In Turkey's occupational health system, doctors must use the International Labor Organization's (ILO) standards to classify the chest radiographs of workers at risk of lung diseases caused by dust exposure. Yet these standards do not provide a uniformity of care within the tripartite structure of the occupational health system, which divides disease surveillance, disease diagnosis, and worker compensation into distinct silos. This division often produces ambiguity and unpredictable outcomes for occupational disease claims. The traffic of diagnostic decisions among workplaces and medico-legal institutions-what I refer to as diagnostic ecologies-shapes medical knowledge. The tripartite organization of the occupational health system in Turkey makes the evaluation of chest radiographs a space where professional expertise and professional ethics are constantly negotiated. A focus on diagnostic ecologies illustrates how disease ontology is distributed across the occupational health system's components.

Attending closely to the lived experiences of people moving in and out of Medicaid-funded institutions, I argue that "the streets" are critical to understanding healthcare in US urban poverty. Exploring the relationship between "the streets" and Medicaid-funded institutions, this essay asks: How does the relationship between "the streets"-and in the words of my research interlocutors-"life on the other side" shape life in Medicaid-funded institutions in the Northeast US city? How do the social and symbolic conditions of this relationship-conditions structured by anti-Blackness-formulate the human in urban poverty? By joining Medicaid-funded institutions together as a broader health-governing network, I demonstrate how these institutions become boundary spaces that reveal the socially and symbolically interdependent worlds of "the streets" and life off them. Ultimately, this essay argues that "the streets" contain the social and symbolic conditions that dehumanize the poor through the logics of anti-Blackness, thus defining the terms of humanization that Medicaid-funded institutions afford.

Based on 28 months of ethnographic research in Deanuleahki-a river valley in Sápmi, the transborder Indigenous Sámi homeland-this article traces my interlocutors' striving to reclaim and repair ecological and kin relations through the everyday praxis of care. I trace this striving through the unmaking and remaking of local relations of care amidst encroachment by post-Second World War Nordic welfare states and regimes of environmental stewardship. I propose a dual conceptualization of ecosocial injury and resurgent care to account for, on the one hand, care's alienation from its social and ecological contexts; and, on the other, the intimate everyday labor of revivifying relations of kinship and belonging, and conditions of material livability, within local ecologies. This defiant and desirous politics of care carves out an opening to attend ethnographically and theoretically to both dislocation and repair in spaces of Indigenous resurgence. In conceptualizing such a politics of care, the article brings into conversation key literatures in medical anthropology and in the interdisciplinary scholarship on care and Indigenous resurgence.

Achieving a target of zero-zero disease, zero disability, and zero discrimination-has become the dominant focus of campaigns to control or eliminate diseases, from HIV/AIDS to malaria to leprosy. Given the historical failure of most eradication programs over the last century, such teleological imaginings of disease-free futures might seem overly utopian. But even if it were possible to eradicate such diseases in their entirety, would this be universally welcomed, even by those most affected by them? In this article, I compare the narratives of national and international bodies concerned with eliminating leprosy, in particular, with the more ambivalent narratives of those affected by the disease in India, the country where the disease is most prevalent. For the latter, the promise of elimination not only seems unrealistic, but represents a potential loss of identity. Imagining disease trajectories in less linear terms, I argue, might also nuance understanding of them.

In this article, we examine the clinical encounters of people diagnosed with a severe mental illness (SMI). Drawing on more than 1-year of ethnographic research and interviews in Indonesia, we show that instances of moral self-reflection occurring in the process of acquiring and appropriating clinical insight emerge at the intersection of heterogeneous discursive regimes. When biomedical notions of health and illness dominate these discourses, they reimagine pre-existing notions about spirituality and religion. Furthermore, consenting to psychiatric notions of health and illness can create common ground and a sense of shared experience, leading to grassroots movements for the empowerment of the mentally ill, self-help groups, and other support structures. At the same time, these processes can increase uncertainty and be generative of a culture of blame, as individuals are caught in overlapping and at times contradictory moral systems that each have the potential to strip patients of their moral status.

This article explores how acuteness is experienced by people with endometriosis in Finland. Drawing on in-depth interviews as well as anonymous written endometriosis stories, we trace instances when the sense of chronicity and cyclicality of endometriosis is disrupted by a possibility of risk to life. These instances include when endometriosis tissue grows in unanticipated and aggressive ways, when medical interventions lead to unexpected complications or medications raise concerns about a gradually developing risk, and when endometriosis diagnosis becomes a catch-all category that could mask the onset of a life-threatening condition. Our analysis of illness experiences suggests that, while risk to life is an unlikely outcome in chronic conditions such as endometriosis, concerns about risk shape how the chronicity and cyclicality of endometriosis are felt and managed in everyday life.

This article examines how Eritrea's realization of Millennium Development Goal 5 (the reduction of maternal mortality) reveals the complex workings of medical sovereignty in sub-Saharan Africa. Through the case study of Eritrea, I demonstrate how postcolonial African countries might approach structuring their healthcare systems to navigate-and challenge-the neoliberal contours of global health humanitarianism. By analyzing both Eritrea's colonial history and the liberation-era history of medicine alongside contemporary healthcare policymaking, I trace how racial and gender dynamics shape the reduction of maternal mortality and the pursuit of medical sovereignty more broadly. To engage in this pursuit, African states must negotiate the tensions between autonomous healthcare development and the political constraints of global health humanitarianism.

Despite the transformative contributions of Black feminist thought, medical anthropology often fails to recognize or center the works of Black feminist thinkers. We argue that Black feminist theory is critical for a study and praxis of new approaches to healing, health, medicine, illness, disability, and care. We can't continue to simply recognize that current systems are failing us; Black feminist theory moves us past recognition toward transformative liberation. This special issue emerges from works and conversations leading up to, during, and after the first Black Feminist Health Science Studies Collaboratory, held virtually in May 2021. Through the Collaboratory, we propose a new form of coming together around the sharing of knowledge and practice based in Black feminist thought and Black feminist healing arts. The collection of works that follow demonstrates and provides practical means toward a more liberatory practice of medical anthropology.

Since the 1990s, preimplantation tests within in vitro fertilization have promised to enhance the selection of embryos for uterine implantation. However, alongside ethical controversies, these diagnostic techniques often identify a high rate of mosaic embryos-those containing a mix of cells deemed normal and abnormal-creating one of the largest technical challenges related to the testing. These cases raise dilemmas for professionals in assisted reproduction and, more intensely, create challenges for individuals whose embryos are identified as mosaic. This article examines the experiences of a woman who decides to implant a mosaic embryo, focusing on her strategies for managing technical uncertainties and evaluating the embryo's potential. It highlights the essential role that online forums play in this process and examines how users utilize these platforms to gain insights and navigate the complex decisions involved with new biomedical technologies.

Selective abortion of female fetuses is a widespread, illegal, and profoundly consequential form of family planning in contemporary India. In Gujarat state, public health campaigns against the practice rely on narratives exhibiting the hallmarks of melodrama: good-evil binaries, stock characters, emotional provocations, simplistic diagnoses, and inevitable triumphs. As biopolitical truths, such narratives resonate ethically and emotionally for people. By individualizing blame, obscuring structure, circumscribing discourse, and legitimizing authority, such narratives also exert many classic biopolitical effects. But they do not necessarily transform subjectivity or behavior, as biopower is often assumed to. Anti-sex selection messaging illustrates how moralistic, sentimentalized interventions against potentially harmful practices can provoke strong responses without changing actions. In highlighting resonance as a relevant biopolitical limit, the not-quite-paradoxes of Gujarati public health narratives-encapsulation without accuracy, regulation without discipline, authority without efficacy, participation without transformation-suggest one approach for analyzing the governance of life without falling into determinism.

Pain can be a pervasive feature of cancer, particularly in regions such as India, where the disease is rarely detected in its early stages. Yet over recent decades, morphine, a "gold standard" pain medicine, has been rarely used in India. This article draws on anthropological discussions of clinical disclosure in Indian cancer care to complicate assertions that this is because pain is missed or ignored by healthcare workers. Instead, in a context where the disclosing of prognoses is partial and indirect, I argue that morphine has gained a communicative function. Typically withheld until the "end of life", the drug has come to be read as a death sentence. It has become an analgesic and a prognosis. It is an object that talks in situations where direct communication is often avoided.

Following the recommendation of the WHO in the mid-2000s, the Ugandan government banned traditional birth attendants (TBAs) and encouraged all women to give birth in biomedical clinics. Yet in rural Luuka district, about half of women still give birth at home or with the assistance of lay providers. This article examines women's healthcare behavior to better understand decisions that are characterized as irrational by officials, in particular women's choices to delay care, move between providers, and defer health decisions to others. Building on anthropological interest in the relationality of care, this article explores how women compel the care of others, especially under conditions of healthcare scarcity and in contexts outside clinical settings. A focus on the gendered nature of kin-based care provides insight into how acts often characterized as irrational can be modes of action for women in ways that exceed a policy focus on healthcare choice and autonomy.

We compare the social determinants of health (SDOH) and the social determination of health (SDET) from the school of Latin American Social Medicine/Collective Health. Whereas SDET acknowledges how capitalist rule continues to shape global structures and public health concerns, SDOH proffers neoliberal solutions that obscure much of the violence and dispossession that influence contemporary migration and health-disease experiences. Working in simultaneous ethnographic teams, the researchers here interviewed Honduran migrants in their respective sites of Honduras, Mexico, and the United States. These interlocutors connected their experiences of disaster and health-disease to lack of economic resources and political corruption. Accordingly, we provide an elucidation of the liberal and dehumanizing foundations of SDOH by relying on theorizations from Africana philosophy and argue that the social determination of health model better captures the intersecting historical inequalities that structure relationships between climate, health-disease, and violence.

Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous-specific racism and its role in decision-making.

In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID-19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vaccine hesitancy, leading to the development and implementation of the state-funded and physician-led "Vaccine Champion" ("VaxChamp") program. Glossing the primary problem as one of "provider confidence," the VaxChamp program emphasized a standardized, scalable intervention that targeted healthcare providers directly, and patients only indirectly. Although the program hit its quantitative benchmarks, a qualitative inquiry into the program's history and context reveals multiple crises of confidence, many beyond the bioscientific domain of the program's focus. Drawing from work in medical and linguistic anthropology, we describe and analyze the "multiple levers of vaccine confidence" at play in the intervention and its surrounding context, as well as how these crises of confidence emerged.

Recent ethnographies have investigated self-care as a socially driven configuration of care. This analysis engages theorizing on the imagination to expose new social dimensions of self-care in cases of mental health as embodied and communal. Based on fieldwork across Canadian universities and in conversation with students, campus wellness providers, and a group of psychiatric epidemiologists seeking to understand the mental health treatment choices of students, this article examines how these different subjects activate what I call an imaginarium of self-care. Among young adults in Canada, mounting social ills that go therapeutically unaccounted for have relocated forms of self-care into the imagination through play and world-building in ways that challenge the distinction between material and speculative healing. Attending to the imaginative dimensions of self-care makes coherent the ways that young people are grasping for hope in a world that-when embodied-resists recovery.

This article examines how militarized regimes of narcotics and price control sustain unpalliated cancer pain in Pakistan. It shows how these regimes of control-reimagined as "regimes of pain"-render morphine, a cheap, effective opiate analgesic, scarce in hospitals. Meanwhile, heroin, morphine's illegal derivative, proliferates in illicit circuits. The article highlights a devastating consequence of the global wars against drugs and "terror": the consignment of cancer patients to agonizing end-of-life pain. Widening the analytic lens upon palliation beyond bodies and their clinical encounters, the article offers a geopolitics of palliation. It shows how narcovigilance targeting illicit drugs has the perverse effect of throttling morphine's licit supply. It shows further how unviably low price ceilings, purported to ensure a poor population's access to morphine, render it scarce on the official market. These mutually reinforcing regimes of control thus thwart their own purported objectives, consigning cancer patients to preventable, yet unpalliated, pain.

Drug overdose is a leading cause of death among adults in the United States, prompting calls for more surveillance data and data sharing across public health and law enforcement to address the crisis. This paper integrates Black feminist science and technology studies (STS) into an anthropological analysis of the collision of public health, policing, and technology as embedded in the US National Overdose Response Strategy and its technological innovation, the Overdose Detection Mapping Application Program (ODMAP). The dystopian Netflix series "Black Mirror," which explores the seemingly useful but quietly destructive potential of technology, offers a lens through which to speculate upon and anticipate the harms of collaborative surveillance projects. Ultimately, I ask: are such technological interventions a benevolent approach to a public health crisis or are we looking into a black mirror of racialized surveillance and criminalization of overdose in the United States?

Biomedicine is organized around interventions. Despite growing concern about overtreatment in healthcare systems, not intervening can still raise questions about potential negligence and the quality of care. Based on ethnographic fieldwork with palliative care teams in England, we explore the work palliative care specialists do to reduce and sometimes halt interventions for patients at the end-of-life, in a general medical environment that is largely interventionist. We describe how judgments about what is an action or not aren't based on obvious or agreed criteria, but ultimately according to what different actors feel constitutes the best form of care. In other words, the underlying values that shape ideas of care determine how action and inaction are nominated, and not the other way around.

Cancer patients and survivors in the United States are increasingly likely to use online crowdfunding as a means of offsetting the expenses associated with their medical care. This practice of making an online appeal for support to a broad public audience constitutes an inadvertent form of informal emotional labor for its practitioners-labor in which striking the right affective notes in one's appeal is believed to be critical to fundraising outcomes. Drawing on ethnographic interviews, we suggest that crowdfunding produces an array of complex, often contradictory sentiments and narrative incentives for cancer patients and survivors-ultimately transforming the experience of serious illness.