Making kinship away from home: chronic disease and the Pakistani diaspora in the US

Abstract

The article considers several generations of Pakistani immigrants from Karachi to various cities in the United States such as Chicago and New York and explores how chronic diseases are shaped by the reverberations of conflict in kin relations in the US and Pakistan. Instead of examining the experience of chronic illness in isolation, the article considers how webs of evolving relations, tensions, competition, and conflicts among distant and close kin are experienced by the vulnerable and those who try to care for them. These conflicts are shaped by the experience of absence and also in the lives of intimate kin, and often appear in violent form. In navigating these relations, caregivers of those with illnesses develop strategies to maintain communications with wider kinship networks while also shielding the sick from the ramifications of ongoing disputes.

Keywords:

• Pakistani migrants
• United States
• kinship
• chronic illness

Acknowledgement

The research for this article has been made possible through generous contributions from the American Institute of Pakistan Studies. I would like to thank Isabella Cook, Alexander Solis and Nicole Illesca for their important contributions in a course I taught at the Johns Hopkins University titled “Migration, Health and Kinship.” I would also like to express my gratitude for the contributions of the study participants. I would like to thank the anonymous reviewers of Asian Anthropology for their feedback and Gordon Mathews, the editor, for facilitating the review. Finally, I would like to thank Kaveri Qureshi for directing me to important studies on South Asian migration to the US. Her work has inspired me to explore the relations between migration and illness in the South Asian Diaspora.

Disclosure statement

No potential conflict of interest was reported by the author.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Notes

1 All names in the article are anonymized.

2 An underpowered bike known for its fuel economy, mainly in use among working-class and lower-middle-class families.

3 Thanks to Dr. Pir Sheraz Ali from the Pakistan Institute of Cardiology for describing the timeline of the first bundle pacing survey in a conversation in Karachi. See https://tribune.com.pk/story/2137392/1-bundle-pacing-performed-first-time-pakistan-nicvd

4 According to Islamic norms, breastfeeding creates “milk-kinship” between the woman and the child (See Parkes 2004).

5 This is partially because sibling sponsorship constitutes the highest number of petitions from most countries, including Pakistan. See https://www.boundless.com/blog/4-million-people-waiting-family-sponsored-green-card/

Additional information

Notes on contributors

Sanaullah Khan

Sanaullah Khan is a medical anthropologist with an interest in mental illness, kinship and displacement in Pakistan.