CONTEMPORARY MEDICAL MISSIONS AND IATROGENIC VIOLENCE IN HONDURAS

The goal of this dissertation is to assess the health and broader social effects of contemporary medical missions in Honduras. Though medical missions are a popular phenomenon that has garnered the attention of researchers across disciplines, existing literature has not provided a framework for evaluating how medical missions are filling gaps in local services, if at all. Nor does existing scholarship evaluate for potential or actual harms that may result from medical mission activities. I conducted participant observation among 11 medical missions and a Honduran health center in the Department of Colón on the northeastern coast of Honduras. This study considers the medical mission encounter through assessments of local health resources and consecutive medical mission clinics and interviews and participant observation with local healthcare workers, residents and mission volunteers. I demonstrate that contemporary medical missions are a revival of missionary medicine and the iatrogenic violence they engage in is directly related to the colonial roots of biomedical healing. I frame the mission encounter as a dialectic of self- and Other making and identify dominant discourses medical mission volunteers circulate to establish moral and intellectual authority and rationalize ongoing interventions, even when they are acknowledged to be ineffective. The mission organization and its volunteers engage in actions that are frequently misaligned with the needs, identified structural factors that complicate health and well-being, and the national priorities for improving access to healthcare identified by local healthcare providers and residents. As a result, the medical mission encounter leads to various forms of clinical, social, and cultural harm. By undermining or discursively erasing local healthcare resources contemporary medical missions contribute to the provoked crises in the Honduran public health system. I apply recent innovations in anthropological approaches to examine the missionary medicine encounter in Honduras as a dialectic and mutually constitutive process – putting the experiences and narratives of local communities at the same level of analysis as that of mission volunteers. This study contributes a much-needed framework for evaluating and analyzing the iatrogenic violence of medical mission encounters and may inform rubrics for monitoring and managing medical mission encounters in host countries.