Gross Corina Salis
Institut für Ethnologie der Universität Bern, Switzerland.
Cult Med Psychiatry. 2004 Jun;28(2):151-67; discussion 211-20. doi: 10.1023/b:medi.0000034408.60968.eb.
This article discusses some effects of migration politics on asylum seekers and refugees and on the Swiss health services. It is based on multisited ethnographic research that tracked interpretative concepts of the refugee experience. Following a grounded theory approach, it identifies imaginaries of trauma and trust as key categories in the field of transnational migration and health. The psychiatric concept of trauma and a more popularized discourse of traumatic memory are strongly emphasized in all of the investigated field sites: the providers of primary health care and psychosocial services and representatives of social welfare agencies and law-making bodies use this "diagnosis" extensively. This leads refugees to develop tactics of a) identifying with the trauma discourse in order to become "good refugees" and achieve legal status in Switzerland; b) struggling with the ascribed pathologies and suffering from retraumatizing effects of these predominant trauma policies; and c) trying to refuse or subvert them by emphasizing the existence of structural violence in the receiving countries. An analysis of the interactions of health providers and refugees shows that it takes place in an environment of social and economic insecurity and in a shared imaginary of (mis)trust, putting at stake the moral economy of recent migration politics and the refugee experience.
本文探讨了移民政策对寻求庇护者和难民以及瑞士医疗服务的一些影响。它基于多地点的民族志研究,该研究追踪了难民经历的解释性概念。遵循扎根理论方法,它将创伤和信任的想象确定为跨国移民与健康领域的关键类别。在所有被调查的实地场所,创伤的精神病学概念以及更普及的创伤记忆话语都得到了强烈强调:初级医疗保健和心理社会服务提供者以及社会福利机构和立法机构的代表广泛使用这种“诊断”。这导致难民形成了以下策略:a)认同创伤话语,以便成为“好难民”并在瑞士获得合法身份;b)与被赋予的病态作斗争,并遭受这些占主导地位的创伤政策的再次创伤影响;c)通过强调接收国存在结构性暴力来试图拒绝或颠覆这些政策。对医疗服务提供者与难民之间互动的分析表明,这种互动发生在社会和经济不安全的环境中,以及在(不信任的)共同想象中,这危及了近期移民政策和难民经历的道德经济。