Abstract
In India, where there is no centralized medical records system, biomedical care providers rely on families to explain their child’s illness and to carry records of any previous treatment the child may have received. Drawing on discussions of documentation, I argue that in the context of medical treatment for pediatric seizures, (1) families collect medical records to enable and shape their child’s medical treatment, and (2) such a merging of medical and familial care is necessitated by the nature of their child’s illness and the structure of the Indian healthcare system. Based on ethnographic fieldwork in Meerut and New Delhi, this paper attends to practices of record keeping to understand the demands biomedical institutions place on families for the treatment of their child’s seizures. I examine the creation, maintenance, and movement of medical records to suggest that documents are a point of intersection between medical and kinship practices. They are artifacts of care that can narrate parallel histories of a patient’s illness and family-clinician efforts to alleviate a child’s suffering.
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Notes
One way of classifying seizures is by type: provoked and unprovoked. Provoked seizures can be traced back to a stimulus, such as flickering light, or activity, such as reading. Unprovoked seizures are divided into symptomatic and idiopathic seizures. The former stem from a particular cause within the patient’s body, such as meningitis or encephalitis. Idiopathic seizures, on the other hand, are believed to have a genetic basis.
Only five percent of households are enrolled in some form of health insurance program (Singh and Kumar 2016). Thus, the majority of expenditures on healthcare are out of pocket, dependent on a family’s current income and savings.
As Das et al. (2016) describe: “Provider qualifications range from MBBS degrees to no medical training at all, and clinics can range from well-equipped structures to small one-room shops, the provider’s residence, or the patients’ home for providers that make home visits.”
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The author, Katyayni Seth, declares that they have no conflict of interest.
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