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Alice Street

University of Edinburgh, Social Anthropology, Chancellors Fellow

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Since 2009 I have held a Nuffield New Career Development Fellowship in the Department of Anthropology at Sussex. This research project explores the health system in PNG as a site of state building and the implications of development interventions focused on "state fragility" for the social and political life of bureaucratic technologies.

Since 9/11 an international discourse on state failure has reconfigured the role of international development in Papua New Guinea, placing 'good governance' and 'state-building' at the core of many aid interventions. This research examines how these new aid relationships are reshaping the country's state-run health system, are reformulating people's relationships to the state and are generating new kinds of health inequalities.

The project builds on long term ethnographic fieldwork in Papua New Guinea's health system conducted since 2003. My doctoral dissertation was based on a year's ethnographic fieldwork in a general hospital in Papua New Guinea and described the knowledge, bodies and persons produced by biomedical technologies in a context of severe resource shortage and political upheaval.

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Pomona College

Susquehanna University

SUNY: University at Albany

San Francisco State University

University of Massachusetts Amherst

University of Leeds

Gabrielle Bouleau

IRSTEA

Armando Salvatore

McGill University

Carolyn Barshay-Szmidt

University of Pennsylvania

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Papers by Alice Street

2012. Seen by the State: Bureaucracy, Visibility and Governmentality in a Papua New Guinean Hospital. The Australian Journal of Anthropology, Vol 23(1).

Drawing on ethnographic material from a government hospital in PNG, this paper examines the relat... more Drawing on ethnographic material from a government hospital in PNG, this paper examines the relationship between power and visibility in two kinds of bureaucratic practice: hospital managers' performance of institutional 'transparency' and patients' careful management of their government health documents. In both examples people engage with bureaucratic and biomedical technologies of visibility to entice governing actors to see and enter into a relationship with them. Against dominant Foucauldian theories of power-vision the article shows that, in the institutional crevices of a 'weak state', bureaucratic technologies operate as relational technologies that elicit affective motivations rather than as disciplinary technologies that transform the self.

2012. Affective Infrastructure: Hospital Landscapes of Hope and Failure. In Hospital Heterotopias: Ethnographies of Biomedical and Non-Biomedical Spaces, special issue of Space and Culture, Vol 15.

Hospitals are designed as spaces of improvement. Yet an accumulation of infrastructural projects ... more Hospitals are designed as spaces of improvement. Yet an accumulation of infrastructural projects can lead over time to the emergence of a layered landscape made up of multiple incongruous planned spaces. This article focuses on Madang General Hospital in Papua New Guinea as one example of such a landscape. Here, deteriorating colonial buildings jostle against new gleaming constructions built with donor funds. The layered effect of the postcolonial landscape draws attention to enduring racial and class inequalities; the colonial past is rendered present in the buildings of the future. Drawing on recent work on affect in anthropology and cultural geography I argue that this landscape impresses affects of hope and disappointment on the people who inhabit it and shapes ambivalent attachments to national and state futures. This double movement of improvement and decay is analysed as a process of ruination that is intrinsic to modern spaces of improvement.

2012. Real and Imaginary Spaces. In Hospital Heterotopias: Ethnographies of Biomedical and Non-Biomedical Spaces, special issue of Space and Culture, Vol 15. (co-authored with Simon Coleman)

The hospital's ambiguous relationship to everyday social space has long been a central theme of h... more The hospital's ambiguous relationship to everyday social space has long been a central theme of hospital ethnography. Often, hospitals are presented either as isolated "islands" defined by biomedical regulation of space (and time) or as continuations and reflections of everyday social space that are very much a part of the "mainland." This polarization of the debate overlooks hospitals' paradoxical capacity to be simultaneously bounded and permeable, both sites of social control and spaces where alternative and transgressive social orders emerge and are contested. We suggest that Foucault's concept of heterotopia usefully captures the complex relationships between order and disorder, stability and instability that define the hospital as a modernist institution of knowledge, governance, and improvement. We expand Foucault's focus on the disciplinary, heterotopic qualities of the hospital to explore the heterotopia as a space of multiple orderings. These orderings are not only biomedical. Rather, hospitals are notable for the intensity and heterogeneity of the ongoing spatial ordering processes, both biomedical and other, that produce them. We outline an approach to heterotopias that traces the contingent configuration of hospital space through relationships between the physical environment, technologies, and persons, while simultaneously considering the kinds of spatial imaginings, hopes for the future, and emotional responses that are rendered possible by those configurations. We provide three thematic frameworks through which the heterotopic and contingent qualities of hospital spaces might be explored: boundary work, generating scale, and layered space.

2012. 'Real and Imagined Spaces' Introduction to: Hospital Heterotopias: Ethnographies of Biomedical and Non-Biomedical Spaces, Special Issue of Space nd Culture Volume 15 (co-edited with Simon Coleman)

The hospital's ambiguous relationship to everyday social space has long been a central theme of h... more The hospital's ambiguous relationship to everyday social space has long been a central theme of hospital ethnography. Often, hospitals are presented either as isolated "islands" defined by biomedical regulation of space (and time) or as continuations and reflections of everyday social space that are very much a part of the "mainland." This polarization of the debate overlooks hospitals' paradoxical capacity to be simultaneously bounded and permeable, both sites of social control and spaces where alternative and transgressive social orders emerge and are contested. We suggest that Foucault's concept of heterotopia usefully captures the complex relationships between order and disorder, stability and instability that define the hospital as a modernist institution of knowledge, governance, and improvement. We expand Foucault's focus on the disciplinary, heterotopic qualities of the hospital to explore the heterotopia as a space of multiple orderings. These orderings are not only biomedical. Rather, hospitals are notable for the intensity and heterogeneity of the ongoing spatial ordering processes, both biomedical and other, that produce them. We outline an approach to heterotopias that traces the contingent configuration of hospital space through relationships between the physical environment, technologies, and persons, while simultaneously considering the kinds of spatial imaginings, hopes for the future, and emotional responses that are rendered possible by those configurations. We provide three thematic frameworks through which the heterotopic and contingent qualities of hospital spaces might be explored: boundary work, generating scale, and layered space.

2011. Artefacts of Not-Knowing: The Medical Record, Diagnosis and the Production of Uncertainty in Papua New Guinean Biomedicine. Social Studies of Science Vol. 42.

Anthropological and STS scholars of biomedical work have traditionally explored contexts where in... more Anthropological and STS scholars of biomedical work have traditionally explored contexts where inconsistencies and lacunas in diagnostic knowledge production are fundamentally problematic for medical practitioners and have consequently focused on the social and political processes by which such epistemic uncertainties are resolved. This article draws on ethnographic material from a Papua New Guinean hospital where diagnostic uncertainty is not rendered problematic and where the open-endedness of the diagnostic process gives rise to new forms of medical expertise and practice. The paper focuses on the medical record as an artefact of not-knowing that both documents and performs uncertainty as a valuable resource. It shows that medical records can operate as either technologies of 'opening' that multiply opportunities for pragmatic action within a hospital space or as technologies of 'closure' that move people and documents between spaces. Practices of not-knowing and knowing are therefore shown to be interdependent and interchangeable 'moments' of bureaucratic-biomedical work.

2009. Anthropology at the bottom of the pyramid

Anthropology Today, Jan 1, 2009

2009. Failed recipients: extracting blood in a Papua New Guinean hospital

Body & Society, Jan 1, 2009

Anthropologists studying voluntary-anonymous systems of blood donation have noted the ways in whi... more Anthropologists studying voluntary-anonymous systems of blood donation have noted the ways in which they facilitate imaginings of national relatedness and integration. This paper focuses on family replacement systems in Papua New Guinea, where blood donated by a patient's relative replaces the units taken from the bank, in order to examine what kinds of relational imaginings are possible when blood is transacted between people who know one another. Patients in Madang Hospital are led to believe that it is their responsibility to obtain blood donations from their relatives within a kinship obligation system. However, articulations of kinship exchange with a biomedical blood economy are not as straightforward as hospital workers suggest. Instead the hospital emerges as a crucial, but hidden, mediator in these transactions. Doctors conceal from patients the fact that blood group incompatibilities mean blood intended for a specific person may be redirected elsewhere. The obviation of this 'biomedical technology' thus enables the hospital to harness patients' 'relational technologies' of gift exchange to feed the institution's blood economy. In contrast to anthropologists' common focus on blood donation, here attention is drawn to the role of recipients in negotiating different regimes of extraction.

2010. Belief as relational action: Christianity and cultural change in Papua New Guinea

Journal of the Royal Anthropological Institute, Jan 1, 2010

This article draws on ethnographic analysis of Christianity in a Papua New Guinean hospital in or... more This article draws on ethnographic analysis of Christianity in a Papua New Guinean hospital in order to develop a theory of belief as 'relational action'. It argues that patients' engagements with Christianity in the hospital derive from a concern with medical efficacy rather than a search for meaning. Patients experience the hospital as a space of stasis in which they are unable to establish relationships effectively with either kin or doctors. Through relationships with God, patients hope to become active Christian agents and yield positive material effects on their bodies. There is a growing anthropological consensus that propositional theories of belief are inadequate to describe Christian and non-Christian religious practice. However, there is still a tendency to contextualize belief within wider cultural wholes. This article argues that patients' practice of belief as 'relational action' should be interpreted not as an attempt to construct moral and cosmological order in the face of change, but as an attempt to realize themselves as new kinds of social agents in the face of social failure.

2010. Anthropology Through Development: Putting Development Practice into Theory

Anthropology Matters, Jan 1, 2010

This special issue of Anthropology Matters frames the canonical question for development anthropo... more This special issue of Anthropology Matters frames the canonical question for development anthropologists in reverse. Instead of asking how anthropological theory might be put into practice in development, it asks how engagements with development policy and practice might transform anthropology. What kinds of theoretical insights have emerged from the anthropology of development? What does the overlapping language of anthropology and development mean for ethnographic methodology? How do relationships between anthropologists and development professionals affect the research process? What can anthropologists learn from development work?

2010. Book Review. The collectors of lost souls: turning kuru scientists into whitemen. By Warwick Anderson

Journal of the Royal Anthropological Institute, Jan 1, 2009

2010. Book Review. Bodies, Commodities, and Biotechnologies: Death, Mourning, and Scientific Desire in the Realm of Human Organ Transfer by Lesley Sharp

Medical Anthropology Quarterly, Jan 1, 2010

2012. Seen by the State: Bureaucracy, Visibility and Governmentality in a Papua New Guinean Hospital. The Australian Journal of Anthropology, Vol 23(1).

Drawing on ethnographic material from a government hospital in PNG, this paper examines the relat... more Drawing on ethnographic material from a government hospital in PNG, this paper examines the relationship between power and visibility in two kinds of bureaucratic practice: hospital managers' performance of institutional 'transparency' and patients' careful management of their government health documents. In both examples people engage with bureaucratic and biomedical technologies of visibility to entice governing actors to see and enter into a relationship with them. Against dominant Foucauldian theories of power-vision the article shows that, in the institutional crevices of a 'weak state', bureaucratic technologies operate as relational technologies that elicit affective motivations rather than as disciplinary technologies that transform the self.

2012. Affective Infrastructure: Hospital Landscapes of Hope and Failure. In Hospital Heterotopias: Ethnographies of Biomedical and Non-Biomedical Spaces, special issue of Space and Culture, Vol 15.

Hospitals are designed as spaces of improvement. Yet an accumulation of infrastructural projects ... more Hospitals are designed as spaces of improvement. Yet an accumulation of infrastructural projects can lead over time to the emergence of a layered landscape made up of multiple incongruous planned spaces. This article focuses on Madang General Hospital in Papua New Guinea as one example of such a landscape. Here, deteriorating colonial buildings jostle against new gleaming constructions built with donor funds. The layered effect of the postcolonial landscape draws attention to enduring racial and class inequalities; the colonial past is rendered present in the buildings of the future. Drawing on recent work on affect in anthropology and cultural geography I argue that this landscape impresses affects of hope and disappointment on the people who inhabit it and shapes ambivalent attachments to national and state futures. This double movement of improvement and decay is analysed as a process of ruination that is intrinsic to modern spaces of improvement.

2012. Real and Imaginary Spaces. In Hospital Heterotopias: Ethnographies of Biomedical and Non-Biomedical Spaces, special issue of Space and Culture, Vol 15. (co-authored with Simon Coleman)

The hospital's ambiguous relationship to everyday social space has long been a central theme of h... more The hospital's ambiguous relationship to everyday social space has long been a central theme of hospital ethnography. Often, hospitals are presented either as isolated "islands" defined by biomedical regulation of space (and time) or as continuations and reflections of everyday social space that are very much a part of the "mainland." This polarization of the debate overlooks hospitals' paradoxical capacity to be simultaneously bounded and permeable, both sites of social control and spaces where alternative and transgressive social orders emerge and are contested. We suggest that Foucault's concept of heterotopia usefully captures the complex relationships between order and disorder, stability and instability that define the hospital as a modernist institution of knowledge, governance, and improvement. We expand Foucault's focus on the disciplinary, heterotopic qualities of the hospital to explore the heterotopia as a space of multiple orderings. These orderings are not only biomedical. Rather, hospitals are notable for the intensity and heterogeneity of the ongoing spatial ordering processes, both biomedical and other, that produce them. We outline an approach to heterotopias that traces the contingent configuration of hospital space through relationships between the physical environment, technologies, and persons, while simultaneously considering the kinds of spatial imaginings, hopes for the future, and emotional responses that are rendered possible by those configurations. We provide three thematic frameworks through which the heterotopic and contingent qualities of hospital spaces might be explored: boundary work, generating scale, and layered space.

2012. 'Real and Imagined Spaces' Introduction to: Hospital Heterotopias: Ethnographies of Biomedical and Non-Biomedical Spaces, Special Issue of Space nd Culture Volume 15 (co-edited with Simon Coleman)

The hospital's ambiguous relationship to everyday social space has long been a central theme of h... more The hospital's ambiguous relationship to everyday social space has long been a central theme of hospital ethnography. Often, hospitals are presented either as isolated "islands" defined by biomedical regulation of space (and time) or as continuations and reflections of everyday social space that are very much a part of the "mainland." This polarization of the debate overlooks hospitals' paradoxical capacity to be simultaneously bounded and permeable, both sites of social control and spaces where alternative and transgressive social orders emerge and are contested. We suggest that Foucault's concept of heterotopia usefully captures the complex relationships between order and disorder, stability and instability that define the hospital as a modernist institution of knowledge, governance, and improvement. We expand Foucault's focus on the disciplinary, heterotopic qualities of the hospital to explore the heterotopia as a space of multiple orderings. These orderings are not only biomedical. Rather, hospitals are notable for the intensity and heterogeneity of the ongoing spatial ordering processes, both biomedical and other, that produce them. We outline an approach to heterotopias that traces the contingent configuration of hospital space through relationships between the physical environment, technologies, and persons, while simultaneously considering the kinds of spatial imaginings, hopes for the future, and emotional responses that are rendered possible by those configurations. We provide three thematic frameworks through which the heterotopic and contingent qualities of hospital spaces might be explored: boundary work, generating scale, and layered space.

2011. Artefacts of Not-Knowing: The Medical Record, Diagnosis and the Production of Uncertainty in Papua New Guinean Biomedicine. Social Studies of Science Vol. 42.

Anthropological and STS scholars of biomedical work have traditionally explored contexts where in... more Anthropological and STS scholars of biomedical work have traditionally explored contexts where inconsistencies and lacunas in diagnostic knowledge production are fundamentally problematic for medical practitioners and have consequently focused on the social and political processes by which such epistemic uncertainties are resolved. This article draws on ethnographic material from a Papua New Guinean hospital where diagnostic uncertainty is not rendered problematic and where the open-endedness of the diagnostic process gives rise to new forms of medical expertise and practice. The paper focuses on the medical record as an artefact of not-knowing that both documents and performs uncertainty as a valuable resource. It shows that medical records can operate as either technologies of 'opening' that multiply opportunities for pragmatic action within a hospital space or as technologies of 'closure' that move people and documents between spaces. Practices of not-knowing and knowing are therefore shown to be interdependent and interchangeable 'moments' of bureaucratic-biomedical work.

2009. Anthropology at the bottom of the pyramid

Anthropology Today, Jan 1, 2009

2009. Failed recipients: extracting blood in a Papua New Guinean hospital

Body & Society, Jan 1, 2009

Anthropologists studying voluntary-anonymous systems of blood donation have noted the ways in whi... more Anthropologists studying voluntary-anonymous systems of blood donation have noted the ways in which they facilitate imaginings of national relatedness and integration. This paper focuses on family replacement systems in Papua New Guinea, where blood donated by a patient's relative replaces the units taken from the bank, in order to examine what kinds of relational imaginings are possible when blood is transacted between people who know one another. Patients in Madang Hospital are led to believe that it is their responsibility to obtain blood donations from their relatives within a kinship obligation system. However, articulations of kinship exchange with a biomedical blood economy are not as straightforward as hospital workers suggest. Instead the hospital emerges as a crucial, but hidden, mediator in these transactions. Doctors conceal from patients the fact that blood group incompatibilities mean blood intended for a specific person may be redirected elsewhere. The obviation of this 'biomedical technology' thus enables the hospital to harness patients' 'relational technologies' of gift exchange to feed the institution's blood economy. In contrast to anthropologists' common focus on blood donation, here attention is drawn to the role of recipients in negotiating different regimes of extraction.

2010. Belief as relational action: Christianity and cultural change in Papua New Guinea

Journal of the Royal Anthropological Institute, Jan 1, 2010

This article draws on ethnographic analysis of Christianity in a Papua New Guinean hospital in or... more This article draws on ethnographic analysis of Christianity in a Papua New Guinean hospital in order to develop a theory of belief as 'relational action'. It argues that patients' engagements with Christianity in the hospital derive from a concern with medical efficacy rather than a search for meaning. Patients experience the hospital as a space of stasis in which they are unable to establish relationships effectively with either kin or doctors. Through relationships with God, patients hope to become active Christian agents and yield positive material effects on their bodies. There is a growing anthropological consensus that propositional theories of belief are inadequate to describe Christian and non-Christian religious practice. However, there is still a tendency to contextualize belief within wider cultural wholes. This article argues that patients' practice of belief as 'relational action' should be interpreted not as an attempt to construct moral and cosmological order in the face of change, but as an attempt to realize themselves as new kinds of social agents in the face of social failure.

2010. Anthropology Through Development: Putting Development Practice into Theory

Anthropology Matters, Jan 1, 2010

This special issue of Anthropology Matters frames the canonical question for development anthropo... more This special issue of Anthropology Matters frames the canonical question for development anthropologists in reverse. Instead of asking how anthropological theory might be put into practice in development, it asks how engagements with development policy and practice might transform anthropology. What kinds of theoretical insights have emerged from the anthropology of development? What does the overlapping language of anthropology and development mean for ethnographic methodology? How do relationships between anthropologists and development professionals affect the research process? What can anthropologists learn from development work?

2010. Book Review. The collectors of lost souls: turning kuru scientists into whitemen. By Warwick Anderson

Journal of the Royal Anthropological Institute, Jan 1, 2009

2010. Book Review. Bodies, Commodities, and Biotechnologies: Death, Mourning, and Scientific Desire in the Realm of Human Organ Transfer by Lesley Sharp

Medical Anthropology Quarterly, Jan 1, 2010