Topologies of Humanitarian Attention. Recruiting Patients Accross Borders for Reconstructive Surgery in Amman

• In Event: Without Borders? The Future of Global Health and Transnational Humanitarianism

Abstract

I will address one form the Nature/Culture divide (Latour, 2008) takes in the critique and practice of transnational humanitarianism. For critics, humanitarianism exists in a regime of exception in which bodies – reduced to bare life – and territory – sovereignty has become mobile – are dispossessed (Agamben, 1998; Fassin, 2010; Pandolfi, 2003). For humanitarians, these are matters of practical urgency: how to care for the suffering bodies of distant people?
Material is ethnographic and archival – from a Médecins Sans Frontières hospital in Amman, Jordan and Paris headquarters – and concerns patient selection procedures.
I will first describe the reflexive organization (Callon, Rabeharisoa, 1998) of a recruitment network that spans the borders of a war-torn Middle East to find patients in need of reconstructive surgery. I will show how MSF inscribed a practical duality (James, 1912) in the apparatus: “medical” against “humanitarian ”. These categories partially coincide with the bios/zoê divide (qualified/bare life), and drive reflection on what serves ethical patient selection. Our understanding of these categories is heightened if we take them as existing in different topologies – network and fluid (De Laet, Mol, 2000) – helping MSF to occupy space in different ways.
Secondly, I will explore how this practical duality affected recruitment practice – medical consultations and a deliberative committee – and how the duality was reformulated, allowing MSF to avoid some kinds of discrimination, while remaining attentive to the immediate and future needs of bodies and persons under reconstruction.
I will contribute to the study of global health by describing the ordering (Law, 1993) of attention (Hennion, Teil, 2002) necessary to the care to distant fragile beings (Tronto, 1993; Mol, 2008).

Author

• Evan Fisher, CSI, Mines-ParisTech