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Murphy UnsettlingcareTroubling 2015
Murphy UnsettlingcareTroubling 2015
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Social Studies of Science
USAGE
practices
Michelle Murphy
Department of History and Women & Gender Studies Institute, University of Toronto, Toronto, ON,
Canada
Abstract
Responding to the call by Maria Puig de la Bellacasa for Science and Technology Studies to take
'matters of care', this article cautions against equating care with positive feelings and, in contr
argues for the importance of grappling with the non-innocent histories in which the politi
care already circulates, particularly in transnational couplings of feminism and health. The art
highlights these histories by tracing multiple versions of the politics of care in a select set of femi
engagements with the pap smear and cervical cancer. Drawing on postcolonial and indigeno
feminist commitments, as well as amplifying Donna Haraway's call to 'stay with the trouble
article seeks to disturb hegemonic histories and arrangements of race, colonialism, and poli
economy, while simultaneously valuing divergent multi-local itineraries as relevant to technoscien
matters of care. This call for a politics of 'unsettling' care strives to stir up and put into motion
is sedimented, while embracing the generativity of discomfort, critique, and non-innocence.
Keywords
affect, care, feminist technoscience studies, pap smear, unsettling
What concerns me is how much this affirmative turn actually depends on the very
distinction between good and bad feelings that presumes that bad feelings are backward
and conservative and good feelings are forward and progressive. Bad feelings are seen as
oriented toward the past, as a kind of stubbornness that 'stops' the subject from embracing
Corresponding author:
Michelle Murphy, Women & Gender Studies Institute, University of Toronto, 40 Willcocks Street, Toronto,
ON M5S IC6, Canada.
Email: michelle.murphy@utoronto.ca
thereby diminishin
studied as extens
blages,renamed 'm
entanglements thr
ing to marginalize
the example of 197
health as a 'matter
knowers, value bo
'happiness' and 'h
must also grapple
simultaneously con
anism (which the
care provokes som
care already weave
situated feminist c
does the politics o
In trying to thin
critique of the pol
happiness, affectio
Ahmed argues that
strictures. To be c
ways of belonging
attention to those
to moments of une
non-nationalist p
matters of care in
(Puig de la Bellacas
bled through non-
and alienation, com
tics of caring hav
dynamics in strati
positing positive f
studies have long w
matters of care?
Care carries (at lea
being emotionally
after, protect, sus
concern, to be care
the first in the O
uneasy, and unsett
ing work of critic
gies, of making u
generative task wit
into the conversat
anti-racist analytic
between subjects.
tion with how com
ity, which seems
possible, for Ahm
tions in bodies an
circulations that a
ty's value is the e
affects such as ha
terns of circulatio
of work arrangin
wise) is conjured
oriented by racia
and so on.
Thus, the embrac
nist self-help pra
of affect in the la
gence of feminist
feminists in many
of 'affective lab
work', and 'social
did in families. Su
was a form of exp
ate (Dalla Costa a
standing this unw
care was crucial t
pliesof labor, tha
feminists of this
of social reproduc
of the labor powe
new workers and
sumed as matters o
At the same mo
unwaged care labo
gendering of wag
as stewardesses, n
nurses, or custom
ing, friendliness,
no irony then th
given to an audi
labor challenged t
20th century tha
care work (as nan
that undermined
work of their ow
economy, care be
oppositional or bet
tations that discon
The broad lesson t
the 'how' of techn
charged knowing,
ties and relations,
a question of eras
appropriations, an
make knowledge
charged work of e
alogies of care tha
I try to think this
pap smears from
exploring the rece
ments with postco
points for circling
Unsettling p
By the 1970s, the
the United States
dated by professi
the pap smear is
However, in the
hence death, for
integrated the pa
women to perfor
as undertaking pr
Yet the pap smear
from feminist ha
or pre-cancer, wa
the pap smear was
Canadian feminis
smear. Thus, the
access: who was a
power operated in
ditions of classism
screening (Vanco
political economy
women should ma
health care 'in he
which wanted dis
submitting to a st
Yet, on a transna
cervical cancer (
cause of cervical cancer and strands of HPV that caused it was conducted in the 'devel-
oping world' in locations such as Zimbabwe, South Africa, Mexico, and Costa Rica,
among women who had never had pap smears.5 Such research sites were not hard to
find. While cervical cancer had declined in countries with the elaborate health-care
systems of the so-called 'Global North', in previously colonized countries of the two-
thirds majority of the world that lacked such health-care infrastructures, cervical cancer
had increased (Bishop et al., 1996). The success of the pap smear in the United States
and elsewhere had depended on both an industrialized laboratory network and a means
to treat women with positive readings. The smear itself depended on equipment, from
swabs to fixatives to microscopes, and treatment depended on lasers and operating
theaters (Gage et al., 2007; Gregg, 2003; Lazcano-Ponce et al., 1999; Ortiz, 1997).
Overall success depended on trained specialists to read slides, transportation to clinics,
as well as clients able to present themselves for screening. Moreover, it depended on
funds from individuals, states, NGOs or insurance to pay for all these elements. This
constellation of conditions was distributed such that most of the world's women were
excluded from the regime for screening cervical cells that had become commonplace in
the United States and Canada. On the profoundly uneven transnational terrain of health
infrastructure, cervical cancers became one of the four 'cancers of underdevelopment':
cancers that were rare or decreasing in metropoles but common or increasing in previ-
ously colonized 'developing' countries (Women and Development Unit (WAND),
1992). Thus, while cancer is often presented as a disease that strikes rich and poor alike,
its fatal results are far from egalitarian. Cervical cancer remained one of the most com-
mon cancers for women in the world, according to the World Health Organization, with
80 percent of all cervical cancer deaths in 'developing' countries. This made cervical
cancer the biggest cancer killer of women in the poorest countries of the world (World
Health Organization, 2003). In such international health measures, cervical cancer
death rates are measured by nation, marking a geopolitics of the previously colonized
world in which not just cervical cancer, but also lack of health infrastructure, killed. No
feminist politics of care at the clinical level, constrained to the ambit of the clinical
exam, could address this infrastructural lack.
In the 1980s, two of the most prominent transnational feminist organizations - the
International Women's Health Coalition (IWHC) based in New York, and the Women
and Development Unit (WAND) of the University of the West Indies - collaborated on a
project in Barbados to rearticulate the politics of cervical cancer. First, cervical cancer
was grouped together with other infections, such as sexually transmitted infections, to
form the category of 'reproductive tract infections' (RTIs) (IWHC and WAND, 1994).
The category RTI was strategically intended as a new policy object for health care, fam-
ily planning, and development governmentality (Germain et al., 1992; Wasserheit, 1989).
The care of RTIs required changes to infrastructures (particularly the expansion and
reorientation of family planning clinics to include care of RTIs) but the project argued
that the problem of RTIs exceeded health care. RTIs were also presented as effects of
gendered 'power imbalances' in a society that condoned coercive sex, stigmatized wom-
en's sexual behavior, and denied women sovereignty over the material conditions of their
sexual encounters - for example, the ability to determine whether a condom was used
(IWHC and WAND, 1994). 'Gender balance' needed to be changed. In this way, the
crafting of RTI a
alterable pivot of
moment when 'ge
at places like the
operated in the af
ology of cancer o
relations writ la
IWHC would go o
health' as a new
Consensus of the
new framework
oriented populatio
the number of co
RTI was the precu
toward a gendere
services, and the
Moreover, US-sup
to enable improv
hinged on women
modern attitudes
could not be achie
ning services had
which in turn ne
moments of choic
any alteration in
ceeding. Developm
transnational rela
out questioning t
Twenty years lat
of care have built
contemporary tra
unsettle and make
Care as empow
At the yearly gal
jewel-bedecked do
banquet room by
such as Hillary Cl
Gere (2007), while
room are decorat
women and girls
affective economi
leaders and power
organizations, wit
Here, we glimpse
care. Accumulatio
mines are mobiliz
affect is extracted
of a feminist mat
tics of care that
capacities to feel c
troubling ways to
porary fashioning
(1965) analysis of
Colonialism offer
as benevolent enh
ism overall. Here,
enjoinders to emp
balized demand to
Care as labor
Working with the Latin American and Caribbean Women's Health Network, WAND
developed its own campaign 'Demystifying and Fighting Cervical Cancer'.8 The cam-
paign was organized by Andaiye, who shared with WAND a critique of 1980s structural
adjustment economic planning. Andaiye is a leading Caribbean grassroots feminist from
Guyana. Along with Walter Rodney (2012), author of the influential Marxist book How
Europe Underdeveloped Africa , she was a founding member of the Working People's
Alliance (WPA) political party, which is dedicated to multiracial decolonization. Andaiye
herself has experienced cancer and was a close friend of the renowned author of The
Cancer Journals , Audre Lorde (1980). Along with her collaborator Selma James,
Andaiye's politics might be called 'left of Marx', in that she sought to radicalize anti-
colonial left politics with questions of sex and race.9 Dedicated to decolonization, her
political and epistemological practices resonate with unsettling.
With Andaiye as coordinator, the campaign opened with a political economic analysis
of the uneven distribution of pap smear screening, speculating that 'Barbados could have
the highest rate of cervical cancer in the world' (WAND, 1992: 31). The question of 'risk'
was dramatically reframed, not in terms of individuals or gender, but as 'the imbalance
of power between rich and poor, North and South, white and nonwhite, men and women'
(WAND, 1992: 32). Moreover, WAND (1992) mapped this political economic distribu-
tion of risk between North and South, as
also aris[ing] from the priorities of Southern Governments - or, rather, from the acceptance by
Southern governments that the priorities for our countries and people are properly set by the
North. Hence their adoption of International Monetary Fund and World Bank structural
adjustment policies, which could contribute to increases in cancer and cancer mortality in the
South, (p. 34)
The politics of risk was implicitly problematized as a calculus of already devalued human
life, which resulted from fostering the 'productive' sectors of the nation and not human
uneasy work of fo
already entangled
pragmatic politics o
the fact that much
Moreover, it does no
amplifying the logi
cized as monetized
care is unsettled th
care's ambit is entan
and the temptation
Unsettled pas
Both these politics
nist humanitariani
how to relate, how
are genealogically
specific fashioning
project of articulat
porary alignments
sion feminists are
force in our world
particular, has com
formations, new an
of critical work. Ex
scholarship on cerv
and Epstein, 2014
In a moment when
tics, this article is
ability and hence t
work of crafting a
science studies eng
different kinds of
arrangements of ra
feminism and quee
sedimented, of dec
the partial, would
ies as relevant to p
against it. Second,
unevenly disposses
include, direct sym
to work through d
ment, that is, the u
Technoscience stu
to doing the intell
Acknowledgements
I am grateful to the organizers and participants of t
held at York University in 2012, particularly Ana V
as Lucy Suchman, for their help in improving this e
a Social Sciences and Humanities Research Counc
Funding
This research received no specific grant from any funding agency in the public, commercial, or
not-for-profit sectors.
Notes
1 . For the purposes of this article, I am using 'affecť in the narrow sense of capacities to f
sense that become coded as emotions, desires, or attachments. This sense traffics closely
understandings of care as forms of affection, worrying, and attending to. This is also the
of affect most commonly invoked in analyses of affective labor. I am not using 4 affecť i
sense of capacities to respond and become, though this second sense can certainly be d
out as implicit to the worlding work of unsettling. On affect in the first sense, see Cvetk
(2012), Ngai (2005), Sedgwick (2003) and Stewart (2007).
2. This section of the article draws from Chapter 3 of Murphy (2012).
3 . Script for slide show courtesy of Lorraine Rothman.
4. This analysis builds on Monica Casper and Adele Clarke s work on the emergence of t
smear as the purportedly 'right tool for the job' (Casper and Clarke, 1998; Clarke and Ca
1996).
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Author biography
Michelle Murphy is a feminist technoscience studies scholar and historian of the recent past. She is
author of Seizing the Means of Reproduction: Entanglements of Feminism, Health, and Technoscience
(Duke University Press, 2012) and Sick Building Syndrome and the Problem of Uncertainty :
Environmental Politics, Technoscience, and Women Workers (Duke University Press, 2006). She is
Professor of History and Women and Gender Studies at the University of Toronto.