Politics and Inequality in Pain Management: The Case of Zimbabwe

疼痛管理中的政治和不平等：津巴布韦的案例

• 批准号: 2877044
• 金额: --
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2877044
• 关键词: Politics; Inequality; Pain; Management; Case

My proposed research addresses the politics of pain and its management in Zimbabwe, as a window onto social inequalities. Pain cuts across divides - it affects us all, and is in this sense a powerful equaliser, but access to clinical pain management is uneven. Of the 298.5 metric tonnes of morphine equivalent opioids produced globally each year, on average only 0.1 metric tonnes go to low-income countries. While clinical pain management is lacking, many developing countries are also experiencing a steady increase in opioid use disorder (OUD). Patterns of opioid use reflect inequalities in socio-economic opportunity; access to clinical care; judgements about acceptable standards of living and levels of discomfort; and racialised discourses about pain tolerance. This is an issue calling for interdisciplinary analysis that has been largely overlooked in social science circles. Zimbabwe's colonial history, decades of related political and economic volatility, and a double burden of HIV/AIDS and cancer have shaped a unique landscape of pain. Today, the country faces a significant lack of clinical pain management and a rise in illicit opioid use. My proposed research will explore these phenomena as a window onto the politics and inequalities of pain management, and the social life of medicine both nationally and globally. I will address two overlapping questions: how do social inequalities shape the distribution of pain, and condition the circumstances of its management? And what is the subjective experience of pain management, both for those who suffer and those who provide care? My research will thus address pain and its management as expressions of social and political processes - as a dimension of Zimbabwe's wider 'crisis', shaped by dynamics that span geographies and timeframes. This approach will be grounded empirically, beginning with the collection of data on the distribution of pain and the circumstances of its management. This will then inform qualitative interviews and participant observation to be carried out during fieldwork in the second year of the DPhil, illustrating how pain and its management are interpreted and experienced on a human level. A post-colonial state experiencing the aftershocks of a string of related crises, Zimbabwe is a powerful prism for understanding how patterns of pain and opioid use highlight a wider politics of inequality. My research will ultimately seek to illustrate the embodied experiences of these phenomena, and from this perspective inform more equitable and sensitive systems of analgesia.

我提议的研究涉及津巴布韦的痛苦政治及其管理，作为社会不平等的一个窗口。疼痛跨越鸿沟-它影响我们所有人，在这个意义上是一个强大的均衡器，但获得临床疼痛管理是不平衡的。在全球每年生产的298.5公吨吗啡当量类阿片中，平均只有0.1公吨流向低收入国家。虽然缺乏临床疼痛管理，但许多发展中国家的阿片类药物使用障碍（OUD）也在稳步增加。阿片类药物的使用模式反映了社会经济机会的不平等;获得临床护理;对可接受的生活标准和不适程度的判断;以及关于疼痛耐受性的种族化话语。这是一个需要跨学科分析的问题，在社会科学界基本上被忽视了。津巴布韦的殖民历史、几十年的相关政治和经济动荡以及艾滋病毒/艾滋病和癌症的双重负担，形成了一幅独特的痛苦景象。今天，该国面临着严重缺乏临床疼痛管理和非法阿片类药物使用增加的问题。我提议的研究将探索这些现象，作为疼痛管理的政治和不平等以及国内和全球医学社会生活的窗口。我将解决两个相互重叠的问题：社会不平等如何塑造痛苦的分布，以及如何制约痛苦管理的环境？对于那些受苦的人和提供护理的人来说，疼痛管理的主观体验是什么？因此，我的研究将解决疼痛及其管理作为社会和政治进程的表达-作为津巴布韦更广泛的“危机”的一个维度，由跨越地理和时间框架的动态塑造。这种方法将以经验为基础，首先收集有关疼痛分布及其管理情况的数据。然后，这将通知定性访谈和参与者观察将在DPhil的第二年实地考察期间进行，说明疼痛及其管理如何在人类层面上解释和体验。津巴布韦是一个经历了一系列相关危机余震的后殖民国家，它是理解疼痛和阿片类药物使用模式如何突出更广泛的不平等政治的强大棱镜。我的研究将最终试图说明这些现象的具体经验，并从这个角度告知更公平和敏感的镇痛系统。