During the four years since our project began, similar ideas have been expressed by publicfigures in the national media. A recent example came from the pen <strong>of</strong> a former Member <strong>of</strong>Parliament in the ACT party, Deborah Coddington, who became a senior writer for themonthly magazine, North <strong>and</strong> South (2006:39-47). In an article titled on the cover page,“Asian Angst: Is It Time to Send Some Back?”, Coddington (2006:39) adopted theunmistakable stance <strong>of</strong> “national manager” (Hage 1998:42) which Peters also espoused. Sheargued that “Asian immigration” has brought “murder, extortion, kidnapping, assassinations<strong>and</strong> disease” into New Zeal<strong>and</strong>. She particularly referred to a recent school outbreak <strong>of</strong> TBwhere the initial case was a school boy who had been in New Zeal<strong>and</strong> with his family for fouryears before being diagnosed with tuberculosis. She appeared to assume that a TB ‘test’ in2002 would have prevented the boy developing TB late in 2005 or early 2006 <strong>and</strong> also wouldhave prevented the transmission <strong>of</strong> TB to his school mates (Coddington 2006:45).Hage’s (1998) work on the way in which “others” are incorporated into the national space aspeople who are under constant suspicion <strong>of</strong> destroying or interfering with the way <strong>of</strong> life <strong>of</strong>those entitled to membership by birth, provides a framework <strong>of</strong> analysis for these publicstatements. He uses the term “national managers” to refer to those who imagine that theyhave an entitlement to include or exclude others <strong>and</strong> to define the terms <strong>of</strong> others’ acceptancewithin the national space. Embedded in these TB <strong>and</strong> immigration discourses is a metaphorequating bodily <strong>and</strong> national margins: a version <strong>of</strong> the body politic as theorised by Lock <strong>and</strong>Scheper-Hughes (1987), who built on the earlier work <strong>of</strong> Mary Douglas (1966, 1973).Refugees, asylum seekers <strong>and</strong> migrants in general are seen as having the capacity to invadethe nation, the body politic, in the same way that TB invades the personal body. As aconsequence, attention to control <strong>of</strong> both TB <strong>and</strong> migration is directed to the borders:dangerous <strong>and</strong> ambiguous margins as Douglas demonstrated.As social scientists who are interested in the critical evaluation <strong>of</strong> appeals to xenophobia, <strong>and</strong>racism <strong>and</strong> discrimination against immigrant groups, as well as in underst<strong>and</strong>ing why NewZeal<strong>and</strong> has almost twice the TB notification rate <strong>of</strong> Australia or Canada, we wished to gobeyond the headlines <strong>and</strong> summary statistics to research the relationships betweenimmigration <strong>and</strong> tuberculosis. This goal led us in several different research directions. Ledby Jody Lawrence, we undertook a systematic survey <strong>of</strong> tuberculosis in the media (Lawrenceet al. 2008). We planned studies with communities classified as ‘other’, specifically <strong>of</strong> Asian<strong>and</strong> African origins, as well as with Pacific peoples. We wished to explore their experience <strong>of</strong>TB <strong>and</strong> settlement in New Zeal<strong>and</strong> (see Anderson, Lawrence, <strong>and</strong> Ng Shiu et al., thisvolume). We undertook a review <strong>of</strong> the international <strong>and</strong> New Zeal<strong>and</strong> data on immigration<strong>and</strong> TB to investigate the relationship between them (Littleton et al. 2008). As a result <strong>of</strong> this,<strong>and</strong> provoked by the theme “Beyond Ethnography” for the November 2005 Association <strong>of</strong>Social Anthropologists <strong>of</strong> Aotearoa New Zeal<strong>and</strong> Conference, Park <strong>and</strong> Littleton (2007)argued that, although ethnography is pivotal to our research on tuberculosis, we needed to gobeyond some narrower conceptualisations <strong>of</strong> ethnography in order to sort out the relationshipsbetween tuberculosis <strong>and</strong> immigration <strong>and</strong> to investigate the social justice issues involved.We argued that we needed a multi-disciplinary, multi-level approach, which we haveattempted through the framework <strong>of</strong> political ecology, <strong>and</strong> we needed to ensure our researchresults were addressed to specific public audiences: to engage in public anthropology. Thisbrief chapter draws on <strong>and</strong> summarises all <strong>of</strong> this work. This task has been made a great dealeasier with the publication, late in 2006, <strong>of</strong> two key New Zeal<strong>and</strong> public health epidemiologypapers (Das et al. 2006, Das, Baker <strong>and</strong> Calder 2006).55
Multi-level <strong>and</strong> multi-disciplinary<strong>The</strong> theoretical orientation <strong>of</strong> the New Zeal<strong>and</strong>-based Political ecology <strong>of</strong> TB project (seeLittleton <strong>and</strong> King, Chapter 3) encouraged an approach which was founded in the disciplines <strong>of</strong>the principal investigators: social-cultural <strong>and</strong> biological anthropology, history <strong>and</strong> geography.In addition we found that we needed to draw on epidemiology, public health, medical researchin TB, infectious diseases, <strong>and</strong> immunology, <strong>and</strong> DNA studies, to know where to focus ourresearch <strong>and</strong> writing <strong>and</strong> how to make optimum use <strong>of</strong> our ethnographic <strong>and</strong> historical data. Wecertainly needed to consider the minutiae <strong>of</strong> everyday life, including material conditions <strong>and</strong>livelihoods, social relationships <strong>and</strong> social-spatial networks, peoples’ aspirations, values,underst<strong>and</strong>ings <strong>and</strong> experience, <strong>and</strong> their exercise <strong>of</strong> agency. Interactions between this personallevel <strong>and</strong> health systems <strong>and</strong> policy, the views <strong>and</strong> values <strong>of</strong> those who work within them, <strong>and</strong> arange <strong>of</strong> other structural features at the regional <strong>and</strong> national levels linked the personal to thestructural dimensions. Settlement patterns <strong>of</strong> recent migrants, greatly affected by the availability<strong>of</strong> affordable <strong>and</strong>, in some cases, appropriate, housing, had a direct relationship to the clustering<strong>of</strong> TB cases. Popular culture, especially media representation <strong>of</strong> TB <strong>and</strong> <strong>of</strong> the groups thoughtto be the most affected by it, was implicated in both the personal <strong>and</strong> structural dimensions.Historical political processes, including transnational <strong>and</strong> globalising forces, related not just todisease epidemiology <strong>and</strong> transmission but also to colonisation, immigration, conflict <strong>and</strong>international markets. Movements <strong>of</strong> people, whether <strong>of</strong> international students, migrants,workers or refugees, or New Zeal<strong>and</strong>ers who travel, linked the local aspects <strong>of</strong> personal, social<strong>and</strong> cultural life to international influences.Although Mr Peters has been silent on “the diseased immigrant” since his promotion toForeign Minister, there are many contenders for his role as xenophobia-inciter, Coddington(2006) being among the most recent. Our research project as a whole provides information<strong>and</strong> perspectives which can be used to evaluate the statements from such figures. This paper isspecifically devoted to unravelling some <strong>of</strong> the issues concerning the incidence rates <strong>of</strong> TBdisease, especially as these relate to migrants, <strong>and</strong> seeking to underst<strong>and</strong> the social <strong>and</strong>political implications <strong>of</strong> these disease patterns <strong>and</strong> the ways in which these patterns areinterpreted. To do this we have had to draw on non-ethnographic research, which led useventually to a new series <strong>of</strong> ethnographic questions. Several <strong>of</strong> the chapters in this volumeare responses to these questions.StatisticsIn a nutshell, we found that the problem with the ‘Winston theory’, i.e., that new immigrantsbring disease, including TB, over the border, is that it does not accord with either internationalor New Zeal<strong>and</strong> epidemiological data for tuberculosis. While here <strong>and</strong> elsewhereapproximately 20 percent <strong>of</strong> new arrivals who eventually are diagnosed with TB (Turnbull2002) are diagnosed in their first year in New Zeal<strong>and</strong> <strong>and</strong> might justifiably be thought tohave active tuberculosis disease when they crossed the border, many develop TB more than ayear after arrival. This suggests that more than 80 percent do not have active TB disease whenthey first arrive (Das et al. 2006). This pattern is typical <strong>of</strong> other low-incidence countries(Littleton et al. 2008:Table 3). It strongly suggests that certain aspects <strong>of</strong> the migration <strong>and</strong>settlement process <strong>and</strong> environments in the host country are implicated in the high non-NewZeal<strong>and</strong>-born notification rate in the years after first arrival.Our first step in seeking to underst<strong>and</strong> this apparent puzzle was to acquire further medicalinformation about tuberculosis, its detection, treatment <strong>and</strong> prevention <strong>and</strong> the circumstances56
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ReferencesAmerican Lung Association
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Stephens, Christianne V., 2004. A p
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Chapter 12Norway House Residential
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thought that Brandon was too far aw
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The greatest number of deaths, almo
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Hardiman EF. 1902. Principal’s Re
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Figure 2Whakarewarewa in the 1920s.
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dilapidated. They were observed als
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ReferencesAllen, A.E. and D.G. Phil
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Wang, P.D. and R.S. Lin, 2000. Tube
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Chapter 14The Bright Light of Actio
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environment” 18 of Taranaki Maori
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Fitzgerald, Criena, 2002. Making tu
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understand vulnerability and suppor
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around when she first had TB knew t
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An article from the Dominion newspa
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Scheper-Hughes, N., 1992. Death Wit
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Tuberculosis: A disease of othersTh
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Tuberculosis and infectionTuberculo
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Bhadrak, an Indian man in his 20s,
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Chapter 17Health, Wellbeing and Dia
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Somalia (Lillebaek et al. 2002:682)
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The Auckland Somali population is h
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mask usually had to be worn by pati
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Warfa, N., K. Bhui, T. Craig, S. Cu
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Health cultures and explanations of
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Duality of TBMany of the older Paci
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Interviewer: “Do you have any ide
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McArthur, N., 1965. Island Populati
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ContributorsAnneka Anderson, Depart
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Moana Oh (Ngati Rarua, Ngati Toraru
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RAL-e1 Geoarchaeological Investigat