Seeking mo‘ui lelei abroad: Tongan medical mobilities and transnational practices of health
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2021
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University of Hawaii at Manoa
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International travel for access to health care, while not a new phenomenon, has grown exponentially since the 1990s, drawing increased attention from anthropologists, who continue to emphasize the diversity of circumstances surrounding medical travel. In this dissertation, I explore the experiences of Tongan medical travelers who draw on diasporic networks to pursue biomedical treatment for noncommunicable diseases in Australia, Aotearoa/New Zealand, and the United States. Based on fieldwork in Nuku‘alofa, Tonga, in which I worked with local biomedical practitioners, patients, and caregivers so as to track state-sponsored and private routes to treatment abroad, this research shows how individuals’ abilities to pursue treatment are largely dependent on the ongoing circulation of biomedical resources in and out of Tonga, including health technologies, volunteer practitioners, and foreign aid. When these resources are either unable or insufficient to support medical travel, Tongan transnational networks of care frequently step in to help address the resulting disparities, sometimes reshaping long-standing socioeconomic networks in the process. For some patients, medical travel thus comes to be characterized not only by issues of practicality but also by a rethinking of the moral and social implications of patienthood and personhood—of what it means to pursue individualized care through collective-oriented social networks—both during and after treatment. This research also reveals how, for those with chronic illnesses, seeking indefinite treatment abroad can entangle patients and caregivers in affectively and politically fraught situations in which treatment access must be continually renegotiated by both familial and state institutions. In exploring these experiences, this work expands anthropological scholarship by illustrating how transnational mobilities and political economies of medical travel are generated through intersections of physical capital (e.g., foreign aid) and network capital (e.g., diasporic connections), in addition to showing how medical travelers must navigate ongoing health disparities and reoriented social relations upon returning to Tonga.
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Medical tourism
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Tonga
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