Science, Medicine, and Anthropology
In a 2013 essay in American Anthropologist, Andrea Muehlebach summarized the concept of “precarity” as “a shorthand for…the multiple forms of nightmarish dispossession and injury that our age entails.” Indeed, the last month has seen a collection of events, acute and ongoing, that characterize the precariousness of the historical present. In the U.S., July 26 marked the court-imposed deadline for reuniting migrant families, while in achingly predictable form, the public outrage over the health effects of separating of children from their parents in the first place appears to have waned or been buried in the backpages. The effects of separation can be added to the particular forms of injury that come along with statelessness – giving new breath to Hannah Arendt’s famous argument about the relationship between citizenship and human rights: that without membership in a political community, people cannot be protected. Yet, despite the enduring legacy of Arendt’s ideas for social activism, thousands of people around the world continue to flee or be driven from their homes without redress. Others remain internally displaced in conflict zones, or, like the many Nigerians who fled Boko Haram, are being forced to return to the conditions of terror, ruin, or instability they left behind. And, of course, even citizenship itself cannot protect – especially in the U.S., where daily forms of injury and dispossession – via police brutality, mass incarceration, gun violence, settler-colonialism, economic inequality, aging infrastructures, failing public housing programs, underfunded schools, and a broken healthcare system – have continued this month to shape, make precarious, and take away the lives of many Americans.
On injury and dispossession around the globe, in brief: Following weeks of relative calm, the stabbing death of an Israeli by a Palestinian in the occupied West Bank has resulted in retaliatory vows by Israel to expand its settlements there. Regarding the slower-burning injuries of dispossession in the Palestinian territories, a short article in Conflict and Health this month highlights the “political determinants,” particularly the effects of Israeli occupation, which influence barriers to the prevention and treatment of cardiovascular disease in the West Bank. Earlier this month, Israel made the news for its role in facilitating the evacuation of hundreds of volunteer rescue workers, the White Helmets, and their families from southern Syria. Seven years into conflict, Syrian civilians continue to live under siege, and Syrian refugees are scattered around the globe. A study published in this month’s issue of the American Journal of Public Health comparing the prevalence of mental disorders between Syrian refugees in Turkey and internally displaced persons in Syria found high rates in both populations; major depressive disorder was more frequent in the refugee population, while posttraumatic stress disorder was more common among internally displaced persons. Meanwhile, according to a Dutch study published online in Transcultural Psychiatry this month, immigrants and ethnic minorities who lose their loved ones or homes to disaster experience greater distress than citizens born within state borders, suggesting that natal citizenship may have a protective effect. Turns out Arendt may still be right after all.
On injury and dispossession stateside: Residents of Flint, Michigan may soon see their ongoing water crisis “fixed,” not by the U.S. government, but through the commitments of a private citizen. Elon Musk, billionaire co-founder of Tesla, tweeted on July 11 that he would fund “fixing the water” in any house in Flint with contamination levels above Food and Drug Administration (FDA) safety standards. Concluding his tweet,“No kidding,” the newly-minted philanthropist then invited Flint residents to tweet their water quality test results to him. Musk has since clarified his commitment, promising to provide water filters to any homes that show high levels of lead. (Mayor Karen Weaver suggested that Musk instead contribute funds to replacing the city’s pipes, as the State of Michigan already offers free filters to Flint residents.) However it plays out, Musk’s promise can be read as a sign of the times in the post-welfare U.S., where the capital and labor of private citizens drive efforts to repair the catastrophic effects of state failure (see Vincanne Adams’ 2013 ethnography of post-Hurricane Katrina recovery efforts, Markets of Sorrow, Labors of Faith).
The apparent resurgence of public interest in Flint’s water problems coincides with the recent publication of pediatrician Dr. Mona Hanna-Attisha’s memoir, What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City. In the book, Hanna-Attisha describes the consequences of lead exposure in Flint, and across the U.S., as a “silent pediatric epidemic.” Lead plumbing is as American as the road; both are infrastructures of distribution that through their very use deliver the daily possibility of danger. Roads crumble and flood. Pipes corrode. As water courses through the networks of piping that supply American cities’ schools, parks, hospitals, and homes, lead particles dislodge, flowing out of taps and fountains into the bodies that drink from them, with devastating effects. Lead is a neurotoxin – early exposure causes life-long and irreversible cognitive and behavioral problems. Earlier this month, the Centers for Disease Control and Prevention (CDC) posted a new funding opportunity for Childhood Lead Poisoning Prevention Projects aimed at supporting local efforts to surveil and reduce children’s blood lead levels. Yet, as Chicago’s public radio station, WBEZ, recently reported, while the U.S. Environmental Protection Agency (EPA) says municipalities must monitor lead levels in homes, federal regulations do not require cities to test in daycare centres, schools, or parks – nor do they require local officials to replace lead piping, even when home levels exceed safety standards.
Of course, the problem with lead isn’t just in the pipes – it’s in the ongoing abandonment of already disenfranchised populations by local, state, and federal governments. For more on this, see The Poisoned City: Flint’s Water and the American Urban Tragedy, by Detroit journalist Anna Clark, which came out at the beginning of this month – or, listen to Clark interviewed by radio host Chuck Mertz on the July 14th podcast edition of his show, This is Hell! On the show, Clark discusses the specific case of Flint and the broader consequences of “strategic inequality” that our current economic system produces. Last month, Mertz also spoke with anthropologist Kathryn Dudley about her recent Jacobin article on the ongoing decimation of family farms and rural communities in the U.S.. Dudley writes, “The trauma of economic dispossession – of land, of labor, and of national belonging – is never restricted to a single event…It is an ongoing experience of political-economic abandonment that links the loss of a person’s expected future to an intolerable sense of exposure and humiliation.” Pointing to the “deaths of despair” caused by suicide and substance use, Dudley argues that dispossession and the repetition of injury it entails has become ritualized, normalized, and individualized over time. As, it seems, have the attempts to address these traumas. Just a few days ago, in a gesture to offset the damages of the trade tariffs he imposed, Trump promised $12 billion in aid to U.S. farmers. For family farmers, however, the long history of aid-over-trade programs has shown this kind of assistance strategy to be ultimately unsustainable. In another unsustainable strategy, this September, Willie Nelson, Neil Young, and John Mellencamp, will once again headline Farm Aid, a benefit concert series to raise money for American family farmers. In the current political and economic climate, the concert’s tagline, “Keep America Growing!” can be read a few different ways – as a desperate plea, a national imperative, and an expression of hypocrisy – specifically, of the agriculture industry’s deeply hypocritical reliance on (and exploitation of) the migrant workers who the federal administration claims are hurting national growth by taking away Americans’ jobs (see for reference Seth Holmes’s 2013 ethnography of Mexican migrants working in the U.S. food system, Fresh Fruit, Broken Bodies).
Speaking of growing, it appears that cannabis may soon become the nation’s biggest cash crop. On June 26, Oklahoma became the 31st state to legalize medical marijuana, through a ballot initiative that passed with 57% of the vote, an outcome that news media outlets have called a “tipping point” towards the legalization of marijuana in the U.S. A number of countries have already legalized the medical use of cannabis; for example, medical marijuana has been legal in Canada since 2001 (and, last month, Canada became the second nation in the world to legalize the recreational use of the drug). Cannabis is used medicinally for a variety of purposes, including to treat nausea related to chemotherapy, improve appetites in people with HIV/AIDS, and reduce chronic pain. Beyond its therapeutic effects and economic value, however, there may be other incentives to legalize the drug. According to a study published in this month’s issue of The Lancet, interest in the effectiveness of cannabis and cannabinoids to treat chronic pain in the U.S. is growing (sorry!), because of their potential to decrease opioid use. Indeed, a study published online in Addiction this month, which examined the relationship between medical cannabis legalization and opioid prescriptions in the U.S. from 1993-2014, found a nearly 30% reduction in Schedule III opioids received by Medicaid enrollees. While the study’s authors suggest that the pain relief cannabis provides is more on par with drugs like Codeine than, for example, Vicodin or Morphine, it seems that treating pain with cannabis first could prevent patients from developing opioid use patterns that lead to more serious forms of dependency.
It may be no coincidence that these cannabis studies are emerging now, in concert with the latest and largest-ever congressional effort to address opioid addiction. Indeed, whatever the push to legalize medical marijuana may mean for commercial agriculture, its potential to curb the development of opioid dependency suggests a new approach to therapeutic intervention. Another somewhat new approach to addiction treatment (and agriculture!) can be found in the documentary Recovery Boys (2018), released by Netflix on June 29th, which follows four young men at a farming-based drug rehabilitation center in West Virginia. Set in the geographical epicenter of America’s sprawling opioid epidemic, the film cuts scenes of support group meetings with shots of the men clumsily herding sheep, collecting fresh eggs, castrating pigs, and revelling in other pastoral pleasures. In a recent interview, Recovery Boys director and West Virginian Elaine McMillion Sheldon explains that she wanted to capture the “resilience” and “hope” of people managing opioid addiction in her home state, which has the highest rate of deaths from overdose in the country. The back-to-the-land approach of farming rehab may be new(ish), but the narratives Sheldon documents feel archetypal, laced with the bromidic hallmarks of recovery discourse. “This is life today. And it’s all we’ve got,” says one of the men, tearfully, as he prepares to leave the farm. As the four men move through the program, they encounter various challenges and arrive at conclusions about ways of living in recovery, and, of being in the world. Towards the end of the film, with a fresh haircut, and on the way to his new job as a dishwasher, another one of the men describes himself to the camera: “Alright, acceptable, responsible, and productive!” he exclaims, as if reciting an incantation. The moment feels more tender than the tear-soaked goodbye, though not, as Sheldon might wish, by capturing his resilience or hope; rather, its tenderness comes from his palpable desire for the magic of these words to conjure the quotidian.
Given our current systems and conditions, bids for resilience and hope might sound more like pipe dreams (lead pun AND opiate pun! double sorry!). The events and ongoing crises of this month don’t seem to suggest otherwise. That said, people are everywhere working creatively to buck the systems that bring them down. Martin F. Manalansan’s ethnographic essay on the ways in which queer migrant experiences in New York City involve tactics for actualizing alternative ways of being, and Mel Y. Chen’s analysis of “agitation” as an embodied medico-political concept (and as a chronic symptom of the “durative intoxication” brought on by lead exposure), both published in this month’s issue of the South Atlantic Quarterly, speak to the possibilities of this creativity. So does the vibrancy of online spaces like It’s Going Down, a digital anarchist community center that publishes resources, news, and calls for actions against local forms of injury and dispossession in communities around the globe. Many of these calls invoke “solidarity” as an organizing principle, which might seem as unreliable a thing to ask for as resilience or hope. But abandonment collectivizes, and in precarious times, acting together will surely do more to protect us than our citizenships.