Review of Care Work and Medical Travel: Exploring the Emotional Dimensions of Caring on the Move By Cecilia Vindrola‐Padros (Ed.), Lexington: Lexington Press. 2021. 214 pp.

Amy Speier

University of Texas at Arlington

Care Work and Medical Travel is an important foray toward conceptualizing the myriad ways that care is entangled in medical travel. This interdisciplinary collection builds onto an already large corpus of work related to medical travel, also known as medical tourism. The chapters’ examinations of multiple types of care bring an often overlooked subject to the forefront. Although some scholars have included conceptions of affective or emotional labor within larger studies around medical travel (myself included), care has not been at the forefront of critical examination. The authors of this book push the envelope when it comes to highlighting previously ignored or undervalued care-work as it is enacted by patients, patient families and social networks, medical professionals, as well as medical facilitators or brokers.

Many times, the family of chronically ill patients or of immigrants who have chosen to stay in their country of origin, also practice important forms of care. Often, they will travel with their significant other or parent seeking care, and they must master certain forms of knowledge of their kin’s medical history. Extended kinship networks may also be called upon when patients travel abroad for health care, be it for routine examinations, or for hospitalizations, or for finding herbal and homeopathic treatments from one’s native land.

Scholars who have been concerned with medical settings in which patients interact with doctors, have often highlighted the importance of this relationship toward positive health outcomes. Even further, the chapters in this volume highlight the necessity and enactment of care within a transnational context of medical travel. For those patients who are traveling seeking care, who have already been shown to be motivated by cost, competence, expertise, and technical capabilities, are also motivated by, and seeking elements of care. While some of the chapters in this volume speak to doctors who are enacting affective care for their patients, as in Mexico for foreign patients to distance themselves from health care providers in the United States as well as for Russian doctors working in Finland, many of the chapters here focus on what they call medical travel facilitators, or MTFs.

Obviously, care is a dynamic concept in this volume, often building upon previous understandings of affective or emotional labor. Of course, when “caring” is enacted by MTFs then we must acknowledge there are multiple dimensions—caring as a business action but also as a humane action. Many of the chapters attempt to dispel problematic dichotomous renderings of love and money, business, and family, to reveal the nuance offered by centering care as an analytic lens. Caring for and caring about, logic of choice versus logic of care are two examples of other analytic dichotomies that the authors insist are more complicated. Care is a relational activity, material and symbolic, a practice and a value. It is an element of justice.

Medical travel facilitators pepper this volume with varied examples and vignettes of the type of emotional labor that they are involved in. Once again, dichotomies are upset when we can talk about the emotional connections and senses of familiarity that develop between patients and their facilitators, revealing that there can be compatible exercises of care for and about within a business setting. In fact, caring may also entail advocacy of a patient in different settings. And, as is often the case, patient testimonials often serve to bolster future business for medical travel facilitators.

The authors in this volume render visible the often-invisible acts of caring that are embedded in formal and informal medical and health care strategies, which are now more complex when situated in a transnational context. Also, caring can involve moral commitment, mental work, physical work and cognitive work. Interestingly, in the context of humanitarian aid, it is also shown that care does not necessarily entail affection or emotion. This volume is feminist in theory and praxis, as the authors not only attend to the ways in which care work is often gendered but render varying levels of care visible. More importantly, the authors also remind us of the precarity, complexity and ambivalence that are also associated with care.

Trust is an important dimension of healing. Trust, along with emotional connectedness, is important within the doctor-patient relationship, but also in working with medical travel facilitators. Often, it is a lack of trust amongst immigrant communities of their new medical healthcare systems that stymies their movement back home for better healing outcomes, for a better sense of belong, of home. In fact, biomedical structures in the United States may be equated with imperial, colonial powers.

Medical travel broadly conceived is not only the movement of patients, but also goods/medicines, caregivers, information, gifts. Much of the past medical travel literature has focused on travel to the Global North, yet this volume includes important contributions regarding medical travel within and from the Global South. Some authors historically situate their work within larger global histories of colonialism, displacement, humanitarian relief, and tourism generally conceived. Furthermore, the varying mobilities involved in medical travel often move in both ways, not unidirectionally. For example, in the case of Russian speaking migrants living in Finland seeking care in Russia, as well as Russian speaking doctors practicing in Finland, the ideas, medications and support cross borders from both sides. Digital technologies have also changed the landscape, not only of medical travel, but it can also be involved in the creation of new types of meaning surrounding care.

This book will be appealing to many social scientists engaged in studying affective economies and medical travel. While theoretical, each chapter will be accessible for both undergraduate and graduate students who may be enrolled in a Medical Anthropology of Medical Sociology class. It would also be of interest to any medical professionals who are engaged in providing care to patients from abroad, or who themselves are thinking about providing services abroad.

Finally, some of the chapters in this volume call for instances where more care is needed—for NGO professionals, humanitarian aid workers, as well as certain patients such as those traveling for reproductive care, whose positive outcomes could be strongly correlated with psychological support. There is also a call for medical care facilitators for children who are traveling alone. But then again, don’t we all need a bit more care in our lives to be healthy and well?