Vaibhav Saria | Care and Crisis in India

PFL 2021-2022, Equity + Justice, 2022, Health, President's Faculty Lectures

The COVID-19 pandemic in India has seen a valorization of the work that health care providers do, but at the same time, increased violence against them. Health care workers were appreciated by a grateful state and public through symbolic gestures, including everybody clapping hands at a decided time, but they were also being attacked in their neighbourhoods and hospitals. This contradiction is not particular to the present crisis, but is a characteristic of health care in India. Studying the figure of the doctor in the history of health care in India reveals the clinical encounter to be a complex moral and ethical negotiation. The recognition of the importance of a robust health system alongside its vulnerability to violence influences how health and crisis are defined.

— Vaibhav Saria

Wed, 02 Feb 2022

Online event

The President's Faculty Lectures

The President’s Faculty Lectures shine a light on the research excellence at Simon Fraser University. Hosted by SFU president Joy Johnson, these free public lectures celebrate cutting-edge research and faculty that engage with communities and mobilize knowledge to make real-world impacts.

Each short lecture by an SFU researcher will be followed by a conversation with Joy Johnson and an audience Q&A session.

This year, lecturers will approach the themes of equity and justice from a variety of disciplines.

Vaibhav Saria

Vaibhav Saria received their PhD in Anthropology from Johns Hopkins University in 2014, and is currently assistant professor of gender, sexuality, and women’s studies at SFU. Their book Hijras, Lovers, Brothers: Surviving Sex and Poverty in Rural India was published by Fordham University Press and was awarded the Joseph W. Elder Prize by the American Institute of Indian Studies in 2021. Saria is also a member of QuTUB, an international team of researchers working to advance methodologies to measure and improve the quality of TB care.



Event summary

Care and crisis in India with Dr. Vaibhav Saria

By Victoria Barclay, MA Candidate, UBC Department of Sociology

On February 2, 2022, Dr. Vaibhav Saria, an assistant professor of gender, sexuality and women’s studies at SFU, presented a President’s Faculty Lecture, “Care and Crisis in India.” Dr. Saria holds a PhD in anthropology from Johns Hopkins University and is an award-winning author for their title Hijras, Lovers, Brothers: Surviving Sex and Poverty in Rural India. They are also a member of QuTUB, an international research team working to advance methodologies to measure and improve the quality of tuberculosis care.

The evening began with a traditional welcome from Elder Margaret George. Elder Margaret was born in the Skawahlook First Nation and raised in Ruby Creek by her grandparents, and currently lives in Tsleil-Waututh territory, where she is an active community member. She is a member of the SFU Indigenous Student Centre’s Elders Program, working with SFU Indigenous students and the broader university community.

Dr. Saria began their talk by discussing violence against health care practitioners in India. Amidst the COVID-19 pandemic, there has been an overwhelming increase in patients admitted to health care facilities globally, and India was no exception.

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While health care practitioners in India made personal sacrifices, such as sleeping in their cars to avoid spreading disease to their families, doctors and nurses also reported being evicted because their landlords feared they would spread the infection. Some practitioners experienced physical violence by the family members of individuals who died from COVID-19, and others received death threats.

Dr. Saria pointed out that epidemics and outbreaks have not always led to violence; some, such as the 1918 influenza pandemic, even brought communities together.

While doctors in India are overworked, patients often perceive them to be “uncaring” and “interested only in making profits either through unnecessary medications or unnecessary tests… both of which would earn providers handsome cuts or kickbacks from the companies.” These perceptions are influenced by several factors and contribute to mistrust between providers and patients.

Provider-shopping is where patients will register with multiple doctors, often because their symptoms do not improve as soon as they had expected after seeing the first doctor, Dr. Saria explained. They noted that because of this, doctors can be unsure if patients will return to see them, so they often prescribe them several medications. 

Additionally, health care providers may prescribe several medications due to pressure to respond to patients’ family and social constraints—such as working men being unable to bring family members to medical appointments because they would have to close their shops, and therefore lose wages, to do so.

Prescribing several medications leads to accusations from patients that doctors only desire the incentives from pharmaceutical companies that come with these prescriptions.

Dr. Saria stated that “the logic of profit and market does not equate with the logic of care,” and that this “mistrust emerges from a history of tension between Western and traditional Indian systems of medicine…that puts pressure on traditional healing systems…to also organize and narrativize [their] history to make claims of equally valid scientific thought.”

Different visions of science, modernity and medicine between India and the West are still perpetuated today. India’s current medical providers use a “revivalist notion of Indigenous medicine” to critique the over-medicalization and pharmaceuticalization of the West’s approach to health care.

Moreover, Dr. Saria talked about the “know-do gap,” which was evident in the TB epidemic, in relation to their work with the multidisciplinary QuTUB research team. The know-do gap describes the delayed, missed and incorrect diagnoses that occur because despite practitioners being aware of the correct protocols, they are not implementing them due to the realities of patients’ behaviours and social constraints.

Dr. Saria emphasized that mistrust between providers and patients has a social impact on the health care system. Patients’ misunderstanding of providers’ values connects to the violence—and threats of violence—that providers experience from patients and patients’ families.

Dr. Saria ended their lecture by leaving us to ponder “whether we are living in a world of crises, or a world in crisis.”

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