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This paper examines the affective inequalities underpinning the extensive responsibilities of care that are shouldered by chronically ill middle-aged British Pakistani women. In the context of ethnic health inequalities, chronic illness and premature ageing are ubiquitous. Further, mid-life generates gendered pinchpoints in the dynamics of care. The paper draws on extended conversations with women over seven/eight years and tracks their unsettled perspectives on sabar (patient endurance). Middle-aged women described how, over the long haul of living alongside chronic illness, they intuited that they must place some limits on caring for others, and that care required self-care - not in a biomedical sense, but in the sense of attention to their own bodily and relational needs. The paper extends anthropological critiques of Levinas's philosophy of infinite responsibilities to care, tracking how changes at several temporal scales - the life course, intergenerational re-negotiations - affect care. While social transformations of gender, and the proliferation of neoliberal discourses on self-care do affect the traction of normative notions of selfless care for others, the paper locates women's changing perspectives on sabar primarily in the provocations of everyday life. [ABSTRACT FROM AUTHOR]

Experiences of autism-spectrum disorder are now increasingly studied by social scientists. Human-animal relations have also become a major focus of social inquiry in recent years. Examining horse-assisted therapy for autistic spectrum disorders, this is the first paper that brings these fields together. Drawing on participant observation and interviews at a UK horse therapy Centre, this article examines how staff and the parents of riders account for the successes and limitations of equine therapy. To the respondents, horses ‘open up’ autistic children and make possible interactions that seemed impossible before. Horses were regarded as facilitating the emergence of apparently social behaviours, which included eye contact, pointing, and speech. Three key explanations emerged for therapeutic success: the sensorial, embodied experience of riding the horse; the specific movements and rhythms of the horse; and, the ‘personality’ of the horse. Equine therapy can be regarded as enabling a form of multispecies intersubjectivity, with the resonance between rider and horse seeming to make possible a new attunement between humans. Practices of equine therapy, and perceptions of its efficacy, serve in turn to attune social scientists to a version of empathy constituted through lively and sensorial interactions, as opposed to one that is restricted to particular kinds of humans. [ABSTRACT FROM AUTHOR]

Organ donation is constructed in the UK as a public responsibility, but more particularly as an obligation for members of minority ethnic communities. This paper draws attention to the ways in which ‘ethnicity’ has been made problematic by the allocation practices of transplant medicine, health promotion discourses and policy developments. Taken together, they have served to culturalise and racialise the procurement of organs. As the problem of organ donation is as much made inside medicine as outside it, this paper argues greater attention ought to be paid to these institutional practices and processes. Drawing on ethnographic work in the north of England, and with a specific focus on the organ consent encounter, this paper shows how categories of ethnicity in organ transplantation are an outcome of biopolitical and institutional practices. It argues that organ donation is best thought of, less as a discrete temporally-bounded act of decision-making, and more as a set of variegated situated practices that, in all manner of ways, problematically produce the publics that transplant medicine has come to rely upon so profoundly. [ABSTRACT FROM PUBLISHER]

This paper examines the grid of sentiment that structures medical travel to India. In contrast to studies that render emotion as ancillary, the paper argues that affect is fundamental to medical travel's ability to ease the linked somatic, emotional, financial, and political injuries of being ill 'back home'. The ethnographic approach follows the scenes of medical travel within the Indian corporate hospital room, based on observations and interviews among foreign patients, caregivers, and hospital staff in Mumbai, New Delhi, Chennai, and Bangalore. Foreign patients conveyed diverse sentiments about their journey to India ranging from betrayal to gratitude, and their expressions of risk, healthcare costs, and cultural difference help sustain India's popularity as a medical travel destination. However, although the affective dimensions of medical travel promise a remedy for foreign patients, they also reveal the fault lines of market medicine in India. [ABSTRACT FROM AUTHOR]

From September 1990 to June 1991, the UK deployed 53,462 military personnel in the Gulf War. In 1993 reports began to surface in the UK about unexplained health problems occurring amongst Gulf War veterans. This paper considers the way sufferers of Gulf War Syndrome (GWS) came to label their condition in this way. Unlike other research into this illness, this work focuses on sufferers' own accounts to better understand the way GWS is perceived by those it affects. Based on 14 months of ethnographic fieldwork in the UK, data for this paper were collected mainly by in-depth semi-structured interviews with GWS sufferers, their family members, doctors and scientists, as well as Gulf veterans. Findings suggest that GWS narratives provide a template to make sense of life events and illness. Investigating the way veterans came to ascribe to GWS as an explanation of their suffering, it became clear that contact with other sufferers was central to this process. Through participation in the veterans group and by assimilating the stories of other sufferers, a culturally specific narrative form is learned. This provides a framework for the reflexive re-interpretation of one's past and helps to construct a narrative of GWS. Unlike most work on narrative which focuses on the individual, this interpretation suggests that the collective aspect is central. In the absence of a diagnostic test and a coherence of symptoms, it is the concordance between the individual and collective narrative that is persuasive. [ABSTRACT FROM AUTHOR]

This paper examines a central image in UK academic clinical research – the patient as altruistic research subject – by means of an interpretive review of social science, bioethical and bioscience research and development policy literatures. The review examines this image as it is indicted in discussions about the nature of clinical science; is consolidated in the ethical regulation of this science; and is articulated in recent bioscience research and development government initiatives. Drawing on Strathern's notion of the virtual (public-sector) subject, the review identifies the anticipation of NHS patients as alternatively ‘available’ or ‘entitled’ to the expanding translational medicine industry. [ABSTRACT FROM AUTHOR]

This paper examines the supernatural beliefs of najar (evil eye) and bhut (ghost) and their roles in illness causation in Gujarati families in Britain today. The data arose unexpectedly in an ethnography of child rearing patterns carried out in Harrow, North West London and a short period of observation in Ahmedabad, India. I used anthropological methods of participant observation and unstructured interviews, which were transcribed using pseudonyms. The study group involved 70 Hindu and Jain Gujarati households with children and the fieldwork was conducted over a period of four years. Many of the individuals studied had migrated from India to East Africa before coming to the UK in the 1970s, but maintain links with both countries through kinship ties, marriage and rituals. I set out to study the continuity of women's roles in the transmission of religious and moral values, the rituals of childhood, views about infant feeding, and parenting relationships within joint families. The beliefs of najar and bhut in poor, rural settings in India have been described, but these Gujarati beliefs in Britain have not been well documented. This study indicates that najar and bhut continue to be a concern of women in most Gujarati families in Britain today and across all socio-economic groups, not confined to those on the ‘bread-line’, as have been previously suggested. These beliefs align themselves with Hindu ideas of the soul and reincarnation: powerful forces residing outside the body. An understanding of these beliefs could be informative to health professionals working with Gujarati communities in the UK. [ABSTRACT FROM AUTHOR]

Much of the social scientific work on psychiatry and mental health, from a variety of competing perspectives, has focused upon power and the social construction of 'mental illness'. Very little attention has been paid to resistance or to the various ways in which 'patients' or 'survivors' (as some now prefer to refer to themselves) have sought to socially deconstruct 'mental illness'. This paper seeks to redress that balance by way of a detailed examination of some of the key practices of resistance which have developed within the context of the UK mental health survivors movement. Using key concepts from Bourdieu's theory of practice, it examines the challenge which survivors have mounted to the symbolic power of psychiatry, and the resistance habitus which their opposition has given rise to. [ABSTRACT FROM AUTHOR]