinical and city spaces and through changing familial and residential situations. Showing how health is shaped by gendered relations and material circumstances (or condições) as they are refracted through urban space, her experiences make clear that care both requires and creates complex material‐relational conditions rooted in clinic practice, urban forms, and gendered social and familial life. In the midst of complex medical regimes and rapidly changing urban spaces, these conditions constitute the ground on which women access medicine but also give rise to exclusions from forms of care produced by both biomedicine and social relations. Arguing for greater attention to the role of gender, urban space, economy, and exchange in theorizing health in situated urban and transnational spaces, this article advocates for accounts that go beyond biomedical and clinical framings of life, health, and well‐being and that centre relational accounts of life in the city.     

Candi(e)d action: biosocialities of Turkish Berliners living with diabetes

In this article, I explore Turkish migrants' responses to diabetes in Germany. Anthropological studies on health inequalities tend to theorize "social suffering" as passive experiences; those that analyze active social engagement by patient groups as "biosociality" do so solely in the realm of biotechnologies and suggest that social disadvantage prevent active engagement. This article draws on 12 months of ethnographic fieldwork in Berlin from 2006 to 2007. Although Turkish Berliners seem burdened by diabetes, informal diabetes care, for example through a self-help group, is nonetheless collectively negotiated. Increasing incidence and awareness of diabetes in Berlin's Turkish population and their growing political organization and economic entrepreneurship, against the backdrop of experiences of marginality, gives rise to biosociality unanticipated in previous accounts. Addressing the limitations of previous uses of biosociality, this ethnography suggests that social interaction and belonging that formed around altered biologies, here diabetes, are complex and fragmented.     

The scaling of green space coverage in European cities

Most people on the planet live in dense aggregations, and policy directives emphasize green areas within cities to ameliorate some of the problems of urban living. Benefits of urban green spaces range from physical and psychological health to social cohesion, ecosystem service provision and biodiversity conservation. Green space coverage differs enormously among cities, yet little is known about the correlates or geography of this variation. This is important because urbanization is accelerating and the consequences for green space are unclear. Here, we use standardized major axis regression to explore the relationships between urban green space coverage, city area and population size across 386 European cities. We show that green space coverage increases more rapidly than city area, yet declines only weakly as human population density increases. Thus, green space provision within a city is primarily related to city area rather than the number of inhabitants that it serves, or a simple space-filling effect. Thus, compact cities (small size and high density) show very low per capita green space allocation. However, at high levels of urbanicity, the green space network is robust to further city compaction. As cities grow, interactions between people and nature depend increasingly on landscape quality outside formal green space networks, such as street plantings, or the size, composition and management of backyards and gardens.     

Genetics and prevention: a policy in the making

Abstract

This article explores the processes through which the advances of genetic research are incorporated into public health care in Denmark. Drawing on ethnographic fieldwork in cancer genetic counselling, the implementation of new medical advances is investigated by following the establishment of a policy on informing relatives at risk of hereditary cancer. This case material provides the occasion to examine how policies are shaped in a governmental process through which different actors seek to establish a common goal for a specific health practice. The struggle to define such a goal implies a struggle to define where to draw the line between health and disease and what makes up a healthy person in the context of genetic knowledge. The authors argue that in the process of establishing a policy in the field of cancer genetics the imperative of prevention comes to provide the framework within which an ethics of rights and responsibilities is constituted and the target group of cancer genetic counselling defined. This ethics is not determined by or inherent in genetic technology itself, but constituted in a social process and therefore negotiated within pre-existing frameworks of understanding in professional practice.     

Pocahontas Goes to the Clinic: Popular Culture as Lingua Franca in a Cultural Borderland

Urban hospitals constitute an example of what is arguably the most visible site in anthropology these days—the border zone. Negotiating health care requires trafficking in tricky spaces where patients and their families must pay vigilant attention about when to submit, when to resist, and how to collaborate. Drawing from ethnographic research carried out over the past nine years among African American families who have children with severe illnesses and disabilities, I examine how children's popular culture operates in the fraught borderland that constitutes the urban clinic. Global icons like a Disneyfied Pocahantas can function as a lingua franca, offering a language of publicly available symbols on which families, health professionals, and children can draw to create a shared imaginative space across race and class divides and across the sometimes even more radical divide between sufferer and healer.     

Health and the city: physical health and mental health

In France, city size has very little bearing on the mortality rate as a function of age and life expectancy and it is in large cities that these indicators are the most favorable. No increase in maternal or infant mortality rates or deaths due to cancers has been observed in large cities. The lower mortality rate linked to respiratory and cardiovascular diseases in large urban areas contradicts the fears concerning the impact of air pollution. Deaths linked to lifestyle are less frequent in big cities, which could be due to social structures (socio-professional level: the proportion of white-collar workers and professionals is higher in bigger cities than in the suburbs or small cities). However, although the overall mortality rate is lower, it should be emphasized that there is in large cities a greater incidence of sexually transmitted diseases, AIDS and certain infectious diseases (because of social diversity and the fact that certain individuals seeking anonymity and marginality are drawn to large cities). In terms of mental health, the breakdown of family structures, instability, unemployment, the lack of parental authority and failing schools render adolescents vulnerable and hinder their social integration. When the proportion of adolescents at risk is high in a neighborhood, individual problems are amplified and social problems result. In order to restore mental and social health to these neighborhoods, ambitious strategies are necessary which take into account family and social factors as well as environmental ones. At the present time, when physical health is constantly improving, the most pressing problems are those related to lifestyle and mental health which depend for a large part on social factors.     

Medical Humanitarianism Under Atmospheric Violence: Health Professionals in the 2013 Gezi Protests in Turkey

During the 2013 Gezi protests in Turkey, volunteering health professionals provided on-site medical assistance to protesters faced with police violence characterized by the extensive use of riot control agents. This led to a government crackdown on the medical community and the criminalization of “unauthorized” first aid amidst international criticisms over violations of medical neutrality. Drawing from ethnographic observations, in-depth interviews with health care professionals, and archival research, this article ethnographically analyzes the polarized encounter between the Turkish government and medical professionals aligned with social protest. I demonstrate how the context of “atmospheric violence”—the extensive use of riot control agents like tear gas—brings about new politico-ethical spaces and dilemmas for healthcare professionals. I then analyze how Turkish health professionals framed their provision of health services to protestors in the language of medical humanitarianism, and how the state dismissed their claims to humanitarian neutrality by criminalizing emergency care. Exploring the vexed role that health workers and medical organizations played in the Gezi protests and the consequent political contestations over doctors’ ethical, professional, and political responsibilities, this article examines challenges to medical humanitarianism and neutrality at times of social protest in and beyond the Middle East.     

‘No caps,no coconuts,no all-male groups’ … the regulation of Asians in London clubs

Abstract

Until now, British Asian popular music culture and leisure spaces have attracted little sociological investigation. This article redresses the lack of attention paid to this area by focusing on an ethnographic study of the ‘desi’ South Asian club scene in London. It explores the relationship between contemporary discourses of Asianness as they are constructed within an East London desi club space and made to matter through embodied social practices. Asian bodies are disciplined in the making of normative ethnic, gendered and sexual subjectivities, which demonstrates how discourses of difference create complex subjectivities and practices that theories of diaspora and cultural studies have not fully explored. It offers a rethinking of diasporic identities as lived and embodied experiences that are ambivalently constructed and performative projects, neither entirely resistant to white, dominant discourses nor wholly complicit with its existing norms.     

Playing through differences: black–white racial logic and interrogating South Asian American identity

Abstract

This article examines how South Asian American communities ascribe meaning to the category of ‘race’ while adding their own sensibilities to racial categories of ‘black’ and ‘white’. Drawing upon ethnographic methods, I analyse leisure spaces of basketball to demonstrate how racial formation in the US for non-white ethnic American subjects engages the black–white racial binary while simultaneously critiquing this racial logic. Racial categories provide a lexicon for comprehending South Asian American difference, while South Asian idioms perpetuate racializing discourses.     

Consumer demand for caesarean sections in Brazil: informed decision making,patient choice,or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods

ObjectivesTo investigate why some women prefer caesarean sections and how decisions to medicalise birthing are influenced by patients, doctors, and the sociomedical environment.DesignPopulation based birth cohort study, using ethnographic and epidemiological methods.SettingEpidemiological study: women living in the urban area of Pelotas, Brazil who gave birth in hospital during the study. Ethnographic study: subsample of 80 women selected at random from the birth cohort. Nineteen medical staff were interviewed.Participants5304 women who gave birth in any of the city''s hospitals in 1993.ResultsIn both samples women from families with higher incomes and higher levels of education had caesarean sections more often than other women. Many lower to middle class women sought caesarean sections to avoid what they considered poor quality care and medical neglect, resulting from social prejudice. These women used medicalised prenatal and birthing health care to increase their chance of acquiring a caesarean section, particularly if they had social power in the home. Both social power and women''s behaviour towards seeking medicalised health care remained significantly associated with type of birth after controlling for family income and maternal education.ConclusionsFear of substandard care is behind many poor women''s preferences for a caesarean section. Variables pertaining to women''s role in the process of redefining and negotiating medical risks were much stronger correlates of caesarean section rates than income or education. The unequal distribution of medical technology has altered concepts of good and normal birthing. Arguments supporting interventionist birthing for all on the basis of equal access to health care must be reviewed.

What is already known on this topic

Women''s preferences for caesarean sections are understood to result from lack of knowledge and psychological aptitude to handle vaginal delivery and its consequencesEfforts to reduce the demand for caesarean sections have focused on providing consumers with correct information on the relative risks associated with vaginal and operative deliveries

What this study adds

In Brazil, many women prefer caesarean sections because they consider it good quality careRich women are more likely to have caesarean sections, supporting the notion that medical intervention represents superior carePoor women may implement a series of medicalised practices that justifies the need for greater medical intervention during birthInterventions for reducing caesarean sections by educating physicians and patients about risk factors associated with birthing procedures are not sufficient     

Urban Forest Justice and the Rights to Wild Foods, Medicines, and Materials in the City

Urban forests are multifunctional socio-ecological landscapes, yet some of their social benefits remain poorly understood. This paper draws on ethnographic evidence from Seattle, Washington to demonstrate that urban forests contain nontimber forest products that contribute a variety of wild foods, medicines, and materials for the wellbeing of urban residents. We show that gathering wild plants and fungi in urban forests is a persistent subsistence and livelihood practice that provides sociocultural and material benefits to city residents, and creates opportunities for connecting with nature and enhancing social ties. We suggest that an orientation toward human-nature interactions in cities that conceptualizes the gathering of forest products as a legitimate social benefit may support and expand urban forest justice. Urban forest justice recognizes the rights of local people to have control over their own culturally appropriate wild food and health systems, including access to natural resources and to the decision-making processes affecting them.     

Cultural Competence in Diabetes Mellitus Care: An Urgent Need

Background:Multicultural societies exist worldwide. Two important challenges can be appreciated in this scenario. Minority populations, due to a combination of genetic and lifestyle factors, have a particularly high risk for developing type 2 diabetes mellitus (DM). In addition, the quality of health care provided to minority populations, including that for DM, has lagged behind that provided to the white population. Because multiple medical, social, and cultural factors influence the development and progression of type 2 DM, management of patients becomes even more challenging if health care providers cannot identify and address the many contributing factors.Objective:The objective of this article was to raise awareness about the most common social and cultural factors that may influence the development of type 2 DM, progression of the disease, and adherence to treatment plans in patients from culturally diverse populations.Methods:A PubMed search of English-language articles published primarily between 1996 and 2006 was conductedusing the search terms Latino, Hispanic, culture, and diabetes, and a list of social and cultural factors associated with type 2 DM was created based on relevant articles and on the author's expertise and experience in the Latino Diabetes Initiative at the Joslin Diabetes Center.Results:There is increasing evidence that social and cultural factors such as body image, educational level, fears, general family integration and support, health literary, language, myths, and nutritional preferences, among others, may affect the success of the physician patient relationship and influence patients' adherence to treatment. Specific strategies to help clinicians remember to address multiple factors in the day-to-day management of patients with type 2 DM who are from culturally diverse populations include asking questions about patients' personal goals, ascertaining what behaviors they have adopted from mainstream culture, understanding how family ties may affect DM care and prevention, and being aware of patients' educational level when implementing any educational activity.Conclusions:The standards of DM care apply to every individual with this disease and should continue to be the core of every clinicians practice. However, improving health care providers' cultural competence may help improve the quality of care provided to minority groups and may ultimately reduce health care disparities. Increased cultural competence may also improve patient-provider trust and communication, as well as help patients adhere to prevention and treatment plans.     

Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea,Uganda, and Sierra Leone

BackgroundLittle is known about the social and political factors that influence priority setting for different health services in low- and middle-income countries (LMICs), yet these factors are integral to understanding how national health agendas are established. We investigated factors that facilitate or prevent surgical care from being prioritized in LMICs.ConclusionsNational health agenda setting is a complex social and political process. To embed surgical care within national health policy, sustained advocacy efforts, effective framing of the problem and solutions, and country-specific data are required. Political, technical, and financial support from regional and international partners is also important.