Biomedical disenchantments: practices, discourses, and imaginaries of transnational biomedicalization in rural Ethiopia

"This dissertation examines practices, discourses, and imaginaries of biomedicine within hospital spaces produced by transnational processes in a rural Ethiopian community. I examine how Ethiopian and volunteer American physicians navigate intersections of globalized standards and technologies with site-specific clinical realities and sociopolitical structures to provide patient care and engage in professionally-satisfying endeavors. Extending sociological theories of biomedicalization into this postcolonial space constructed by unpredictable mobilities of global health technologies, but largely disconnected from formal networks of biocapital reveals biomedical imaginaries of physicians in tension with severely limited material and symbolic resources. The instability that characterizes biomedicine in Gelel, Ethiopia, is evident in physician practices and discourses in two community hospitals, representing different forms of institutional governance and fraught engagements with national and international policies and resources. Data were collected between July 2013 and March 2014 in the form of participant observation in the wards, operating rooms, and clinics of the hospitals, qualitative interviews with Ethiopian and American physicians, hospital administrators, NGO coordinators, and other medical staff, and community member surveys. This dissertation contends that biomedicalization in these spaces is a variegated construct of neoliberal capitalism and thus produces disenchantments and contradictions evident within the embodied and socially embedded practices understood through analysis of the integration of globalized macroinstitutional structures and local clinical realities. Contemporary medical missions allow American volunteers to participate in one- to two-week projects in a particular mode of ""global health"" practice and produce boundaried clinical enclaves and novel forms of biomedical subjects. These processes work through frontier imaginaries and utilize spaces of exclusion and technologies of modularity that further enmesh Gelel's biomedical processes and practitioners in particular moral and bio-economies. The tensions that emerge from these various friction-laden interactions of individuals, communities, resources, and imaginaries are productive of variegated biomedicalization itself and reinforce the inequalities and exclusions that promote ""global health"" projects."

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Sociology

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2016

Author dc:creator

• Rieder, Stephanie Margrit

Contributors dc:contributor

• Gille, Zsuzsa
• Dill, Brian
• Zerai, Assata
• Decoteau, Claire

• Biomedicalization
• Global health
• Medical missions
• Ethiopia
• Biomedicine
• Voluntourism
• Biomedical imaginary
• Variegated biomedicalization
• Modularity

Statement dc:rights

• Copyright 2016 Stephanie Margrit Rieder

Language dc:language

en

Handle dc:identifier

http://hdl.handle.net/2142/90585

OAI identifier oai:identifier

oai:www.ideals.illinois.edu:2142/90585