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Drawing on three years of ethnographic engagement with the rare disease community in the United Kingdom and Europe, this article explores the experiences of families who seek and (sometimes) receive a genomic diagnosis. I trace how families learn to enact unexplained symptoms and common disabilities as rare, genetic disorders, and how they coordinate genomic and non-genomic ways of "doing" disease within and beyond the clinic. These experiences shed light on the socio-material processes through which genomic variants become "diseases" (or fail to do so), and on the implications for those whose lives have become entangled with the genomic agenda.

Starting from the unsettling ambiguity of the aborted but not-quite-dead fetus, I scrutinize how clinical staff interpret, decide on, and grapple with fetal life signs following disability-selective pregnancy terminations in Austria. Understanding their practices as attempts to provide certainty in a context of ontological and moral uncertainty, I conceptualize them as acts of care that contribute to an intricate "ontological careography" and facilitate classifying the not-quite-dead as an already-dead fetus. I show that the interpretation of life signs is not a simple matter of biological "facts" - what is ultimately at stake is the active making of life and death.

Based on fieldwork in Danish families living with ADHD, we expand on Nielsen's insight that ADHD is experienced as a state of desynchronization by showing how family members' rhythms mutually affect each other. We argue that ADHD is not only a biological and psychiatric condition, but also a temporal and socially responsive phenomenon. The intensity of ADHD is influenced by mutual affect in families and by general life circumstances. Families constitute bodily networks through which sensations, moods, rhythms, and practices spread and are passed down through generations. Yet, families use various time work strategies to manage rhythm affect.

Osteopathy is a complementary treatment method that targets motor restrictions and enhances motility through touch. While recent studies have explored the functions, dimensions, and effects of touch in osteopathy, there is a lack of research on how touch renders bodies intelligible - or what bodies, for that matter. In this article, we use the verb to affect/to be affected to explore how bodies become known by and to Dutch osteopaths, and how the senses play a role in this. Our analysis shows how touch allows osteopaths to affect and be affected by their patients' bodies - as well as by their own.

Shamans, neo-shamans, atheists, and others describe gaining special knowledge from drinking ayahuasca, supporting the cross-cultural idea of ayahuasca as a plant teacher. While secular enthusiasts interpret this metaphorically, animists and others take it literally. This article examines ontological collisions at a healing retreat in the Peruvian Amazon, considering Shipibo shamans and their international clients. It explores how embodied experiences, such as purging and visions, inform both literal and metaphorical views of healing and illness. By addressing incommensurable ontologies, the article highlights how a polyontological framework approaches ontological collision without necessarily privileging specific ways of knowing.

Despite concerted attempts by colonial governments to stamp out traditional healing practices, the Korekore-speaking Shona people have continued to seek healing for mental illness from traditional healers in present-day Zimbabwe. In this article, I discuss the health-seeking trajectories of Korekore people when confronted with mental illness, particularly when and why they seek out traditional healing, and the role that traditional healers play in the quest for therapy.

Jihan, a former Kurdish guerilla fighter, struggles to gain medical treatment for the health problems she suffers as a result of war and trauma. The provision of care in Turkey has been motivated by ethno-political security concerns. Therefore, medical encounters are characterized by silences, not-knowing and of averting danger. Based on theories of ignorance, I explore how experiences of war and torture constitute dangerous knowledge that are difficult to share in a context, without a guaranteed therapeutic safe space. Patient and doctor navigate mistrust, silences and proxy-reasons in an attempt to deal with the traumata and violent experiences left unsaid.

Recent ethnographies have investigated self-care as a socially driven configuration of care. This analysis engages theorizing on the imagination to expose new social dimensions of self-care in cases of mental health as embodied and communal. Based on fieldwork across Canadian universities and in conversation with students, campus wellness providers, and a group of psychiatric epidemiologists seeking to understand the mental health treatment choices of students, this article examines how these different subjects activate what I call an imaginarium of self-care. Among young adults in Canada, mounting social ills that go therapeutically unaccounted for have relocated forms of self-care into the imagination through play and world-building in ways that challenge the distinction between material and speculative healing. Attending to the imaginative dimensions of self-care makes coherent the ways that young people are grasping for hope in a world that-when embodied-resists recovery., (© 2024 American Anthropological Association.)

This article examines how militarized regimes of narcotics and price control sustain unpalliated cancer pain in Pakistan. It shows how these regimes of control-reimagined as "regimes of pain"-render morphine, a cheap, effective opiate analgesic, scarce in hospitals. Meanwhile, heroin, morphine's illegal derivative, proliferates in illicit circuits. The article highlights a devastating consequence of the global wars against drugs and "terror": the consignment of cancer patients to agonizing end-of-life pain. Widening the analytic lens upon palliation beyond bodies and their clinical encounters, the article offers a geopolitics of palliation. It shows how narcovigilance targeting illicit drugs has the perverse effect of throttling morphine's licit supply. It shows further how unviably low price ceilings, purported to ensure a poor population's access to morphine, render it scarce on the official market. These mutually reinforcing regimes of control thus thwart their own purported objectives, consigning cancer patients to preventable, yet unpalliated, pain., (© 2024 The Authors. Medical Anthropology Quarterly published by Wiley Periodicals LLC on behalf of American Anthropological Association.)

We compare the social determinants of health (SDOH) and the social determination of health (SDET) from the school of Latin American Social Medicine/Collective Health. Whereas SDET acknowledges how capitalist rule continues to shape global structures and public health concerns, SDOH proffers neoliberal solutions that obscure much of the violence and dispossession that influence contemporary migration and health-disease experiences. Working in simultaneous ethnographic teams, the researchers here interviewed Honduran migrants in their respective sites of Honduras, Mexico, and the United States. These interlocutors connected their experiences of disaster and health-disease to lack of economic resources and political corruption. Accordingly, we provide an elucidation of the liberal and dehumanizing foundations of SDOH by relying on theorizations from Africana philosophy and argue that the social determination of health model better captures the intersecting historical inequalities that structure relationships between climate, health-disease, and violence., (© 2024 American Anthropological Association.)

In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID-19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vaccine hesitancy, leading to the development and implementation of the state-funded and physician-led "Vaccine Champion" ("VaxChamp") program. Glossing the primary problem as one of "provider confidence," the VaxChamp program emphasized a standardized, scalable intervention that targeted healthcare providers directly, and patients only indirectly. Although the program hit its quantitative benchmarks, a qualitative inquiry into the program's history and context reveals multiple crises of confidence, many beyond the bioscientific domain of the program's focus. Drawing from work in medical and linguistic anthropology, we describe and analyze the "multiple levers of vaccine confidence" at play in the intervention and its surrounding context, as well as how these crises of confidence emerged., (© 2024 American Anthropological Association.)

Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous-specific racism and its role in decision-making., (© 2024 The Authors. Medical Anthropology Quarterly published by Wiley Periodicals LLC on behalf of American Anthropological Association.)

Practice theories offer potential to reveal, understand, and attribute value to the everyday thoughts and actions of dementia caregivers. Drawing on ethnographic data from research in rural South Africa, on everyday dementia care practices, we highlight the profound importance of mundane practices - especially "sitting in wait" - for optimizing wellbeing of people with dementia who are cared for at home. We draw attention to the structural drivers of homebased (informal) care, which is underpinned by state inaction. This situates the act of sitting in wait as both an act of care and an embodied form of structural powerlessness.

In a tragically ironic twist, antiretroviral therapy (ART) that promised an end to AIDS ushered in a syndemic of viral cancers, transforming hope to despair. In this article we draw from the illness narratives of HIV positive women attending a cervical cancer screening clinic in Johannesburg, South Africa, and chart their pathways from HIV to cancer, and their quest for treatment. Our interlocutors described protracted struggles to access surgical procedures to prevent the onset of cervical cancer. Dealt a double blow of HIV and cervical cancer, women's narratives reveal the intersections of exposure to pathogens and the precarity of hope.

This ethnographic exploration of death in the Peruvian context draws on fieldwork among abandoned-both by their families and the state-older adults in a shelter for the homeless in Lima, Peru. I examine the conditions and local forces that shape the ways people at this institution socially and physically die. My argument is that people in this long-term care facility who have lived entire lives on the margins, usually, end up having irrelevant deaths to their families, other residents of the institution, and the Peruvian state. At this shelter, dying in an irrelevant way means dying without companionship from family members and receiving poor and flawed care from the institution that shelters them.

We draw on ethnographic fieldwork conducted in Brussels (Belgium) on the health care experiences of undocumented migrants. We explore the implications of the double position of the ethnographer, who is both a researcher and a practicing doctor. We describe how the intimate knowledge the ethnographer-cum-clinician holds about the health care system influenced and shaped the data collection, analysis and subsequent policy recommendations. We examine the ethical dilemmas in conducting research from an engaged position about care practices toward vulnerable populations in one's own professional field. We conclude with recommendations on how to challenge and interrupt complexities faced by multi-positioned ethnographers.

The introduction of personalized medicine marks a shift in pregnancy-related screening, from fetal to maternal health risks putting the pregnant woman's future orientations center stage. Drawing on fieldwork from pregnancy outpatient clinics and 11 interviews with pregnant women diagnosed with gestational diabetes and offered genetic testing, we use their experiences of time to explore how futurity is reshaped by notions of early detection and at-riskness. We offer the concept of "future prism" to capture how multiple situations of orienting toward the future shape and circumscribe one's experience of the future - an orientation that makes genetic testing almost impossible to refuse.

I explore the experience of managing type 1 diabetes with wearable technology. Type 1 diabetes is a chronic illness which requires continuous maintenance to keep the blood glucose levels within range. Using autoethnography, I investigate both the practices of translating information from technology and from senses, and also from health authorities, into practices. I conclude that the management of type 1 diabetes is informed by an urge to control the body, but this situation can be understood otherwise from a logic of care.

The social efficacy of vaccines has been a central concern around COVID-19 vaccine uptake rates. As partners on the Vaccinate West Michigan Coalition, we conducted a rapid ethnographic assessment project among adults living in West Michigan. Three case studies are presented to convey the nuanced context around decisions with a focus on the influence of fear, trust, and the ripple effect of healthcare workers' (HCW) beliefs around vaccines. While HCWs' attitudes and beliefs influence their patients, the unique contribution of this study is its focus on how HCWs' perceptions influence friends and family members.

In today's China, countless parents embark on a journey of moral peril in search of treatment for their children with autism, navigating a bustling yet chaotic market of therapies. Based on 13 months of fieldwork in the Pearl River Delta, this study examines how the boom of China's autism therapy industry has plunged parents, who are relentlessly striving for their children's futures, into deeper vulnerability. I view the "ethics of trying" as parental enactment of their moral agency in seeking therapy and reveal how it serves as a moral engine for the industry's growth in the early 21st century, as well as how it leads to moral tragedies for parents as new norms of therapeutic choice emerge with government and professional guidance compelling them to make optimal therapeutic choices within a critical developmental window. Although parental efforts to avoid "agent-regret" can paradoxically lead to significant remorse, the moral tragedy they encounter can also prompt reflection and reevaluation of their approach to their child's condition.

Yoga-informed sound bath providers orchestrate vibrations from singing bowls, chimes, gongs, and other simple instruments to promote client well-being - sometimes in ways that create a trauma trap. Drawing on immersive research with sound bath providers and receivers in California, USA, I explore how these ritual performances feed on and fuel narratives regarding trauma, stress, and dysregulation, diverting attention from structural and cultural factors creating said disharmony. Beyond thereby ensuring a market, they can perpetuate a trauma-informed self-identification and subjectivity that harmonizes with the American work ethic, diminishes nonproductive sensual enjoyment, promotes self-care over community care, undermines resilience, and amplifies suffering.

US government quality measures prioritize pharmaceuticalization and care coordination to promote patient treatment adherence. How these measures affect outpatient mental health service delivery and patient-provider communication where psychiatrists and nonphysicians collaborate is understudied. Analyzing 500 hours of participant-observation, 117 appointments, and 98 interviews with 45 new patients and providers, I show that psychiatrists and social workers coordinated care by encouraging medications and seeing two mental health providers as the default treatment, irrespective of patient preferences. Ethnographic perspectives crucially account for models of service delivery and provider behaviors in researching treatment adherence.

Pregnancy is seen as a window of opportunity for health interventions, with the potential to produce long-term health changes for mother and child. The RCT FitMum investigates the effects of different regimes of physical activity during pregnancy. We suggest that rather than hitting a window of opportunity, the trial works in choreography with different timescapes through the processes of management of time. These timescapes are characterized by linear progression and futurity, alongside composite, complex time. We reconceptualize the intervention as a navigation of flows and passages in collective efforts, providing a situated and sustainable approach to interventions.

A growing concern in clinical literature with the "treatment burden" of living with multimorbidity raises questions about how we can study and produce knowledge on the impact of health care. In this article, we draw on ethnographic material from fieldwork among people with multimorbidity in Denmark and recent theorization on "values" in health care, to show how an ongoing "trying out" and ways of "just getting on with it" are enacted in illness trajectories marked by multimorbidity. Our findings point to the importance of attending to the subject positions that particular healthcare relations and encounters make possible.

Diabetic foot (DF) is a leading cause of nontraumatic lower-extremity amputations, premature death, and a sign of social inequality in diabetes treatment. In Mexico, the incidence of DF is on the rise yet little is known about its impact among indigenous people, a disadvantaged group. Based on ethnographic research conducted in Oaxaca and analysis of institutional health-data, in this article we show the health care delays that rural indigenous people face when dealing with DF. Indigenous people's uncertainty regarding their right to health and the structural barriers to medical care favor DF complications, a phenomenon that should be read as social suffering. Since health data concerning indigenous health care service users is patchy and imprecise, indigenous people's social suffering is invisibilized. This omission or partiality in the official records limits public health decision-making and undermines the human rights of the population.

Health technologies to monitor glucose values are an important part of daily diabetes self-care. Based on 12 months of fieldwork in Denmark with 14 people with type 2 diabetes, I explore people's experience of living with Continuous Glucose Monitoring. This new technology automatically measures glucose levels throughout the day but is not yet common in type 2 diabetes treatment in Denmark. In this article, I capture the social shaping of Continuous Glucose Monitoring, employing the concept of time. I show how adoption of the technology is embedded in a form of biographical time. This refers to people's use of the technology linked to their stories about themselves. Drawing on a notion of habitus, people's embodied past experiences and future prospects come to shape its use, I propose. My main claim is that while people with diabetes implement the technology into their lives in unique ways, adapting it to their circumstances and social conditions, practice of Continuous Glucose Monitoring reproduce social structures. This is evinced, I argue, in people's tinkering with the technology and the frames of reference used to inform it. I introduce the term "tinkering in time", highlighting the introduction of new health technology within the frame of lived human time.

The development of public health in Latin America during the 20th century combined, early on, the social medicine framework on the social, political, and environmental origins of disease with the contributions of medical anthropological fieldwork. Despite the hegemony of the medical model, the surge of the preventive medicine framework further legitimized the involvement of social scientists in the study of the multicausality of disease. However, the limitations brought by the preventive medicine model's lack of historical and political contextualization gave way to the Latin American social medicine movement, which was grounded in historical materialism, and the development of both critical epidemiology and critical medical anthropology., Competing Interests: Conflicto de intereses. Ninguno declarado.

Puerto Rico (PR) is facing an unprecedented healthcare crisis due to accelerating migration of physicians to the mainland United States (US), leaving residents with diminishing healthcare and excessively long provider wait times. While scholars and journalists have identified economic factors driving physician migration, our study analyzes the effects of spatial stigma within the broader context of coloniality as unexamined dimensions of physician loss. Drawing on 50 semi-structured interviews with physicians throughout PR and the US, we identified how stigmatizing meanings are attached to PR, its people, and its biomedical system, often incorporating colonial notions of the island's presumed backwardness, lagging medical technology, and lack of cutting-edge career opportunities. We conclude that in addition to economically motivated policies, efforts to curb physician migration should also address globally circulating ideas about PR, acknowledge their roots in coloniality, and valorize local responses to the crisis that are in danger of being lost to history., (© 2024 American Anthropological Association.)

After the legalization of abortion in 2018, Ireland needed clinicians to become abortion providers and make this political win a medical reality. Yet Irish doctors had next-to-no training in abortion care, and barriers ranging from stigma to economic pressures in the healthcare system impacted doctors' desire to volunteer. How did hundreds of Irish doctors make the shift from family doctor to abortion provider? Drawing on ethnographic research conducted between 2017 and 2020, this article explores the process by which Irish general practitioners became abortion providers, attending to the material impact of medical technologies on that journey. Drawing from medical anthropologists who have examined similar themes of agency, pharmaceuticals, and medico-legal frameworks within the topic of assisted dying, I build on Anita Hannig's idea of "agentive displacement" to frame the productive impact of abortion pills on this transition., (© 2024 American Anthropological Association.)

The COVID-19 pandemic has prompted a re-examination of public health preparedness with an emphasis on lessons learned following the West African Ebola epidemic. However, much of this work focuses on technological solutions rather than social learning. Drawing upon anthropological work, this paper examines how Sierra Leoneans prepared for COVID-19 through a lens of "embodied epidemic memory." Findings reveal that while people felt more empowered to respond to COVID-19 due to their past experiences, traumatic memories from the Ebola outbreak also sparked logics of fear and avoidance, driven by mistrust toward the state and its healthcare system. As a result, people avoided healthcare facilities, and rumors concerning government corruption threatened mitigation efforts. While local populations should be better leveraged for their existing epidemic expertise, greater attention is needed to the "higher hanging fruit" of preparedness: restoring trust in the government's ability to respond to epidemics., (© 2024 The Authors. Medical Anthropology Quarterly published by Wiley Periodicals LLC on behalf of American Anthropological Association.)

What does it mean that hospitals in Haiti have become widespread sites of "kidnapping" for mothers and babies? In at least 46 countries, including Haiti, indebted patients are extralegally held prisoner in hospitals until family members, kin, outside groups, or charities pay their outstanding bills. The majority of those detained globally are women following complicated births. This article introduces and situates the global problem of "hospital detention" as it is practiced in Haiti, tying it to transnational architectures that target Black reproduction in global health. In this piece, Senisha and Mari share their experiences of detention, revealing the practice as continuous with other forms of coercion, neglect, and violence they face in seeking safe births, and highlighting the communal care, refusals, and acts of self-liberation that oppose these oppressions., (© 2024 The Authors. Medical Anthropology Quarterly published by Wiley Periodicals LLC on behalf of American Anthropological Association.)

In the contemporary American political landscape, gerrymandering and the passage of anti-abortion legislation are intimately connected in what I call reproductive gerrymandering. I develop this concept as an analytic tool to understand the disjuncture between the passage of laws restricting reproductive healthcare access and the will of the majority of voters. In this ethnographic project, Ohio serves as an important case study where efforts to elect a supermajority of extremist anti-abortion Republican officials has allowed for the passage of unpopular legislation restricting abortion. I argue that the mundane bureaucratic processes involved in electoral redistricting and state budget procedures are forms of bureaucratic violence that result in structural harm experienced by pregnant people, especially those who are most marginalized. Reproductive gerrymandering provides a means for theorizing the connections across domains involving partisan redistricting, reproductive governance in the form of anti-abortion legislation, and the structural violence experienced by pregnant people seeking abortion., (© 2024 by the American Anthropological Association.)

The COVID-19 pandemic prompted critical attention to the performative power of metrics. We suggest that the existential capacities of metrics as a means of pandemic living warrant further consideration. We describe how the COVID-19 pandemic that came into existence as a public health and political event could only have occurred because of the anticipatory metrical practices that were used to transform SARS-COV-2 into a matter of global health concern. By exploring the affective potencies of COVID-19 metrics we show their abilities to engage the public in ways that cannot be contained; in detailing the narrative arcs created through metrics we show their opportunities, misdirections, and erasures. A pandemic way of life persists: a pandemic of metrics., (© 2024 The Authors. Medical Anthropology Quarterly published by Wiley Periodicals LLC on behalf of American Anthropological Association.)

Pregnancy is a processual dialectic that involves continual acts of tactical, responsive, and creative accommodation by pregnant women. This article is a phenomenological investigation of pregnancy experience of working-class women in Manila. In it, I provide an outline of "accommodation:" acts which vary according to the political ecology of procreation in which they are enmeshed, and which are particularly evident in unexpected or unplanned pregnancies. Accommodation constitutes the core act in which the mother-to-be is engaged as the protagonist of procreation, transforming the character of unexpected pregnancy from uncertain and troubled to stable and even joyous as acts of accommodation restore bodily integrity.

In Denmark, people are expected to take responsibility for their health, not least as their bodies age and they experience signs of physical or mental decline. Drawing on fieldwork among older Danes, I illustrate that an excessive focus on health gives rise to social and structural controversies and disparities, linking ideas of healthy behavior at the individual level with the societal framing of disease and aging. I argue that this emphasis contributes to the unwarranted diagnosis of bodily variations that naturally occur in the aging process, a phenomenon referred to as overdiagnosis, adding to a broader medicalization of old age.

We explore the temporalities that shape and alleviate serious health-related suffering among those with chronic and terminal conditions in Kerala, India. Drawing on ethnographic fieldwork between 2009 and 2019, we examine the entanglements between waiting for care within dominant institutions and the community organizing that palliates this waiting. Specifically, people navigate multiple medical institutions, experience loneliness and abandonment, loss of autonomy, and delays and denials of recognition as they wait for care. Community palliative care organizations offering free, routine, home-based care provide samadhanam (peace of mind) and swatantrayam (self-determination) in lifeworlds mired with chronic waiting. We document how community care sustains an alternative politics of shared time, untethered from marketized notions of efficiency and productivity toward profits. In so doing, we cast in high relief community healthcare imaginaries that alleviate serious health-related suffering and reconfigure Global North-centric perspectives.

In this article, we examine a group of older marginalized substance-using citizens and their relations to Danish health care. We offer empirical examples collected through ethnographic fieldwork, about how they handle their health situation and encounters with the Danish healthcare system. Analytically, we particularly draw on the concept of disposable ties, and suggest the term "brittle ties" to nuance the term and examine how perceived individual autonomy is weighted against health care trajectories and how these citizens often prefer to fend for themselves or lean on provisional networks rather than enter into health care trajectories and follow-up treatment.

COVID-19 testing programs in the UK often called on people to test to "protect others." In this article we explore motivations to test and the relationships to "others" involved in an asymptomatic testing program at a Scottish university. We show that participants engaged with testing as a relational technology, through which they navigated multiple overlapping responsibilities to kin, colleagues, flatmates, strangers, and to more diffuse publics. We argue that the success of testing as a technique of governance depends not only on the production of disciplined selves, but also on the program's capacity to align interpersonal and public scales of responsibility.

Medical anthropologists working in interdisciplinary teams often articulate expertise with respect to ethnography. Yet increasingly, health scientists utilize ethnographic methods. Through a comparative review of health ethnographies, and autoethnographic observations from interdisciplinary research, we find that anthropological ethnographies and health science ethnographies are founded on different epistemic sensibilities. Differences center on temporalities of research, writing processes, sites of social intervention, uses of theory, and analytic processes. Understanding what distinguishes anthropological ethnography from health science ethnography enables medical anthropologists - who sometimes straddle these two ethnographic modes - to better articulate their epistemic positionality and facilitate interdisciplinary research collaborations.

Drawing on a two-year ethnography of care practices during the COVID-19 pandemic in Germany, we discuss the affordances of voice-based technologies (smartphones, basic mobile phones, and landline telephones) in collecting ethnographic data and crafting relationships with participants. We illustrate how such technologies allowed us to move with participants, eased data collection through the social expectations around their use, and reoriented our attention to the multiple qualities of sound. Adapting research on the performativity of technology, we argue that voice-based technologies integrated us into participants' everyday lives while also maintaining physical distance in times of infectious sociality.

In Brazil, lack of quality in the delivery of prenatal care is a persistent concern. In this study, I analyze the dynamics taking place in the prenatal clinical encounter, and illuminate how the requirement to produce metrics through registration and monitoring endorses a form of bureaucratic care. This form of care develops in a context characterized by scarcity and a lack of medical resources, where healthcare professionals attempt to contain uncertainty. Ruled by notions of risk, centered in measuring practices, and saturated by an overvaluation of technology, bureaucratic care reinforces the disenfranchizement and stigmatization of Black rural women.

The quest for how to deal with a crisis in a community setting, with the aim of deinstitutionalizing mental health care, and reducing hospitalization and coercion, is important. In this article, we argue that to understand how this can be done, we need to shift the attention from acute moments to daily uncertainty work conducted in community mental health teams. By drawing on an empirical ethics approach, we contrast the modes of caring of two teams in Utrecht and Trieste. Our analysis shows how temporality structures, such as watchful waiting, are important in dealing with the uncertainty of a crisis.

Based on a multi-sited ethnography conducted over 14 months in northern Santiago, I examine how the introduction of a series of health policies and the global mental health agenda has interacted with and impacted Haitian migrants in the context of a postdictatorship neoliberal Chile (1990-2019). Specifically, I explore the interactions between health and social institutions, mental health practitioners, psy technologies, and Haitian migrants, highlighting migrants' subjectivation processes and everyday life. I argue that Haitian migrants engage with heterogeneous subjectivation processes in their interactions with health and social institutions, challenging normative values of integration into Chilean society. These processes are marked not only by the presence of, or exposure to, psy interventions and mental health discourses but also by the degree of compatibility between a psychiatric and neurological language and Haitians' ideals and moral frameworks.

Whilst NHS Health Service management is usually characterized by hierarchized bureaucracy and profit-driven competitiveness, the COVID-19 pandemic drastically disrupted these ways of working and allowed London-based non-clinical management to experience their roles otherwise. This paper is based on 35 interviews with senior non-clinical management at a London-based NHS Trust during 'Alpha phase' of Britain's pandemic response (May-August 2020), an oft-overlooked group in the literature. I will draw upon Graeber's theory of "total bureaucratization" to argue that though the increasing neo-liberalization of the health-services has hitherto contributed toward a corporate mentality, the pandemic gave managers a chance to experience more collaboration and freedom than usual, which ultimately led to more effective realization of decision-making and change. The pandemic has shown NHS managers that there are alternatives to neoliberal logics of competition and hierarchy, and that those alternatives actually result in happier and effectively, more capable staff.

Drawing on ethnographic research at a hospital in rural Zambia, I show how the presence of white Christian medical volunteers from the United States damaged relations between local health workers and patients. Working from a position of economic and racial privilege, medical volunteers received praise from many patients and residents. However, these positive attitudes incited resentment among many Zambian health workers who felt that their own efforts and expertise were being undervalued or ignored. Focusing on these disrupted relationships, I argue that it is crucial to understand how global health volunteering can produce enduring forms of "relational harm".

ABSTRACT Objectives: to analyze how children with type 1 diabetes mellitus and their families explain the pathology, based on their understanding of the factors related to the discovery of diabetes, the etiology, treatment, and prognosis of the disease. Methods: qualitative methodological approach, based on medical anthropology and the narrative method. In-depth interviews were conducted with 12 families of children with type 1 diabetes mellitus attending follow-up consultations at a specialized center. The statements were subjected to inductive thematic analysis. Results: the explanatory models identified describe the families search for the clarification of the signs and symptoms that the child had. Faced with the disease, families reorganized themselves to meet new health care needs of children, such as adequate nutrition, physical exercise, and blood glucose monitoring. Final Considerations: knowing the explanatory models allows the understanding of how families give meaning to the child’s illness, favoring daily nursing care and an effective control of the disease.