POSITION PIECES

“I’m Trapped Here”

— Tali Ziv

Published: 26 April 2023

Ethnography Fieldwork Relationships Moral injury Care

https://doi.org/10.17157/mat.10.1.6871

Abstract

In scenes of deep poverty and precarity, intimate relationships are shaped by the moral aftermath of a life of surviving scarcity. These moral histories are riddled with interpersonal harm, experiences of harming others and being seriously harmed oneself. As intimacy deepens, so does the prospect of harm, mistrust, and humiliation. These relational experiences can erode moral agency, or the sense that one is deserving of love and has the capacity to be seen as a ‘good’ person (Myers 2019; Blacksher 2002). Within the hermeneutic of moral injury—a concept largely defined by and elaborated in clinical settings—this Position Piece explores the messy relational life of scarcity in the context of conducting ethnography. Further, it examines the ethnographer’s responsibility to respond to such lives with an attention to moral injury and moral agency (Carpenter-Song 2019). This journey, guided by personal commitment, can lead to engagements that do not feel like care, yet are. This essay explores this reformulation of care as moral labour while concluding with the political stakes of this mode of intimate work.

The trap

The recovery house was a hotbed of rumour and intrigue. No one wanted to be there. Well, some people did, but only in the way that one wants to brush their teeth. It was the ‘right’ place to be, but not the most pleasurable. A drug and alcohol treatment centre off the street, yet separated by only a door and four walls; the sociality that defined street-based poverty, too, defined the sociality of the house. The rumours continuously circulated: who was getting high, who was stealing from whom, who was being sincere and who was ‘getting [one] over’ (lying to someone).

After three years of fieldwork in Philadelphia’s recovery houses, intensive outpatient treatment centres, and the jails with which they collaborate, I had just begun to grasp the nature of relationships in this context. A deeply human context suffocated by scarcity, relationships within the recovery house were overdetermined and thus fragmented. Staff were trying to police the residents, and the residents were trying to con or ‘get one over’ on the staff, roles that were determined far before either party set foot into the house. As Ruben, the recovery house director always said, ‘I been burned too many times’. Perhaps he was particularly sensitive to the moments of being burned, because in the past it had been Ruben who had done the ‘burning’, something we would reflect on together over time.

I soon became overwhelmed by the ways in which moral roles were predetermined in this context, including my own. These roles mirrored the overdetermined moralised narratives of racialised street-based poverty and the institutions put in place to manage it. The racialised and class-based ‘negativity’ of the streets that was shaped and moulded around the ‘positivity’ of the ‘program’—the recovery house, the treatment centre, or the inpatient rehabilitation centre. This positivity defined the essence of the counsellor and the social worker. This term defined all the people put it in place ‘to help’. It took months of fieldwork to realise I was blind to the ways in which my positionality as a White, middle-class ethnographer placed me in the same role as the social worker, the ‘positive’ person in the helper position who had avoided the societal, moral degradation of street-based poverty and addiction.

Despite my best efforts to forge an alternative role, I was positioned as someone who was there to help (or, in moments, police) people to ‘do positive,’ in the words of treatment centre clients. This role embodied (however unconsciously) the simple moral duality of the dispossession of the streets and the racialised possession of the domestic sphere and the formal labour market. Thus, I was someone who was assumed to be either an easy person to ‘get [one] over’ on or someone who sought to assert the moral superiority of the programme and ‘to police’ the residents. Either way, these roles were a trap that kept two people locked in a relational loop defined by dynamics reminiscent of transference and counter transference. Ironic indeed, as drug dealing in this context was colloquially referred to as ‘trapping.’

While the majority of my work otherwise focuses on how these racialised traps function within urban political economy and its systems of care, here I want to work through a relational and perhaps more humanistic engagement with this dualism. I ask: what is the experiential aftermath of being a self-identified ‘addict’ or ‘criminal’ in the context of racialised, street-based poverty? What are the relational forms one must assume to occupy these subjectivities, and what is lost when one assumes those forms? And finally, what room, if any, is there for an ethnographer to relate to these subjectivities–the totalizing, subhuman categories of the ‘criminal’ or ‘addict’—in a way that avoids reifying them as real and fantastically complete? I will argue that there is indeed room to relate differently—or to not be bound by a predetermined role—if we reframe these questions in the existential terms of moral injury and moral agency. However, such an effort requires forms of relating that do not always feel like care, yet are. These modes of relating offer a way to engage vulnerable people beyond the walls of predetermined, subjective reductions—categories enforced by historically informed, social valuations of moral worth. These modes circumvent the trap and its power.

The Structural and the subjective

I first met Poderoso at the Tapehouse East, a drug and alcohol recovery house where I had been conducting research for over a year. Well, that is when I officially met him. I had observed his young gangly frame, warm face, and deep respect for authority at a distance in Drug Court. He was in Drug Court for the activities he had undertaken during an active phase of his addiction. Both Poderoso and his roommate, who I will call G, identified as Puerto Rican. G was addicted to crack cocaine and Poderoso wanted to help him. Yet this care was deeply interwoven with feelings of indebtedness and precarity. G had given him a place off the streets and Poderoso was terrified of losing him. Poderoso fell in and out of touch with the courts, in and out of street-based activities, and in and out of contacting me. We had been doing this dance for over two years, but the lights had notably dimmed. His life was getting harder and harder.

Up until the point of conducting my dissertation research, I related to vulnerable interlocutors from a structural position. This is what I had learned from my graduate training. I fought to support participants in acknowledging the role that structural violence had played in shaping their activities and lives, treating intimate spaces as sites of structural politicisation (Farmer 2003; Bourgois et. al 1997). For example, I had been taught that people did not choose to start selling drugs, they were forced into it by structurally produced conditions of constraint and the political and economic production of poverty, labour exclusion, and drug prohibition. I was working on a research project in New York City when a man who chose the pseudonym Garvin and identified as Black set me straight. ‘It’s my life, choosing to sell drugs and now choosing to do this business, that’s my life [his emphasis]’. His words stayed with me. I realised I was creating a different type of trap, but a trap nonetheless: I was the powerful ethnographer who understood root causes and structural forces, and he was the vulnerable subject who was a victim to those forces. In trying to humanise Garvin, to help him see how much of his life had been determined by forces outside of his control, I had dehumanised Garvin further by stripping him of his human complexity and autobiographical power (Myers 2019, Myers and Ziv 2016). I had unintentionally tried to rob him of the capacity to structure the terms of his own life.

Joseph Wiinikka-Lydon defines moral subjectivity, the type of subjectivity that Garvin is articulating, as ‘the experience of being a moral subject, one who is constantly orienting the self toward and away from a culturally constructed and internalised image of the human person, working toward certain goods, and negotiating between various locations of account, obligation, and responsibility’ (2019, 28). Garvin found meaning, as we all do, in his reorientation toward a culturally normative image of what it means to be a moral human in the United States. My way of relating to him sabotaged his relationship to that meaning. While engaging with Poderoso and others, I returned to that moment with Garvin and the consciousness raising it afforded me with renewed commitment to move beyond this trap. This commitment led me to recent literature on moral injury [or a wound to one’s moral subjectivity] that straddles psychology, psychoanalysis, philosophy, and religious studies. In his canonical text on moral injury, Jonathan Shay argues that ‘PTSD alone, as officially defined, with no complications such as substance abuse or danger seeking, is rarely what wrecks veterans’ lives, crushes them to suicide, or promotes domestic and/or criminal violence.’ (2019, 184). He argues, instead, that it is moral injury that causes this destruction:

How does moral injury change someone? It deteriorates their character; their ideals, ambitions, and attachments begin to change and shrink. Both flavors of moral injury impair and sometimes destroy the capacity for trust. When social trust is destroyed, it is replaced by the settled expectancy of harm, exploitation, and humiliation from others. With this expectancy, there are few options: strike first; withdraw and isolate oneself from others; or create deceptions, distractions, false identities, and narratives to spoil the aim of what is expected (2019, 186).

Aspects of moral injury, though relevant for PTSD, can define the lived experience of addiction, severe mental illness, violence, and deep poverty as well. Garvin was teaching me that this process of rebuilding moral agency from a space of moral injury was what gave his life meaning. The structures of social and cultural normativity which define our legal codes had carved out a moral ‘right’ and ‘wrong’ from which Garvin had deviated. In refusing the dehumanisation of the victim position, Garvin was refusing the totalising space of moral injury and establishing his own space of agency within a field of violent, structural relations. We can understand moral injury, then, as the deeper, intimate and relational afterlife of structural violence, and moral agency as the process of rebuilding from this space of injury. For those still fighting through extreme conditions of racialised poverty, violence, and scarcity, how can ethnographers relate intimately to support individuals in ways that do not reinforce or aggravate this space of injury?

Much ink has been spilled on the possibilities of relational reciprocity in the ethnographic relationship. Bourgois and Schoenberg (2009) discuss the economic circuits that defined fieldwork amongst the unhoused in San Francisco, offering money and food to vulnerable interlocutors in exchange for accompaniment. Ruth Behar (1996) engages the possibilities of vulnerability and love as part of this reciprocal circuitry as it is unfolded in her fieldwork. Much of this literature is haunted by the spectre of exploitation, the same spectre that has haunted the discipline at large at least since the postmodern turn. Though I do not seek to intervene upon these debates here, I do suggest that the frame of moral agency can illuminate a more human space of relational parity. Even if the asymmetries of power and gain can never be surmounted—despite much disciplinary fretting—there are still modes of reciprocity forged within these asymmetries that are more human than others. Here, I am particularly worried about the effects that structural violence and other critical, theoretical orientations can have on the reciprocal, relational and practical modes we choose to invest in during fieldwork. The term friendship often arises in anthropological descriptions of fieldwork collaboration (Bourgois and Schoenberg 2009), and though aspects of ethnographic relationships forged across gradients of power are deeply friendly, there are elements which are fundamentally distinct and require different modes of ethical navigation. To look away from those distinct elements, or to look away from the profound vulnerability that often defines one end of these power gradients and not the other, and further, to pretend that this asymmetry does not fundamentally alter the relationship, is to engage in an active fantasy.

‘I haven’t been doing nothing positive, makes me feel like I’m not worth it’

Towards the end of the first year of knowing one another, Poderoso and I had a particularly difficult conversation over the phone. I put my cell phone on speaker and placed it on my bed, needing to put some physical distance between him and me. I hoped the distance would help me stand firm in the emotional distance between us. Poderoso had called me to ask for money and I had responded by saying no. ‘That’s fine, whatever’, he had responded curtly, almost hanging up before I quickly interjected. Offering interlocutors twenty dollars every few weeks or months felt ethical, as did treating folks to a coffee or a meal when together. I had set a boundary around consistent financial support. Financial support, like emotional support, can also enmesh.

Primarily, I was concerned that I was hurting rather than supporting Poderoso by bolstering life circumstances which were not sustainable and thus potentially harming him. During these months, Poderoso only heard my concern as doubts about what he was really doing with the money: how he was spending it, or when I would receive it back. These concerns persisted in spite of the fact that I had told him again and again, ‘I only offer money when I do not expect it back’. He would repeat, ‘You’ll get the money back, I promise, I’ll send you a photo of the train ticket. I’ll get it back to you next week. I promise I’m just using it to get to this job. I can show you a photo of me working’.

Despite my best efforts, I could not engage with Poderoso outside the terms of exchange, betrayal, and humiliation (particularly around a lack of licit employment) that characterises life in deep poverty. Despite years of working together, mistrust and looming betrayal chipped away at our relationship. Over the course of these few months, I would also raise my concerns about being triangulated between Poderoso and G, his roommate. G would urge Poderoso to call me and ask for money. On this particular call, Poderoso became increasingly agitated with me, ‘I don’t have any choice, like what the fuck do you want me to do, I don’t got nowhere to go. G threatens to kick me out if I don’t call’. His voice blasted through the speaker. I imagined that his frustration would shake the phone and ripple the sheets, but it did not. ‘But you do; there is always a choice, you can leave there and go to the shelter, you can leave. It won’t be easy, but you can. You call me on behalf of G, which you have the right to do, but then you need to hear what it is like for me to be on the other end of those calls. I have to be able to “be a person” in this’. I quoted a phrase here that he had used with me months ago. In that previous conversation, Poderoso had asked me to ‘give it to him straight’ and tell him the truth if I ever felt annoyed or frustrated with him.

Refusing the perpetrator / victim binary

Let’s return briefly to Garvin to theorise what was happening here. By devaluing Garvin’s reckoning with his moral implication in his local, moral world, as Kleinman (1995) would have it, I was sabotaging his ‘moral agency’, or the ‘freedom to aspire to a good life in a way that leads to intimate connections to others’ (Myers 2019, 13). Inadvertently, I had attempted to trap him in the victim position. Similarly, with Poderoso, I had to refuse the role of the perpetrator to make space for him outside the predetermined role of the victim.

Poderoso’s voice lowered after I finished telling him that I needed to be ‘a person’ in our relationship. ‘It’s just like I’m drowning and when I’m with you or people in my family I get out for a minute, and then I go right back under and I forget. It feels like no one can reach me there’. I paused and then reflected back, ‘That’s so real, Poderoso, but when you drown, you flail; drowning people often punch others in the face, the very people who are trying to help them. If we are in a relationship, I am gonna tell you if you’re punching me. I’m not gonna go anywhere, but I am gonna tell you that it hurts’.

This is the space of moral injury: a space of drowning, where life is reduced to survival, to getting air, to getting money, to expecting betrayal, humiliation, or exploitation from others because that is what you expect from yourself. When I asserted my need to ‘be a person in this’, I refused the space of the rescuer or the perpetrator. It was tempting to contain Poderoso, to absorb his behaviour, to give him money when he asked—he was struggling in such a profound way. In other moments, it was tempting to get angry, indignant even, to show him that his behaviour was hurtful. And even though each of these responses felt compelling or like the most caring possibility in the space of moral overlap between Poderoso and me, they were not. Poderoso would either remain in the position of the victim, proving to himself that he was not capable of complex relationships and being held accountable, or in the position of the perpetrator, proving to himself that he was too negative and subhuman to be in a loving relationship.

Neither of these positions would lead him to establish other more sustainable and meaningful relationships outside of the limited ethnographic space of our relationship. In the first scenario, I would continue to keep Poderoso at a distance, as a human fundamentally different than me or others I love because of his structural position. And in the second scenario, I would get too close to Poderoso, responding as one might to a friend who had enacted this behaviour, eschewing the power differential in our structural and relational positions. I did not call Poderoso for money, nor did I call him to talk about my life or feelings, nor did I depend on his support in a life that was otherwise punishing; we were not in a reciprocal friendship. His needs were more robust and complex than the ones I brought to our relationship. And thus, in these moments, I could not act from that place of proximity. We were, however, in a reciprocal ethnographic relationship. I had the tools, space, and time to reflect on what was happening for Poderoso structurally—an outcome not only of my privilege and structural position as a middle-class, White woman, but also as a social scientist trained in the analysis of these very dynamics—and thus could offer him more flexibility because of that knowledge.

This knowledge is never complete, of course. It is never right or wrong. It never takes the form of ‘expertise’ or ‘authority’. Rather, it is knowledge forged from particular contexts that are situated in specific moments in time. It is knowledge that Poderoso and others had taught me, implicitly, over the years of conducting fieldwork. I wanted to offer him the flexibility this knowledge affords in an effort to establish some reciprocity in our relationship. Money, food, or connections to social services did not come close to the professional and personal meaning that doing fieldwork with him and others had offered and continues to offer me. Despite this social, economic, racialised, and professional power, this meaning in me was human and needed to be conveyed as equal and relational. I needed to be a person while relating to him, to be able to demonstrate my love and care for him as such. The context-specific practice that develops between these polar positions of power/distance and humanity/closeness, in my understanding, is the closest thing to a reciprocal, ethnographic practice of moral parity we can hope for in scenes of inequality and scarcity. It is one that has to be cultivated and recultivated anew in each fieldwork context as it changes through and around the collaborators in each of these research spaces.

After two months of silence, Poderoso asked to speak on the phone again. When he called, I was shocked. His voice was back. He sounded like him. The connection was vitalising. He offered a declaration, ‘If I want to stay in Drug Court I have to leave Kensington. I been saying this for years but I mean it. I don’t even wanna talk about it no more, I just wanna do it.’ Peeling potatoes to fry for his breakfast, he continued, ‘I know I get in this hole where it’s like I am so alone and I think no one cares about me, that no one is supporting me, and I get angry, resentful. But that’s not true, I do have people in my corner and when I’m in that place I push people away’. I reflected back that this felt true for me, and then articulated the disrespect I felt when he called for money and tried to hang up immediately after.

There was a long pause. He quietly responded, ‘No I know, that’s how I get in this place. Honestly, it’s not me. What you’re saying is true, but it hurts. Like damn, I don’t wanna be that person... I can’t keep trying to help somebody when they don’t wanna do nothing for themselves and I can’t do nothing for myself. I can’t do it no more’. He continued on, ‘I keep thinking I’m free, but I’m not. I’m trapped here. It’s worse than jail. That’s how messed up my thinking gets though, bro, but I don’t wanna lose your friendship, Tal, honestly, I don’t wanna lose you because of this hole I’m in. And I know I was on the way to losing it, you can sugar coat shit but I’m gonna take the sugar off it and let you know that I was fucking up’. I let his words settle for a moment and then responded:

You’re never gonna lose me, Poderoso. You may lose aspects of me until you can see how you’re treating me, but I will always show up for you, no matter what is going on. It’s important to me that you know that you won’t ever lose me. You’re letting me into your life to learn with you, support you, and write about you, and what I can give you in return is a deeper basement’.

He barely waited a second before responding. ‘I appreciate that, Tal, but I want the real friendship. I don’t want the peripheral shit, I don’t want a deeper basement because I wanna be me, do right by people, I don’t want you to have to deal with that shit. I don’t wanna put you through that’. When Poderoso said ‘friendship’ I heard him saying ‘relationship’. He often referred to me as a caseworker with his friends, and thus I was confident that he knew we were not simply ‘friends’ but something more complicated. Yet in pushing for a closer relationship, Poderoso was accomplishing something profound.

Life outside the trap

There were three things that Poderoso was achieving with his two statements here. First, he was stating that he wanted a ‘real friendship’, a fuller relationship where he could engage with and relate to more of me rather than a thinned version who was simply deflecting and containing his space of drowning. He then stated that he did not want me ‘to have to deal with that shit,’ he did not ‘wanna put me through that’. This is the second thing he accomplished here. Poderoso maintained empathy and a relational connection. He sustained an awareness of how he impacts others, and engaged his human capacity ‘to account’, or to be accountable to others when he said, ‘I know I was fucking up’. And third, by using a flexible tense structure, ‘I don’t want to put you through that’, a statement that was both backward and forward facing, he was acknowledging what he had done in the past, and that he was able to retain a hold on the future by showing that he did not want to act in a way that created pain for me in the future. In maintaining this connection, Poderoso was showing himself that he remained capable of empathy and care, that he deserved love and connection, and that he had the possibility of a life outside of the trap.

After this call, Poderoso went off the grid again and stopped answering text messages or calls. After three months, I went to knock on his door to see if he was okay and check in on him. I worried he had started using heroin again. Calling in on him without notice was something he had given me consent to do in prior moments in our relationship. When he emerged, he made brief eye contact before looking down at the ground. With a voice that was low and unsteady, he said, ‘Sorry I haven’t called, I just haven’t been doing nothing positive; makes me feel like I’m not worth it’. Poderoso had slipped back into a totalising space of moral injury. He was not able to access the part of himself that had achieved connection with me over the phone a few months prior. He was back in the hole. Associating me with positivity and deserving of a positivity that he felt he lacked, he hid from me. He felt that he ‘wasn’t worth it’. Showing up that day and going for a short walk with him refused this moralising split. No person and no thing is just ‘positive’ or ‘negative’. These are socially and politically constructed moral fantasies which are contained in people, activities, and structures and need to be relationally (not just politically) refused in order for people to live and not just survive.

Today, Poderoso is still living with G, is still in Kensington, is still cycling in and out of street-based activities, and is still in and out of contact with me. I wait for his calls and attempt to embody the steadiness of this approach to relating while I do so. I am not a rescuer, I am not a moral arbiter or a perpetrator; we are on equal moral footing. It is a plodding form of labour that contains hope, a commitment to an otherwise for Poderoso that remains distant and far too precarious.

Committing to the kind of relational work I have undertaken with Poderoso is not a simple or light matter. It requires a great deal of reflexive and emotional labour and is therefore contingent upon a host of institutional and personal factors. For example, building these kinds of ethnographic relationships is a process fitting for long-term, open-ended ethnographic work and less so for short-term, or interview-based ethnographic research; methodological decisions which are deeply contingent upon institutional funding and position. As academic work becomes more and more precarious, taking on more labour of any kind is something to carefully consider. It is also dependent on one’s other emotional investments—children, ill or otherwise dependent family members, among many other personal factors. Even further, our own lives can change in unexpected ways. Thus, committing to a relationship in one moment might feel doable and in another completely unfeasible. It is worthwhile to touch briefly on these critical concerns before closing.

My relationship with Poderoso is on a broad, relational spectrum. There are countless versions of this orientation that can play out in simple and even brief interaction-based ways. Take the moment I shared with Garvin as an example. I did not develop a long-term relationship with him, nor would I say we shared much relational intimacy. But reflecting back to him the pride and validation he shared when discussing the changes he had made in his life—rather than devaluing the moral codes or social inequality that defined those changes— is one such example of this moral mode of ethnographic engagement.

There is room for politicisation in every context, yet I deeply believe that these personal, intimate narratives are not an ethical space for that politicisation. We are all moral beings, and feelings of remorse, regret, and shame for having transgressed socially agreed upon moral codes are as human and necessary as any others that we feel. This is especially true for people who are in societal positions which are socially and morally denigrated, regardless of ones activity within them, like those of deep poverty, racialisation, addiction, and mental illness. This orientation would change how we listen to people when they talk about their guilt and shame, or when they express longing for a life that they deem to be ‘normal’ and ‘positive’. These shifts are small, maybe even imperceptible to those doing the talking, yet I argue that they matter deeply. And though I have made a long-term commitment to Poderoso which I have reinforced with phrases like ‘I’ll always be here for you’, I am not promising him that I will always be there in the same way. I am not promising him that I will not change. Just as he changes, I will and should change, too. What I am committing to is holding in me a relational space of moral parity between us as I move through my life and career. I am promising that I will continue to show up for him in the ways that I can. If those modes of showing up change significantly, and he perceives this and has feelings about those changes, I am committing to processing those feelings with him. I am not his therapist, I am not his social worker, I am his ethnographer, and the most important thing I can do is be open and honest about the affordances and limits of that position as I understand it and occupy it. This, in my understanding, is the core definition of and commitment to consent in ethnographic relationships.

This Position Piece has argued that anthropological understandings of structural violence can be deepened by attending to the ways in which moral injuries manifest for individuals living in conditions of extraordinary precarity. Ethnographic relationships can be a tiny part of the journey towards healing, if not a more modest journey of maintenance that avoids the deepening of these injuries. This approach humanises people by not splitting their activities between the dualistic hermeneutics of victimhood and agency, but rather attending to their moral subjectivity and the struggle for accountability, transformation, and relationality therein. This is of course fraught terrain. We know the pernicious impacts that the ‘culture of poverty’ thesis, or other victim-blaming narratives, have had on poor, racialised, and colonised populations. Engaging intimately with the sole intention of countering these structural logics, however, can create forms of relationality that, too, dehumanise and victimise, albeit in a different way. As ethnographers, we not only need to analyse the conditions that structural and historical forms of violence have wrought, but to act and most importantly listen, care, and relate responsibly within them.

Authorship statement

Tali Ziv is the only author who conducted this research as well as its analysis between 2017 and 2023.

Ethics statement

This work was supported by the US National Science Foundation (NSF) [grant number: 1851033] and the Wenner-Gren Foundation [grant number: 9446]. The author declares no existing conflict of interests. The research carried out received IRB approval at the University of Pennsylvania (IRB number 826720) and a reliance agreement from Johns Hopkins University.

Acknowledgements

Poderoso, this commentary is dedicated to you. I wrote this piece holding what you have shared of your life, and what it has built between us, in my heart. A big thank you to Neely Myers for organising a wonderful SPA Panel in 2021, and to Michael D’Arcy and Julia Brown, whose friendship and collegial spirit not only made this commentary stronger but brought this special section to the finish line. Thank you. Finally, I am incredibly grateful to the anonymous reviewers who read this piece with an unusual amount of care and generosity.

About the author

Tali Ziv is a postdoctoral fellow at Johns Hopkins University. Her research agenda is situated at the intersection of mass incarceration and community-based health and social services as they combine to govern inequality in the United States. By bringing a political and economic attention to racial justice as well as carcerality in the study of addiction, Medicaid, and drug treatment, her research interrogates the fundamental, multifaceted relationships between healthcare, governance, and inequality in the United States. Spanning the fields of Anthropology, Public Health, and Africana Studies, she has defined questions—both historical and contemporary—that place health and health systems squarely within racialised inequality.

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