Engaged Critical Medical Anthropology: Five Steps for Influencing conversations on “Illegal” Im/migration and health
By Sarah S Willen (U Connecticut), Jessica Mulligan (Providence C) and Heide Castañeda (U South Florida)
Of the estimated 214 million people who have migrated from poorer to wealthier countries in search of a better life, 20–30 million have migrated on an unauthorized or “illegal” basis. All have health needs, or will in the future, yet most are denied health care available to citizens and authorized residents. To many in receiving countries, the exclusion of unauthorized im/migrants intuitively “makes sense.” As scholars of health, social justice and human rights, however, we find this logic deeply flawed and are committed to advancing a constructive program of engaged critique. In our view, medical anthropologists can, and should, claim an active role in reframing scholarly and public debates about this pressing global health issue.
This objective guides the work of the “Take a Stand Initiative on Unauthorized Im/migration and Health,” initiated in 2008 under the auspices of the SMA’s Critical Anthropology of Global Health (CAGH) special interest group. To date, the collaborative activities of the initiative include a commentary in Medical Anthropology Quarterly (Take a Stand Commentary: How Can Medical Anthropologists Contribute to Contemporary Conversations on “Illegal” Im/migration and Health? MAQ 25: 331–56), excerpted below, as well as a new multidisciplinary blog, AccessDenied: A Conversation on Unauthorized Im/migration and Health. “AccessDenied” features analytic essays, news round-ups, a dynamic working bibliography, and suggested action steps. New contributors are particularly welcome.
A growing body of medical anthropological scholarship attends to the negative health implications of migrant “illegality.” We celebrate this important new work, but also contend that two issues urgently need to be added to this emerging research agenda. First, we need a clear, robust theoretical framework for research on “illegality” and health in our own field—a challenge we take up in our MAQ commentary. Second, we need to put medical anthropology more actively in dialogue both with partner disciplines that are now consolidating their own research agendas, and with wider public discourses. We propose five ways medical anthropologists can take more active roles in shaping scholarly discourse and influencing public and policy debate:
- We can listen differently;
- We can teach differently;
- We can democratize knowledge production;
- We can translate ourselves for colleagues in other disciplines; and
- We can write differently to communicate more effectively with the broader public.
Below, we elaborate briefly on practical ways to achieve these goals. We can listen differently by engaging a wider range of informants than usual; by avoiding the assumption that we already understand actors’ motivations or political investments; and by conceptualizing our work as engaged listening, rather than giving voice. We can teach differently by, for instance, approaching advocacy as a form of teaching to a broader-than-usual audience. Strategies that work in the classroom—including clear examples that call attention to power, cultural context, and historical depth—can translate well into non-academic settings. We can democratize knowledge production by allowing collaboration to more thoroughly inform all phases of the research process. We also need to translate ourselves for colleagues in related fields such as public health, clinical medicine, nursing, sociology, political science, and bioethics and show them what our field can offer. And since issues of im/migration, otherness, deservingness and human rights are both urgent and contentious in our home and research communities, we need better ways of communicating with the world outside of the academy. One particularly valuable strategy is to write differently through more traditional channels such as policy papers, newspaper op-eds, and organizational newsletters, as well as through channels that utilize new media outlets, including blogs like AccessDenied.
The health-related challenges associated with unauthorized im/migration are growing in scope and magnitude. At the same time, public discussions about unauthorized im/migration are becoming increasingly polarized and contentious. We need a reinvigorated critical medical anthropology that is ready to intervene in the public debates through which exclusionary health policies come to be accepted as common sense. The time is ripe to sharpen our research agenda and expand our roles in public and policy conversations about unauthorized im/migration and health.
To submit a contribution, contact SMA Contributing Editor Kathleen Ragsdale (kathleen.ragsdale@ssrc. msstate.edu).