Biomedicine in an unstable place

Alice Street, Biomedicine in an Unstable Place: Infrastructure and Personhood in a Papua New Guinean Hospital. Duke University Press, 2014. Paperback, 304 pp., $24.95. ISBN: 978-8223-5778-0.

In the prologue to her monograph, Biomedicine in an Unstable Place, Alice Street shares the story of William Gambe. This opening expertly foreshadows the rest of the book: as William becomes increasingly unwell, we see the interplay of kinship tensions and sickness, resource shortages and diagnostic uncertainty, and a pervasive concern about feeling invisible. Street’s ethnography is based in Madang Hospital, Papua New Guinea, and is based on fieldwork spanning ten years. The book is an excellent contribution to the canon of hospital ethnographies, and its place-based approach illuminates grounds on which multiple worlds collide. Madang Hospital sees constant frictions between medical practice and scientific research, kin and professional relationships, state-making projects and colonial histories. Despite this capacious subject matter, this work feels cohesive and makes clear contributions to existing theoretical, ethnographic, and political conversations.

In the Introduction, Street comments that surprisingly few hospital ethnographies engage with postcolonial problems. She sets out to remedy this with a close examination of the historical processes that created both Madang Hospital and the Papua New Guinean state that exists today. Thus we see how Papua New Guinea, like many other colonies, was seen as a valuable site for medical experimentation by both German and Australian rulers, and how it later became an object of international development agendas. Today the country is again a popular site amongst overseas researchers. These people bring in money and infrastructure, but at the same time serve to sustain a devastating disparity between well-provisioned medical research and under-resourced public health, both of which coexist in the very same spaces.

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