Book Review: Medical Humanitarianism: Ethnographies of Practice

Medical Humanitarianism: Ethnographies of Practice. Sharon Abramowitz, and Catherine Panter-Brick eds., Philadelphia: University of Pennsylvania Press, 2015, 274 pp.

The anthropology of humanitarianism has grown steadily in the past decade, drawing from work in medical anthropology, the study of international development, historical studies of aid, and other bodies of scholarship to constitute an emerging field in its own right. A number of edited volumes have presented the work of anthropologists around the world working on issues ranging from intervention in states of exception to new forms of care. Medical Humanitarianism: Ethnographies of Practice, edited by Sharon Abramowitz and Catherine Panter-Brick, contributes to this effort with a collection of 12 case studies from conflict and disaster settings around the world.

The volume is unique in two ways. First, all the cases presented ostensibly focus on medical humanitarianism, as opposed to other forms of humanitarian activity. As is the case for medical anthropology (which happens to be the primary discipline of most of the volume’s authors), the medical dimension of medical humanitarianism can be applied to a wide range of processes (including malnutrition, tsunami recovery, the training of American physicians); this is reflected in the diversity of topics covered. Furthermore, it is challenging to create distinctions between different dimensions of humanitarianism: economic, geopolitical, military, medical, and the like. As Amy Moran-Thomas reminds us in her chapter on the “afterlife” of guinea worm eradication programs in Ghana, anthropology can serve to “unsettle abstractions” and to “filter things otherwise” (p. 214). The works in this volume are as much about state sovereignty as they are about medical services, and the authors all situate the provision of clinical services within larger economies and political processes.

The volume’s second defining characteristic is its focus on ethnographic case studies rather than philosophical or abstract reflections on the nature or meanings of humanitarianism. The editors hope that these “comparative humanitarian ethnographies [will] bring medical humanitarian life into sharper relief, inspiring innovation, accountability and relevance in the field” (p. 3). They aim to find ways for ethnography to “engage with humanitarianism work without becoming mired in struggles over practical relevance and moral legitimacy” (p. 4). For students and scholars of humanitarianism, particularly those familiar with anthropological analyses, the book’s appeal is certain: The chapters are engaging and rich in ethnographic detail, illustrating both the seemingly universal characteristics of contemporary transnational humanitarianism and the diversity of structures, actors, and tensions in the sites where humanitarian activities take place.

For humanitarian practitioners, however, it is not clear if the nuance, detail, and texture provided in these texts will provide tools to solve pragmatic problems or simply confirm what they often seem to know about the sites where they work: It’s complicated. In the introduction, Peter Piot suggests that scholarship is this vein is particularly useful in fostering reflexivity and providing others’ points of view on humanitarian dilemmas. However, this can be at odds with humanitarianism’s quest for universals, most commonly in the form of humanity and rights.

The chapters in this volume are intended to provide ethnographic perspectives on medical humanitarianism, so they are less concerned with generating new conceptual or analytic tools. Several of them do engage with recent theoretical work on humanitarianism and strive to provide empirical data to refine or critique concepts and paradigms. In particular, some authors question Mariella Pandolfi’s concept of “mobile sovereignties (Pandolfi, 2003), whether in the context of strong states such as Indonesia (Good et al.) or when considering organizations’ withdrawal from sites of intervention (Abramowitz). Overall, however, the authors focus on providing a sense of the messiness and complexity of medical humanitarian interventions, either in highlighting the lived experiences of diverse categories of humanitarian aid workers, examining the production of knowledge and data, or studying the afterlives of interventions.

Ethnographic research offers the advantage of long-term and sustained engagements with populations and field sites, and all the authors demonstrate in-depth knowledge of social relations and power dynamics in the areas where they have worked. The brevity of the chapters, however, do not always allow for this depth to emerge, and readers will want to seek out the authors’ lengthier publications that allow for more extensive descriptions and analyses.

In sum, the volume provides rich, grounded, and nuanced data on humanitarian processes. The chapters are succinct and well written and will be appropriate for use in undergraduate and graduate courses on humanitarianism and related topics. In addition, they will be of particular interest to experienced humanitarian practitioners who may be seeking terms and language with which to frame and interpret their experiences.

Reference Cited
Pandolfi, M.
2003 Contract of Mutual (In)Difference: Governance and the Humanitarian Apparatus in Contemporary Albania and Kosovo. Indiana Journal of Global Legal Studies 10:369–381.

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