“Love Isn't There in Your Stomach”

Abstract

Drawing on participant‐observation in Nicaraguan dengue prevention campaigns and a series of semistructured interviews with Nicaraguan health ministry personnel, this article shows how community health workers (CHWs) balanced two kinds of “medical citizenship.” In some situations, CHWs acted as professional monitors and models of hygienic behavior. At other times, CHWs acted as compassionate advocates for their poor neighbors. In 2008, Nicaragua's Sandinista government moved to end a long‐standing policy of paying CHWs, recasting them as citizen–volunteers in a “popular struggle” against dengue. Although CHWs approved of the revival of grassroots advocacy, they were hostile to the elimination of compensation. Framing this ambivalence as part of CHWs’ desire to serve as “brokers” between the poor and the state, I suggest that attention to medical citizenship provides insight into the sometimes contradictory ways in which CHWs engage the participatory health policies now taking hold in Latin America and elsewhere.

‘All they do is pray’: Community labour and the narrowing of ‘care’ during Mozambique's HIV scale-up

“…Though the intertwined biography framework highlights the particularities of this context, CHWs and other global health volunteers in diverse contexts across the Global South occupy a similar structural position, a grey zone between formal and informal labour and permanent and temporary employment, where there is neither adequate recognition nor remuneration (Akintola, 2011;Maes, 2012;Nading, 2013;Prince, 2014;Rödlach, 2009;Swartz, 2013;Swidler & Watkins, 2009). This is not an inevitable development, however.…”

Everyday translation: health practitioners’ perspectives on obesity and metabolic disorders in Samoa

“…Health practitioners balance biomedical knowledge, which prioritizes health as an individual project, with local cultural knowledge, which prioritizes socially oriented well-being (cf. Nading, 2013). Contrasting health and well-being makes visible health practitioners' struggles to shift from biomedical metrics, measurements, and numbers to socially significant meanings around food, body, and wealth in everyday life.…”

Special Issue: Complexity, Routines, and Reflexivity in Professional Work

“…This research has tended to focus on the formats and logics of such governance and accountability frameworks or upon workers' experiences of reporting on and accounting for their work, rather than the practicalities, experiences and (potential) tensions in the handling of uncertainty via risk within everyday work practices (for exceptions, see Fischer & McGivern, 2016;Horlick-Jones, 2005;Nading, 2013;Warner, 2006; two chapters within Power, 2016 though the book overall focuses on organizational contexts away from the frontline).…”

“…Recent work in medical sociology, the sociology of risk and uncertainty and related disciplines such as anthropology have produced quite some evidence that workers within client-facing occupations in health and social care continue to face an array of tensions in their everyday work (see Nading, 2013, Warner & Gabe, 2004, even if this is often not the central focus of the research.…”