(Dis)connectivities in wartime: The therapeutic geographies of Iraqi healthcare–seeking in Lebanon

ABSTRACT

The proliferation of conflicts across borders of Middle Eastern States has transformed the landscapes of health and healthcare across the region. In the case of Iraq, state healthcare has collapsed under the strain of protracted conflicts. Meanwhile, Lebanon’s post-war healthcare system is booming, and becoming more privatised. In this paper, we build on an ethnographic study on the movements and experiences of Iraqi patients in Lebanon to show how one of the consequences of war is the rise of alternative forms of healthcare–seeking practices and survival strategies – a therapeutic geography that is embedded in regional economies and geopolitical relations and reconfigurations. We argue for the need to reimagine the disconnectivity and connectivity of healthcare systems under war and conflict as grounded in the empirical realities and experiences of mobility in the Middle East.

KEYWORDS:

• Connectivity
• mobility
• Iraq
• war
• therapeutic geography

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Authors’ own data (unpublished).

2 Health literature has predominantly highlighted the profound direct and indirect consequences of war, conflict and violence and the destruction of healthcare systems on health (Hindin, Brugge, & Panikkar, 2005; Levy & Sidel, 2007, 2013).

3 On the relationship between the nexus of state building, governance, and citizenship-making in Iraq, see: Dewachi (2017).

4 Costs and expenses for a delegation of patients is negotiated. This may sometimes include a flat rate for each patient as well as the provision of transport to and from the airport, hospice and meals for the patient and one companion, in addition to the travel expense and the hospital bill itself (Iraqi Ministry of Health [Iraqi MoH], n.d.).

5 For more on the post-civil war reconstruction and the fragmentation of the Lebanese healthcare system see: Kronfol (2006); Van Lerberghe, Ammar, El Rashidi, Sales, and Mechbal (1997); Van Lerberghe, Ammar, El Rashidi, Awar, et al. (1997).

6 The hospital had hired a special liaison to coordinate the arrival and departure of the patients and follow up with their needs. Meanwhile, the Iraqi Embassy had created the new position of medical attaché to facilitate its coordination with other hospitals in Lebanon.

7 All names used here are pseudonyms.

Additional information

Funding

This work was supported by Fogarty International Center [grant number 102518].