发热程度:肯尼亚社区卫生黄热病应对中的殖民性和争论。

IF 2.1 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Global Public Health Pub Date : 2025-12-01 Epub Date: 2025-06-22 DOI:10.1080/17441692.2025.2519659
Kathy Dodworth, Brenda N Mukungu
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引用次数: 0

摘要

2022年1月,肯尼亚Isiolo县首次发现了若干黄热病病例,引发了以居民接种疫苗为中心的国家级应对行动。7月份有18.1万人接种了疫苗,约占合格人口的72%。面对这种表面上的成功,本文探讨了持续的殖民主义,即长期存在的统治模式,在肯尼亚东北部的疾病控制中运作,因此与国家的惩罚性遭遇变得越来越大。尽管卫生事务得到了下放,但由国家控制的行为体自上而下的实施加剧了地方的不信任,导致围绕该计划的推出及其背后的当局的争论。本文以民族志为基础,辅以2022-2023年12个月的深度访谈和焦点小组讨论,集中介绍了社区卫生志愿者(chv)在为期10天的活动中的经验。我们采用Fanonian的视角来解释我们的发现,将chv面临的来自社区的争论历史化,在这个地区,政府的做法在忽视和严厉的补救行动之间摇摆。我们运用了法农的“心理存在主义情结”,chv将他们作为社区代表和国家执法者的角色之间的冲突内化,这种冲突因他们的不稳定性和对他人的不可见性而加剧。最后,我们呼吁在疫情应对中对冠状病毒所在的地方进行保护、防范和观察。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Fever pitch: Coloniality and contention within community health's yellow fever response in Kenya.

Fever pitch: Coloniality and contention within community health's yellow fever response in Kenya.

Fever pitch: Coloniality and contention within community health's yellow fever response in Kenya.

In January 2022, a number of Yellow Fever cases were identified in Kenya's Isiolo County for the first time, triggering a national-level response centred on vaccinating residents. 181,000 people were vaccinated in July, around 72% of the eligible population. In the face of this ostensible success, this article explores the continuing coloniality, that is, long-standing patterns of domination, operating within disease control in Kenya's northeast, whereby punitive encounters with the state loom large. Despite health matters being devolved, top-down implementation from nationally-controlled actors exacerbated local distrust, resulting in contention around the roll-out and of the authorities behind it. This article, drawing on ethnography supplemented by in-depth interviews and Focus Group Discussions over 12 months 2022-2023, centres the experiences of Community Health Volunteers (CHVs) over the ten-day campaign. We adopt a Fanonian lens to interpret our findings, historicizing the contention CHVs faced from their communities, in a region where governmental approaches oscillate between neglect and heavy-handed remedial action. We operationalise Fanon's 'psychoexistential complex', whereby CHVs internalise the conflict between their roles of community representative and state-enforcer, exacerbated by their precarity and invisibility to others. We conclude with a call for CHVs' place to be protected, capacitated and seen within outbreak response.

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来源期刊
Global Public Health
Global Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
3.00%
发文量
120
期刊介绍: Global Public Health is an essential peer-reviewed journal that energetically engages with key public health issues that have come to the fore in the global environment — mounting inequalities between rich and poor; the globalization of trade; new patterns of travel and migration; epidemics of newly-emerging and re-emerging infectious diseases; the HIV/AIDS pandemic; the increase in chronic illnesses; escalating pressure on public health infrastructures around the world; and the growing range and scale of conflict situations, terrorist threats, environmental pressures, natural and human-made disasters.
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