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AO: notes the importance of flooding in thinking about malaria disease.
AO: Tichenor writes a one paragraph summary of her data collection methods which included fieldwork between 2011 and 2014 (unclear if it was continuous). She does not describe any data storage or sharing mechanisms.
AO: Tichenor notes that the Senegalese media undermined the moral arguments that framed the unions’ strike and focused on the irresponsibility of health workers and how “they were making it impossible for the country to reach the Millennium Development Goals by 2015.” (443)
Notes the moral undertone of providing or withholding data (444)
AO: Tichenor notes that data collection takes many forms. Diagnostic data are the skeleton upon which a representation of malaria in Senegal is estimated. The data that stand in for Senegal from the global malaria perspective are based on approximate diagnoses performed by nurses, physicians, and laboratory technicians and involves a process of “filling out” data that raises questions about data ownership, utility, and representativeness.
AO: Tichnor notes the multiple challenges with defining malaria, including the changing standards (between clinical reporting of Malaria to microscophy testing in 2008); experiences of different malarias; continued ambiguity in diagnostic method. These lead to very rough “approximations” that Tichenor argues is a key part of mapping global boundaries of malaria.
AO: “The data the Ministry demands from health workers do not represent, by design, the local realities.” (444)
AO: the production of quantitative diagnostic data about malaria through microscopy analysis and clinical tests in labs in Dakar, Senegal.
AO: Using STS (Austin 1975) and feminist (Butler 2006) literature on performativity, Tichenor talks about “data performativity” or the way that words do more than just describe the world but in fact enact realities and categories are performed. She cites Callon (2006) and Erikson (2012) to describe the work that global health and scientific numbers do or the place they have in maintaining health systems in places that receive global health funding.
AO: Tichenor writes: “Data performativity, then, indicates the ways that data collection and synthesis maintain the model that funding agencies construct, reifying both the definitions of health problems and the power relations embedded within global health glows of capital, technology, and knowledge.” (437)
AO: Tichenor engages with the literature on malaria including history of the disease; labor of health workers; critiques of the business of global health; and STS work on performativity.
AO: Tichenor notes how the data production strike was discussed by media as undermining the country’s attempt to achieve the MDGs.
AO: Tichenor notes how WHO recommendations on diagnostic practices shape national protocols in Senegal and determine who is eligible for global health funding. She tracks the history of diagnostic of malaria and its relationship to capital investments by WHO and Gates foundation (and UN MDGs).
AO: Tichenor also notes how the increase in “public-private partnerships” for global health development goals has contributed to the rule of economically focused performance-based funding models for short-term, “efficient” solutions to complex health problems (440)
AO: Tichenor is worried about how the complex realities of global health in Africa are simplified through the generation of data that makes it easier to address the “problem” with “front-line” tools that development and global health organizations have like insecticidal nets (437). She notes a return to technological fixes to health problems, despite critiques of the individual disease eradication campaigns from the 1980s.
AO: Tichenor illustrates how the practices of certainty and exact “data” do not align with the differential meanings and spaces of understanding “malaria.” Despite the genre of the journal article, she is able to touch on nearly all levels of analysis. Her techno analysis and macro analysis are especially strong and she shows the interlinking between the growing global political will and focus on eradicating the “health problem of malaria” (with success being tracked via quantitative metrics) with the need for performativity of data at the local level.
AO: Tichenor is explicit in saying that malaria and all health problems in Senegal are in fact labor and infrastructural problems. She notes how difficult it is to disrupt the vision that global health problems can be addressed by the enumeration of short-term technological fixes.