Society for Medical Anthropology
Oral Presentation Session
Leah Katzelnick (School of Public Health, U.C. Berkeley)
Dengue is a relatively new arrival in coastal Ecuador, and is relatively difficult to diagnose, yet as a viral infection it leaves traces of its presence in the immune system. So-called “rapid diagnostic tests” (RDTs) can provide information about both past and present exposure to these viruses, even though effective treatments are still unavailable. RDTs thus prompt ideas about exposure, infection, and risk in the context of an infection without cure.
To understand how different interest groups conceptualize what dengue viruses are, how and where they spread, what risks they pose, and how they are diagnosed, managed, and prevented, we are using ethnography within a five-year epidemiological study of dengue and Zika virus incidence and transmission in rural coastal Ecuador. Rapid Diagnostic Tests help community members, our own research team, local health service workers, and provincial and national health authorities to visualize dengue variously. For some it is a present health concern; for others an ill-defined sense of future menace; an epidemiological category of incidence or burden of disease; a rationale for experimenting with or purchasing new vaccines; and proof of government competence or ineptitude. Our ethnographic interviews and observations cover a rural province and its capital as well as relevant health ministries in Quito and Guayaquil. They allow us to see how a single device creates complex and contradictory meanings for different actors in the health system: it provokes uncertainty about risk and the meaning of health among villagers while creating certainty about epidemics and health policies among politicians.