RESEARCH AREAS

(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.

BOOK MANUSCRIPTS

September 2021 Love and Liberation: Humanitarian work in the Somali Region of Ethiopia. Cornell University Press. https://www.cornellpress.cornell.edu/book/9781501759666/love-and-liberation/#bookTabs=1

In progress, with Lahra Smith. “Escape and power: women’s migrations between Africa and the Middle East.”

PEER-REVIEWED PUBLICATIONS

Carruth, Lauren, Carlos Martinez, Lahra Smith, Katharine Donato, Carlos Piñones-Rivera, James Quesada and the Global Migration Working Group.

Under review. “Structural vulnerability: migration, healthcare, and structures that make us all vulnerable.” BMJ.

Roess, A. A., Morton, L.C., Bestul, N. Hosh, F. M., Davis, J., and Carruth, Lauren

Under review. “Associations between unpasteurized camel and other milk consumption, livestock ownership, and self-reported illness among semi-pastoralists in the Somali Region of Ethiopia.” Epidemiology and Infection.

Kohrt, Brandon and Lauren Carruth

Accepted, Forthcoming 2020. “Syndemic effects in complex humanitarian emergencies: a framework for understanding political violence and improving multi-morbidity health outcomes.” Social Science & Medicine.

Carruth, Lauren and Scott Freeman

2021 Aid or exploitation?: Food-for-work, cash-for-work, and the production of “beneficiary-workers” in Ethiopia and Haiti. World Development, 140, 105283–. https://doi.org/10.1016/j.worlddev.2020.105283

Carruth, Lauren, Mohamed Jama Ateye, Ahmed Nassir, Farah Mussa Hosh, and Emily Mendenhall.

2020 “Diabetes in a humanitarian crisis-affected population: atypical clinical presentations, and challenges to clinical- and community-based management.” Global Public Health. 15(6): 828-839. https://doi.org/10.1080/17441692.2020.1718735.

Carruth, Lauren, Sarah Chard, Heather A. Howard, Lenore Manderson, Emily Mendenhall, Emily Vasquez, and Emily Yates-Doerr.

2019 Disaggregating diabetes: new subtypes, causes, and care. Medicine Anthropology Theory (MAT). 6(4):119-126. doi.org/10.17157/mat.6.4.730 http://www.medanthrotheory.org/read/11519/disaggregating-diabetes

Carruth, Lauren

2020 “Rethinking fatness, rethinking diabetes.” American Anthropologist. 122(3): 643-645. Vital Topics Forum: Chronic Disaster: Reimagining Non-Communicable Chronic Disease. Alyshia Gálvez, Megan Carney, and Emily Yates-Doerr, eds. https://doi.org/10.1111/aman.13440.

Carruth, Lauren

In Press, 2020. “Epidemic” In, Humanitarianism: Keywords. Edited by Antonio de Lauri. Brill Publishers.

Carruth, Lauren

In Press, 2020. “Medical Neutrality” In, Humanitarianism: Keywords. Edited by Antonio de Lauri. Brill Publishers.

Carruth, Lauren and Emily Mendenhall

2019 “Wasting away:” food insecurity, medical insecurity, and diabetes in the Somali Region of Ethiopia. Social Science & Medicine. 288(May 2019):155-163. https://doi.org/10.1016/j.socscimed.2019.03.026

Carruth, Lauren and Emily Mendenhall

2018 Social aetiologies of type 2 diabetes. BMJ. 2018(361):k1795. https://doi.org/10.1136/bmj.k1795

Carruth, Lauren

2018 The data hustle: how beneficiaries benefit from continual data collection and humanitarian aid research in the Somali Region of Ethiopia. Medical Anthropology Quarterly. 32(3):340-364. DOI: 10.1111/maq.12431

Carruth, Lauren

2018 Kinship, nomadism, and humanitarian aid among Somalis in Ethiopia. 42(1): 149-168. Disasters. DOI: 10.1111/disa.12236. London: Overseas Development Institute.

Carruth, Lauren

2018 Refugee Health. International Encyclopedia of Anthropology. Wiley Blackwell. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118924396.wbiea2077

Carruth, Lauren, A Roess, Yitagele T, Farah MH, M Salman

2017 Antimicrobial Resistance and Food Safety in Africa. The Lancet Infectious Diseases. 17(6): 575-576. https://doi.org/10.1016/S1473-3099(17)30273-6

Carruth, Lauren, A Roess, Y Terefe, S Keskes, M Nichter, and M Salman

2016 Zoonotic Tuberculosis: Challenges and Ways Forward. The Lancet. 388(10059): 2460–2461. DOI: http://dx.doi.org/10.1016/S0140-6736(16)32186-9

Carruth, Lauren

2016 Peace in the clinic: rethinking “global health diplomacy” in the Somali Region of Ethiopia. Culture, Medicine, & Psychiatry. 40(2): 181-197. Special Issue: The Clinic in Crisis: Medicine and Politics in the Context of Social Upheaval. Issue Editors: Adia Benton, Sa’ed Atshan.

Roess, Amira, L Carruth, S Lahm, and M Salman

2016 Camels, MERS-CoV, and other emerging infections in east Africa. The Lancet Infectious Diseases. 16(1):14-15.

Roess, Amira, L Carruth, M Mann, I Kabbash, S Melaku, M Atia, M Mohamed, S Bansal, S Lahm, Y Terefe, and M Salman

2015 Livestock movement and emerging zoonotic disease outbreaks: applying ecological, network, and sociocultural theories to assess the risk of Middle East respiratory syndrome from camel trade in Ethiopia and Egypt. The Lancet Global Health. 3(S26). DOI: http://dx.doi.org/10.1016/S2214-109X(15)70145-2

Carruth, Lauren

2015 Trust and Care-Giving During a UNICEF-Funded Relief Operation in the Somali Region of Ethiopia. In Medical Humanitarianism: Ethnographies of Practice. Eds, Abramowitz, Sharon and Catherine Panter-Brick. Pp. 58-73. The University of Pennsylvania Press.

Carruth, Lauren

2015 Bridging Ethnography and Bildungsroman. Review, “Life in Crisis: The Ethical Journey of Doctors Without Borders” by Peter Redfield. Current Anthropology. 56(1)148-149.

Carruth, Lauren

2015 “Doctors without borders: Humanitarian quests, impossible dreams of Médecins Sans Frontières” by Renee C. Fox. Global Public Health. 10(3):412-413.

Carruth, Lauren

2014 Camel Milk, Amoxicillin, and a Prayer: Medical Pluralism and Medical Humanitarian Aid in the Somali Region of Ethiopia. Special Issue on Medical Humanitarianism. Social Science & Medicine. 120:405-412.

Yuan NP, Castañeda H, Nichter M, Nichter M, Wind S, Carruth L, Muramoto M

2011 Lay Health Influencers: How They Tailor Brief Tobacco Cessation Interventions. Health Education & Behavior. 39(5):544-54.

Yuan NP, Wind S, Nichter M, Nichter M, Castañeda H, Carruth L, Muramoto M.

2010 Types of lay health influencers in tobacco cessation: a qualitative study. American Journal of Health Behavior. 34(5):607-17.

de Waal, Alexander, Taffesse AS and Carruth, L.

2006 Child survival during the 2002-2003 drought in Ethiopia. Global Public Health, 1(2): 125-132.

BLOG PUBLICATIONS

Carruth, Lauren

2018 “The subjects and objects of relief: how local aid workers articulate and remake what it means to be humanitarian.” Public Anthropologist Journal Blog. October 1, 2018. http://publicanthropologist.cmi.no/2018/10/01/the-subjects-and-objects-of-relief-how-local-aid-workers-articulate-and-remake-what-it-means-to-be-humanitarian/

Carruth, Lauren

2018 “The hustle for data: Side gigs that change science, policies, and lives.” April 12, 2018. https://www.devex.com/news/opinion-the-hustle-for-data-side-gigs-that-change-science-policies-and-lives-92498

Carruth, Lauren

2017 “Cholera fears rise following Atlantic hurricanes: Are we making any progress?” The Conversation. September 10, 2017. https://theconversation.com/cholera-fears-rise-following-atlantic-hurricanes-are-we-making-any-progress-83694. Featured in Scientific American, https://www.scientificamerican.com/article/cholera-fears-rise-following-atlantic-hurricanes/

Smith, Lahra and Lauren Carruth

2017 “Wealthier nations can learn from how tiny Djibouti welcomes refugees.” The Washington Post. Monkey Cage. March 30, 2017. https://www.washingtonpost.com/news/monkey-cage/wp/2017/03/30/wealthier-nations-can-learn-from-how-tiny-djibouti-welcomes-refugees/?utm_term=.7d8ebfaccf71

Carruth, Lauren

2017 “Want to End TB? Treat all forms of the disease.” The Conversation. March 24, 2017. https://theconversation.com/want-to-end-tb-diagnose-and-treat-all-forms-of-the-disease-69766. Featured on the cover of Scientific American, https://www.scientificamerican.com/article/to-end-tuberculosis-it-must-be-eliminated-from-animals/

MEDIA CONTRIBUTIONS

Carruth, Lauren

2018 What forced migration can tell us about diabetes. Podcast. BMJ Talk Medicine. May 8. (23:07) https://soundcloud.com/bmjpodcasts/what-forced-migration-can-tell-us-about-diabetes

Carruth, Lauren

2018 “The hustle for data: Side gigs that change science, policies, and lives.” Devex. April 12, 2018. https://www.devex.com/news/opinion-the-hustle-for-data-side-gigs-that-change-science-policies-and-lives-92498

Carruth, Lauren