Pia Juul Bjertrup defends her PhD thesis at the Department of Anthropology
Candidate
Pia Juul Bjertrup, Department of Anthropology, University of Copenhagen.
Title
(IN)VISIBLE EPIDEMICS
Negotiating Hierarchies and the Quest for Recognition in Burkina Faso
Supervisor
Associate Professor Helle Samuelsen, Department of Anthropology, University of Copenhagen
Committee
- Associate Professor Hanne Overgaard Mogensen, University of Copenhagen (chair)
- Senior Researcher Jesper Bjarnesen, Uppsala University
- Senior Lecturer Alice Street, the University of Edinburgh
Host
- Head of Department, Professor MSO Bjarke Oxlund
Time and Place
Tuesday 20 December 2022, 2 PM
University of Copenhagen, Faculty of Social Sciences,
Gammeltoftsgade 13, 1355 Copenhagen K, Auditorium 35.01.06.
Reception:
After the defence, the Department will host a reception at the Ethnographic Exploratory in room 4.1.12, CSS.
Zoom
Topic: PhD Defence - Pia Juul Bjertrup
Time: Dec 20, 2022 02:00 PM Copenhagen
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Summary
Inspired by contemporary discussions about state-citizen relationships (Shepler 2017; Street 2012, 2014,), this dissertation tells the story of lay people’s continuous efforts to engage with public health and social services in a peri-urban context of Burkina Faso with a strong sense of being at the bottom of global health hierarchies.
Epidemic diseases such as COVID-19 and before that HIV, SARS, Influenza A (H1N1) and Ebola have received much attention on the global health agenda and, resources are increasingly being allocated for improving epidemic preparedness in the public health sector in Burkina Faso. In addition, the dominant position of so-called vertical disease programmes, in Burkina Faso, targeting malaria, HIV and tuberculosis risks overshadowing other intersecting needs and health conditions of the majority population. With this background, the dissertation aims to understand how lay people in peri-urban Burkina Faso seek public (health) care and support in the “era of epidemics”.
To answer this question, I conducted ethnographic fieldwork in peri-urban Burkina Faso in late 2019 and the first half of 2020, before and during the COVID-19 pandemic in collaboration with my research assistant, Landry Bambara. Before the pandemic, the PhD study’s focus was primarily on “the sick” and how they persistently sought out public health services for their undiagnosed chronic health conditions. During the pandemic the study focused more specifically on how lay people experience, read and negotiate epidemic measures (shaped by hierarchies in global health), which presented a severe challenge to already precarious livelihoods.
The dissertation is article-based and consists of two scientific articles, a book chapter and a frame that situates the project within the regional, historical and political context and within the larger sub-field of critical medical anthropology. Overall, I show that people in their quest for treatment and cure, and in their endeavour to overcome socioeconomic challenges, engage (sometimes critically) the bureaucratic public system and that they, at times, refrain from following imposed COVID-19 restrictions when these measures become too disruptive for their everyday life. People attempt and often fail to make the state recognise them and their challenges, thus they become immobilised or at times prompted to take matters into own hands in ways, which may be in conflict with epidemic restrictions.
In article I titled, (In)visible Disease: Motions and Emotions Engendered by Papers and Diagnostics of People Accessing Healthcare in Burkina Faso, I turn to the materiality (various papers, empty tablet cartoons etc.) the sick employ in attempts to become visible to the public healthcare system. In doing so I examine how papers and diagnostic technologies present both opportunities and challenges and how they engender hope, uncertainty, disappointment, and despair for the sick seeking a diagnosis, treatment and cure.
Secondly, in article II, Is COVID-19 a Disease of the Elite? Stories about Inequality during the COVID-19 Pandemic in Burkina Faso, Landry Bambara and I show how people associate COVID-19 with the elite in different ways and with different effects. First, our interlocutors blame the elite for the outbreak and their increasingly precarious livelihoods, due to the epidemic restrictions. Second, the narratives show how our interlocutors experience the COVID-19 measures to be favouring the elite and their living conditions and how, in this light, the idea of COVID-19 as a political plot becomes attractive and serves to delegitimise epidemic restrictions.
Lastly, in the book chapter, titled Missing Trust and to Miss Trust - Popular Responses to COVID-19 in Burkina Faso, Landry Bambara and I examine lay people’s trust in the state during the COVID-19 pandemic. We show how trust and mistrust, in this context, are highly related to precarity, contingency and power and we propose to ‘miss trust’ (Bürge 2019) as a more fitting term to describe people’s experiences with the state than the trust/mistrust dichotomy. To miss trust signifies a missing and a longing for the state and state institutions to tend to (material) needs.
The dissertation is embedded in a larger interdisciplinary research project titled Emerging Epidemics: Improving Preparedness in Burkina Faso, a collaborative project between the University of Copenhagen, Université Joseph Ki-Zerbo in Ouagadougou and Institut de Recherche en Sciences de la Santé in Bobo-Dioulasso. My contribution to this project is the attention to intersecting concerns of lay people such as chronic health conditions, which are rarely diagnosed, treated effectively or cured, and the added precarities that epidemic preparedness and response measures might entail.
In the conclusion of the dissertation, I argue that through engagements with public services, at times disengagements, and not following epidemic restrictions and by means of pandemic counter-narratives, lay people in different and sometimes subtle ways negotiate global health hierarchies, which have placed them in an unfavourable and neglected position.