Recovering pleasure: Frontline health workers, sexuality, and global health

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 15. Global Health

Abstract

Frontline health workers play a critical role in global health. Frontline health workers’ experiences are usually studied through the challenging work conditions they face, the health outcomes they advance, and the nature of rewards in their work. Some critical scholarship examines how frontline health workers move towards or against the interests of sexually marginalized clients. But rarely if ever does the scholarship consider frontline health workers’ own sexuality and how it might shape their work and life experiences. I focus on a large and important frontline health workforce—India’s women community health workers called Accredited Social Health Activists or ASHAs—to ask, how do ASHAs experience their own sexuality? Based on 14 months of ethnographic fieldwork in north India from 2017-19, including 80 interviews, I find that ASHAs experience their sexuality in three key modes: 1) as self-presentation and impression management aimed at respectability, 2) as a vector of control imposed by institutions like the workplace and family, and 3) as a subjectivity constituted by aspirations and the threats invoked by aspiration. Significantly, across all three modes, I find that while a pleasure-denying ethos is the public face of ASHAs’ sexuality, there is also a hidden face. This hidden face of ASHAs’ sexuality is an active enjoyment of illicit sexual pleasures that the high mobility of frontline health work affords women. I show how the public and hidden faces of sexuality constantly interact to produce frontline health workers’ experience of their work and lives. My findings, then, recover sexual pleasure in frontline health work. My findings bridge and advance two sociological literatures: on rewards in frontline health work, and on the place of sexuality in global health.

Author

• Vrinda Marwah, University of South Florida