Resistant bugs, porous borders and ecologies of care in India
1Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, New South Wales, Australia.
Abstract:
As social science scholarship has routinely illustrated, professional practice is rarely as contained or coherent as it is often imagined to be. The increasing emphasis on the rise of antimicrobial resistance (AMR) has drawn renewed attention to the interconnectedness of clinic, community, environment and planet, and how proposed 'solutions' to major problems such as AMR require a broad, cross-cutting lens. In this study, set in Hyderabad, India, we draw on a series of interviews with hospital-based clinicians completed during 2019 and early 2020, to unpack the multidimensional, ecological acceleration of AMR and the implications for everyday practice. Their accounts make visible how practice operates in relation to industrial economies, community vulnerabilities, and ecologies. This in turn highlights the problem of epistemic bordering, where 'sites' of AMR are targeted but are prone to leakage and transgressions. We propose an ecological approach to conceptualising antimicrobial practices with implications for AMR interventions being rolled out in the sub-continent and beyond.
Insights
Antimicrobial resistance (AMR) is accelerated by interconnected clinic, community, and environmental factors. Understanding these ecological links is crucial for effective AMR interventions in India and globally.
Area of Science:
- Social Sciences
- Public Health
- Ecology
Background:
- Professional practice is complex and interconnected, contrary to simplistic views.
- Antimicrobial resistance (AMR) necessitates a holistic, cross-cutting approach considering multiple factors.
- The study examines the ecological acceleration of AMR and its impact on clinical practice.
Purpose of the Study:
- To unpack the multidimensional, ecological acceleration of antimicrobial resistance (AMR).
- To explore the implications of AMR acceleration for everyday clinical practice.
- To highlight the problem of epistemic bordering in AMR interventions.
Main Methods:
- Qualitative study using interviews with hospital-based clinicians.
- Conducted in Hyderabad, India, between 2019 and early 2020.
- Analysis focused on how clinical practice relates to industrial economies, community vulnerabilities, and ecologies.
Main Results:
- Clinician accounts reveal practice is intertwined with industrial economies, community vulnerabilities, and broader ecologies.
- AMR 'solutions' often face challenges due to 'epistemic bordering,' leading to leakage and transgressions.
- The study illustrates the ecological dimensions of AMR acceleration.
Conclusions:
- An ecological approach is proposed for conceptualizing antimicrobial practices.
- This approach has significant implications for AMR interventions in the Indian subcontinent and beyond.
- Recognizing interconnectedness is key to addressing AMR effectively.
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