Improvising Knowledge: A Case Study of Practices in and Around World Spine Care's Evidence-based Clinics in Shoshong and Mahalapye, Botswana

Abstract

Global health organizations attend to populations around the world applying an evidence-based model of care that often does not correspond with local realities on the ground. My thesis provides an in-depth anthropological study of how this occurs within practices in and around World Spine Care's (WSC) clinics in Shoshong and Mahalapye, Botswana. More specifically I explore how knowledge is negotiated and improvised on the ground, paying particular attention to the ways WSC volunteers are (un)able to work with local health workers as they desire. I show the flows and counter-flows implicated in the difficult task of reconciling skills with standards. The study is based on a total of 15 months of participation with WSC's organization through attending meetings, activities and shadowing practitioners both in Ottawa and in Botswana. Expanding the scope of their creative improvisational skills beyond the closed settings of WSC clinics is proposed as a way to move forward.