Stanford University, Center for International Security and Cooperation, USA.
Soc Sci Med. 2022 May;301:114903. doi: 10.1016/j.socscimed.2022.114903. Epub 2022 Mar 19.
In a crisis, there is widespread recognition and acceptance that not all lives can be saved. But whose lives can legitimately be saved and who decides? Recent scholarship has begun to examine how refugees perceived as 'vulnerable', such as women and children, are frequently prioritized over other groups in humanitarian responses. Such analyses, however, fail to adequately explain why some groups - such as older persons - are considered vulnerable and yet are largely neglected. Based on the case of older Syrian refugees in Jordan, this article critically examines the ways in which humanitarian health actors make sense of the humanitarian principle of 'impartiality' in the face of limited resources. Based on 61 interviews and observational data collected in Jordan between 2017 and 2019, my results show that humanitarians routinely classify older refugees as 'vulnerable' and in need of medical assistance. Yet I find that three neoliberal considerations - including perceptions of the reduced lifespan, disproportionate disease burden, and limited contributions to the economy of older refugees - make this demographic low 'value for money'. This article expands our understanding of how medical humanitarian understandings of 'deservingness' are increasingly shaped by market-driven logics, and how these (re)create ageist, gendered and racialized hierarchies within refugee health.
在危机中，人们普遍认识到并接受并非所有生命都能得救。但是，谁的生命可以合法地被拯救，以及谁来决定呢？最近的学术研究开始探讨被视为“脆弱”的难民，如妇女和儿童，如何在人道主义反应中经常优先于其他群体。然而，这种分析未能充分解释为什么一些群体，如老年人，被认为是脆弱的，但却在很大程度上被忽视。本文以在约旦的老年叙利亚难民为例，批判性地审视了人道主义卫生行为者在资源有限的情况下如何理解人道主义的“中立”原则。本文基于 2017 年至 2019 年期间在约旦收集的 61 次访谈和观察数据，研究结果表明，人道主义者通常将老年难民归类为“脆弱”，需要医疗援助。然而，我发现有三个新自由主义的考虑因素，包括对预期寿命缩短、疾病负担不成比例以及老年难民对经济贡献有限的看法，使这一人群的价值相对较低。本文扩展了我们对医疗人道主义对“应得性”的理解，即越来越受到市场驱动逻辑的影响，以及这些逻辑如何在难民健康领域内重新创造出年龄歧视、性别歧视和种族主义的等级制度。
