Using the case of the Pan-African e-Network, this Think Piece describes some of the practical and theoretical challenges presented by eHealth. At the junction of 'networked thinking' and clinical work, human lives come to matter in new ways, taking shape as objects of knowledge and intervention. The terrain on which this is happening is discursive, and deeply enmeshed with living and technical systems. Studying eHealth reveals how contemporary arrangements create new spaces in which lives are cared for. As such, it is inseparable from wider questions being raised by global eHealth practices: How are spaces of care to be designed in the era of global connectivity? What are the emergent relations between space, information technology, and the government of care on a global scale?
Keywords telemedicine, global health, networks
Medicine Anthropology Theory
155Networked thinking, or the everywhere-ness of healthcare Global health is being transformed by a proliferation of screens, interfaces, and networksinfrastructures that link bodies, knowledge, and care practices in new spatial and temporal configurations. These connect patients, medical practitioners, hospitals, and laypeople, either through private networks or the Internet, and affect the circulation of medical knowledge, expertise, and data. From network science literature to everyday public health settings, digital connectivity has become highly correlated with access to care and protection against healthrelated risk.eHealth champion Gunther Eysenbach (2001, e20) famously argued that eHealth is 'not only a technical development, but a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking'. Such an 'attitude' translates into especially high expectations regarding network connectivity and its impact on global health. eHealth has been referred to as the 'next breakthrough in health systems improvement in developing nations ' (Gerber et al. 2010); 'a great equalizer between rich and poor, healthy and ill' (Rockefeller Foundation 2010, 51); and a 'life-saving tool' (Vital Wave Consulting 2012).The notion of eHealth as a 'game changer' in global health is directly linked to a vision of the digital, connected clinic, with its instant availability, synchronicity, and 'everywhere-ness' of health data, information, and, ultimately, care. In such a clinic, network connectivity is expected to reduce the amount of both economic and energetic expenses required to access medical care and expertise. It is expected to render distance meaningless and to break down barriers to the provision of health care (Mort, May and Williams 2003;Bashshur and Shannon 2009). In a world where people are apparently 'dying for lack of knowledge' (Global Healthcare Information Network 2014), this envisioned digital clinic is anticipated to 'reach out and heal someone ' (Cartwright 2000), no matter where they are physically located.The suggestion that digital networks reduce obstacles related to distance is not unique to eHealth. Over the last few...