Cancer Itineraries Across Borders in Post-invasion Iraq: War, Displacement, and Geographies of Care

Recent studies have documented how successive wars and sanctions have led to a deterioration of the Iraqi national health care system and the emergence of geographies of care spanning beyond the borders of the state. Focusing specifically on cancer and oncology, this dissertation develops an ethnography of these geographies by accompanying patients and their companions across provinces and borders in the pursuit of treatment. In post-invasion Iraq, lack of security and an absence of meaningful reconstruction compels an increasing number of cancer patients from central and southern Iraq to piece together treatments through movement. They travel northward to the emerging public oncology hubs of Kirkuk, Erbil and Sulaymaniyah in addition to regional private centers in Amman, Istanbul and Beirut. The ethnography follows such illness journeys over multi-year periods, accompanying patients as they traverse sites of treatment in Iraq and Lebanon. These itineraries constantly intersect with ongoing conditions of war and forced displacements, in addition to violent events from past wars that remain imprinted on the body and the roadways. Part I is an attempt to engage with conversations in medical oncology, geography, and refugee studies – fields that shape health policy in the region. In keeping with this genre of scholarship the material is molded into case studies, drawing from hospital-based fieldwork in Sulaymaniyah, Kirkuk, Erbil, and Beirut. The cases extend beyond the circumscribed spatiality of the hospital through a methodology of accompaniment between sites of treatment. Part II consists of an extended ethnographic study of a single patient's cancer journey. It shows how changing dynamics of conflict shape the kinship network’s evolving justifications for either granting or withholding resources towards high-cost cancer treatments. The ethnography eventually moves with the patient across borders to Lebanon’s oncology centers. Following a cancer itinerary across borders reveals how a wide array of non-medical actors are brought into the scene of care through movement, indicating that Iraq's emerging geographies of cancer care are not solely oriented towards the healing promised by biomedicine. The study reworks anthropological understandings of the spatial, social, and temporal breadth of chronic illness in a region of war