Productive Pathologies: Professional Patients and the Commodification of Disease in Egypt
Final Report Abstract
The research among professional patients highlights a situation where disease and physical debility have taken a different turn and function in Egyptian society, which has been going through major economic restructuring and social pressures over the past few decades. In this sense, certain patients, especially those with chronic diseases, have been attempting to take advantage of their ailing bodies and diseases to generate income not only to make economic gains for themselves, but also to provide for their families and to manage disease itself. By doing so, they engage in what we call disease-work, where they attempt to master formal medical knowledge about their diseases and accordingly sell this knowledge to medical students during periods of exams and also in private tutoring centers. This is happening at a moment when the medical system is experiencing major deteriorations and the absence of opportunities for medical students to interact with patients in a more formalized curricular setting. In this regard, professional patients make their ailing bodies available in medical settings for examination and teaching purposes for which they receive monetary compensation for the disease services they provide in medical settings. In this context, the research shows that the dynamics of disease-work challenge the ways in which social science research has observed the sickness experience, which is characterized by dependence and frailty. In this regard, professional patients have turned their experience of disease into a moment of productivity, independence, empowerment, gaining agency in the family and in the community as well as an opportunity to forge social relations with other patients and medical professionals alike. This said, the workings of disease on the ailing bodies of professional patients demonstrate a case where professional patients sacrifice their physical wellbeing in order to attain economic gains for their social wellbeing, namely taking care and providing for healthy, but in many cases, unemployed members of the family. This happens in response to augmenting unemployment rates as a result of the shift to neoliberal economic policies, which have resulted in rising living costs coupled with the inability to provide for the family. The experience of professional patients and their utilization of disease for surviving poverty show multilayered negotiations of their relationship to state institutions and their roles in the society and in the family in order to reverse their marginalized status in society. Yet, the research shows that male experience with disease differs drastically from the ways in which female professional patients experience their disease-work. While male professional patients engage in disease-work to attain a level of masculinity, independence, responsibility for themselves and others, as well as control over their bodies and their diseases. Women, in most cases divorcees or widows, enter disease-markets as a means to shed light on their marginality and their neglect by their male members of their paternal families and the families of their husbands. This shows a case where women attempt to claim their right of becoming dependent housewives through employing disease to shame male relatives for neglecting them and their children. At the same time, engaging in disease-markets provides women with a different sense of belonging, friendship, care and sociality. In this process, disease-work opens the horizons of professional patients to new ways of social and economic relations as members of disease groupings. In this regard, they forge social relations to their fellow patients and medical professionals alike. Disease-work and becoming professionals of disease introduces them to a different kind of lifestyles, friendships, collaborations, independence and even business orientations. The research among professional patients thus reveals a case where disease-work has become a medium through which one’s position in the society is negotiated and the relationships to the state and to fellow citizens are redefined. In difficult economic situations, the meaning of disease has shifted to connote more social and economic significance. But it has also contributed to other shifts in the medical practice and the ways in which disease is being observed. While professional patients try to improve their life conditions through engaging in disease-work and entering relations of activity and passivity, independence, responsibility, empowerment and shame, the medical system, the place where these relations are nurtured, has experienced a shift in its nature: from an institution that provides healthcare services and of being the safeguard of people’s wellbeing to a space where disease-markets flourish and disease itself is appreciated, promoted and utilized. Patients, the bearers of disease, have also experienced a shift in their position from ailing bodies that need support and care to bodies that provide for the healthy ones. Disease-work itself has become the tool to attain medical support to manage disease through the social relations, which professional patients forge with medical people that consequently guarantee them, their family members and people in their proximity, with access to medical services, which are inaccessible to many other patients. In this regard, engaging in disease-work becomes the prerequisite for managing and surviving disease where the patients gain access to free medications through their social contacts or use the remittances they made through disease-work to buy medications to control disease.
Publications
- 2015. “Productive Pathologies: Poverty, Biovalue and the Commodification of Disease in Urban Egypt. Medizinethnologie, Körper, Gesundheit und Heilung in einer globalisierten Welt
Abdalla, M.
- 2015. “The Encounter with Disease Experts: Medical Students’ Experiences with Professional Patients in Egypt.” In Nichter, M. and R. Raffaetá (guest editors): Special Issue “Negotiating Care in Uncertain Settings and looking Beneath the Surface of Health Governance Projects.” Anthropology in Action: Journal for Applied Anthropology in Policy and Practice. 22(1): 27-35
Abdalla, M.
(See online at https://doi.org/10.3167/aia.2015.220104) - 2018. “Transfigurative Experiences of Sickness. Medical Regimes, Disease Commodification, and Professional Patients in Egypt.” In Kehr, J., H. Dilger, P. van Eeuwijk (guest editors): Special Issue "Transfigurations of Health and the Moral Economy of Medicine: Values, Infrastructures and Subjectivities.” Zeitschrift für Ethnologie 143:1
Abdalla, M.
- 2018: Special issue “Transfigurations of Health and the Moral Economy of Medicine: Values, Infrastructures and Subjectivities.” Zeitschrift für Ethnologie 143:1
Kehr, J., H. Dilger and P. van Eeuwijk (eds.)
(See online at https://doi.org/10.7892/boris.142320)
