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“Not a free version of a broken system:” Medical humanitarianism and immigrant health justice in the United States

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  • Hoekstra, Erin

Abstract

Medical humanitarian organizations are increasingly the primary healthcare providers for unauthorized migrants in high-income countries. Existing studies of medical humanitarianism in the Global North reveal tensions between principles of traditionally apolitical humanitarianism and human rights. In practice, these tensions translate into organizational debates about prioritizing direct service provision to meet immediate needs or advocacy to effect long-term systemic change. Informed by these debates, this paper asserts the importance of immigration and health policy contexts as central to shaping the relationship between healthcare provision and political advocacy within medical humanitarian NGOs. Drawing from twelve months of fieldwork with medical humanitarian NGOs in Arizona, I analyze data from ethnographic participant observation and interviews with volunteer healthcare providers at a medical humanitarian organization I call Community Clinic of Phoenix (CCP), a free clinic for uninsured, undocumented immigrants. I find that, in the context of Arizona's anti-immigrant rhetoric and policies, CCP employs medical humanitarianism as both a discourse and a model of care to challenge immigrants' exclusion from health coverage and criminalization through immigration enforcement. The clinic's emphasis on immigrant health justice shapes their critiques of the structural failures of U.S. immigration and health systems, their approach to providing equitable access to quality healthcare for uninsured immigrants, and their work to create broad social change for immigrant rights and health justice. Driven by their mission of “not replicating a free version of a broken system,” the clinic's healthcare provision amid a climate inhospitable to immigrants demonstrates the importance of both conceptualizing and practicing medical humanitarianism as healthcare advocacy.

Suggested Citation

  • Hoekstra, Erin, 2021. "“Not a free version of a broken system:” Medical humanitarianism and immigrant health justice in the United States," Social Science & Medicine, Elsevier, vol. 285(C).
  • Handle: RePEc:eee:socmed:v:285:y:2021:i:c:s0277953621006195
    DOI: 10.1016/j.socscimed.2021.114287
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    References listed on IDEAS

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    1. Willen, Sarah S., 2012. "How is health-related “deservingness” reckoned? Perspectives from unauthorized im/migrants in Tel Aviv," Social Science & Medicine, Elsevier, vol. 74(6), pages 812-821.
    2. Toomey, R.B. & Umaña-Taylor, A.J. & Williams, D.R. & Harvey-Mendoza, E. & Jahromi, L.B. & Updegraff, K.A., 2014. "Impact of Arizona's SB 1070 immigration law on utilization of health care and public assistance among mexican-origin adolescent mothers and their mother figures," American Journal of Public Health, American Public Health Association, vol. 104(S1), pages 28-34.
    3. Fox, Renée C., 1995. "Medical humanitarianism and human rights: Reflections on Doctors Without Borders and Doctors of the World," Social Science & Medicine, Elsevier, vol. 41(12), pages 1607-1616, December.
    4. Gottlieb, Nora & Filc, Dani & Davidovitch, Nadav, 2012. "Medical humanitarianism, human rights and political advocacy: The case of the Israeli Open Clinic," Social Science & Medicine, Elsevier, vol. 74(6), pages 839-845.
    5. Tiedje, Kristina & Plevak, David J., 2014. "Medical humanitarianism in the United States: Alternative healthcare, spirituality and political advocacy in the case of Our Lady Guadalupe Free Clinic," Social Science & Medicine, Elsevier, vol. 120(C), pages 360-367.
    6. Tim Allen & David Styan, 2000. "A right to interfere? Bernard Kouchner and the new humanitarianism," Journal of International Development, John Wiley & Sons, Ltd., vol. 12(6), pages 825-842.
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