(1) Institutional and community-based ethnography of the humanitarian aid industry:
I have conducted over twenty-eight months of ethnographic field work in eastern Ethiopia, in predominantly Somali communities where humanitarian relief interventions recur and within aid organizations and clinical facilities funded by relief efforts. My forthcoming book based on this work, Love and liberation: humanitarian work in the Somali Region of Ethiopia (Cornell University Press), reveals the labor hierarchies and gig economies inherent to the global humanitarian aid industry, provides an ethnographically rich portrait of humanitarian response from the perspectives of local aid workers, and uncovers subaltern, postcolonial, and powerful forms of humanitarianism at work in recipient communities. I show how Somali policymakers, clinical medical providers, and aid workers creatively use mercurial international humanitarian funding to build responsive Somali governmental structures within the Ethiopian state.
In addition to the book, based on this research I have published four peer-reviewed research articles in the journals Medical Anthropology Quarterly, Disasters, Culture, Medicine & Psychiatry, and Social Science & Medicine, a chapter in an edited book, blogs and encyclopedia chapters, and additional articles under review, as listed in my CV. These publications, very generally, argue that what I call “medical insecurity” -- defined as a lack of access to high-quality and trustworthy clinical medical care during and after humanitarian emergencies -- shapes health outcomes, recipients’ evaluations of interventions, and even more crucially, local efforts to foster peace and reconciliation.
(2) Ethnography and ecology of infectious zoonotic diseases:
For this research, I bring my regional expertise, language competence, professional connections, and experience in ethnographic research methods to multi-disciplinary teams investigating Middle Eastern Respiratory Syndrome-Coronavirus (MERS-CoV) and zoonotic and multi-drug resistant forms of tuberculosis. First, in 2017 I organized a field team with epidemiologist Amira Roess (George Mason University) to study how zoonotic disease risks are shaped by Somali pastoralists’ multispecies social interactions, diets, natural environments, and migrations (n=335). We found that people’s exposures to camels and unpasteurized camel milk are associated with increased risk of infectious disease symptoms, even controlling for other risk factors. These results have been presented at conferences and are discussed in a paper under review in the journal Epidemiology and Infections. Second, since 2018 I have also been working with a team of Ethiopian microbiologists at Addis Ababa University to understand emerging patterns of zoonotic and multi-drug resistant tuberculosis among hospitalized patients in eastern Ethiopia (n=281). Preliminary laboratory analysis ended in February 2020, and data analysis and publications are in progress.
Third, these projects led to a three-year (2019-2021) multidisciplinary NSF Ecology of Emergency Infectious Disease grant ($2,487,071) to study MERS-CoV, a zoonotic infectious disease prevalent in Somali camels. As Co-Principal Investigator, I am leading qualitative data collection and analysis. I also led the publication of two of our three peer-reviewed commentaries in The Lancet and The Lancet Infectious Diseases presenting our preliminary findings and demonstrating the importance of long-term ethnographic research to disease modeling, disease ecology, and understanding zoonotic disease risk factors. Once complete, this research will help scientists and global health security officials predict when and how MERS-CoV and other viral pathogens are likely to emerge and spread in Ethiopia and other places with political insecurity, weak infrastructure, a changing climate, high population mobility, and/or reliance on transnational livestock markets. Related to this work, I authored two editorial essays for The Conversation, also published in Scientific American, making the case to a general scientific audience for the value of ethnographic perspectives in understanding infectious diseases and global health responses.
(3) Ethnography of diabetes in food insecure and crisis-affected communities:
In 2018 I led a field team to investigate the challenges of diagnosing and managing type-2 diabetes in the midst of a humanitarian crisis using ethnographic, epidemiological, and biological data (n=108). This research, conducted with three of my Somali colleagues, Mohammad Jama, Farah Mussa Hosh, and Ahmed Nassir, and Emily Mendenhall from Georgetown University, describes diabetes disease and risk factors in crisis-affected, food insecure Somali communities in eastern Ethiopia. Our findings, published in Global Public Health, Social Science & Medicine and BMJ, and discussed in my essay in American Anthropologist, demonstrate unexpected patterns of risks and symptoms of diabetes, and advocate for the inclusion of non-communicable disease care in relief operations.
Further, we find it is inappropriate and unhelpful for clinicians to blame patients’ diets for their diabetes, when people remain dependent on limited food aid rations and limited food markets. Health inequalities, such as unequal diabetes outcomes between Somalis and other Ethiopians, are not the product of cultural, behavioral, or lifestyle differences, but primarily of longstanding structural inequities within health systems, local histories of political violence, personal experiences of trauma, and ethnic discrimination within Ethiopia. My research on diabetes also exemplifies the importance of collaborative and policy-relevant research: it should be grounded in local concerns, led by local experts, and afterwards, integrated into local institutions and practices.
(4) Ethnography of the violence of migration from Ethiopia to the Gulf States:
My emerging line of research, in collaboration with Lahra Smith, from Georgetown University, uses ethnographic research methods and policy analysis to investigate the causes and effects of so-called “irregular” migrations of women out of politically insecure communities in the Horn of Africa for work in Yemen and Saudi Arabia (n=75 to date, in Djibouti and Ethiopia, with more data collection planned in 2020-2021). We find that because of the overextension and incapacity of international asylum and resettlement systems, as well as the vulnerability of internally displaced persons (IDPs) in Ethiopia, women facing different forms of violence (intimate partner, sexual, structural, and political) are choosing to migrate extralegally abroad instead of fleeing to IDP camps or seeking asylum. Many of these women then experience sexual violence, extortion, acute diarrheal diseases, and even death during migration—outcomes that, we find, are systematically rendered invisible and ignored by involved governments and humanitarian organizations. We described our preliminary work in an Op-Ed in the Washington Post and our findings will ultimately be published in a book in progress titled, Escape and power: women’s migrations between Africa and the Middle East.