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Blind Spot: How Neoliberalism Infiltrated Global Health (California Series in Public Anthropology) Paperback – August 16, 2014

4.6 out of 5 stars 7 customer reviews

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Editorial Reviews

Review

"An accessible summary of the rise of neoliberalism following World War II and its impact on global health and development programs into the late 20th century and beyond. . . . A valuable resource."--Kristin E. Yarris"American Journal of Human Biology" (06/01/2015)

From the Inside Flap

"This excellent historical-anthropological case study documents how the market-based ideology of neoliberalism has shaped global health and development policy since the 1980s.  Despite evidence to the contrary, this unquestioned (and ultimately harmful) set of ideas became the 'common sense' basis of a problematic health reform effort.  With a sympathetic eye towards NGOs and local health practitioners in poverty-stricken Tajikistan, Keshavjee shows how a particular program failed but the underlying assumptions remained unstoppable. This elegantly written book exemplifies the power of shifting the anthropological analytical gaze to the social processes of policy formation that exacerbated the horrific post-Soviet mortality crisis."—Peter J. Brown, Professor of Anthropology and Global Health, Emory University

"All newcomers to the work of global health should read this book. Writing elegantly about the devastating effects of the Bamako Initiative, but more importantly about the history of neoliberalism itself, Keshavjee offers a cautionary lesson to those who are still enthusiastic about allowing market-driven policies to guide our global health work. Indeed, the case of reduced access to drugs in the post-Soviet Tajikistan community of Badakhshan presents a stunning example of the hypocrisy, ideological blindness, and institutional failures that allowed the principles of supply side economics to both inform the provisioning of health care resources and, ultimately, derail even the best intentions of many a good NGO or global health worker, including physicians like Keshavjee himself. Blind Spot is a quick and pithy study of a problem that refuses to go away."—Vincanne Adams, Professor of Medical Anthropology at the University of California, San Francisco, and author of Markets of Sorrow, Labors of Faith: New Orleans in the Wake of Katrina

"Blind Spot provides a singularly nuanced critique of neoliberal health policies as they play out on the ground in a desperately impoverished, post-war, post-Soviet setting. Taking readers from the boardrooms of Geneva to the high mountains of Tajikistan, this book is bound to become a classic in medical anthropology and critical global health studies. There is no other book quite like it."—Marcia Inhorn, William K. Lanman Jr. Professor of Anthropology and International Affairs at Yale University

"Keshavjee's Blind Spot is quite possibly the most important ethnography of social development under neoliberalism applied to health that has been written to date. It is a telling moral lesson in how humanitarian assistance--despite its noble intentions--fails and actually at times even intensifies social suffering."—Arthur Kleinman, Harvard University
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Product Details

  • Series: California Series in Public Anthropology (Book 30)
  • Paperback: 288 pages
  • Publisher: University of California Press (August 16, 2014)
  • Language: English
  • ISBN-10: 0520282841
  • ISBN-13: 978-0520282841
  • Product Dimensions: 6 x 0.7 x 9 inches
  • Shipping Weight: 14.4 ounces (View shipping rates and policies)
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (7 customer reviews)
  • Amazon Best Sellers Rank: #726,435 in Books (See Top 100 in Books)

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Most of the other reviews posted here discuss the merits of the Blind Spot as an academic work. The positive reviews aptly describe what is an exemplary (as well as uncommon) ethnographic and geo-political analysis. And, as a professional in health care and student of public health, I believe the Blind Spot is a must read.

However, what author Salmaan Keshavjee is able to accomplish in the Blind Spot is much more. Through thoughtful organization and narration, Keshavjee has crafted an intelligent, humanistic story that should (and importantly could) be read by a broader audience.

Written in a clear and accessible voice, Keshavjee takes you on a journey through an otherwise complicated and muddled history. His narration encourages the reader to drop any pretense and engage in a frank dialogue about the world’s ideological foundations. Like a conversation with a close friend, Keshavjee leaves you eager to discuss more, mulling over perspectives previously unexplored.

Perhaps most importantly, Keshavjee illustrates that even looking back today, hindsight is not 20/20—we still have much, and need, to learn. To this end, the Blind Spot is an important step towards learning a better way forward. Further Keshavjee’s voice ensures that his work will preserve its relevance over the years to come.
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Format: Paperback
With some notable exceptions, it's quite rare to find a passionate, critical voice of this kind among those who actively practice in the field as physicians. Presumably this lack of broad analysis of the political economy of global health is due to experts' reluctance to criticize colleagues or funders, devotion to reputation only within very specialized fields, and good old fashioned ignorance of how political and funding decisions are made and how structural historical factors influence the outcomes of their work.

Keshavjee as an anthropologist seems willing to dive in here, focusing on a part of the world that is often overlooked in the development and public health literature, post-Soviet central Asia. While the summary has grabbed the major points above, suffice it to say that he has chipped away at the assumption that global health is somehow not burdened by the deep political and ideological struggles that are more openly discussed in other arenas of international policy. It should not be only general "aid effectiveness" that animates the discussions of how health aid should work, but how such work is situated among swirling economic, social, and geopolitical factors.
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Format: Kindle Edition Verified Purchase
This is a profound, provocative book. It will, appropriately, unsettle those who believe "markets" are the best and most just allocators. In healthcare that is simply not the case. While the subject of the case is Tajikistan. more particularly a part of it (Badakhshan), it is really about health, philanthropy, NGOs, and how many well-meaning individuals and organizations have made life worse for many. A reader will not be the same after reading this book.
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Format: Paperback
Salmaan Keshavjee's book is a must-read. He brings together his fieldwork in the Badakshan region of Tajikistan with an incisive analysis of the history of neoliberalism. What he shows us is how ideas like neoliberalism gain power and work themselves right into the operations of NGOs and health programs, often with dire consequences for patients and people living in poverty. For scholars, development workers, policy-makers, or any one interested in global health, reading this book will make you think twice about the "blind spot" in your own work and the ideas circulating around it. If reading this book makes you pause and reflect (as it did for me), Keshavjee will have succeeded and you will be better prepared.
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