UC San Francisco
Raphael’s research explores the securitization of the Sierra Leonean healthcare system, and the effects of securitization on patients’ relationships towards, and affects and experiences of illness and care. In the wake of the 2014–2016 Ebola epidemic (and likely propelled by the COVID-19 pandemic) “Global Health Security” has become a central priority for donors and global health experts in the region, signifying a shift from conceiving of rural clinics as sites primarily for the provision of therapeutics to instead sites for disease surveillance and threat mitigation. New technologies of disease containment and surveillance have proliferated in remote health facilities, displacing many of the supplies necessary to care for even the most basic of health conditions.
Drawing on ethnographic research at three different scales of securitization— rural communities with public clinics; a district level hospital; and the Ministry of Health and Sanitation—Raphael’s dissertation traces how these shifting logics in global health policy are actually materializing in remote clinics. By following patients as they seek out and then withdraw from the healthcare system, it pursues the central question: what are the social and affective repercussions of a health system that is no longer oriented towards providing routine care?
Proposal Title: Global Health Securitization in Kono District, Sierra Leone: Social Repercussions and The Work of Affect