Contesting Measles and Vaccination in Pakistan

Inayat Ali is in charge of the Department of Public Health and Allied Sciences and Assistant Professor in the Department of Anthropology at Fatima Jinnah Women University, Rawalpindi, Pakistan. He is also a Research Fellow in the Department of Social and Cultural Anthropology at the University of Vienna, Austria.

• Preface by Merrill SingerPrologue Introduction1 Many Anthropologies: Reflections on Theoretical Threads and the Medical Anthropology of Pakistan2 Researchlogue: Design, Methodology, and Circumstances of Data collection 3 The Setting: From Sindh Province to the Sindhi Villages4 Competing Healthcare Systems: Revisiting Medical Pluralism in Pakistan5 Health and Illness: Socio-cultural Understanding6 Local Rituals of Containment: Emic Perceptions and Practices around Measles7 Social Dramas: Two Measles Outbreaks and Multiple Narratives in Pakistan8 The Critical Geopolitical Events: Making Sense of Anti-Vaccination Sentiment9 National and Global Rituals of Containment: Controversies, Contestations, and Mistrust Surrounding Vaccination in Pakistan10 Measles Vaccine: From General to Particular 11 Creating an Anthropology of Vaccination: The International "Anti-Vaxx" Movement and Multiple Narratives Conclusions: Interrelations between Measle’s Sacredness and Systematic Disparities EpilogueBibliography

"This exciting ethnographic account of the measles epidemic in Pakistan, focuses on the ultimate causes of vaccination resistance. While biomedical and global public health officials point to 'backward' cultural beliefs and behaviors and the irrational embrace of conspiracy theories (e.g., vaccination is a plot to achieve Muslim sterilization), Inayat Ali reveals the fundamental role of socioeconomic inequality, locally, nationally, and globally, in fueling the measles epidemic in his country. Moreover, Ali mobilizes the social insights of Foucault on the social distribution of power, and the ideas of various medical anthropologists, to affirm measles vaccination avoidance in Pakistan as an expression of resistance." - Merrill Singer, University of Connecticut, USA"A credible research resource, addressing a public health issue through anthropological lens, for public health professionals, practitioners, and policy makers particularly relevant to Pakistan in the COVID-19 pandemic affected health care systems and vaccination programs. Inayat Ali has examined the issues surrounding measles in the larger context of fragile health system and inequitable social structures of Pakistan. He illustrates that the disease outbreaks are indeed the outcome of competing narratives, inequalities, and social conflicts. This dimension is largely missing in the public health professionals’ dialogues. His work is guided by theoretical and methodological frameworks that have relevance to other public health problems. The author argues the need for a comprehensive effective governance approach to deal with global Covid 19 pandemic as well as draw upon a deep understanding of vaccine hesitancy to improve the vaccination programs. A must read for public health professionals." - Saima Hamid, Fatima Jinnah Women University, Pakistan