Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon area

Leading researcher: Chiara Pussetti
Research group: Governance, Policies and Livelihoods
Type of project: National project
Status: Concluded
Keywords: Migrants | Suffering | Emotions | Therapeutic itineraries


Main institution: CRIA
Participant institutions: CEA-IUL
Funding: FCT
Reference: PTDC/ANT/65857/2006
Starting date: 01-09-07

More information: link

Abstract

Vulnerability is a characteristic which is socially recognized as being common in migrant communities. Health problems are exacerbated by poor integration into the general community, social and economic levels that are below the average in the country of residence, cultural and linguistic barriers, etc. Though these factors have long been recognized, and a number of campaigns have taken place to improve awareness of the risks of infectious diseases (such as TB, hepatitis and AIDS) among this population, there has been in Portugal, up to the present, no anthropological reflection with any degree of depth on this process of encounter between different kinds of knowledge and practice of cure, linked to specific historical and cultural contexts, nor a thorough analysis of the opportunities and risks which stem from medical pluralism. The need for this reflection on migrant’s pathways to care is particularly felt in na area such as Lisbon, whose urban space is also a space where autonomous logics and worlds coexist, a field of dramatic change, of deep social contrast and power struggles, of new identity dynamics, of unpredictable shades of individual subjectivity. On the one hand, health care providers are confronted by such a sharp gradient of cultural otherness that a real risk arises of inadequacy and even inability to apply routine processes of clinical intervention; at the very least, their effectiveness is strongly reduced. On the other hand, in many cases migrants lose their bearings when confronted with a biomedical “morality” – defining risk, disease, health and cure, and conditioning the perception and representation of the body – that, for them, does not make any sense. When they demand na explanation, the inadequacy of the biomedical interpretations is felt with acute discomfort by the migrants. The research project we propose to undertake finds the main objectives of its reflection in the suffering, the emotions and the discontent of migrants: it is in those concepts that we acknowledge the dimension of illness, but also of the broader discomfort which links individual aspects with the larger historical, economic and sociopolitical processes. Hence, we will first try to explore the connections between health and culture in the build-up of the experience of differing social groups, and probe into the mechanisms through which social factors such as poverty, racism, gender, migration, colonial past, health policies and social exclusion become embedded into risk and pathology factors. Then, we will delineate and make explicit the relations between the several levels which contribute to the process of defining and building the reality of suffering for the migrants, analyzing the different ways of understanding, defining, explaining, and acting in the face of disease. Finally, we will investigate the problematic of cultural and social change which these communities have to face daily, particularly when it comes to public health, by looking into the many paths and behaviors the migrants use in the search for care, and by exploring the dynamics of the encounter between patient and agent of recovery. The experience of affliction is framed within a complex set of dimensions whose analysis demands a comprehensive understanding of the relationships between health and strategies of resistance. Side by side with increasingly stringent and restrictive migration policies, na increase in temporary residence permits for medical reasons has been identified. The ill body links itself to the legislative logic, becoming na unprecedented resource of legitimatization for irregular migrants. This project attempts to gain insight into the way in which different stakeholders (e.g. doctors, care users, care user’s family members) appropriate and strategically use ill-health. The geographic field of work will be the Greater Lisbon area, especially the municipalities where there is a significant migrant population. At the same time, we consider the possibility of working in different regions and countries should these contexts prove relevant to reconstruct personal histories, therapeutic pathways or nets of meanings that may have been placed at risk by the migration experience. Migrants’ countries of origin or other European countries are examples of these possible work sites. These sites are likely to host, for various reasons, significant stages in the clinical itineraries of our target population. This ethnographic work will be conducted with the help of graduate students (both at the MSc and PhD levels) trained and guided by the senior researchers. Meetings planned with migrants will constitute the main ground for data collection and ethnographic observation by creating a space where migrants’ can express their desires, doubts, knowledge and strategies; these will constitute privileged occasions to acknowledge “occult” dimensions that are often absent from the literature on the subject, and that are nevertheless relevant if we are to understand what truly happens when a border is crossed.

Researchers from CRIA

IDNamePositionProjTitleProject typeStatus
pub38*Chiara PussettiPrincipal Investigatorproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub109*Clara SaraivaResearcherproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub110*Cristina SantinhoResearcherproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub227*Sílvia OlivençaResearcherproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub43*Cláudia FreitasResearcherproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub51*Elsa LechnerResearcherproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub94*Luís Silva PereiraResearcherproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub11*Ana MourãoResearch scholarproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub529*Ana Mafalda FalcãoResearch scholarproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
pub530*Elisabete CurtinhalResearch scholarproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon areaNational projectConcluded
Other researchers

ResearcherPositionInstitutionProjOutrosTitulo_EN
Ramon SarróResearcherICS-ULproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon area
Vítor BarrosResearcherICS-ULproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon area
Clara CarvalhoResearcherISCTE-IULproj4*Public health policies and therapeutic practices: suffering and treatment strategies of migrants in the Greater Lisbon area