Careful tubercolosis control An ethnography of public health practices in a Colombian city

In this dissertation, I show how tuberculosis (TB) control and care are not opposites; they coexist in clinical encounters. Caring for individuals with TB and their communities implies preventive intervention, monitoring and surveillance, which can be experienced as domination in practice, and may lead to suffering and stigmatization. However, I argue that controlling TB epidemics is also a form of care and without TB control strategies, care is difficult to achieve.
I present an analysis of Colombia’s multileveled public health system and the social complexities of TB care and control in which the central questions are: a) how are TB public health strategies reproduced and experienced in care encounters, and b) how can care practices expose the aims of controlling the spread of TB? I depart from the idea that answers to these questions can be found in the accounts and actions of those who aim to control TB infection.
Inspired by a critical perspective, this study examines the experiences and practices of TB carers and their relationship to TB control strategies in a Colombian city using the accounts of people with TB, their relatives, managers and healthcare workers (HCWs) as well as my observations of their encounters and actions
TB care involves us all in multiple scenarios of social life. When someone is attentive, responsible and competent to provide care for a person who is sick with TB, and respect the dignity of this patient population and their communities, then, good TB control and care are possible.