What can ethnography contribute to our understandings of health and disability in Jordan and elsewhere? In this roundtable event, Morgen Chalmiers (University of California San Diego), Timothy Loh (MIT), and I offered provisional responses by drawing on fieldwork in Jordan and the United States while reflecting on broader research trends in the Middle East and North Africa region. Here, I (Christine Sargent, University of Colorado Denver) write primarily in the first person to recap our event and provide additional reflections.
Frameworks and landscapes
Carole McGranahan (2018, 2) describes “an ethnographic sensibility” as:
“a culturally-grounded way of both being in and seeing the world… It is all that goes without saying in terms of what is considered normative or natural, and yet it is also the very rules and proclaimed truths — about the way things are, and the way they should be — that underlie both everyday and ritual beliefs and practices.”
Building on this generative description, I’d like to suggest that ethnography can offer three significant contributions to studies on health and disability. First and foremost, ethnographic approaches work from the ground up. This means ethnography can center the perspectives and projects of diverse communities as they attempt to survive and thrive in unequal conditions of prosperity and precarity. Second, ethnographers understand biomedicine, global health, and rehabilitative therapies as politically and historically particular institutions rather than universal truths. An ethnographic orientation focuses on the actors, practices, and technologies that enable powerful institutions to function, revealing their tangible but often surprisingly fragile day-day-day operations. It also allows us to trace how these institutions rely on and reproduce — but are not reducible to — (post)colonial relations of value and labor. Finally, ethnography embraces the messiness and multiplicity of lived experience, attending to the macro- and microstructures of power that shape how people to make their way through the world and the world makes its way through them. While biomedicine and biomedically adjacent fields are increasingly hegemonic, they remain entangled in other frameworks for understanding and feeling fundamentally human experiences of health and illness.
From the outset of our event, the timeliness of the topic weighed heavily on speakers and audience members alike. We began by mourning and honoring longtime ACOR staff member Cesar Octavo, who had succumbed to COVID-19 just days earlier, on March 15. His passing occurred during the peak of the pandemic’s second wave in Jordan, as the country grappled with then-rising infection and mortality rates. Three months later, we continue to live through the uneven ebbs and flows of a global pandemic whose impacts underscore how biological, environmental, material, social, cultural, and political dimensions of health and illness are fundamentally interconnected. Only by thinking about these categories together and recognizing how each is deeply embedded in the others can we begin to imagine effective, ethical responses to the world being remade in the pandemic’s wake. Globally and locally, exposure and vulnerability to COVID-19 reflect pre-existing racialized and classed inequities, and these familiar patterns remind us “how certain social and cultural norms around health disparities, values about differences between certain bodies and social groups, and health and welfare structures were in existence long before COVID-19” (Sangaramoorthy 2020).
ACOR’s speaker series and fellowships offer platforms for generating collaboration and criticism — across disciplines, institutions, and continents. As enduring colonial inequities shape contemporary (research) worlds, the production of knowledge and distribution of its benefits do not occur randomly or equally. All three panelists acknowledged the institutional, financial, and geographic mobilities afforded by U.S. institutional affiliations. Additionally, our positionalities (gender, race, ethnicity, class, citizenship status, disability) shape our everyday interactions as early-career researchers conducting fieldwork in Jordan, and they locate us in broader structures of racial capitalism, underdevelopment, and “North-South” geopolitics. Attuned to these inequities, we are eager to cultivate models to build better research, where “better” means research driven by local agendas and priorities and grounded in materially transparent partnerships and exchange, rather than extraction.
Inspired by feminist scholars such as Sarah Ahmed and collectives such as the Cite Black Women movement, I began by mapping the citational landscape that has converged around questions of health in Jordan, along with more nascent research on disability. Citations, Ahmed reminds us, work as “screening techniques,” shaping the creation of knowledge that comes to build disciplinary “canons” through inclusion and exclusion. And as Seteney Shami pointed out in her recent (May 2021) ACOR presentation, the gaps between research conducted on Jordan and research conducted in Jordan remain troubling (and index deeper questions about research for whom and by whom). Indicative of Jordan’s highly developed healthcare system and geopolitical location, research outputs dealing with health are robust; those concerning disability remain emergent. While ethnography and ethnographic methods remain less commonly cited among qualitative researchers, an array of methodological companions, such as “critical phenomenology” and “interpretive phenomenology,” appear increasingly popular (Bawadi and Al-Hamdan 2017; Obeidat and Lally 2014; Nabolsi and Carson 2011; Nazzal and AL-Rawajfah 2018). Ethnography’s muted presence in an otherwise dynamic qualitative landscape invites further opportunities for discussion and collaboration. Beyond conventional academic publications, however, multimedia, open-access, and bilingual outlets including Kohl: A Journal for Gender and Body Research, Eib (part of the Sowt podcast platform), and 7iber bring ethnographic commitments and methods to their explorations of health and disability. These platforms mobilize ethnography’s most transgressive and generative qualities, centering the expertise of local knowledge makers while refusing to be limited by academic paywalls.
Building from fieldwork
We began our individual presentations with doctoral candidate Morgen Chalmiers, a feminist ethnographer and physician in training who has been conducting multi-sited fieldwork on Syrian refugee women’s reproductive experiences in San Diego and Amman. In her work, Chalmiers brings together the paradigms of reproductive justice and critical refugee studies. As articulated by the SisterSong Women of Color Reproductive Justice Collective, reproductive justice centers the “human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” Key for Chalmiers’s work is putting this framework in conversation with the interdisciplinary field of critical refugee studies. The Critical Refugee Studies Collective defines the latter as “a humane and ethical site of inquiry that re-conceptualizes refugee lifeworlds not as a problem to be solved by global elites but as a site of social, political and historical critiques that, when carefully traced, make transparent processes of colonization, war, and displacement.” Accompanying Syrian refugees seeking reproductive healthcare, Chalmiers is studying clinical interactions — in the U.S. and Jordan — “as sites where macrosocial structures of power, privilege, and inequity are manifest, challenged, and negotiated through everyday interactions.”
Next, I offered an overview of my research on the experiences of mothers raising children with Down syndrome in greater Amman. Anthropology recognizes disability as a form of human diversity present across time and space. Ethnographic methods allow us to explore how people make sense of normative and non-normative bodyminds (Price 2015, Schalk 2018) while attending to the historical and material conditions that inform these processes. Jordan is home to dynamic and engaged disability activist and ally communities. It also boasts some of the most progressive laws in the region and was one of the first signatories to the United Nations Convention of the Rights of Persons with Disabilities (UNCRPD). Materializing the cultural, political, economic, and infrastructural transformations required to build an accessible and inclusive Jordan, however, remain an ongoing struggle. My fieldwork took place during a period of significant legislative development (2013–2015), but many families struggled with the gaps between progressive policy and practical implementation. I spoke with activists, advocates, educators, therapists, kin, and neighbors about the complexities of disability stigma, which continues to shape the lives of individuals with Down syndrome and their families. At the same time, I documented diverse strategies that family- and community-based organizations have developed to challenge stereotypes and assumptions about what Down syndrome is and what living with Down syndrome entails. These strategies weave together different resources, including transnational Down syndrome advocacy networks, human- and disability-rights vocabularies, Islamic and Christian visions of humanity, and biomedical or biogenetic models of heredity. Ultimately, I argue that centering disability as an analytic and dimension of lived experience can illuminate broader dynamics of change and struggle in Jordan today.
Finally, doctoral candidate Timothy Loh connected theoretical frameworks on language in medicine and disability to his dissertation research examining deaf Jordanians’ engagements with new assistive technologies that have recently emerged in the country, including the cochlear implant, a surgically implanted device that provides its users with some electronic access to sound. Taking an anthropological approach to language, which emphasizes the multifunctionality of language rather than merely its capacity to describe things in the world, Loh’s research builds on recent conversations between medical and linguistic anthropologists about how language is constituted in medicine and vice versa. Loh asks how language ideologies influence the ways that medical professionals provide biomedical interventions for deaf children and how deaf people and their families engage with these technologies. The question of which technologies deaf people should use is bound up in the question of which language and languages they should learn (Friedner and Kusters 2020). In fact, Loh argued that this question takes on salience in the Middle East, a site of intense language ideologies where both scholars and the public actively debate the relationships between modern standard Arabic and colloquial dialects, indigenous languages such as Tamazight, colonial languages including French and Spanish, and English as a global language. The fact that Arabic is the both the language of the Quran as well as of the nation-state in Jordan, Loh pointed out, has implications for what languages deaf Jordanians are expected to know and to learn.
Collectively, our research and data (re)emphasize the centrality of caregiving and care-seeking practices to projects of health and wellbeing in Jordan. We have lived through different stages of the pandemic across our different countries of residence, research, and the places we call home, raising new questions about anthropology, fieldwork, and what ethnography has to offer. We hope that our panel (and this summary) invite further discussion and new relationships that further ethnographic approaches to health and disability in Jordan and beyond.
About the contributors:
Morgen A. Chalmiers is a student in the Medical Scientist Training Program at University of California San Diego School of Medicine. Her anthropological research broadly examines women’s experiences of reproductive healthcare using the tools and theoretical lens of psychological anthropology. Her fieldwork and clinical practice are informed by the paradigm of reproductive justice and a commitment to addressing health disparities through an intersectional framework. She is passionate about integrating anthropological insights into clinical practice and health policy through interdisciplinary collaboration.
Timothy Loh is a PhD student at the Massachusetts Institute of Technology (MIT) in History, Anthropology, Science, Technology, and Society (HASTS). His research examines the politics of deafness and disability, particularly in relation to assistive technologies, in Jordan and the broader Middle East through the lens of medical anthropology, linguistic anthropology, and the social study of science.
Citations and Resources
Bawadi, H.A., and Z. Al-Hamdan. 2017. “The Cultural Beliefs of Jordanian Women during Childbearing: Implications for Nursing Care.” International Nursing Review 64 (2): 187–194.
Eib. Sowt Podcasts.
Friedner, Michele and Anneliese Kusters. 2020. “Deaf Anthropology.” Annual Review of Anthropology 49:31–46.
McGranahan, Carole. 2018. “Ethnography Beyond Method: The Importance of an Ethnographic Sensibility.” Sites: A Journal of Social Anthropology and Cultural Studies 15 (1): 1–10.
Moghnieh, Lamia, Mustafa Abdalla, Suhad Daher-Nashaf, Abdelhadi Elhalhouli. 2021.
العيش والموت في زمن الكورونا: مقاربات من الأنثروبولوجيا الطبيّة في مجتمعات المنطقة العربيّة. Arab Council for Social Sciences.
Nabolsi, Manar M., and Alexander M. Carson. 2011. “Spirituality, Illness and Personal Responsibility: The Experience of Jordanian Muslim Men with Coronary Artery Disease.” Scandinavian Journal of Caring Sciences 25 (4): 716–724.
Nazzal, Mohammad S., and Omar M. AL-Rawajfah. 2018. “Lived Experiences of Jordanian Mothers Caring for a Child with Disability.” Disability and Rehabilitation 40 (23): 2723–2733.
Obeidat, Rana F., and Robin M. Lally. 2014. “Health-Related Information Exchange Experiences of Jordanian Women at Breast Cancer Diagnosis.” Journal of Cancer Education 29 (3): 548–554.
Price, Margaret. 2015. ” The Bodymind Problem and the Possibilities of Pain.” Hypatia 30 (1): 268-284.
Sangaramoorthy, Thurka. 2020. “From HIV to COVID19: Anthropology, Urgency, and the Politics of Engagement.” Somatosphere, 1 May 2020.
Schalk, Sami. 2018. Bodyminds Reimagined: (Dis)ability, Race, and Gender in Black Women’s Speculative Fiction. Durham: Duke University Press.
SisterSong Women of Color Reproductive Justice Network. “What is Reproductive Justice?”
United Nations Department of Economic and Social Affairs. “Convention on the Rights of Persons with Disabilities (CRPD).”