Health

At EthnoLab, we are guided by the World Health Organization’s 1948 definition of health: A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. A community’s physical, mental and social well-being are interwoven and are impacted by factors including a strong social safety net, access to healthy affordable food, the presence of green spaces, safe homes and neighborhoods, fulfillment of basic human rights, and more. aCommunity well-being impacts individuals’ health and access to care, and

While most illnesses have a biological expression in the body and the body is the site of treatment for most illnesses, the social nature of health is paramount - conditions and structures that increase the likelihood of being unwell including, stigma, racism, generational trauma, gender norms and social inequalities; kin and caregivers’ roles in providing and accessing care; places and spaces of healing and the patient-centered care offered there; unintended health-related impacts of policies and programs; the experience of suffering from a disorder or illness and the further harms that follow - and it’s in these social dynamics of health that we address at EthnoLab.

Vulnerabilities to HIV in Somalia

In this project with UNICEF for The Global Fund, we partnered with local HIV organizations in four cities in Somalia, Somaliland and Puntland to learn about how certain experiences and practices are related to vulnerability to contracting HIV. In sensitive interviews and intimate discussions with more than 75 people, we spoke with former street children, soldiers, taxi and tuktuk drivers, truck drivers, pharmacists, women whose work makes them vulnerable to power dynamics from the men they encounter, people who habitually chew khat and people who facilitate socialization around khat, men and women who are displaced from their clan, family and other sources of support due to work or war, people who use opioids, and others about what they need and how they get it, what makes them vulnerable and how they protect themselves and what they worry about. Based on our findings we were able to identify particular hotspots where informational outreach could be effectively implemented through peer educators, and this programming has begun. We also found evidence that there is an ongoing unreported opioid epidemic in Somalia. Finally, in clarifying the social arrangements that allow men and women to take care of themselves and their families when all other resources were absent, our work provides foundational information for executing future research, programming and policy design.

Understanding the Opioid Epidemic in Philadelphia

We are currently working in collaboration with the Philadelphia Department of Public Health to learn from health care provider about barriers and bottlenecks to prescribing buprenorphine for patients who want to stop using opioids.

Other work on the opioid epidemic in Philadelphia includes the Next of Kin project Anastasia spearheaded while at Ethnologica. In that project, researchers interviewed next of kin of 35 people who died of opioid overdose in 2017, the year Narcan became widely available and the same year there was a surge in overdose deaths. Of the 1217 people who died of overdose in Philadelphia that year, more than 75% died at a private residence. Little was known about this hidden population of drug users - whether they had accessed any social or health services in the past, and how their kin interpreted harm reduction interventions. Scholarship from that work includes:

• Hudgins, A, B Uzwiak, L Pizzicato, and K Viner. “Barriers to Treatment and Quality Care – Insights from Qualitative Research with Next of Kin of Persons Who Died of Overdose in Philadelphia.” Journal of Substance Abuse Treatment. Under review.

• 2021 Uzwiak, B, A Hudgins and L Pizzicato. “Legacies of War on Drugs: Next of kin of persons who died of opioid overdose and harm reduction interventions in Philadelphia.” International Journal of Drug Policy. 97; 103351. https://doi.org/10.1016/j.drugpo.2021.103351.

• Uzwiak, Beth and Anastasia Hudgins. “Dying Alone, Dying at Home: Qualitative research with next of kin of opioid overdose victims in Philadelphia.” Poster presented on the panel entitled “Addiction.” Society for Medical Anthropology, Havana, Cuba. March 2020.

• Anastasia Hudgins. “Narrating Addiction: Weaving Subjectivity through Ethnography,” Global Studies Lecture Series: Mellon Wide Angle Learning Grant Project in Health Humanities. Global Studies Department, St. Lawrence University, Canton, NY. March 2019.