The Causes of Cholera: Public Health in Post-Transition Vietnam
Item
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Title
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The Causes of Cholera: Public Health in Post-Transition Vietnam
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Identifier
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d_2009_2013:fee2ac95c928:12060
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identifier
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12114
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Creator
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Lincoln, Martha,
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Contributor
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Victoria Sanford
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Date
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2013
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Language
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English
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Publisher
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City University of New York.
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Subject
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Public health | Epidemiology | Asian studies | infectious disease | medical anthropology | post-socialism | Southeast Asian studies | urban anthropology | Vietnamese studies
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Abstract
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This dissertation argues that market transition in Vietnam, while enabling rapid economic growth, has generated new vulnerability to a classic disease of poverty. Using a series of recent cholera outbreaks as a case study, it argues that the transition has sharpened the contradiction between the promises of development and modernization and experiences of inequity and poverty. Fieldwork was conducted between August 2009 and September 2010 in Hanoi, Vietnam among poor and near-poor urban households as well as foreign and Vietnamese public health professionals. Additional source materials included news media, weblogs, state accounts of the outbreaks, and the reports of international health agencies. Interpretive readings of these texts demonstrated how diverse actors ascribed social, moral, and political significance to infectious disease and health care in Vietnamese society, and traced how Vietnam's economic transition has reshaped moral imaginaries of risk and responsibility.;Ethnographic interviews with everyday citizens and public health workers also revealed anxieties about the contagious circuits of capitalism and the unpredictable, potentially destructive consequences of profit-motivated practices of petty traders. Such explanations of disease outbreaks gave voice to Vietnam's shifting ideological valuations of social class during a period of economic upheaval, rapid economic stratification, and massive rural-to-urban migration. However, as I argue, these perspectives, and the Vietnamese state's response to the cholera outbreaks, neglected the more likely risk factors: lack of capacity in urban water management, sanitation, and public health.;These episodes reflect the costs of market transition for public health, especially among the urban poor. While some of the historic institutions of Vietnam's socialist health care system continue to provide security for vulnerable populations, the significance of socioeconomic inequity and health disparities is increasing. By drawing attention to public health, sanitary conditions, and living standards in the national capital, the cholera outbreaks threatened to disclose economic transition's association with deteriorating living standards and the advent of new forms of risk and precariousness. As a result, cholera's political "sensitivity" for the Vietnamese state posed significant obstacles to research. This dissertation represents the first substantive and critical account of these episodes.
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Type
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dissertation
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Source
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2009_2013.csv
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degree
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Ph.D.
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Program
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Anthropology
