TY - JOUR
T1 - Mediating abundance and scarcity
T2 - Implementing an HIV/AIDS-targeted project within a government hospital in Tanzania
AU - Sullivan, Noelle
N1 - Funding Information:
The research on which this article is based was supported by a Fulbright-Hays Doctoral Dissertation Research Abroad fellowship. I am grateful to the special issue editors, Anita Hardon and Hansjörg Dilger, for their close readings and insightful comments, and to the anonymous reviewers for Medical Anthropology for their suggestions. I also wish to thank Brenda Chalfin, and recently, Giorgio Blundo, who have stimulated my thinking on bureaucracy and civil servants in light of humanitarian aid and policies of good governance, and Claire Wendland for pointing me to the concept of ‘‘enclaves’’ in relation to biomedicine and NGOs in Africa.
PY - 2011/3
Y1 - 2011/3
N2 - While free antiretroviral therapy (ART) in Tanzania has undeniably increased accessibility of services, the effects of ART programs as they are brought into existing health facilities are more ambiguous. As transnational nongovernmental organizations (NGOs) establish clinics within government hospitals, we see a telling example of how NGOs are providing services from within the state. The conditions of NGO-operated clinics within government health facilities act as a daily reminder of the failures of the government to provide health workers with that to which they feel entitled: adequate pay, access to sophisticated technology, upgraded training, extra-duty allowances, and a professional working environment. At the same time, health personnel compete to position themselves in such a way to be able to make claims on the state through these NGO clinics, which is the only means available for them to access the very resources to which they feel entitled by their profession.
AB - While free antiretroviral therapy (ART) in Tanzania has undeniably increased accessibility of services, the effects of ART programs as they are brought into existing health facilities are more ambiguous. As transnational nongovernmental organizations (NGOs) establish clinics within government hospitals, we see a telling example of how NGOs are providing services from within the state. The conditions of NGO-operated clinics within government health facilities act as a daily reminder of the failures of the government to provide health workers with that to which they feel entitled: adequate pay, access to sophisticated technology, upgraded training, extra-duty allowances, and a professional working environment. At the same time, health personnel compete to position themselves in such a way to be able to make claims on the state through these NGO clinics, which is the only means available for them to access the very resources to which they feel entitled by their profession.
KW - Government hospitals
KW - HIV/AIDS
KW - Health sector reform
KW - Medical personnel
KW - PEPFAR
KW - Tanzania
UR - http://www.scopus.com/inward/record.url?scp=79952679081&partnerID=8YFLogxK
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U2 - 10.1080/01459740.2011.552453
DO - 10.1080/01459740.2011.552453
M3 - Article
C2 - 21400353
AN - SCOPUS:79952679081
SN - 0145-9740
VL - 30
SP - 202
EP - 221
JO - Medical Anthropology: Cross Cultural Studies in Health and Illness
JF - Medical Anthropology: Cross Cultural Studies in Health and Illness
IS - 2
ER -
