Repair in Translation

Abstract

In this article, the author juxtaposes writing and conversation about care for, with, and in spite of technology in Cambodia. The scene is medical care, and the actors are radiologists, engineers, cadres, and X-ray machines. A radiologist is forced to repair an X-ray machine for doctors of the revolution; the pressure and constraints are almost unreal, yet his skill in repair affirms his humanity and the specialized knowledge and creativity required for problem solving. An engineer teaches repair as he fixes an old X-ray machine. He finds words and necessary tools are missing in Phnom Penh, a familiar story of lack, yet repair is material practice that enables improvisation in spite of linguistic and epistemic challenges. A radiologist, the same one from before, in the twilight of his life, questions the dominance of technologies within medical care and the deskilling of doctors. Juxtaposing these stories bolsters attention for the mundane and creative work of keeping things going in a “broken world,” in line with the ways that care and repair are mobilized in STS. It also shows how the radical potential of “broken world thinking” is circumscribed when a broken world is the one from which people are struggling to distance themselves. What we are left with are multiple, overlapping, fraught stories of modernity in which need, choice, and pleasure of repair all have a place.

• Cambodia
• care
• repair
• technology

Acknowledgments

Sincere thanks to Catelijne Coopmans and Karen McNamara for inviting me to the 2017 Asia Research Institute/National University of Singapore workshop Framing Technology and Care in Asian Contexts and for their careful and patient work bringing this special issue to life. Their editorial comments, and those of Casper Bruun Jensen and an anonymous EASTS reviewer, helped to improve this article. Thanks, too, to fellow workshop participants for their comments and stimulating papers. This article benefited from discussion with members of the Indigenous Studies Writing Group at the University of Washington and participants and audience at the Technopolitics in Southeast Asia roundtable at the Association for Asian Studies 2018. Research and writing were supported by the Wenner Gren Foundation, the Center for Khmer Studies, and the University of Washington Southeast Asia Center.

Notes

¹ Michael Adas’s Machines as the Measure of Men (1989) surveys these practices over centuries.

² Kuan-Hsing Chen (2010) argues that the problems of colonialism, the structuring of the world during the Cold War, and imperialism must be addressed together, and that historical experience in Asia must be an “imaginary anchoring point” (xv) for analysis. The “de-” signals its corollary, that movements against these problems must proceed together. There can be no decolonization, no transformation of subjectivity, without both colonizer and colonized reckoning with legacies of colonialism and the Cold War and ongoing forms of imperialism in Asia.

³ Thanks to Noah Tamarkin, who saw resonances between John L. Jackson Jr.’s and my projects.

⁴ This is not the only or even the best way to think about care. As I am explicitly focused on medicine and machines, my thinking here aligns with feminist work that takes technologies as part of care and life, not other to them (Mol 2008: 5; see also Benjamin 2016; Downey and Dumit 1997; Haraway 1991; Pols 2012). Furthermore, this is not the only way to think about care, or health care, in Cambodia. It is not speaking comprehensively, and one of the things it does not speak to are traditional or spiritual healers who are prominent actors. See Au 2011; Guillou 2009; Ovesen and Trankell 2010.

⁵ As Joan Gross commented to me, a sense of breakdown and repair as normal and expected constituents of social life is central to studies of language. Conversation analysis, for example, views repair as the communicative means through which intersubjectivity is maintained. See Kitzinger 2012 for a review of work on repair in conversation analysis. As Denis, Mongili, and Pontille (2016: 7) note, ethnomethodology and conversation analysis assume mundane, face-to-face exchanges are the (vulnerable) constituents of social life; maintenance and repair studies in STS build on this assumption to include the material features.

⁶ Thanks to Ann Anagnost for talking with me about Steven J. Jackson’s work.

⁷ My discussion draws on these important works in history, anthropology, and memoir: Au 2011; Bourdier 2016; Crochet 2008; Guillou 2009; Kong 2014; Ngor 1988; Ovesen and Trankell 2010.

⁸ See Stevenson 2014 for a comparative case of neglectful, anonymous care in the Canadian Arctic.

⁹ The quotation is “In the first place, it is a difficult question if one can distinguish invasion and solidarity in a concrete situation.” Takeuchi Yoshimi, “Nihon no Ajia-shugi” (“Japanese Asianism”), cited in Morita 2017: 239.

¹⁰ Science and technology are of central importance to states borne out of anti-imperialist movements. This is because, as Itty Abraham (2006: 211) notes, science and technology reinforced colonial and neocolonial dominance; technological transformation realized modernity on a practical level; and technology marked the missing modern, the rationale for the colonial project.

¹¹ Engineering World Health began work in Cambodia in 2012. They set up a training program for biomedical-equipment technicians from provincial and national hospitals, in partnership with GE Healthcare and the University of Puthisastra, and the Center of Excellence at Calmette Hospital. The university took over the training program in 2016. Ed Hutton’s (2014) diary, quoted from at the beginning of this article, was published on Engineering World Health’s blog.

¹² I use the Franco-Khmer transcription system developed by Huffman in 1983 and modified by Ebihara, Mortland, and Edgerwood (1994).

¹³ Thanks to Christine Hauskeller for this phrasing.

¹⁴ In addition to how technologies shape care as a skill is the question of how technologies shape health care as an as extractive practice. Health care is already a significant source of debt for poor and middle-class families. The cost of imaging services amplifies this, raising important political questions of resource distribution, regulation of costs, and standards of care.

¹⁵ See Aulino 2016, Funahashi 2016, Seo 2017, and Stonington 2012 for approaches to care in Thailand as embodied routine, moral governance, circuits of infrastructure, and ethical location. Despite different histories and political economies, Theravada Buddhist Thais and Cambodians share ontological commitments to rebirth, karma, and impermanence that configure care practices.

¹⁶ See Dwyer 2009 and Taussig 1989 on terror’s transvaluation of terms.

Additional information

Notes on contributors

Jenna Grant

Jenna Grant is assistant professor of anthropology and faculty at the Southeast Asia Center and Science, Technology, and Society Studies Network at the University of Washington. She is completing a manuscript, titled Fixing the Image, about medical imaging in Phnom Penh.