Medical Travel Facilitation Between Oman and India: Articulating Spaces, Creating Smoothness and Negotiating Ethical Complexities

Hartmann, Sarah Savina Anna (2021). Medical Travel Facilitation Between Oman and India: Articulating Spaces, Creating Smoothness and Negotiating Ethical Complexities. PhD thesis The Open University.



This thesis thinks through practices of medical travel facilitation in order to contribute to current conversations about transnational healthcare (TNHC) and care as sociotech-nical practice. TNHC has gained significance in recent decades as a rapidly developing industry with shifting modes of health governance and the number of people seeking care abroad rising. Political, economic and social implications of TNHC are debated within the social sciences, whilst the transnational configuration of care is provoking conceptual reflection within and across the fields of ethics, policy, and Science and Technology Studies (STS).

Entering these conversations through an analysis of medical travel facilitation, this the-sis contributes to them with an empirically-informed theorisation of the relationships between facilitation and care as encountered in ethnographic fieldwork in Oman and India. Having traced practices of medical travel facilitation in this context this thesis proposes that they are integral to TNHC in three interrelated ways. First, for how they articulate spaces and spatialities, proposing that medical travel facilitation relates, stretches and folds spaces to constitute the possibility of and a certain receptivity for treatment abroad. Second, for the way they make TNHC feasible in everyday practice following the exploration of smoothness as a disposition, spatio-temporal manoeuvre and outcome of medical travel facilitation. And third, for how they negotiate ethical complexities involved in TNHC, generating a compromise that makes TNHC ‘good enough’.

Working through these dimensions of medical travel facilitation in conversation with recent work on care in STS and the ethics of care, I propose that these practices are productively thought not just about setting up the possibility of care transnationally, but that relating, smoothing, negotiating are key forms of care in itself. I suggest that this conclusion potentially has implications not just for the geographical study of transnational healthcare, but also that of care and transnational phenomena more generally.

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