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ABSTRACT
Sensationalistic media coverage has fueled stereotypes of the Mexican border city of Tijuana as a violent battleground of the global drug war. While the drug war shapes health and social harms in profoundly public ways, less visible are the experiences and practices of hope that forge communities of care and represent more private responses to this crisis. In this article, we draw on ethnographic fieldwork and photo elicitation with female sex workers who inject drugs and their intimate, non-commercial partners in Tijuana to examine the personal effects of the drug war. Drawing on a critical phenomenology framework, which links political economy with phenomenological concern for subjective experience, we explore the ways in which couples try to find hope amidst the horrors of the drug war. Critical visual scholarship may provide a powerful alternative to dominant media depictions of violence, and ultimately clarify why this drug war must end.
Acknowledgments
We would like to warmly thank the participants who shared their lives with us. Thanks to Elizabeth Cartwright and Jerome W. Crowder for organizing the AAA panel where this article was originally presented and for providing valuable feedback on subsequent drafts. We also acknowledge Nancy Romero-Daza, David Himmelgreen, Liz Bird, Robin Pollini, Bryan Page, and Shana Hughes for their valuable insight and guidance on this project. Finally, we thank the helpful anonymous reviewers whose comments strengthened this article. Institutional review boards at the University of California, San Diego, The University of South Florida, and El Colegio de la Frontera Norte in Tijuana approved all study protocols.
Supplemental data
Supplemental data for this article can be accessed on the publisher’s website.
Notes
1. For an explanation of the parent study, see Syvertsen et al. (Citation2012). Study protocol for the recruitment of female sex workers and their non-commercial partners into couple-based HIV research. BMC Public Health 12(1):136. For a photo blog discussing several analyses from the parent study, see http://ajphtalks.blogspot.com/2015/07/q-with-jennifer-syvertsen-of-ohio-state.html.
2. The final sample included six couples. One woman was given a camera, but was lost to follow-up before she returned it, so we excluded the couple from the study. One woman became seriously ill and was unable to participate in the photograph portion of the project, but her male partner was included. Each participant received one 27-exposure disposable camera, except that the first two women enrolled were given additional cameras for pilot testing. In total, we collected 301 images from 11 individuals. While we considered using smartphones or digital cameras, we opted for disposable cameras to reduce participants’ risk for theft or police violence.
3. One participant claimed to have witnessed someone get run over by a car and badly injured as he ran out of the canal to escape the police; she said she thought about taking photographs of the incident, but decided against it.
4. All names have been changed to protect identities.
5. This practice is no longer in place under universal health coverage in Mexico. Unfortunately, Mildred and Ronaldo’s daughter was born before Mexico’s national health insurance program, Seguro Popular, was introduced in 2003. Seguro Popular did not reach universal coverage until nine years after implementation. It is unknown how many drug-involved families are continuously marginalized by lack of access to health care services (Knaul et al. Citation2012).
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Notes on contributors
Jennifer L. Syvertsen
Jennifer L. Syvertsen, PhD, MPH, is an assistant professor of anthropology at The Ohio State University. She received her PhD in medical anthropology and MPH in epidemiology from the University of South Florida and completed postdoctoral training in Global Public Health at the University of California, San Diego. Her work addresses health disparities, structural vulnerability, gender, and emotional well-being among socially marginalized populations most at risk for HIV.
Angela Robertson Bazzi
Angela Robertson Bazzi, PhD, MPH, is an assistant professor in the Department of Community Health Sciences at the Boston University School of Public Health. She received her PhD in Global Health from the University of California, San Diego, and completed postdoctoral training at the Harvard School of Public Health. Her mixed methods research is focused on substance use, sexual health disparities, and the social determinants of infectious diseases among marginalized populations globally and in the United States.
María Luisa Mittal
María Luisa Mittal, MD, is a postdoctoral fellow at the Division of Global Public Health at UC San Diego, and an Adjunct Professor of Community Medicine at her alma mater Universidad Xochicalco in Tijuana, Mexico. Her research focuses on reducing harms associated with substance use worldwide, especially in the Mexico–USA border region. In collaboration with the Division of Global Public Health at the UCSD School of Medicine and the Mexico–USA Border Health Commission, her work has concentrated on HIV prevention with underserved, marginalized populations, including female sex workers and people who inject drugs in Tijuana, Mexico.