The Ironies of Freedom: Sex, Culture, and Neoliberal Governance in Vietnam

3 The Rise of the Empirical and the Case of Medical Expertise: A Genealogy of Governance

CHAPTER 3 The Rise of the Empirical and the Case of Medical Expertise A Genealogy of Governance IN PART 1, I SHOW how neoliberal choice in entrepreneurial decisions and consumption shaped the sex trade as Vietnam marketized primarily from the late 1980s to the mid-1990s. In part 2, I examine how the governmentapproachedprostitutionasasocialproblemthroughpublic health, policing, and rehabilitation measures and in doing so show the shiftfromstatesocialismtowardtwosimultaneousmodesof governance that were based on both choice and coercion and were more amenable to the global market economy. Fromthe1950s,theVietnameseCommunistPartyanditsstateapparatuses sought to curb the autonomy of knowledge, folding them into an all-encompassing party-state. This process was most evident in the state’streatmentof expertsandintellectualsduringtheNhânVăn–Giai Phẩm affair of the mid-1950s and the anti-revisionist campaign of the early 1960s. I argue that the feature distinguishing state socialism as led by a Leninist party is not repression per se but the rejection of an imagined social realm separate from the state. The case of medicine illustrates how the socialist state had started to useexpertandempiricalknowledgeduringmarketization.Theincreasing use of expert medical knowledge was symptomatic of a reimagined relationship between the erstwhile all-encompassing socialist state and asocietyseparatefromit.Thesocialiststatecametoresemblemoreand more a government in relation to society. Medicine as a body of knowledge became important in the government’s dealing with prostitution throughpublichealthmeasures.Itisthroughthesehealthmeasuresthat a mode of governance based on knowledge and choice emerged. 65 EXPERTISE IN SOCIALIST GOVERNANCE The changing place of expertise in governance can be seen in the shift in the relationship between state and society from socialism to market. The two historical episodes mentioned best exemplify the socialist mode of governing. Besides artistic conflict, the Nhân Văn–Giai Phẩm affairandtheanti-revisionistcampaignlessthanadecadelateralsoillustratetherelatedstrugglebetweenthepartyandexpertsandtheirexpert ise . In modern forms of government, including governance by Leninist partiessuchastherulingCommunistpartiesinstatesocialistcountries, expertise occupies an important place. Why then would one find the new socialist government waging a fierce battle against experts? Analyses of the “totalitarian model” that stress how rulers use expert knowledge as a tool to control and manipulate the population according to the political ends of the regime are not unfamiliar.1 By comparison , proponents of the industrial convergence model point to the tendency even in Leninist systems toward rule by expert knowledge as a result of the demands of advanced industrial economies.2 Mark Beissinger points out that both models entail a unidirectional developmentof Leninistsystemstowardmoretotalcontrolinthefirstcaseand towardmoreautonomyforexpertsandtheirexpertiseinthesecondcase.3 Beissinger instead uses organizational theory to suggest that there is a contradiction or tension inherent in bureaucratic organization of hierarchical discipline, on the one hand, and pursuit of rational goals, on the other.4 The inherent tension here is that between the requirement forcohesionunderpartyruleensuredbyhierarchicalcommandandthe goal-fulfillingtasksrequiringexpertiseinvolvedinrunningacommand economy. Compared to the more familiar totalitarian and convergence models,Beissinger’ssuggestionexplainsbetterthehistoricalcyclesof promotion of expertise and its political suppression in Leninist societies. However,thereisalsoatensioninBeissinger’sapplicationof generalorganizational theory to Leninist systems. On the one hand, he claims that Leninist systems fall prey to the same contradiction besetting bureaucraticorganizationingeneral .Ontheotherhand,Marxist-Leninistideologymakesitswayintohistheoryfromanexternalpositionasthesource 66 Part II. The Real and the True of the “technocratic utopianism” behind the command economy. As a result, Beissinger mentions the historically recurring official concerns over the class status of experts but does not fully account for such ideological consideration in his organizational explanation. THE STATIZATION OF EXPERTISE AND LENINIST GOVERNANCE IN VIETNAM Inmyanalysisof knowledgeandgovernanceinVietnambeforethestart of economic liberalization, I benefit from Beissinger’s insights into this tension in Leninist governance as coming from the need for both expertiseandcohesionthroughhierarchicalcontrolbytheLeninistparty. However, my purpose is not to advance a better theory to account for the use of knowledge and Leninist governance. Rather, from an examination of cycles of tension over expertise in the history of socialist Vietnam,Ishowhowgovernancewasbeingimaginedinrelationtosociety . In this sense, I look at the bourgeois class designation of experts ill accountedforinBeissinger’sorganizationaltheory.Butratherthanchalk it up to the party’s ideological assertion of class struggle, I suggest that it points to a certain mentality of governing in which there was no conception of a realm, such as “society,” separate from the political state. This mentality was again evident in the assertions by the party of a raisond ’étatinitswartimeforeignpolicyoverthedangersposedbyexperts. Atthebeginningof theanticolonialwar,thepartyhadidentifiednative possessors of Western knowledge, such as doctors, engineers, lawyers, and those in the natural, technical, and human scientific disciplines, as belonging to the bourgeois class, whose interests essentially conflicted with those of the revolution. Western knowledge was part and parcel of themissioncivilisatriceof colonialrule,whichhadtobereformedand put to new uses in a new culture of anticolonialism and socialism.5 This ambivalencewasmaintainedatvarioushistoricalmomentsintheparty...