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Saiba Varma

University of California, San Diego, Anthropology, Faculty Member

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I am a cultural and medical anthropologist with long-term fieldwork experience in the Kashmir valley. My work examines military and humanitarian care, psychiatry, expertise, and the embodied and psychic effects of political violence.

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Christine Vanpool

el-Sayed el-Aswad

American Anthropological Association

University of Missouri Columbia

Haverford College

Indiana University

The University of Texas at Austin

Patrick Eisenlohr

University of Göttingen

Christopher Santiago

College of Staten Island

Indiana University

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Papers by Saiba Varma

Touch in digitalized worlds: An introduction

by Saiba Varma and Tuva Broch

Anthropology of Consciousness, 2024

The English word digital (from the Latin, digitus) etymologically connects both fingers and techn... more The English word digital (from the Latin, digitus) etymologically connects both fingers and technologies. In this special issue, we honor this dual meaning of the digital by foregrounding how living in a digital era both challenges and actualizes our senses, particularly our sense of touch. As Classen (2020 [2005]) argues, touch is not a private act; it is fundamental to how people express themselves, their relationship to the worlds they inhabit, and their relationship to others (see also Barker

Troubling Complicities: the anthropologist as (im)moral subject

by Saiba Varma and Kali Rubaii

Hau: Journal of Ethnographic Theory, 2023

This creative article seeks to trouble dominant modes of how anthropologists position themselves ... more This creative article seeks to trouble dominant modes of how anthropologists position themselves as moral subjects and grapple with their complicity with/in empire today: what we call "bearing witness" and "denunciation/confession." In contrast to these models, we perform and theorize our own complicities by staying with the multiple social, relational, political, and epistemological entanglements that our fieldwork produces. Through a braided dialogue, we demonstrate the multiple responsibilities and relationalities that come with the positions we occupy as subjects, researchers, and narrators of empire. We define complicity as an active, transitive engagement with others as we are situated in multiple structures of power. Theorizing complicity helps us reveal what relations of knowledge and power we are responsible for making visible and how we can analytically respond to them. By pluralizing complicity, our aim is to stimulate much needed conversation on questions of anthropology's relation to tentacles of empire.

Why Calls to Diversify Trial Populations Fall Short

Med, 2021

Drawing on a SARS-CoV-2 vaccine trial in a Latinx community in San Diego, we show how trial desig... more Drawing on a SARS-CoV-2 vaccine trial in a Latinx community in San Diego, we show how trial designs fail to redress structural racism and may introduce new harms. While important, trial diversity alone cannot redress entrenched inequities that affect Black, Indigenous, and People of Color (BIPOC) communities.

Militarism Psychiatry and Social Impunity in Kashmir

Routledge, 2023

Compared to other places of long-term violence, at fi rst blush, Kashmir's public and mental heal... more Compared to other places of long-term violence, at fi rst blush, Kashmir's public and mental health infrastructure looks remarkably intact. While human rights and humanitarian reports of public health infrastructures in war tend to focus on the most spectacular and egregious violations of medical neutrality, this chapter argues for the need for a more expansive understanding of the e ects wrought by militarism and violence on public health systems. In particular, this chapter shifts beyond an accounting of incidents of physical harm-such as destruction of hospitals or attacks on medical professionals-to reveal the phenomenological and a ective scars left by violence in psychiatric spaces, as well as in patient and practitioner subjectivities. To do so, I deploy the concept of social impunity , a concept that draws on a legal vocabulary to show how Kashmiris themselves theorize dysfunction, disorder and harm in the public health system, and how they see that disorder as directly tied to the politics of Indian state control of Kashmir. Legal and political exceptionalism, they argue, has led to pervasive, ordinary harms that permeate spaces of care. In other words, social impunity refers to how Kashmiris understand how a legal system of exceptionalism a ects social relations and the practice of medicine. This chapter draws on more than 24 months of ethnographic fi eldwork conducted between 2009 and 2019, including interviews with clinicians and patients and observations of clinician-patient interactions in public health settings, including a large teaching hospital, a standalone psychiatric hospital, a district hospital and an inpatient substance abuse treatment center. 1 Public healthcare in Kashmir, though protected by international humanitarian legal norms of neutrality, immunity and impartiality, has been subjected to direct attacks as well as more insidious and indirect harms. In ethnographic interviews, both patients and providers

The Work of Ambivalence: Autonomy, Collaboration and Care in the Neoliberal US University

by Saiba Varma, Leslie Quintanilla, and Kalindi Vora

Feminist Formations, 2022

Can science be feminist? Can feminist science emerge from and take hold within the neoliberal uni... more Can science be feminist? Can feminist science emerge from and take hold within the neoliberal university? As a collaboratory of researchers and educators under the name Star Fem Co*Lab, the previous questions have shaped our in-progress book, The Science We are For: A Feminist Pocket Guide. The aim of the guide is to take readers, with a focus on undergraduate and popular audiences, away from routinized ways of thinking about and doing science– such as science in the service of profit over people– towards a feminist science practice that is focused on always asking “who is science for?” In this article, we discuss how feminist collaboration might take shape within the neoliberal university as a challenge to the Eurocentric models of scientific knowledge production and valuation on which the institution rests. Our six-member collaboratory reflects on the experiences and motivations that shaped our co-labor of thinking, writing, and care to shed light on roots and routes toward a feminist pedagogy invested in equipping students with practical tools for social justice science engagement. As such, this article makes the case for a vision of feminist science that brings together feminist theory with scientific research and social studies of science to retool and reclaim scientific knowledge production by and for social justice imperatives to redirect power, resources, and knowledge to benefit communities most impacted by imperialistic science and its histories.

Affective governance, disaster, and the unfinished colonial project

Kashmir and the Future of South Asia, 2020

This chapter examines Indian state occupation as a project of racialized “affective governance,” ... more This chapter examines Indian state occupation as a project of racialized “affective governance,” that is, one that seeks to transform Kashmiri aspirations for self-determination into acquiescence to Indian rule by producing in Kashmiris a psychological, affective, and emotional disposition of dependency and gratitude vis-à-vis the Indian state. In a range of social, institutional, and military settings, including in the aftermath of the 2014 flood, Kashmiri Muslims are continuously called upon to demonstrate their gratitude toward the Indian nation-state, military, and public. Their inevitable failure to properly demonstrate gratitude becomes the engine for further military and psychological intervention. The chapter also spotlights moments of political refusal on the part of Kashmiris to perform obeisance to the Indian state. Together these examples reveal how sovereign power must be analyzed as a project of not just political and military, but also subjective, psychological, and affective control.

Introduction: medicine’s shadowside: revisiting clinical iatrogenesis

Anthropology & Medicine, 2021

Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept ... more Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogenesis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to medical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis' immediate and lingering presences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics. I want my voice to be harsh, I don't want it to be beautiful, I don't want it to be pure, I don't want it to have all dimensions. I want it to be torn through and through, I don't want it to be enticing, for I am speaking of man and his refusal, of the day-to-day rottenness of man, of his dreadful failure. I want you to tell. -Frantz Fanon, Letter to a Frenchman, Toward the African Revolution This special issue is dedicated to Leah M. Ashe (1980Ashe ( -2020)). This special issue grew out of our experiences as ethnographers of the clinic who witnessed a number of uncomfortable and distressing situations, which starkly limited our agency and capacities to theorize. One of us watched patients receive electroconvulsive therapy in psychiatric settings without anesthesia or sedatives, in contravention to Indian law and UN human rights guidelines (UN Human Rights Council 2013). The short-circuiting of law was justified as necessary in a resource-poor setting; some care, psychiatrists argued, was better than no care. Another of us was a bedside witness to the cumulative impacts of © 2021 informa UK limited, trading as taylor & Francis group CONTACT Saiba Varma

Anatomy of a Siege

Anthropology and Humanism, 2020

Eliciting recovery narratives in global mental health: Benefits and potential harms in service user participation

Psychiatric Rehabilitation Journal, 2019

The engagement of peers and service users is increasingly emphasized in mental health clinical, e... more The engagement of peers and service users is increasingly emphasized in mental health clinical, educational, and research activities. A core means of engagement is via the sharing of recovery narratives, through which service users present their personal history of moving from psychiatric disability to recovery. We critically examine the range of contexts and purposes for which recovery narratives are elicited in global mental health. We present four case studies that represent the variability in recovery narrative elicitation, purpose, and geography: a mental health Gap Action Programme clinician training program in Nepal, an inpatient clinical service in Indian-controlled Kashmir, a recovery-oriented care program in urban Australia, and an undergraduate education program in the rural United States. In each case study, we explore the context, purpose, process of elicitation, content, and implications of incorporating recovery narratives. Results: Within each context, organizations engaging service users had a specific intention of what 'recovery' should constitute. This was influenced by the anticipated audience for the recovery stories. These expectations influenced the types of service users included, narrative content, and training provided for service users to prepare and share narratives. Our cases illustrate the benefit of these co-constructed narratives and potential negative impacts on service users in some contexts, especially when used as a prerequisite for accessing or being discharged from clinical care.

Spectral Ties: Hospital Hauntings Across the Line of Control

Medical anthropology, Jan 8, 2018

In this article, we trace encounters between humans and phantasmic entities in hospitals in India... more In this article, we trace encounters between humans and phantasmic entities in hospitals in Indian-occupied and Pakistan-controlled Kashmir. In Pakistan, the presence of spectral beings (jinni) in hospitals is linked to state and sectarian violence, which precipitates ruptures between jinni and human worlds. Such breaches permit jinni to manifest in the medical present, where insecure actors harness them to ventriloquize unspoken anxieties. In Indian-occupied Kashmir, jinn-like, chronically mentally ill patients haunt psychiatric modernization projects. In embracing a jinneaological approach to medical crises, we theorize hospitals as multi-temporal and multi-dimensional spaces called "tesseracts," in which human-nonhuman encounters serve existential and political purposes.

Disappearing the asylum: Modernizing psychiatry and generating manpower in India

Transcultural Psychiatry, 2016

In recent years, the Movement for Global Mental Health (MGMH) and the World Health Organization h... more In recent years, the Movement for Global Mental Health (MGMH) and the World Health Organization have worked closely with governments across the global South to redress major treatment gaps to improve access to mental health services. In India, recent reforms include transforming public psychiatric institutions from sites of treatment to research and training institutes, known as “Centres of Excellence,” to combat acute manpower shortages and modernize psychiatry. Drawing on ethnographic fieldwork at a public psychiatric hospital in Srinagar, Kashmir, one of the institutions selected to be a future “Centre of Excellence,” this article focuses on how these reforms have affected psychiatric institutions themselves. Efforts at modernizing and increasing access to mental health care—that is, emphasizing shortened stays, increasing outpatient treatment, and providing care in the “community”—depend on quarantining stigmatized, chronically ill, long-term patients who reside in custodial con...

Love in the time of occupation: Reveries, longing, and intoxication in Kashmir

American Ethnologist, 2016

At a drug rehabilitation clinic in Indian-occupied Kashmir, patients were subjected to a range of... more At a drug rehabilitation clinic in Indian-occupied Kashmir, patients were subjected to a range of biomedical and penitentiary techniques. These techniques included group therapy sessions in which substance users performed narratives of their recovery-a practice that made visible their gratitude to the police, which oversaw the clinic and which, as an arm of the Indian military, many view as an illegal occupying force. While patients publicly pledged to remain sober and technically complied with the clinic's demands, they privately demonstrated ongoing commitments to nasha (intoxication), which places substance use, romantic love, and the search for divine unity in Sufism on the same phenomenological register. Through nasha, patients defied biomedical injunctions to forget their pasts and recuperated intoxication as a worthwhile experience. [addiction, substance abuse treatment, military humanitarianism, recovery, reverie, Kashmir]

The Occupied Clinic final proofs

In The Occupied Clinic, Saiba Varma explores the psychological, ontological, and political entang... more In The Occupied Clinic, Saiba Varma explores the psychological, ontological, and political entanglements between medicine and violence in Indian-controlled Kashmir—the world's most densely militarized place. Into a long history of occupations, insurgencies, suppressions, natural disasters, and a crisis of public health infrastructure come interventions in human distress, especially those of doctors and humanitarians, who struggle against an epidemic: more than sixty percent of the civilian population suffers from depression, anxiety, PTSD, or acute stress. Drawing on encounters between medical providers and patients in an array of settings, Varma reveals how colonization is embodied and how overlapping state practices of care and violence create disorienting worlds for doctors and patients alike. Varma shows how occupation creates worlds of disrupted meaning in which clinical life is connected to political disorder, subverting biomedical neutrality, ethics, and processes of care in profound ways. By highlighting the imbrications between humanitarianism and militarism and between care and violence, Varma theorizes care not as a redemptive practice, but as a fraught sphere of action that is never quite what it seems.

The Medical Net: Patients, Psychiatrists And Paper Trails In The Kashmir Valley

This dissertation examines psychosocial interventions as specific social, political, medical, and... more This dissertation examines psychosocial interventions as specific social, political, medical, and ontological formations in the Kashmir valley. Till recently, medical humanitarianism was dominated by short-term, surgical interventions that focused on providing emergency biomedical care. In recent years, however, humanitarian organizations have increasingly focused on mental health interventions, particularly in places marked by low-intensity, long-term conflict, such as Kashmir. This dissertation traces the indeterminacies that have arisen as the outcome and effects of humanitarian work have shifted away from questions of life and death to the terrain of psychosocial wellbeing. Specifically, it argues that while humanitarianism is constituted by new subjects and objects of knowledge-such as psychiatrists, counselors, PTSD, and trauma therapies-it is also made up by less visible moments of (mis)translation, (mis)apprehension, and doubt. As such, I argue that medical humanitarianism takes the form of a "net" (jal), an object that is constituted by both its visible nodes and threads, as well as by "gaps" in between. Taking its inspiration from feminist science studies, the dissertation enacts the form of the net by moving from a focus on the visible nodes, that is, asylum and experts, to the threads that move between the clinic and the outside, namely medical cards and pills, to finally, the "gaps" in the net, that is, love stories. ! iv The "politics of visibility" that marks humanitarian practice is also replicated within the anthropology of humanitarianism. Anthropology has traditionally approached humanitarianism as providing the gift of life-in the form of citizenship, asylum, or legal residency-for victims of violence. Yet organizations that focus on psychosocial suffering do not hold out the promise of life as much as they provide limited techniques for living with suffering. Far from universally embraced, this latter gift raises questions about the worthiness of humanitarian endeavors in places of long-term suffering. This dissertation thus goes beyond a focus on humanitarianism as a "politics of life" to an ethnographically rich account of the everyday contestations and misapprehensions that characterize humanitarianism in a zone of political stagnation.

The Occupied Clinic

Grace Lee Boggs reminds us that everything we know of ourselves and the world comes through conve... more Grace Lee Boggs reminds us that everything we know of ourselves and the world comes through conversation. Every idea here was born with someone: in cars, cafés, couches, conferences, and classrooms. My deepest thanks to all those named and unnamed who co-journeyed with me. Professional journeys and book writing are long and tenuous processes, especially in academia today. Like many academic books, this one began as a PhD dissertation and with a writing group. I am deeply grateful for almost fifteen years of thinking, communing, and togetherness with Chika Watanabe and Gökçe Günel. Thank you for being my touchstones on this crazy journey. With Melissa Rosario, Aftab Jassal, and Courtney Work, we made an unflappable writing community that set the tone for years to come. My dissertation committee supported and challenged me in all the right ways. Annelise Riles provided a bedrock of enthusiasm, while demanding courage, originality, and disciplinary care. Lucinda Ramberg made me kin, inviting me into her home and life, and taught me how to blur the personal, ethical, affective, and intellectual with the most joyous results. My studies with Stacey Langwick were intellectually transformative, exciting, and full of mirth. Durba Ghosh always asked the big questions, reminding me of the unsaid and what's at stake. Her tenacity and curiosity continue to inspire me. I also thank the teachers who forged an intellectual path for me early in life: Misty

A pandemic is not a war: COVID‐19 urgent anthropological reflections

Social Anthropology

Introduction: Medicine's shadowside: revisiting clinical iatrogenesis

by Saiba Varma and Emma Varley

Anthropology and Medicine, 2021

Drawing on the work of Ivan Illich, our special issue reanimates iatro- genesis as a vital concep... more Drawing on the work of Ivan Illich, our special issue reanimates iatro- genesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogen- esis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to med- ical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis’ immediate and lingering pres- ences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics.

Beyond PTSD: Politics of Visibility in a Kashmiri Clinic

Traumatic Pasts in Asia: History, Psychiatry and Trauma from the 1930s to the Present, 2021

The Doctor and Mrs. A book review essay

Journal of the History of the Behavioral Sciences, 2021

If archival and ethnographic encounters are ethical encounters, what kind of ethical encounters a... more If archival and ethnographic encounters are ethical encounters, what kind of ethical encounters are they? How we do history and ethnography now, in this moment of estrangement and suspension from fieldsites and archives? This essay responds to these questions by reflecting on Sarah Pinto's The Doctor and Mrs. A. (2020) alongside other recent works in feminist history and anthropology, such as Saidiya Hartman's Wayward Lives, Beautiful Experiments (2019). 1 This essay does not compare these two works, given the impossibility of doing justice to the specificities of local moral worlds, place, and intellectual traditions (theories of Black feminist life 2 and feminist South Asian history) from which they emerge, but at moments it makes their braiding visible. Though neither text is explicitly about historical or ethnographic methods, they carry invaluable ethical and methodological lessons for our contemporary moment. Both set up conversations about what counts as a research archive and how to engage it (or when to leave it behind), what are the stories that need to be told, who are the protagonists of those stories, and what analysis (both scholarly and psychoanalytic) itself looks like. Both Wayward Lives and The Doctor and Mrs. A offer imaginative leaps forward in response to these questions. It goes without saying that imaginative leaps can be risky, and while perhaps taking risks might feel counterintuitive one year into a world-altering pandemic, this is precisely what these texts authorize us to do as historians and anthropologists. As works about the stakes of ethics and ethical lives, of doing and telling history otherwise, both open up counter ethical gestures in the disciplines of anthropology and history.

Gender Conflict and Peace in Kashmir Seema Shekhawat review

Journal of Asian Studies, 2016

Touch in digitalized worlds: An introduction

by Saiba Varma and Tuva Broch

Anthropology of Consciousness, 2024

The English word digital (from the Latin, digitus) etymologically connects both fingers and techn... more The English word digital (from the Latin, digitus) etymologically connects both fingers and technologies. In this special issue, we honor this dual meaning of the digital by foregrounding how living in a digital era both challenges and actualizes our senses, particularly our sense of touch. As Classen (2020 [2005]) argues, touch is not a private act; it is fundamental to how people express themselves, their relationship to the worlds they inhabit, and their relationship to others (see also Barker

Troubling Complicities: the anthropologist as (im)moral subject

by Saiba Varma and Kali Rubaii

Hau: Journal of Ethnographic Theory, 2023

This creative article seeks to trouble dominant modes of how anthropologists position themselves ... more This creative article seeks to trouble dominant modes of how anthropologists position themselves as moral subjects and grapple with their complicity with/in empire today: what we call "bearing witness" and "denunciation/confession." In contrast to these models, we perform and theorize our own complicities by staying with the multiple social, relational, political, and epistemological entanglements that our fieldwork produces. Through a braided dialogue, we demonstrate the multiple responsibilities and relationalities that come with the positions we occupy as subjects, researchers, and narrators of empire. We define complicity as an active, transitive engagement with others as we are situated in multiple structures of power. Theorizing complicity helps us reveal what relations of knowledge and power we are responsible for making visible and how we can analytically respond to them. By pluralizing complicity, our aim is to stimulate much needed conversation on questions of anthropology's relation to tentacles of empire.

Why Calls to Diversify Trial Populations Fall Short

Med, 2021

Drawing on a SARS-CoV-2 vaccine trial in a Latinx community in San Diego, we show how trial desig... more Drawing on a SARS-CoV-2 vaccine trial in a Latinx community in San Diego, we show how trial designs fail to redress structural racism and may introduce new harms. While important, trial diversity alone cannot redress entrenched inequities that affect Black, Indigenous, and People of Color (BIPOC) communities.

Militarism Psychiatry and Social Impunity in Kashmir

Routledge, 2023

Compared to other places of long-term violence, at fi rst blush, Kashmir's public and mental heal... more Compared to other places of long-term violence, at fi rst blush, Kashmir's public and mental health infrastructure looks remarkably intact. While human rights and humanitarian reports of public health infrastructures in war tend to focus on the most spectacular and egregious violations of medical neutrality, this chapter argues for the need for a more expansive understanding of the e ects wrought by militarism and violence on public health systems. In particular, this chapter shifts beyond an accounting of incidents of physical harm-such as destruction of hospitals or attacks on medical professionals-to reveal the phenomenological and a ective scars left by violence in psychiatric spaces, as well as in patient and practitioner subjectivities. To do so, I deploy the concept of social impunity , a concept that draws on a legal vocabulary to show how Kashmiris themselves theorize dysfunction, disorder and harm in the public health system, and how they see that disorder as directly tied to the politics of Indian state control of Kashmir. Legal and political exceptionalism, they argue, has led to pervasive, ordinary harms that permeate spaces of care. In other words, social impunity refers to how Kashmiris understand how a legal system of exceptionalism a ects social relations and the practice of medicine. This chapter draws on more than 24 months of ethnographic fi eldwork conducted between 2009 and 2019, including interviews with clinicians and patients and observations of clinician-patient interactions in public health settings, including a large teaching hospital, a standalone psychiatric hospital, a district hospital and an inpatient substance abuse treatment center. 1 Public healthcare in Kashmir, though protected by international humanitarian legal norms of neutrality, immunity and impartiality, has been subjected to direct attacks as well as more insidious and indirect harms. In ethnographic interviews, both patients and providers

The Work of Ambivalence: Autonomy, Collaboration and Care in the Neoliberal US University

by Saiba Varma, Leslie Quintanilla, and Kalindi Vora

Feminist Formations, 2022

Can science be feminist? Can feminist science emerge from and take hold within the neoliberal uni... more Can science be feminist? Can feminist science emerge from and take hold within the neoliberal university? As a collaboratory of researchers and educators under the name Star Fem Co*Lab, the previous questions have shaped our in-progress book, The Science We are For: A Feminist Pocket Guide. The aim of the guide is to take readers, with a focus on undergraduate and popular audiences, away from routinized ways of thinking about and doing science– such as science in the service of profit over people– towards a feminist science practice that is focused on always asking “who is science for?” In this article, we discuss how feminist collaboration might take shape within the neoliberal university as a challenge to the Eurocentric models of scientific knowledge production and valuation on which the institution rests. Our six-member collaboratory reflects on the experiences and motivations that shaped our co-labor of thinking, writing, and care to shed light on roots and routes toward a feminist pedagogy invested in equipping students with practical tools for social justice science engagement. As such, this article makes the case for a vision of feminist science that brings together feminist theory with scientific research and social studies of science to retool and reclaim scientific knowledge production by and for social justice imperatives to redirect power, resources, and knowledge to benefit communities most impacted by imperialistic science and its histories.

Affective governance, disaster, and the unfinished colonial project

Kashmir and the Future of South Asia, 2020

This chapter examines Indian state occupation as a project of racialized “affective governance,” ... more This chapter examines Indian state occupation as a project of racialized “affective governance,” that is, one that seeks to transform Kashmiri aspirations for self-determination into acquiescence to Indian rule by producing in Kashmiris a psychological, affective, and emotional disposition of dependency and gratitude vis-à-vis the Indian state. In a range of social, institutional, and military settings, including in the aftermath of the 2014 flood, Kashmiri Muslims are continuously called upon to demonstrate their gratitude toward the Indian nation-state, military, and public. Their inevitable failure to properly demonstrate gratitude becomes the engine for further military and psychological intervention. The chapter also spotlights moments of political refusal on the part of Kashmiris to perform obeisance to the Indian state. Together these examples reveal how sovereign power must be analyzed as a project of not just political and military, but also subjective, psychological, and affective control.

Introduction: medicine’s shadowside: revisiting clinical iatrogenesis

Anthropology & Medicine, 2021

Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept ... more Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogenesis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to medical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis' immediate and lingering presences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics. I want my voice to be harsh, I don't want it to be beautiful, I don't want it to be pure, I don't want it to have all dimensions. I want it to be torn through and through, I don't want it to be enticing, for I am speaking of man and his refusal, of the day-to-day rottenness of man, of his dreadful failure. I want you to tell. -Frantz Fanon, Letter to a Frenchman, Toward the African Revolution This special issue is dedicated to Leah M. Ashe (1980Ashe ( -2020)). This special issue grew out of our experiences as ethnographers of the clinic who witnessed a number of uncomfortable and distressing situations, which starkly limited our agency and capacities to theorize. One of us watched patients receive electroconvulsive therapy in psychiatric settings without anesthesia or sedatives, in contravention to Indian law and UN human rights guidelines (UN Human Rights Council 2013). The short-circuiting of law was justified as necessary in a resource-poor setting; some care, psychiatrists argued, was better than no care. Another of us was a bedside witness to the cumulative impacts of © 2021 informa UK limited, trading as taylor & Francis group CONTACT Saiba Varma

Anatomy of a Siege

Anthropology and Humanism, 2020

Eliciting recovery narratives in global mental health: Benefits and potential harms in service user participation

Psychiatric Rehabilitation Journal, 2019

The engagement of peers and service users is increasingly emphasized in mental health clinical, e... more The engagement of peers and service users is increasingly emphasized in mental health clinical, educational, and research activities. A core means of engagement is via the sharing of recovery narratives, through which service users present their personal history of moving from psychiatric disability to recovery. We critically examine the range of contexts and purposes for which recovery narratives are elicited in global mental health. We present four case studies that represent the variability in recovery narrative elicitation, purpose, and geography: a mental health Gap Action Programme clinician training program in Nepal, an inpatient clinical service in Indian-controlled Kashmir, a recovery-oriented care program in urban Australia, and an undergraduate education program in the rural United States. In each case study, we explore the context, purpose, process of elicitation, content, and implications of incorporating recovery narratives. Results: Within each context, organizations engaging service users had a specific intention of what 'recovery' should constitute. This was influenced by the anticipated audience for the recovery stories. These expectations influenced the types of service users included, narrative content, and training provided for service users to prepare and share narratives. Our cases illustrate the benefit of these co-constructed narratives and potential negative impacts on service users in some contexts, especially when used as a prerequisite for accessing or being discharged from clinical care.

Spectral Ties: Hospital Hauntings Across the Line of Control

Medical anthropology, Jan 8, 2018

In this article, we trace encounters between humans and phantasmic entities in hospitals in India... more In this article, we trace encounters between humans and phantasmic entities in hospitals in Indian-occupied and Pakistan-controlled Kashmir. In Pakistan, the presence of spectral beings (jinni) in hospitals is linked to state and sectarian violence, which precipitates ruptures between jinni and human worlds. Such breaches permit jinni to manifest in the medical present, where insecure actors harness them to ventriloquize unspoken anxieties. In Indian-occupied Kashmir, jinn-like, chronically mentally ill patients haunt psychiatric modernization projects. In embracing a jinneaological approach to medical crises, we theorize hospitals as multi-temporal and multi-dimensional spaces called "tesseracts," in which human-nonhuman encounters serve existential and political purposes.

Disappearing the asylum: Modernizing psychiatry and generating manpower in India

Transcultural Psychiatry, 2016

In recent years, the Movement for Global Mental Health (MGMH) and the World Health Organization h... more In recent years, the Movement for Global Mental Health (MGMH) and the World Health Organization have worked closely with governments across the global South to redress major treatment gaps to improve access to mental health services. In India, recent reforms include transforming public psychiatric institutions from sites of treatment to research and training institutes, known as “Centres of Excellence,” to combat acute manpower shortages and modernize psychiatry. Drawing on ethnographic fieldwork at a public psychiatric hospital in Srinagar, Kashmir, one of the institutions selected to be a future “Centre of Excellence,” this article focuses on how these reforms have affected psychiatric institutions themselves. Efforts at modernizing and increasing access to mental health care—that is, emphasizing shortened stays, increasing outpatient treatment, and providing care in the “community”—depend on quarantining stigmatized, chronically ill, long-term patients who reside in custodial con...

Love in the time of occupation: Reveries, longing, and intoxication in Kashmir

American Ethnologist, 2016

At a drug rehabilitation clinic in Indian-occupied Kashmir, patients were subjected to a range of... more At a drug rehabilitation clinic in Indian-occupied Kashmir, patients were subjected to a range of biomedical and penitentiary techniques. These techniques included group therapy sessions in which substance users performed narratives of their recovery-a practice that made visible their gratitude to the police, which oversaw the clinic and which, as an arm of the Indian military, many view as an illegal occupying force. While patients publicly pledged to remain sober and technically complied with the clinic's demands, they privately demonstrated ongoing commitments to nasha (intoxication), which places substance use, romantic love, and the search for divine unity in Sufism on the same phenomenological register. Through nasha, patients defied biomedical injunctions to forget their pasts and recuperated intoxication as a worthwhile experience. [addiction, substance abuse treatment, military humanitarianism, recovery, reverie, Kashmir]

The Occupied Clinic final proofs

In The Occupied Clinic, Saiba Varma explores the psychological, ontological, and political entang... more In The Occupied Clinic, Saiba Varma explores the psychological, ontological, and political entanglements between medicine and violence in Indian-controlled Kashmir—the world's most densely militarized place. Into a long history of occupations, insurgencies, suppressions, natural disasters, and a crisis of public health infrastructure come interventions in human distress, especially those of doctors and humanitarians, who struggle against an epidemic: more than sixty percent of the civilian population suffers from depression, anxiety, PTSD, or acute stress. Drawing on encounters between medical providers and patients in an array of settings, Varma reveals how colonization is embodied and how overlapping state practices of care and violence create disorienting worlds for doctors and patients alike. Varma shows how occupation creates worlds of disrupted meaning in which clinical life is connected to political disorder, subverting biomedical neutrality, ethics, and processes of care in profound ways. By highlighting the imbrications between humanitarianism and militarism and between care and violence, Varma theorizes care not as a redemptive practice, but as a fraught sphere of action that is never quite what it seems.

The Medical Net: Patients, Psychiatrists And Paper Trails In The Kashmir Valley

This dissertation examines psychosocial interventions as specific social, political, medical, and... more This dissertation examines psychosocial interventions as specific social, political, medical, and ontological formations in the Kashmir valley. Till recently, medical humanitarianism was dominated by short-term, surgical interventions that focused on providing emergency biomedical care. In recent years, however, humanitarian organizations have increasingly focused on mental health interventions, particularly in places marked by low-intensity, long-term conflict, such as Kashmir. This dissertation traces the indeterminacies that have arisen as the outcome and effects of humanitarian work have shifted away from questions of life and death to the terrain of psychosocial wellbeing. Specifically, it argues that while humanitarianism is constituted by new subjects and objects of knowledge-such as psychiatrists, counselors, PTSD, and trauma therapies-it is also made up by less visible moments of (mis)translation, (mis)apprehension, and doubt. As such, I argue that medical humanitarianism takes the form of a "net" (jal), an object that is constituted by both its visible nodes and threads, as well as by "gaps" in between. Taking its inspiration from feminist science studies, the dissertation enacts the form of the net by moving from a focus on the visible nodes, that is, asylum and experts, to the threads that move between the clinic and the outside, namely medical cards and pills, to finally, the "gaps" in the net, that is, love stories. ! iv The "politics of visibility" that marks humanitarian practice is also replicated within the anthropology of humanitarianism. Anthropology has traditionally approached humanitarianism as providing the gift of life-in the form of citizenship, asylum, or legal residency-for victims of violence. Yet organizations that focus on psychosocial suffering do not hold out the promise of life as much as they provide limited techniques for living with suffering. Far from universally embraced, this latter gift raises questions about the worthiness of humanitarian endeavors in places of long-term suffering. This dissertation thus goes beyond a focus on humanitarianism as a "politics of life" to an ethnographically rich account of the everyday contestations and misapprehensions that characterize humanitarianism in a zone of political stagnation.

The Occupied Clinic

Grace Lee Boggs reminds us that everything we know of ourselves and the world comes through conve... more Grace Lee Boggs reminds us that everything we know of ourselves and the world comes through conversation. Every idea here was born with someone: in cars, cafés, couches, conferences, and classrooms. My deepest thanks to all those named and unnamed who co-journeyed with me. Professional journeys and book writing are long and tenuous processes, especially in academia today. Like many academic books, this one began as a PhD dissertation and with a writing group. I am deeply grateful for almost fifteen years of thinking, communing, and togetherness with Chika Watanabe and Gökçe Günel. Thank you for being my touchstones on this crazy journey. With Melissa Rosario, Aftab Jassal, and Courtney Work, we made an unflappable writing community that set the tone for years to come. My dissertation committee supported and challenged me in all the right ways. Annelise Riles provided a bedrock of enthusiasm, while demanding courage, originality, and disciplinary care. Lucinda Ramberg made me kin, inviting me into her home and life, and taught me how to blur the personal, ethical, affective, and intellectual with the most joyous results. My studies with Stacey Langwick were intellectually transformative, exciting, and full of mirth. Durba Ghosh always asked the big questions, reminding me of the unsaid and what's at stake. Her tenacity and curiosity continue to inspire me. I also thank the teachers who forged an intellectual path for me early in life: Misty

A pandemic is not a war: COVID‐19 urgent anthropological reflections

Social Anthropology

Introduction: Medicine's shadowside: revisiting clinical iatrogenesis

by Saiba Varma and Emma Varley

Anthropology and Medicine, 2021

Drawing on the work of Ivan Illich, our special issue reanimates iatro- genesis as a vital concep... more Drawing on the work of Ivan Illich, our special issue reanimates iatro- genesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogen- esis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to med- ical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis’ immediate and lingering pres- ences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics.

Beyond PTSD: Politics of Visibility in a Kashmiri Clinic

Traumatic Pasts in Asia: History, Psychiatry and Trauma from the 1930s to the Present, 2021

The Doctor and Mrs. A book review essay

Journal of the History of the Behavioral Sciences, 2021

If archival and ethnographic encounters are ethical encounters, what kind of ethical encounters a... more If archival and ethnographic encounters are ethical encounters, what kind of ethical encounters are they? How we do history and ethnography now, in this moment of estrangement and suspension from fieldsites and archives? This essay responds to these questions by reflecting on Sarah Pinto's The Doctor and Mrs. A. (2020) alongside other recent works in feminist history and anthropology, such as Saidiya Hartman's Wayward Lives, Beautiful Experiments (2019). 1 This essay does not compare these two works, given the impossibility of doing justice to the specificities of local moral worlds, place, and intellectual traditions (theories of Black feminist life 2 and feminist South Asian history) from which they emerge, but at moments it makes their braiding visible. Though neither text is explicitly about historical or ethnographic methods, they carry invaluable ethical and methodological lessons for our contemporary moment. Both set up conversations about what counts as a research archive and how to engage it (or when to leave it behind), what are the stories that need to be told, who are the protagonists of those stories, and what analysis (both scholarly and psychoanalytic) itself looks like. Both Wayward Lives and The Doctor and Mrs. A offer imaginative leaps forward in response to these questions. It goes without saying that imaginative leaps can be risky, and while perhaps taking risks might feel counterintuitive one year into a world-altering pandemic, this is precisely what these texts authorize us to do as historians and anthropologists. As works about the stakes of ethics and ethical lives, of doing and telling history otherwise, both open up counter ethical gestures in the disciplines of anthropology and history.

Gender Conflict and Peace in Kashmir Seema Shekhawat review

Journal of Asian Studies, 2016

Geographies of occupation in South Asia

by Nosheen Ali, Mona Bhan, Zunaira Komal, nishant upadhyay, Saiba Varma, and Deepti Misri

Feminist Studies, Special Issue: Indigenous Feminisms in Settler Contexts, 2019

Review of Myriad Intimacies by Lata Mani

Anthropology Book Forum, 2024

In a recent essay, Tanya Luhrmann (2023) described ethnography as a spiritual practice. Spiritual... more In a recent essay, Tanya Luhrmann (2023) described ethnography as a spiritual practice. Spiritual practices, writes Luhrmann, are "practices that are meant to transform your life." Myriad Intimacies holds this potential: it does not merely describe but embodies and enacts what a spiritually-driven intellectual and activist practice can be. Myriad Intimacies is Lata Mani's eighth book (not counting the four children's books she has also authored) in a long and storied journey as a feminist theorist, scholar, and filmmaker. A graduate of the History of Consciousness program at UC Santa Cruz, Mani studied alongside Ruth Frankenberg, Chela Sandoval, Lisa Lowe, bell hooks, and others who would become, along with Mani herself, leading figures in postcolonial and women of color feminism. In 1993, Mani's life irrevocably changed after a traumatic head injury. As she describes in Interleaves (2011), her disability simultaneously opened a new meaning, purpose and promise of life, what she came to describe as a tantrically-attuned path. 1 Mani's body of work not only questions Euro-American 1 The word tantra is derived from the Sanskrit root tan, which means to expand, spread, or stretch; the word tantra is also translated as 'loom' or 'weaving,' suggesting the interconnectedness of all things. Tantra is an ancient, heterogeneous Indian tradition of knowledge and practicethat seeks to 'divinize' the human person by harnessing mental and physical energies as well as the 'magical' properties of language and sacred visual imagery, among other things. In Tantra, the universe is alive, a manifestation of divine consciousness. Tantra is thus a world-and bodyaffirming tradition that cuts across popular and elite expressions of Hinduism, Buddhism, Jainism, and other religions.

Review of Enduring Cancer: Life, Death and Diagnosis in Delhi by Dwaipayan Banerjee

Medical Anthropology Quarterly , 2022

Recovery's Elusive Horizon: Recovering Histories x The Occupied Clinic

Somatosphere, 2021

520344136/recovering-histories)In Nicholas Bartlett's meditative and poignant ethnography about f... more 520344136/recovering-histories)In Nicholas Bartlett's meditative and poignant ethnography about former heroin users in Gejiu, China, Recovering Histories: Life and Labor after Heroin in Post-Reform China () (University of California Press 2020), he writes of arriving too late to the scene of the epidemic. Heroin use was widespread in this tin mining region in the 1980s, had peaked in the 1990s, and was now relegated to a small cohort, thanks to a combination of effective biomedical and carceral techniques. Many people from the so-called "heroin generation"-those who came of age in the late 1960s and early 1970s-had already successfully "quit" heroin. So, what was there to study? Temporal incongruity-the anxiety of anthropologists being out of step with the lifeworlds of our interlocutors-has much to tell us about the subjects of Recovering Histories themselves as well as the craft of ethnography. Other

Life, survival and "care" in times of occupation

Indian Journal of Medical Ethics, 2021

During fieldwork, I was often given friendly warnings, like 'you never know who anyone is in Kash... more During fieldwork, I was often given friendly warnings, like 'you never know who anyone is in Kashmir,' a statement meant to warn me not to trust too easily, given the longstanding history of informers, spies and collaborators in Kashmir. Several times after I interviewed someone, I learned of their 'other' identity as a former militant, collaborator, or someone with highup state connections. This knowledge, a virtual map overlaid on everyday sociality, always came after the fact, and it unnerved me. How would I ever grasp these subterranean histories? I also worried about the virtual map circulating about me: Who was I spying for? Did people trust me?" Saiba Varma, The Occupied Clinic: Militarism and Care in Kashmir Was there a sense of foreboding in this paragraph written by medical anthropologist Saiba Varma in her book, The Occupied Clinic: Militarism and Care in Kashmir? The book, described as "beautifully crafted ethnography", deals with entanglements between medicine, mental health and militarism, and received the Edie Turner First Book Prize presented by the Society for Humanistic Anthropology section of the American Anthropological Association.

Book Review. The Occupied Clinic: Militarism and Care in Kashmir.

Anthropology and Humanism, 2022

Saiba Varma's The Occupied Clinic: Militarism and Care in Kashmir-2021 winner of the Edie Turner ... more Saiba Varma's The Occupied Clinic: Militarism and Care in Kashmir-2021 winner of the Edie Turner First Book Award-is a brilliant and gripping ethnographic analysis of psychiatric care in response to an epidemic of trauma and a burgeoning field of psychiatry in Indian-occupied Kashmir. Many anthropologists may be familiar with this text because of the controversy surrounding Varma's proximity to the topic of study. I would encourage scholars to read it for themselves before making any quick judgments of it. Varma examines what care looks like in a context of ever-present militarism in a region that has faced ongoing occupation from different forces since the 16 th century. Varma's rich ethnographic insights demonstrate how militarism and care are not distinct but rather closely bounded. Indeed, early on in fieldwork, Varma noted that the line between medicine and militarism dissolved: "I realized that I had it inside out I had been trying to tell a story of medicine in violence. But I had to tell a story of violence through medicine" (9). In other words, violence was not a contextual feature, but rather it actively shaped how patients understood their conditions of distress and how doctors and patients interacted with one another. Varma begins this exceptional ethnography by taking readers on a journey to the outpatient department (OPD) of the Government Psychiatric Diseases Hospital, Kashmir's only public psychiatric hospital for eight million people. The narratives of patients and clinicians drive Varma's rich ethnography. For instance, we learn how most patients do not know their diagnosis; while patients know that pharmaceutical treatment will not cure them, they also know that something is better than nothing (3). The clinical space, as Varma persuasively argues, is one where military and humanitarian aims are latticed, and it is a critical space to examine how Kashmiris understand mental illness and collective trauma to be the direct product of colonial, social, economic, and political violence (29).

Life, survival and "care" in times of occupation

by Saiba Varma and Freny Manecksha

Indian Journal of Medical Ethics, 2021

Book review of The Occupied Clinic: Militarism and Care in Kashmir. To cite: Manecksha F. Life, ... more

Occupied Clinic: Militarism and Care in Kashmir (proofs)

Includes bibliographical references and index. Identifiers: lccn 2019058232 (print) | lccn 201905... more Includes bibliographical references and index. Identifiers: lccn 2019058232 (print) | lccn 2019058233 (ebook) isbn 9781478009924 (hardcover) isbn 9781478010982 (paperback) isbn 9781478012511 (ebook) Subjects: lcsh: Psychiatric clinics-India-Jammu and Kashmir. | War victims-Mental health-India-Jammu and Kashmir. | War victims-Mental health services-India-Jammu and Kashmir. | Civil-military relations-India-Jammu and Kashmir. | Military occupation-Psychological aspects. Classification: lcc rc451.i42 j36 2020 (print) | lcc rc451.i42 (ebook) | ddc 362.2/109546-dc23