ABSTRACT

In India, marginalised people with serious or chronic illness face particular challenges to finding sustainable treatment, and often experience financial devastation. One state welfare scheme (the EWS hospital bed quotas) holds the promise of treatment for those in Delhi's margins, through partnerships with corporate hospitals. Yet, the process of gaining access to treatment via the scheme is very frustrating. This ethnography illustrates the ways in which low-income patients’ attempts to lay claim to state services often bring them into play with a mode of the state that is, in anthropologists’ conceptions, opaque, arbitrary and erratic. In response to the ‘illegible’ modes of access to the scheme, patients and their families are compelled to construct and reproduce their eligibility to access treatment, through a repertoire of intricate and entwined practices, namely: the attainment of credible low-income documentation, the use of big men to leverage resources, and different kinds of performance. The burden of enacting these practices is further compounded and troubled by the state scheme's blurry entanglement with the private sector, in which roles and responsibilities for a ‘duty of care’ to citizens with illness are elusive. This paper therefore aims to be an original contribution to the social sciences, in interpreting health-seekers’ experiences of state-private schemes in Delhi within anthropological understandings of the state and marginalised people's meaning-making of illegible state processes.

摘要

在印度，患有严重或慢性疾病的边缘人群在寻找可持续治疗方面面临特殊挑战，并且经常遭受经济损失。一项国家福利计划（EWS 医院床位配额）承诺通过与企业医院的合作为德里边缘的人提供治疗。然而，通过该计划获得治疗的过程非常令人沮丧。这份民族志说明了低收入患者试图要求国家服务的方式，往往使他们陷入一种国家模式，在人类学家的概念中，这种模式是不透明的、任意的和不稳定的。为了应对“难以辨认”的获得该计划的模式，患者及其家人被迫构建和复制他们获得治疗的资格，通过一系列错综复杂的实践，即：获得可靠的低收入文件，利用大人物来利用资源，以及不同类型的表现。国家计划与私营部门之间的模糊纠缠进一步加重了实施这些做法的负担，在私营部门中，对患病公民的“照料义务”的角色和责任难以捉摸。因此，本文旨在对社会科学做出原创性贡献，在人类学对国家的理解和边缘化人群对难以辨认的国家过程的意义制定的范围内，解释德里的健康寻求者对国家-私人计划的体验。以及各种不同的表演。国家计划与私营部门之间的模糊纠缠进一步加重了实施这些做法的负担，在私营部门中，对患病公民的“照料义务”的角色和责任难以捉摸。因此，本文旨在对社会科学做出原创性贡献，在人类学对国家的理解和边缘化人群对难以辨认的国家过程的意义制定的范围内，解释德里的健康寻求者对国家-私人计划的体验。以及各种不同的表演。国家计划与私营部门之间的模糊纠缠进一步加重了实施这些做法的负担，在私营部门中，对患病公民的“照料义务”的角色和责任难以捉摸。因此，本文旨在对社会科学做出原创性贡献，在人类学对国家的理解和边缘化人群对难以辨认的国家过程的意义制定的范围内，解释德里的健康寻求者对国家-私人计划的体验。