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17 Anthropological Approach to Religion

Anthropological insights are useful for understanding such distinctions and situating them within broader concerns around the management of the sick body. Jeffs et al. Patients expect injections and IV treatment in this area of Angola, and the number of individuals presenting to the Marburg ward for assessment increased after these treatment measures were introduced.

Such insights resonate with anthropological observations about perceptions of effectiveness associated with different kinds of medicines and medical interventions e. In many African contexts, intravenous treatment is reserved for the most severe types of sickness; one of Brown's informants recently recounted the severity of a recent illness by repeatedly emphasizing the number of bottles of rehydration fluid maji she was given intravenously. Thus, it is not surprising, from an anthropological perspective, that people often expect IV treatment for an infection as serious as VHF or that they might associate its provision with the delivery of proper care.

Our program for future research extends these analytical frameworks. Conceptualizing the hotspot in the hospital gives empirical priority to the ways in which clinical spaces and objects dynamically emerge through medical encounters.


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Like the monkey park, hospitals are a composite of diverse and divergent interactions; the materiality of medical therapies, instruments, or diseases is brought into being through diverse socio—spatial practices Mol Take gloves for example: A standard tool of barrier nursing, gloves are used to prevent contamination of caregivers and patients; their effectiveness hinges on their rapid disposal.

But in situations where the availability of medical instruments is erratic, gloves continue to perform modern care and appropriate practice, even when used repeatedly. Further, when nursing a family member or even a friend, the restraints gloves place on intimacy can be more important than the barriers they provide against contagion; during these interactions, they become something else entirely—a form of social distance, a mechanism of detachment. Such meetings of radically different realities are not, by definition, problematic. However, this ontological multiplicity can create opportunities for viral transmission.

As in the case of the twin village, it is in its capacity to mark out the emergence and convergence of difference within a shared landscape—or in this case, within the same object—that the hotspot gains its analytical traction. Demonstrating that VHF outbreaks are a consequence of intersections between infected animals and colonial pasts is a central ethnographic task. Yet, as a means to render visible the diverse social, political, and material conjunctions on which transmission depends, structural violence has considerable limitations.

Although it clarifies the interplay between macro forces and micro events, the concept elides the materiality of pathogenic encounters by limiting transmission processes to questions of economic vulnerability. Nor does it capture the varied agencies and interactions that connect deep structure to local experiences. This is where the hotspot provides analytical mileage. The concept captures the complex relationality of VHF: the heterogeneous interactions between individuals, populations, and environments that lead to an outbreak.

It elaborates these contextures across multiple scales, but without flattening them into a static network of connection. The hotspot denotes a thickening of fields; a layering of the relational possibilities and intensities that occasion transmission.

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For what is at issue is not simply that there are many different factors—ecological, economic, social, and political—that trigger and shape the spread of disease. Rather, outbreaks are the product of latent relations, the contingent convergence of pathogenic potentials. The hotspot does not stabilize an outbreak narrative but rather draws attention to the sudden, ephemeral, and material concurrences between humans, animals, non-humans, institutions, and pasts that occasion contagion.

It is not a means of prospectively or retrospectively specifying the factors that might lead or have led to transmission, but a way of alerting us to the radical and contingent relationality through which outbreaks emerge. An anthropology of the hotspot would explore viral movement by attending to the multiple material, historical, and social forms of connection brought about through closeness, contiguity, and propinquity.

Rather than focusing on difference through an analytic of separation—between local politics and imperial policies, say, or village life and commercial development—Fontein takes up burial grounds, and the white and African ghosts that haunt them, to explore how distinct histories and representations co-exist within a landscape:.

Just as graves and ruins around Mutirikwi are not inert material expressions of politically deployed languages of belonging and authority, but rather are active and affective in complex ways, so we should envisage historical, material, and conceptual proximities as involving active, changing engagements between peoples, things, epistemologies, and even ontologies. Fontein A heuristic of proximity is clearly fundamental to understanding viral transmission.

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Fontein's interest in proximity, however, is more intimate than contiguity—a state of being in physical contact. In his analysis, legacies of eviction and dispossession—of both white and black farmers—are entangled with diverse claims to ancestral authority; different pasts are co-present in the ruins of regimes, often in the same sites and objects. Difference is not manifest as a radical separation but emerges through a variety of material entanglements and coexistences within a shared landscape. Attention to how radical forms of difference play out in the hotspot points to some of the connections neglected by conventional analysis—consider, for instance, that the outbreak ward is formed both through the construction of hyper-protective barriers and obligations to provide loving care; that abandoned plantations are remnants of declining colonial economies and sites of new hunting practices and markets for bushmeat.

It is often at occasions when such differences become materially proximate that transmission occurs. Critical too, are the spatial, temporal, and affective dynamics of these proximities: just as graves shape the contemporary politics of land in Zimbabwe, so the hotspot draws attention to the co-presence of divergent histories within sites of VHF transmission and management. The intersections between colonial remainders, independence policies, public health practice, and the emotive registers that inflect practices of care and support have tremendous significance for the pathogenicity of a milieu.

The distinct human, animal, political, and institutional practices that shape hotspots mark out both the differences of these arenas and their entangled material and historical proximities. The purpose of researching the hotspot ethnographically is not to arrive at a more precise explanation of an outbreak—a more complete picture of how, where, and when a virus moved across bodies and space. Rather, in eschewing the assumption of a stable and singular context of disease, an ethnography of the hotspot would elucidate the interactivity of pathogenic things and places through processes of transmission.

Hotspots are places defined by excess and lack, the absence of resources and an abundance of pathogens. Here—as in many other public health contexts—anthropological research is carried out with the purpose of interrupting, uprooting, and undoing the density of these connections by drawing attention to the institutional politics, histories of violence, and intimate entanglements that bring them together.

In this article, we have sought to mark out a terrain for future ethnographic engagements with VHF by drawing on insights from multispecies ethnography, studies in material culture, and post-structuralist understandings of space. The theoretical concept of the hotspot provides a heuristic to explore the divergent and complex forms of material proximity that encourage viral movement, and is indicative of ways in which these different anthropological conversations might be made relevant to public health.

Finally, by bringing together sites and practices traditionally held apart within and beyond anthropology, the hotspot opens up possibilities for new forms of collaboration between anthropologists, ecologists, and disease managers. Conceptualizing expertise as falling into discrete domains—bat bodies and ape behavior, the genetic make-up of a virus and the rate of deforestation, hunting practices and hospital hygiene—has considerable limitations. We hope that extending the ethnographic scope of engagements with VHF will also enable a rethinking of the terms of interdisciplinary exchange.

A robust multi-dimensional approach to public health interventions rests on drawing together distinct ways of knowing rather than integrating different objects of knowledge. This collaborative zone is, perhaps itself a hotspot, where ideas can move between hosts as they approximate or make proximate their differing knowledge practices. Our first thanks go to Matthias Borchert, Steven Belmain and all the members of the ESEI-VHF team who introduced us to the world of viral hemorrhagic fevers and who provided extensive and encouraging guidance on this article.

We are equally indebted to Almudena Mari Saez for inspiring ethnographic insights during recent work in Guinea. This article has also benefited from comments by the members of the Anthropologies of African Biosciences Group at Cambridge; participants at the Contagion Workshop at the University of Exeter; and audiences at the American Anthropological Association Meeting in San Francisco. Ben Woods kindly loaned Hannah Brown health promotion material used in the DRC from which the reproductions in this article were taken.

This article was written while Ann H. Kelly and Hannah Brown were working at the London School of Hygiene and Tropical Medicine and both benefited from its institutional support. These viruses are found around the globe in a number of different forms. This article concentrates on African strains of Ebola, Marburg, and Lassa fever. Although these share some key epidemiological and ecological characteristics e. We hope that this article will lead to development of a methodological approach that will help open up these categorizations for reflection and reconfiguration.

When outbreaks do occur, the virulence of these diseases inhibits widespread transmission, as the majority of sufferers die before they can infect others M. Borchert, personal communication. Despite this epidemiological reality, social theorists have argued that these diseases are emblematic of the new and unruly connectivities ranging from terrorism to economic crises that shape national security concerns and prompt imperialistic approaches to global health Clarke ; Hinchliffe and Bingham We were granted considerable freedom to describe the nature of an anthropological contribution, though there were some key objects e.

This article takes both that empirical latitude and that collaborative spirit seriously by aiming to extend ethnographic engagement across the three themes. However, where Rappaport argues for an expanded understanding of environment through his concept of human systems, our concern is with the particular way in which the social is conceptualized. However, Lassa can produce epidemic exacerbations often through hospital amplification , and involves the mobilization of new forms of hospital-based care e. For instance, Merlin, the U. National Center for Biotechnology Information , U.

Medical Anthropology Quarterly. Med Anthropol Q. Published online Apr Hannah Brown and Ann H Kelly. Author information Copyright and License information Disclaimer. Department of Anthropology, Durham University. E-mail: ku. All rights reserved. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract This article outlines a research program for an anthropology of viral hemorrhagic fevers collectively known as VHFs.


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Keywords: hotspot, viral hemorrhagic fevers, material proximities, animal studies, space. Introduction The problems that define the global health agenda are linked to transnational determinates: urbanization, migration, war, market integration, environmental degradation, and climate change. Repositioning Anthropology Three anthropologists are notable for their work with communities with direct exposure to Ebola and Marburg: Barry and Bonny Hewlett and the French physician—anthropologist Alain Epelboin.

Open in a separate window. Figure 1.


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  4. Figure 2. Outbreak: Hospitals as Contexts for Viral Control and Amplification During an outbreak of VHF, the problem for disease managers is to reorder human—human and human—object proximities to prevent the spread of the virus, while also providing care and treatment to sufferers. Figure 3. Rather than focusing on difference through an analytic of separation—between local politics and imperial policies, say, or village life and commercial development—Fontein takes up burial grounds, and the white and African ghosts that haunt them, to explore how distinct histories and representations co-exist within a landscape: Just as graves and ruins around Mutirikwi are not inert material expressions of politically deployed languages of belonging and authority, but rather are active and affective in complex ways, so we should envisage historical, material, and conceptual proximities as involving active, changing engagements between peoples, things, epistemologies, and even ontologies.

    Fontein A heuristic of proximity is clearly fundamental to understanding viral transmission. Conclusion Hotspots are places defined by excess and lack, the absence of resources and an abundance of pathogens. Acknowledgments Our first thanks go to Matthias Borchert, Steven Belmain and all the members of the ESEI-VHF team who introduced us to the world of viral hemorrhagic fevers and who provided extensive and encouraging guidance on this article.

    References Cited Appadurai A. Cambridge: Cambridge University Press; Biological Approach to Medical Geography.

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    The British Medical Journal. Wilkie DS. New York: Colombia University Press; Quarterly Journal of Speech. Fadiyimu AA. African Journal of Agricultural Research. Kenyon G. Nature Medicine. Borchert M.