UCSF

Balochistan, the largest Province in Pakistan, where more than ninety percent of births are attended by traditional midwives- outside of hospitals-functions as a site whose geography and population are racialized across multiple scales in colonial and postcolonial Pakistani state discourses. It is part of a region economically marginalized and divided between Pakistan, Iran, and Afghanistan. Through an ethnography of local medical practices and national development policies and analysis of discourses operating across these different scales, I address the relations between local midwives' practices, their knowledge about reproductive health and plant medicines and the historical and contemporary policy construction of their identities and social worth in the context of a multi-ethnic society. I examine political technologies of intervention to deconstruct the mechanisms by which the contemporary marginalized group of healers (local midwives), Balochi medicine, and Balochistan is represented through gender and racialized terms of 'backward tribes'.

In particular, I address how colonial medical practices and present flows of scientific knowledge informing biomedical and health development agendas intersect to influence contemporary power structures and the medicalization of the social body in Pakistan. I elucidate the latter context and link it to delineate how this impacts healing practices in Pakistan, shaping and constituting dais' (midwives) work and the production of dais' and biomedical practitioners' identities. Principally, I argue that epistemological and material violence are inseparable. That is, the discourses about "traditional birth attendants" enable a type of invisible violence against both them and the large number of women in Pakistan who rely on them. I argue that the conditional inclusion of local midwives is the violence that restructures social relations outside of the bio-medical context such that while the aim is to advance women's health, in fact it often damages it by producing new and reinforcing old hierarchical structures. Informed by a vast and multi-dimensional archive including ethnographic research comprising: interviews with local midwives, childbearing women, biomedical practitioners, policymakers, and government officials; archival research of organizational documents; print media; and the existing and historical literature on reproductive health and midwives, my research contributes to the understanding of an understudied region and people.