Gareth+-+Memo+-+17

__Memo 17: Study Components__

This is additional/alternative to a more crafted version of the same material in the HASS proposal

1. Preparation and Literature Review This stage of the project is to develop a repertoire of theoretical lenses to carry into the field, as well as a preliminary familiarity with local culture and history through documentary and published records. I am focusing on theoretical work in three areas that I can predict will have bearing on observations of medical tourism 1) “What constitutes medicine in disparate places?” as represented in Medical anthropological focus on patient care, local conceptualization of biological fact and medical practice, and the influence of cultural belief on construction of medical fact and practice. 2) “How do people form institutions and phenomena between disparate sites?” as a focus within Transnationalism studies, centering on the shift away from traditional notions of citizenship and locality of culture, as well as the multiple effects of the export, circulation and localization of neoliberal governmentalities and logics. 3) “How do political and economic systems differentially encourage types of care, and how does Medical tourism (a transnational system) affect healthcare delivery locally?” as a subject of study in the literature in Comparative Health Systems, and Comparative Health Policy, both fields in communication with Medical Anthropology, that have focused on the effects of national political culture and legislation on construction of healthcare contexts. To supplement these theoretical avenues, I am also attempting to read broadly in ethnography and history of international healthcare, and about the local healthcare system in the countries I have selected for my case studies, of particular interest are established literatures on the development and expansion of colonial medicine and recent studies of the expanding of pharmaceutical testing and biomedicalization in the developing world, which offer suggestions about the way the transplantation of underlying logics effect the lived experiences of patients across international borders.

2. Fieldwork - Primary fieldwork is intended to be three 3-month trips to Asian field sites, during which I will conduct semi-structured interviews, participant observation, and continue to gather materials for and perform discursive analysis. This mixture of methodologies is expanded upon in further writing but is intended to offer multiple avenues for this author to evaluate and to refract his own interpretations given a relatively brief period of fieldwork. The initial three trips will be divided between more in-depth travel to Manila, Philippines and Chennai, India where the core comparative study will be made. Shorter trips will be made where possible for contrast to a recently opened genetic and stem cell therapy facility aiming at tourists in Cebu, Philippines, and another cluster of private hospitals in Northern india that is comparable to Chennai. These trips will be separated so as to allow analysis and writing in between phases and to offer a chance for evaluation via conference presentations during fieldwork. Field sites will focus on specific health centers in these sites, focusing on the development of the industry, changes in the practices of participant healthcare workers, using them as sites for meeting tourists, and to evaluate their participation and status in the broader field of healthcare delivery in situ. - Follow-up & Secondary Fieldwork – Due to time constraints the center of my fieldwork is on these limited sites, but secondary work will bracket the international work with interviews and analysis of the American healthcare context, and local US healthcare practices and such. This part will be primarily discursive analysis and review of published literatures supplemented with Interviews, rather than Participant Observation. Focused attention will be on Doctors, Health insurance company policy decisions, Legislative attention, and the growth and activity of private travel arrangement companies that are integral to the industry. At each stage of the fieldwork the interviews and sites for the next step will be evaluated based on the last, snowball determination of interviews will be balanced against the initial list of subjects and sites will be recast. If suffient time is available an additional fieldsite visit will be Bangkok, Thailand, where a major industry is present.

3. Analysis The analysis of all data will follow a combination of cultural interpretive appreciation of meaning and the sociological methods of grounded theory and institutional ethnography. This is to say that the people and practices that constitute the phenomena will be considered from an emic perspective as multiply interpretable, and variable, while attempting to look for firm and lasting constructs and patterns upon which observation may develop theory, and upon which a conception of the sources of power and ruling relations may be developed to demonstrate that which may be unseen by the local participants.