Academic journal article Anthropological Quarterly

How to Rename a Hospital: Biomedical Technologies and New Combinations of Business and Charity in Cambodian Public Health

Academic journal article Anthropological Quarterly

How to Rename a Hospital: Biomedical Technologies and New Combinations of Business and Charity in Cambodian Public Health

Article excerpt

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On a sticky evening in late May 2009, I sat with Mary and Heng on the multicolored plastic mat on their floor, eating plates of rice and ginger chicken. As I was telling them about my morning in the imagery ward at the Khmer-Soviet Friendship Hospital, Heng interrupted me with a snort. Russian Hospital, as it was commonly called, didn't have good ultrasound machines. The really nice machines were made by General Electric (GE) and would soon be at Kossamak, another government hospital on the opposite side of the city. I had been doing research on imaging practices at Russian Hospital for the past few months, and I was curious. Why were new GE machines going to Kossamak, a smaller government hospital, originally built for monks? And how did Heng know about ultrasound machines, anyway? He worked in advertising.

It turned out Heng was working on an ad campaign for GE Cambodia, and saw the new machines when he attended meetings in their office. His advertising work was unrelated to the movements of these particular technologies, yet his attention to their quality-new and up to date, better than those at other hospitals-is indicative of the novelty of this donation program. GE was donating new machines, not used or out-of-date ones. And these gifts would be available as commodities, too. Many of the models would be available for purchase through local medical equipment distributors.

A few months after my dinner with Mary and Heng, I went to GE Cambodia's office on the ground floor of a luxury hotel by the Bassac River to learn more about the donations. I talked with the GE Market Development Manager and Country Representative, and learned that GE was donating mobile ultrasound and X-ray machines, suction pumps, ventilators, anesthesia machines, incubators, and regular and fetal monitors1 to government hospitals in Phnom Penh and in every province as part of its Developing Health Globally (DHG) corporate citizenship initiative. Cambodia was the newest DHG country, chosen because of its rankings based on indicators such as infant mortality and per capita income. The DHG Cambodia program was officially started in April 2009, two years after GE opened its Cambodia office.2 The Market Development Manager told me that GE did not play up its DHG program, as it wanted to focus on its commercial activities in energy and health care and "keep corporate responsibility in the background." This was the first instance of it, but in time, I would see that GE Cambodia was marbled with discourses of commercial activities in an emerging market and philanthropy in a resource-poor country.

It was clear even to Heng, who worked outside of the medical field, that aid of the past three decades had rarely involved objects of high value. Cambodia's recent history of war, political conflict, and mass dislocation caused serious problems for people's health and for health infrastructures, prompting humanitarian responses since the 1980s. Since the turn of the century, aid is oriented less towards crisis response, and more towards poverty reduction and economic growth. Technology donations have been part of these aid projects, though donations have taken different forms: bilateral aid agencies equipping a clinic or lab, international NGOs sponsoring a hospital ward, foreign companies offloading single machines to small NGOs.

In this article, I show how, in the GE donation, local and foreign corporate staff, Ministry of Health officials, and hospital administrators configured Cambodia as a country needing technological aid to bring public health care to an acceptable level. The Ministry of Health is the mediator of the most advanced biomedical technologies, but with the taint of being a recipient of donation. The private sector is held out as the domain where individual actors will flourish for the common good. Corporate philanthropy with an eye to the private market marks a reconfiguration of elements-public and private, business and charity-that constitute Cambodia's public health field. …

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