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ElEVEN Mobility and Connectedness: Chinese Medical Doctors in Kenya Elisabeth Hsu Since the late 1980s, Kenya has seen a constant coming and going of Chinese medical doctors. These traveling medical experts have not been excessively numerous (during the last 20 years their numbers have ranged between only 20 and 40 persons at any point in time), and they are not exactly a public health issue, but the complexities of their situation are worthy of anthropological investigation. During my fieldwork, one of the most pressing questions that local patients, health personnel, acquaintances on the bus, or colleagues at the university asked was: who are these Chinese medical doctors and why have they come to us? In order to answer this question asked by one set of actors during my fieldwork, I elicited the individual life stories of another set of actors, the Chinese doctors themselves. The question was simple; it came from the grassroots . The stories were moving, and they stand for themselves. However, their analysis points out important blanks in the medical anthropological literature. First, while medical anthropology has seen a flurry of studies on patients’ illness narratives (e.g., Kleinman 1988; Good and Good 1994; Mattingly 1998), practitioner narratives that highlight their vulnerability, and how it affects their medical practice, are few and far between (e.g., Katz 1985 and Hunter 1993).1 Second, only a few medical anthropologists have researched complementary and alternative medicines (CAM) in the urban centers of Third World countries (e.g., Napolitano 2002), and Chinese medicine in Africa belongs into this under-studied category. It appears as though medical anthropologists consider the First World to have CAM and the Third World to have TM, traditional medicines (the latter have been widely discussed in Kenya, see, e.g., Beckerleg 1994; Parkin 1995; Giles 1999; Geissler and Prince 2010).2 Third, particular patterns of mobility emerged from these narratives, patterns which—in good medical anthropological fashion—put the individual center-stage. They also highlight how little researched these patterns of mobility are.3 Importantly, South–South relations, or more precisely, East–South relations have only recently attracted the interest of social scientists,4 and even 296 ELISABETH HSU though China–Africa relations have now become a hot topic in the political sciences, ethnographic studies are still fairly limited (but see Haugen and Carling 2005; Dobler 2008; Hsu 2002, 2007, 2008). With regard to Chinese patterns of mobility, the finding that in Tanzania Chinese medical doctors mostly originated from northeastern China (Hsu 2002), rather than from the old sending areas of southeastern China (e.g., Pieke 2007: 83), pointed to a newly emerging sending region (Xiang forthcoming). The finding that in Kenya many Chinese medical doctors came from Shandong province, by contrast, falls into another well-known pattern of migratory flows between defined areas of origin and destination5: one Chinese medical doctor, who formerly had worked as a medical expert in one of the many Shandong medical teams sent on two-year missions to Tanzania and who shortly after his return to China had chosen to emigrate to Kenya, invited many Chinese medical physicians to work with him on his Kenyan premises, most of whom thereafter independently set foot elsewhere in the country. The narratives reveal what could be interpreted as push and pull factors. on the one hand, they concern individuals who not infrequently had enjoyed a secure livelihood in the People’s Republic of China (PRC) during the Cultural Revolution (1966–1976) but lost it due to the economic reforms that have taken place from 1978 until today.6 on the other hand, they highlight certain conditions of the Kenyan health system that have facilitated the incursion of Chinese medical health provision. They touch on well-known problems within Kenyan biomedicine, where overwork, burnout syndromes, and an excess of red tape mutually reinforce each other in a downward spiral (Iliffe 1998: 169–199; Raviola et al. 2002), and where the profession is weakened by a relentless exodus of trained medical and paramedical personnel. However, to speak of push factors in the PRC and pull factors in Kenya would oversimplify the issue. Rather, this East–South medical transfer testifies to dynamics that recently have affected global health at large. The medical experts interviewed openly declared of themselves that they made their living as business people, a finding that can be understood only in the light of the economic reforms in the PRC and of the current global trend toward the commercialization of health care. Biomedical ideology...

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