Infection Prevention and Control (IPC) is considered to be the foundation for reducing healthcare associated infections (HAIs), the spread of antimicrobial resistance (AMR), and the containment of emerging pathogens in healthcare settings (Tomczyk et al. 2022). The Robert Koch Institute, represented by the Center for International Health Protection (ZIG), has established partnerships to build IPC capacities at the only tertiary level hospital in Côte d’Ivoire located outside of Abidjan – the Centre Hospitalier et Universitaire de Bouaké CHUB – and the Hôpital Régional de Faranah located in the Upper Guinea region, one of the most underserved areas in Guinea. My research provides an analysis of the IPC capacity building activities embedded in this partnership.

I make use of the concept “traveling models” to underpin the journey that links Germany’s Public Health Institute and the hospitals in West Africa. Building on, and expanding, approaches to the study of traveling models, which have focused on the travel of a development policy and the possible shortcomings related to its implementation and the expected social change (Behrends et al. 2014; Olivier de Sardan 2021), I conceptualize the IPC model as a complex network made of several actors (patients, families, healthcare workers, public health “experts”, microbes, infections, bacteria). In this way, I seek to enrich the understanding of IPC by following different paths that compose this network to unravel how infections are studied, lived and experienced by humans, the other-than-humans, the objects, the spaces, the materials and the technologies that make up the hospital universe where the global health discourse on IPC is expected to be lodged. My positionality in the partnership as ethnographer and at the same time part of the implementation team allows me to trace the inside and the outside of this network. Methodologically, this involves the undertaking of a multispecies, multi-sited ethnographic approach. The capacity building strategies from the partnership can trigger these more-than-human assemblages.

In order to understand and analyze the IPC network from the partnership, my research draws on science and technology studies. It further includes critical perspectives on global health from a medical anthropology viewpoint as well as affect theories and felt spaces. I focus my analysis on three different dimensions of this network, each with its own logic (Mol 2008) that reveals distinct but interconnected infectious trajectories. In the first place, I examine an infectious itinerancy from patients, their families and their caregivers which encompasses an embodied logic of movement within the hospital that allows the enactment (Mol et al. 2003) of infections and the galvanization from the infectious space. Secondly, I track the momentum acquired by bacterial infections at the hospitals due to the partnership-funded research on surveillance of healthcare-associated infections. Lastly, I address laboratory logics to underpin a more-than-human interaction between humans and bacteria that stands at the crossroads of the infectious itinerancy and the infectious momentum analyzed in the previous two dimensions.    

My research aims at providing ethnographic insights on the IPC capacity building strategies from this particular partnership in order to highlight blind spots, grey areas and points of tension while contributing to medical anthropology by advocating for a multispecies approach within the medical space and in global health partnerships.

Funding: This project is co-funded by the Global Health Protection Program (GHPP), Center for International Health Protection (ZIG) at the Robert Koch Institute (RKI) and the Deutscher Akademischer Austausch Dienst (DAAD).

Duration: 2023-2026

References:

Behrends, Andrea, Park, Sung-Joon, and Rottenburg, Richard (2014), Travelling models in African conflict resolution : translating technologies of social ordering / edited by Andrea Behrends, Sung-Joon Park, Richard Rottenburg (Africa-Europe Group for Interdisciplinary Studies, Volume 13; Leiden, Netherlands: Brill).

Mol, Annemarie (2008), The logic of care : health and the problem of patient choice / Annemarie Mol (London ; New York: Routledge).

Mol, Annemarie, Smith, Barbara Herrnstein, and Weintraub, E. Roy (2003), The Body Multiple : Ontology in Medical Practice (Science and Cultural Theory; Durham: Duke University Press).

Olivier de Sardan, Jean-Pierre (2021), La revanche des contextes: Des mésaventures de l’ingénierie sociale, en Afrique et au-delà.

Tomczyk, Sara, et al. (2022), 'The first WHO global survey on infection prevention and control in health-care facilities', The Lancet Infectious Diseases.