Searching for therapies, seeking for hope: transnational cancer care in Asia

ABSTRACT

This paper is about transnational cancer care in Asia. People with terminal diseases such as cancer increasingly escape devastating prognosis of their local regimes of clinical diagnostic truth by traveling to destinations where medicine is more advanced, yet affordable for them, and hence offers a broader scope for hope. The paper suggests that transnational cancer care provides an instructive case of the enormous geographical disparities in the availability of therapies and how this, combined with economies of hope and the marketization of health care, affects patients and their family caregivers. The primary contribution of the paper is the introduction of the concept of relational subjectivities to the health mobilities literature. The findings presented proof that the concept provides a fruitful analytical lens, yielding not only fresh empirical insights but prompting re-conceptualizations of medical travel itself as hopeful, yet risky transnational acts of family care.

KEYWORDS:

• Transnational cancer care
• medical travel
• family caregivers
• patient-subjectivity
• medical globalization
• political economy of hope
• Central Asia
• India

Acknowledgments

I am indebted to all patients, family caregivers, health care and medical professionals, travel agency and hospital managers for taking the time and sharing their view and expertise. I thank Prof Dr Lawrence Cohen for the thought-provoking exchanges we had on the issue of medical mobilities during my visiting fellowship; his reflections inspired me to focus on shifting patient subjectivities in changing health care systems. I also thank Prof Dr Sunita Reddy for the numerous fruitful conversations on the topic and good teamwork during our research collaboration.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. For reasons of data protection, the country must not be named.

2. In total, we interacted with 64 foreign patients and accompanying caregivers in Delhi and 40 professionals working in or with corporate hospitals in Delhi.

3. Following ethical guidelines, all provided informants’ names are pseudonyms.

4. See e.g. Whittaker, Chee, and Por (2017) for mistrust and medical horror stories in Indonesia that motivate medical travel to Penang, Malaysia or Gawande (2002) who elaborates on the dreadful amount of medical errors in the USA.

Additional information

Funding

This work was supported by the Swiss National Science Foundation under Early Postdoc.Mobility [number P2ZHP1_148809]; Swiss State Secretariat for Education, Research and Innovation (SERI) and Indian Council for Social Science Research (ICSSR) under Indo-Swiss Joint Research Programme in the Social Sciences, Seed Money Grants (SMG) [call for projects 2014]; and Prof. Dr. Christian Berndt under institutional funding.