Réparer des cæurs, façonner des enfants. Trajectoires d'enfants béninois et togolais bénéficiant d'interventions chirurgicales en Suisse
Details
Serval ID
serval:BIB_07C0C3E0DC12
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
Réparer des cæurs, façonner des enfants. Trajectoires d'enfants béninois et togolais bénéficiant d'interventions chirurgicales en Suisse
Director(s)
Panese Francesco
Institution details
Université de Lausanne, Faculté des sciences sociales et politiques
Publication state
Accepted
Issued date
2023
Language
french
Abstract
Les cardiopathies congénitales sont les malformations congénitales les plus répandues à la naissance à travers le monde. Les progrès spectaculaires de la chirurgie cardiaque depuis les années 1950 se limitent cependant aux pays dits industrialisés, 90% des enfants nés avec une cardiopathie congénitale vivant dans des régions ne possédant pas d'accès adéquat au diagnostic et aux soins. Visant à pallier ces inégalités de santé, certaines ONG mettent sur pied des programmes de « transfert médical » permettant à des enfants ouest-africains de voyager vers l'Europe en vue d'interventions chirurgicales salvatrices, également motivées par des logiques dépassant l'humanitaire. Cette thèse porte sur l'expérience d'enfants béninois et togolais souffrant de cardiopathies congénitales et voyageant seuls vers la Suisse dans le cadre de leur prise en charge par un tel dispositif. À travers une ethnographie itinérante, sensorielle et impliquée d'une durée de 18 mois, j'ai suivi et accompagné 81 enfants âgés de deux mois à 16 ans à une ou plusieurs étapes de leur trajectoire en Suisse, au Bénin et au Togo. Ce travail explore la manière dont les profondes inégalités d'accès à la santé ainsi que les représentations des relations entre pays du « Nord » et pays du « Sud » façonnent le type de soins dont ces enfants bénéficient. Cette thèse permet de valoriser le travail-pratique, émotionnel, de care -des acteur·trice·s impliqué·e·s dans la trajectoire des enfants. Elle documente la participation active, bien que souvent silencieuse, discrète et peu reconnue, des enfants - y compris des bébés - à leurs soins et à ceux d'autres enfants. Questionnant certaines représentations générationnelles, culturelles et de genre, elle souligne ainsi la coexistence, chez la totalité des acteur·trice·s, de vulnérabilités et de capacités d'agir, s'exprimant à des degrés divers selon les contextes. Le fait d'accompagner les enfants à plusieurs étapes du dispositif permet de mettre en évidence leur façonnage biologique, identitaire et moral au fil de leurs déplacements à travers des espaces géographiques, institutionnels et moraux différents de ceux qu'ils connaissent. Cela permet également de souligner les effets inattendus et non-souhaités des politiques d'aide humanitaire, qui participent à maintenir des inégalités d'accès au cure et au care. La décision prise par l'ONG de se retirer du programme en 2022 et les tensions qu'elle génère témoignent finalement des questionnements en cours au sujet des valeurs qui animent le champ de l'aide humanitaire.
--
Congenital heart defects are the most common type of congenital defect worldwide. The spectacular progress of heart surgery since the 1950s have however been limited to so-called industrialized countries. Indeed, 90% of children born with a congenital heart defect live in regions that do not have "adequate" access to diagnosis or treatment. To address this unequal access to healthcare, some Western NGOs have built humanitarian programs of "medical transfers," where West African children are brought to Europe for this life-saving surgery. Whilst these programs do participate in "saving children 's lives," they are motivated by logics beyond the humanitarian. This dissertation explores the experience of Beninese and Togolese children who traveled alone to Switzerland as part of a humanitarian medical transfer program. Over 18 months of itinerant, sensory and engaged fieldwork, I followed and accompanied 81 children (aged two months to 16 years old) at one or more stages of their trajectories, from Benin and Togo to Switzerland and back. I examine how deep inequalities in access to health, as well as representations of relations between countries of the global "North" and countries of the "South" shape the kind of care these children receive. In bringing to light the challenges that enrolled children and their families face, this thesis shows the practical, emotional and care work of al! the actors who are involved in the children's trajectories. As such, it highlights the active, albeit often silent, discreet, and unacknowledged participation of children - including babies - in their care. Questioning perceptions of generational, cultural, and gendered differences, I underline the coexistence - in children and in adults - of agency and vulnerabilities, expressed to varying degrees depending on the contexts. Accompanying the children at several stages of their trajectories brings out the way children's biology, identity and morality are shaped as they travel through geographical, institutional, and moral spaces that are sometimes different from those they are used to. lt also allows to underlie the unexpected and undesired effects of humanitarian aid policies, which paradoxically contribute to maintaining certain inequalities m access to cure and care. I close with the decision by the NGO to withdraw from its medical transfer program in 2022 and the tensions it created. This withdrawal speaks to ongoing questions about and transformations of the moral values that underlie the field of humanitarian aid.
--
Congenital heart defects are the most common type of congenital defect worldwide. The spectacular progress of heart surgery since the 1950s have however been limited to so-called industrialized countries. Indeed, 90% of children born with a congenital heart defect live in regions that do not have "adequate" access to diagnosis or treatment. To address this unequal access to healthcare, some Western NGOs have built humanitarian programs of "medical transfers," where West African children are brought to Europe for this life-saving surgery. Whilst these programs do participate in "saving children 's lives," they are motivated by logics beyond the humanitarian. This dissertation explores the experience of Beninese and Togolese children who traveled alone to Switzerland as part of a humanitarian medical transfer program. Over 18 months of itinerant, sensory and engaged fieldwork, I followed and accompanied 81 children (aged two months to 16 years old) at one or more stages of their trajectories, from Benin and Togo to Switzerland and back. I examine how deep inequalities in access to health, as well as representations of relations between countries of the global "North" and countries of the "South" shape the kind of care these children receive. In bringing to light the challenges that enrolled children and their families face, this thesis shows the practical, emotional and care work of al! the actors who are involved in the children's trajectories. As such, it highlights the active, albeit often silent, discreet, and unacknowledged participation of children - including babies - in their care. Questioning perceptions of generational, cultural, and gendered differences, I underline the coexistence - in children and in adults - of agency and vulnerabilities, expressed to varying degrees depending on the contexts. Accompanying the children at several stages of their trajectories brings out the way children's biology, identity and morality are shaped as they travel through geographical, institutional, and moral spaces that are sometimes different from those they are used to. lt also allows to underlie the unexpected and undesired effects of humanitarian aid policies, which paradoxically contribute to maintaining certain inequalities m access to cure and care. I close with the decision by the NGO to withdraw from its medical transfer program in 2022 and the tensions it created. This withdrawal speaks to ongoing questions about and transformations of the moral values that underlie the field of humanitarian aid.
Create date
30/08/2023 8:53
Last modification date
31/08/2023 6:00