School of Global Studies Blog

This post is written by Dr. Ben Kasstan, a medical anthropologist at the University of Sussex.

*The views in the following article are the personal views of the author and are not an official position of the School.*

It is unreasonable to expect hesitant parents to accept vaccinations automatically. Vaccinations are among the most successful public health interventions to reduce childhood morbidity and mortality, but they also remain one of the most controversial. 

Uptake of the Measles, Mumps and Rubella (MMR) vaccination in England has suffered since 1998, when Andrew Wakefield and colleagues falsely claimed in The Lancet that the triple-vaccine may be a cause of childhood autism. Whilst their article has since been retracted and Wakefield’s claims refuted, the legacy for vaccination coverage has been catastrophic. Parents continue to fear that the all-in-one vaccine could put their children at risk of developing autism, which has been linked to outbreaks of measles in UK media. 

From a public health perspective, maintaining high levels of vaccination coverage across the population is vital to prevent and resist the spread of infectious outbreaks. High coverage rates help to protect people with vulnerable immune systems, such as newborn babies, pregnant women, or people who can’t be vaccinated. 95% of the population need to be vaccinated for protection against measles, though coverage rates at the national level do not reflect rates at local levels. 

Recent outbreaks of measles in areas of New York have been largely blamed on Haredi Jews, who are otherwise described as being ‘ultra-Orthodox’ or ‘non-compliant communities’ because of ‘culture’ or ‘beliefs.’ Yet there is little understanding around the vaccine decision-making and hesitancies among Haredi Jewish parents. Reactions to the outbreak have been so damaging that age-old anti-semitic representations of Jews as public health risks have resurfaced. Public health in the United States was used as a political technique to contain and control reviled migrant groups in the late nineteenth and early twentieth centuries, such as European Jews and Italians. 

Similarly Haredi Jews are viewed as a ‘hard to reach’ group by Public Health England due to lower vaccination coverage in London and Manchester neighbourhoods. Haredi families tend to be much larger than the national average, which presents a concern of more unvaccinated or partially-vaccinated children.  

My research has explored vaccine decision-making among Haredi Jewish families in England. What is true of any community is diversity, and I found a range of responses that included complete acceptance, selective acceptance, delayed acceptance and refusal of childhood vaccines. Parents were not opposed to vaccinations because of ‘religious beliefs,’ to the contrary, I was frequently told that they were important to preserve health and save lives (a core Jewish principle known as pikuach nefesh). The most common problem for parents with vaccine hesitancies, or who opposed vaccinations altogether, was safety and a lingering concern that the MMR vaccine could cause autism. More importantly, parents felt healthcare professionals did not treat their concerns seriously, and parents perceived healthcare professionals as not being able to address their concerns transparently. Whilst non-vaccination is seen as a moral issue (‘good’ parents vaccinate, ‘bad’ parents don’t vaccinate) – and even ‘child endangerment’ as one friend put it – the Haredi parents in my study declined vaccinations to protect their children. 

There is a danger here in scapegoating minority groups for what is, in reality, a national anxiety. The Childhood Vaccination Coverage Statistics for 2017-18 in England indicates a worrying trend towards lower vaccine uptake, which raises critical questions of the trust between England’s diverse population and public health services. The statistics report that rates of MMR coverage at two years of age have lowered for the fourth year in a row, with coverage stalling at around 91.2%. This falls short of the 95% threshold of MMR coverage needed to protect population health. Whilst the 95% threshold was secured in County Durham, regions such as the Isle of Wight and Camden (London) were below 90%.Recent media reports claim that up to half a million children in the UK remain unvaccinated against measles, which could spread like ‘wildfire’ without action. 

It is not enough to tell parents that ‘vaccines work’ (as the 2019 World Immunisation Week hashtag puts it), and it is unreasonable to expect hesitant parents to accept vaccinations automatically — without a process of informed consent. Healthcare professionals need to be responsive and sensitive to the vaccine hesitancies of parents in order to promote public confidence, and they need to be prepared to address questions of safety by offering clear information about vaccine products, processing and procurement. 

If parents are to accept that vaccinations are the safest way to protect their children, then healthcare professionals and public health services should accept that some parents need assurance and reassurance of why and how vaccines are so safe. 

Protecting child health is the aspiration of parents, healthcare professionals, and anthropologists like me. Working together to understand how concerns can be addressed is the most sustainable and effective way to show that vaccines can work for everybody.

This post is written by Dr. Ben Kasstan. Ben’s research focuses on reproductive and family health among ethnic and religious minority groups. His forthcoming book ‘Making Bodies Kosher’ (Berghahn Books) explores vaccine and child health decision-making among Haredi Jews in England.

This post is written by Dr. Gemma Houldey of International Development as part of our ‘Anxieties and Mental Health During Stressful Academic Times’ blog series. Gemma and Evie Browne are promoting mental health workshops for researchers that will run in June and July 2019.

*The views in the following article are the personal views of the author and are not an official position of the School.*

Last week was Mental Health Week, an opportunity for all of us, no matter who we are, to bring awareness to our personal struggles and those of others. It is likely that you or someone you know has suffered from depression, anxiety or emotional upheavals which are not only debilitating, but can also be a very isolating experience. Whilst it is common for people to talk about physical ailments such as coughs and colds or a broken ankle, it can be far harder for us to share our emotional vulnerabilities, in spite of this comprising part of being human.

Having just completed my doctoral research into stress and wellbeing in the aid sector, I’m fully aware – from my own experience as much as my research participants’ – that many of us, particularly in academia, suffer in silence and in solitude with regard to our own mental health.  Studying a PhD can feel like a lonely experience, especially when it comes to organising our own field research in remote and unfamiliar places, and the pressure of writing up the thesis and being confident in the data and findings. In addition, many of us are dealing with family crises, relationship problems, financial or job-related concerns or other health issues. There is little opportunity to share these multi-faceted challenges with others, particularly in an academic environment where there is significant pressure to perform well and be successful.

With this in mind, in the months of June and July Global Studies will be holding a series of wellbeing workshops*, supported by the Understanding the Mental Health of Doctoral Researchers project.  The sessions aim to be inclusive and participatory, exploring different techniques that can support us in looking after our minds and our bodies. They will cultivate a space in which to listen and to feel heard, and encourage a shared understanding of mental health and wellbeing as both an individual and collective responsibility for the functioning of communities who care about their members.

The workshops are designed to provide a range of services and ideas that researchers will familiarise themselves with and participate in during the sessions but can then use afterwards in their own time as well. They will include activities such as body and breath exercises, walking in nature and journaling, as well as discussions around diversity and inclusion in educational settings, and where researchers can go for help and support. Through the workshops we hope to build community and a sense of belonging so that no one need feel alone in their struggles. They are also an opportunity to celebrate all we achieve and overcome as researchers!

Please do come join us, beginning Tuesday 18^th June, 5.30-7pm, for 5 weeks. Contact Gemma Houldey (gh95@sussex.ac.uk) or Evie Browne (Evie.browne@sussex.ac.uk) for venue details.

*These workshops are open to all doctoral researchers from Global Studies and IDS.

This post is written by Ilaria Alessandrelli and Yuvinka Ribero Hurtado, 3rd year students in Anthropology and International Development. It is written as part of our blog series on ‘Anxieties and Mental Health During Stressful Academic Times’.

*The views in the following article are the personal views of the author and are not an official position of the School.*

Do you remember how you used to imagine University life? Not the frenzy of freshers’ week, but the everyday routine you would settle into after the first month, to slowly but surely work towards achieving a degree. While completing my A-level qualifications, university appeared in my mind as a space where the abyss that had separated theoretical from practical knowledge throughout my educational journey would finally be filled. I imagined that peer-led debates, participatory workshops and case study evaluations would provide me with a creative approach to real-life problems by incorporating analytical issues centered on ‘why’ questions and pragmatic concerns focused on feasible solutions. However, it is only after studying Anthropology for three years that I have found this space where I can approach my personal and academic journey at Sussex as a legitimate source of insights on the fundamental contradictions underpinning the British Higher Education System. Here is what I have noticed about the inner-workings of university when I applied the two anthropological principles that ‘lived experience’ must be taken seriously and subjective emotions can be epistemologically productive to my own experience as a student at Sussex.

Compulsory Education vs. Higher Education, or the Pain of Identity Negotiation 

“I thought studying Anthropology and International Development would make me happy. But that feeling of happiness didn’t come, instead, anxiety came knocking at my door. When I began doubting the soundness of the very system of higher education, my world collapsed on itself. My doubts on the validity of the teaching methods of this institution filled me with desperation. I wish I had had the strength to ask myself ‘which shape of knowledge do I value?’ ‘how can I achieve it?’ ‘what would its purpose be?’ But doubting my life choices brought so much pain it took away my potential to become a successful student and a healthy human being. To adapt to the new academic environment, I couldn’t ask myself these questions, or indeed any questions.” —(extract from a message sent to a friend in 11/07/2017)

This is what I wrote in my first honest reply to the question ‘how are you finding university?’ It took me a long time before being able to pin down what was it that made me doubt ‘the soundness of the higher education system’. Part of the problem was growing up in an academic environment that defines knowledgeability as the amount of data students can recall on any given topic. In this model of education, seemingly neutral narrative strategies (e.g. chronological order) are employed to generate ‘objective’ descriptions of reality. A student’s chief duty is being able to reproduce in spoken and written form all information that has hitherto been selected as expressing universal ‘truths’ about the world and the human condition. Today, I believe this approach to knowledge fails to depict phenomena objectively. It simply creates an illusion of ‘perfect objectivity’ by obscuring the subjective judgments made in the process of selecting and collating data. 

The Joy of Participatory Learning and The Agony of Essay Writing

I came to these conclusions gradually, due to my prolonged exposure to Sussex teaching practices. Rejecting definitions of knowledge centered on the accurate memorization of large bodies of information was a painful process. It stripped my efforts to conform to the education system in which I was raised of any value. However, by taking part in the scheduled peer-led seminars and workshops, I started believing in the power of participatory learning processes. Once the need to repeat what the greatest thinkers have previously written is forgotten, students can freely engage in the co-production of ideas that are truly representative of their doubts, concerns and experiences. This is the first step towards the creation of an inclusive learning process that helps individuals make sense of their surroundings and their own circumstances. Ideally, this should bring some understanding of what we hope to change about the present and how to act on such understanding outside the classroom.

My time at Sussex made me reconceptualise knowledge as the collective endeavour to understand human life in its full material, emotional and spiritual depth and co-produce feasible solutions to real-life issues. Having to structure the weekly study routine around preparing my meaningful contribution for peer-led seminars, encouraged me to place great value on the opportunity to actively participate in knowledge-production processes. However, embracing this new conception of knowledge made me realise that the current assessment structure does not mirror the values Sussex’ curriculum is based on. In fact, despite advocating for participatory learning approaches, this university does not even assess individual seminar attendance and contribution. Essay-writing emerges as a champion over all other modes of assessment. Over the years, the importance of alternative assessment criteria (e.g. exams, presentations, learning diaries and blog articles) capable of measuring students’ proficiency across a wider spectrum of skills, gradually shrinks. Finally, dissertations come to represent 100% of a student’s overall capability and intellectual engagement with their university degree. In practice, to embody the ‘successful student’ becomes repressing one’s genuine interests in favour of focusing on essay-writing and the quest for original arguments.   

Coming to terms with my values

Even though resisting this view of higher education as mere essay writing sometimes resulted in anxiety or depressive episodes and increased academic pressure, I decided to have faith in my view of what it means to be a successful scholar. That is, an individual who can creatively combine theoretical and practical knowledge to bring about a more inclusive future in which a greater number of persons people can pursue the kind of existence they most value. This led me to be proactive in engaging with local institutions addressing environmental and social issues in Brighton, in order to gain a practical understanding of the challenges analysed within the classroom. I took part in participatory workshops and debates on campus to discover alternative forms of knowledge, such as that described by Professor Mario Novelli, produced by social movements. More importantly, I have taken the opportunity to co-write this blog piece with a colleague, who has sincenow become a friend, to make the reflections stemmed from my academic and non-academic experience at Sussex available for others who might be attempting to make sense of and overcome feelings of frustration and anger. This collaboration has encouraged a healing process and made me re-think my career aspirations.       

Today, after almost three years of navigating academia, I can say that the determination to act upon existing inequalities and make change happen by joining forces with other students, I have cultivated in the face of a hostile higher education assessment structure will be my greatest achievement at Sussex.  

This post is written by Lizzi Joyner, a first-year undergraduate in International Development, as part of our ‘Experiences in Diversity’ series. She talks about her experiences on ICS in partnership with Tearfund and Zoe-Life in South Africa. She writes at her own blog https://may-we-never-lose-the-wonder.blog/.

South Africa. A nation brimming with beauty and brokenness. A nation surviving the most turbulent times, from colonial oppression to the apartheid, to its aftermath today. Because South Africa is such a meshing of languages (there are currently eleven official languages), races and cultures, its make-up is massively distinctive.

ICS is a UK government-funded programme giving young people the opportunity to explore the world of development in an overseas context. Its structure is brilliant: by building partnerships with grassroot movements in relationship with communities and demonstrated by living in host homes and splitting teams between UK and in-country volunteers.

To say that South Africa is a country of contrasts would be an understatement. According to the GINI Index via the World Bank, it is the most unequal society in the world. Inequality has actually increased since the ending of apartheid, with half of the population living below the poverty line. Shockingly, 1% of the population own 70.9% of the country’s wealth whilst the bottom 60% control just 7% of assets. The unemployment rate is also astoundingly high at 27.1%. These systematic imbalances are seemingly accepted – it’s part and parcel of society.

From my own perspective, I found it inexplicable encountering stark inequalities in varying neighbourhoods. I lived in a township called Chesterville close to Durban, and it was a great community to be in. However, close to our place of work located above a freeway was a shanty town. Tiny houses crafted together of tarpaulin and corrugated iron sheeting were clustered together, with poor local facilities or services available. Yet just a ten-minute drive away, and the story looks a whole lot different. Closer to the Westville area were genuine mansions – complete with perfectly manicured gardens, fleets of cars and probably maids to boot. Inequality is one of the greatest challenges facing this generation as the richer get richer and the poorer get poorer. I can think of no other place this is manifested better than the homes of South Africans.

ICS uses the approach of host homes together with an in-country counterpart within a community setting – one I highly rate. Living in a host home introduced me to a world so unlike my own and it led me to far better understand the surrounding complexities of culture. That said, living in a host home could be incredibly challenging. In a typical South African family (or Zulu culture), it’s incredibly common for extended families to all live together as one. On a given day, there were just under ten of us eating dinner, with a few extra guests often thrown in! We had a very open-door policy (no, quite literally). Yet household tasks tended to fall to the women. On the weekend of our arrival, I vividly remember being asked when we intended to make breakfast for all the family. Instantaneously, I was outraged. But this is the reality for the majority of women. The cooking, the cleaning, the childcare, the washing etc was women’s work. (I did by the way, overcome my frustration but it remained a source of contention!) Communicating across cultures was another interesting one. Our host family were afraid to offend or criticise us as white foreigners, so they voiced their opinions through our team counterparts. This backhanded method of communication was tough, both on ourselves and our counterparts. Being treated differently as the minority was a struggle, but looking back, it transformed my thinking in what it really means to be a minority, especially in the long-term.

Work-wise, we busied ourselves focusing on education and young people within schools and youth work. This again exemplified massive contrasts of inequality. Whilst working in the schools, under-resourced and wholly black, it was difficult not to imagine the privilege enjoyed in richer areas, predominately white. At first, it was hard to conceal my disapproval for corporal punishment. Yet as I became more tolerant (or possibility patient), I better understood how such conditions made teaching such an enduring career. I found immense respect for the teacher I assisted, and so a genuine relationship blossomed between us. This was also mirrored with fellow team members. It says a lot about how much more ‘development’ can be achieved from the fruition of good working partnerships.

The modern-day expectation seems to be that because official apartheid is over and institutional racism is illegal, the issues of segregation are over. While it is no longer policy, it is certainly embedded into culture as practice. Even decades later, you are categorised into black, white, coloured or Indian groupings. There are some extras, like being a ‘yellow-bone’, meaning you have lighter skin but are neither black nor white. Your race becomes your sole identity: this is who you are. Unfortunately, there’s no allowance for grey areas (pun intended) and consequently, social segregation is all too real. It was rare, near impossible even, to see groups like us merge, be it in the shopping mall or on Durban beach, and we often encountered strange looks and comments from passers-by as we walked the streets.

Which leads me onto discussing the best part of ICS: my team. We were a kaleidoscope of characters to say the least; equally split between UK and SA volunteers, male and female plus a UK Team Leader. Living and working with the same nine people day after day in a foreign environment can be intense. It’s super 24/7, and there’s no room to hide tensions. During our pre-departure training, both sets of volunteers were prepped on what to expect from the ‘other’. Sadly, past experiences transpired that SA volunteers were viewed as lazy and uncooperative, UK volunteers as domineering and controlling. Not the best start. Even our female counterparts had expected to dislike us because of previous experiences (happily we weren’t told this until a few weeks in).  Essentially, our team dynamic had every reason to fail. Yet despite our distinctions of backgrounds, religious beliefs, races, cultures, languages and a fair few strong characters thrown in, we genuinely made it work, and emerged as a strong, unified team. Yet we also became like the strangest family dynamic! I viewed my team as my siblings before too long, especially my counterpart Tshedi as we formed remarkable bonds that went far deeper than any other relationship. Perhaps the unusual setting we found ourselves in played a part, but even now a year on, they are still some of the first people I reach out to with news or advice.  

To conclude, perhaps then, this is what development resembles. Development is often portrayed in quick-fix plan headed by organisations who know little on a grassroots level. Or as a second Mandela movement. But I think development stems from relationships. A small and steady changing of hearts and minds towards social justice. To interact as people, not projects. My ICS experience changed my whole life path towards studying International Development, and it was a unique experience I will always treasure. After all, development must be explored, experienced to grow critically optimistic expectations as a result.

This post is written as part of our March series on ‘Experiences in Diversity’ by Rich Thornton, a PhD candidate in Anthropology. Rich is currently conducting fieldwork on the subjectivity and subjectification of teachers and social entrepreneurs of education in Delhi, India.

My girlfriend Jasmine loves to tell a story about how we met. It was the first day of fieldwork for my Master’s in Cultural Anthropology: Delhi, India, February 2016. Eager to meet the school team, I perched on a plastic primary school chair and said to the teachers, ‘Hi! I’m Rich’. Which for them was absolutely hilarious: because I was a white British man sitting amongst a group of younger Indian women and telling them I am ‘rich’.

Jasmine loves to tell this story probably because people here do find it funny; and perhaps as a way of reminding us both that despite how much we try to hide from it, cultural difference will always be present in our relationship. But some things actually aren’t about cultural difference (says the anthropologist nervously), and this piece explores how, in response to being socially produced as different, and by using my role as ‘anthropologist’ as protection, I have been discovering how I mobilise patriarchy as a way of producing myself as a valuable and valued subject.

Before I go on, two things must be said. First: I use the term ‘relationship’ and ‘girlfriend’ here because those are the terms I feel describe how Jasmine and I interact. Jasmine avoids those labels, and doesn’t want to define the relationship we share. Second, in my experience of contemporary Delhi, white privilege looms big and large. And there seems to be a distinction between how me as a white foreigner is imagined and how any darker-skinned foreigner is thought of and treated. Despite this blog’s theme of ‘diversity’, we must be clear that racialism and patriarchy remain violent socially-produced realities, and that difference is always hierarchical. And it is indeed through my mobilisation of patriarchy that I have unconsciously committed violence during the first few months of my PhD fieldwork. Here’s two examples of how.

Good little anthropologist that I am, I have sought to immerse myself in Hindi communities in order to learn the language and ‘get the culture’. In Hindi, there’s a very common swearword that translates as ‘sister-f*cker’. Some say it’s no longer a swearword as it’s used so commonly, but of course, the word carries heavy patriarchal overtones. I began to notice that if I used this word, especially with groups of men, it would get a laugh and I would receive appreciation. Subconsciously, I began to use it to gain trust and momentary respect. But at what cost? When Jasmine questioned my use of it, I admitted that it was patriarchal and that I wasn’t proud of myself for using it, but I also used some flippant casuistry to intellectualise my way out of guilt. I said that I felt lonely and that also as an anthropologist I needed to ‘fit in’, I needed to build bonds with people.

The point, that Jasmine was clear in expressing, was that my attempt to intellectualise my use of the word, and to produce my own victimhood by saying I felt lonely, was of course also deeply patriarchal. This intellectualisation allowed me to stand back from the event and see it as ‘part of research’, the part when I ‘adopted patriarchy’ as a route to being accepted and learning a language. Jasmine had none of this, and I tasted a bitter truth: how many times, much before I had the context of fieldwork and language-learning to shroud it, had I mobilised patriarchy (e.g. laughed at sexist jokes), to help myself ‘fit in’ during anxious social situations?

And I was about to do it again. In short, Jasmine and I are both part of the same very close network of arts-based educational practitioners in Delhi, and indeed, Jasmine is and has been the conduit through which almost all of my now snowballing research connections have come. As Jasmine works freelance, I recently suggested that she could take on the paid-role of ‘Research Assistant’ in my fieldwork. In this way she would be recognised as an important contributor to my research and also get remunerated for that work. She was understandingly appalled. ‘Research Assistant? How about Research Mentor! Or at least Research Collaborator?!’ She couldn’t believe I would cast her in the role of ‘assistant’ after she has and continues to be such an essential partner to ‘my’ work. And she was right, in my hasty attempt to ‘help’ her, I’d adopted a classic patriarchal label from the history of patriarchal social science and unthinkingly tossed it to her as a weak attempt at forging equality. After sitting with her feelings for a day or two, she responded to my offer with a question: Would I ever have asked Zishan (a male friend and colleague) to be a research ‘assistant’? And indeed, I quickly remembered how, only days before, I’d asked Zishan whether he would like to ‘collaborate’ on some research together. Patriarchy in action once again!

I am slowly realising how, despite the glaring patriarchal structures and practices of contemporary India, I bring my own subtle, insidious, but no less powerful patriarchal ideologies into my relationship with Jasmine. Through the colour of my skin and culturally-nuanced way of being, I feel produced as an object of difference by the gaze of the Delhi locals. True, I am often invested with unwarranted respect, but as a human who fears isolation, this investment is something I want to shed in favour of social invisibility, and for the possibility of being ‘one of the team’. And what I notice, as I try to produce myself as both ‘part of it’ and ‘valuable’, is that I mobilise patriarchy. I use patriarchal swearwords to be one of the boys, and attempt to widen my professional capital by trying to hire my girlfriend as a research assistant. The awkward cultural isolation of fieldwork has magnified my latent propensity to use patriarchal structure to make myself feel more comfortable in the world. I am grateful to have a ‘girlfriend’, or as she would see it, ‘friend’, who is sensitive enough to locate, and will put in the emotional labour to explain, the violence of my actions.