Society for Medical Anthropology
Volunteered - Oral Presentation Session
Rural health worker’s realities can often be overlooked in wider discussions about reproductive-governance (Morgan,2012) and biopolitical-policies concerned with the disciplining of indigenous bodies through state-run health care. Although these workers are often made invisible, a focus on the lives they lead and pressures they undergo can contribute to wider understandings of the relationship between the state and the people as this is materialised in the local clinic setting. This is particularly salient in the case of Peru, where state-health personnel have recently been accused of perpetrating the enforced sterilisations of the 1990’s due to personal discriminations against the rural indigenous populations (Villegas,2017), placing the blame on individuals rather than the government.
Drawing on a year of ethnographic fieldwork in Ayacucho, Peru, this paper explores the realities of state health workers with a focus on obstetricians working in family planning within a rural ministry-of-health network serving a majority Quechua population in the Andes.
It will be discussed how these government employees largely engage in census-taking; an activity that Scott calls an 'instrument of statecraft’ (1999:343) intended to render citizens more ‘legible’ and therefore more easily governable (or disciplinable). Thus, workers are often required to collect extensive data on their patients rather than focus on treating them for medical concerns. Furthermore, this relentless administrative work arguably restructures job-roles, (for which the candidates are highly-qualified), into monotonous grinds, echoing Graeber’s theory on the phenomenon of ‘bullshit jobs’ (2018), a condition that can result in de-motivation and affect their ability to provide optimum care.