Bodies in peril: Healthcare workers on the frontlines of global maternal health interventions

ABSTRACT

Drawing on long-term ethnographic fieldwork in maternity settings in Tanzania and Pakistan, we argue that ‘bodywork’ condenses all politically and practically at stake for maternal healthcare providers. Our research confronts how global health programmes expect paramedical providers working on the frontlines of obstetrics to implement interventions without also attending to violent everyday realities of providing care amidst structural constraint and precarity. We demonstrate this approach's dire aftermaths. Healthcare workers’ bodies evidence risks and injuries not only attendant on care in lower-resource settings, but which unfold specifically from their efforts to meet the onerous demands of global health systems. Toxic hospital environments represent a paradox of care – medicine exposes patients and providers to greater risks than if medicine were not involved – but this inherent riskiness barely registers. Elisions of healthcare providers’ experiences of harm are telling; they reveal global health’s neglect of occupational risk and a racialised under-attention and under-valuing of the risks carried by bodies of colour, and women especially. We trace and corroborate providers’ experiences of threats to their wellbeing while enacting global health agendas. We conclude with a provocation that social scientists’ bedside witnessing must result in actionable evidence if a more sustainable global health is to prevail.

KEYWORDS:

• Bodywork
• obstetric nursing
• structural violence
• scarcity
• occupational risk

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Save for recent compelling examples (Liese et al., 2021; Strong, 2020; Varley, 2019; Williamson, 2021), we are concerned to note the relative paucity of ethnographic work which delineates the clinical specifics of maternity patients’ experiences of iatrogenic injury.

2 See Mulla, 2014, p. 22 for discussion of the ways that ‘survival and suffering’ sometimes operate simultaneously in care practices and processes.

Additional information

Funding

The work in Tanzania was supported by a National Science Foundation Doctoral Dissertation Improvement Grant under Grant 1459486 and Fulbright-Hays Doctoral Dissertation Research Abroad grant under Grant P022A140021. The work in Pakistan was supported by a Social Sciences and Humanities Research Council of Canada Doctoral Fellowship under Grant 752-2002-1868, International Development Research Centre Doctoral Research Award, Ontario Women’s Health Scholars Award, Killam Postdoctoral Fellowship, Canadian Institutes of Health Research (CIHR) Research Training Doctoral Fellowship, Ethics of Health Research and Policy (EHRP) Program CIHR Trainee, Anthropology Department Research Committee Grant from the Lahore University of Management Science, Brandon University Research Committee Faculty Awards, and a Wenner-Gren Foundation Post-PhD Fieldwork Grant under Grant 9373.