(In)Visible Disease: Motions and Emotions Engendered by Papers and Diagnostics of People Accessing Healthcare in Burkina Faso

Within the last decade, challenges of diagnosis have emerged on the global health agenda, accompanied by an expansion in the use of point-of-care and rapid detection devices in low-resource contexts where laboratory facilities are scarce. Few studies have explored how these changes are shaping people’s diagnostic journeys and their modes of accessing such technologies. In this paper I show how sick people and their families in a peri-urban area in Burkina Faso attempt to access diagnostic technologies and make themselves visible to the healthcare system through papers. In this context, I show how referral papers and diagnostic papers take on significance for people as they attempt to access care and diagnostic technologies and ‘carry’ knowledge between different levels of the healthcare system. The use of papers is often an uncertain undertaking, as they remain unintelligible to the sick and the layperson. I highlight how the form of the papers makes a crucial difference to the ways that sick people are able to use them. Papers and diagnostic technologies present both opportunities and challenges, and simultaneously engender hope, uncertainty, disappointment, and despair for the sick seeking a cure. Uncertainties, especially financial ones, arise with the possibility of new referrals and diagnostic tests, and along the way many give up or are immobilised when faced with diagnostic ambiguity.