School of Social and Political Science

Background

PhD Research Title: An enigmatic disease: Making melioidosis visible in Thailand

My research is about the complexities and challenges surrounding the understanding and management of a lesser-known infectious disease within global health framings in Thailand. I attempt to make sense of how a highly fatal disease, melioidosis, remains largely neglected despite significantly impacting rice farming communities. Although epidemiological data and biomedical research show that rice farmers are at the highest risk of melioidosis infection, the disease is little heard of even in endemic areas where the microbe is dispersed in the environment. 

This is the first anthropology and social science study on melioidosis. Through fourteen months of multi-sited ethnography, I trace melioidosis through spaces of public health, medical research, hospital care, and health policy, to investigate how it becomes known, to whom it remains unknown and why.  I investigate the efforts made by scientists to draw attention to melioidosis nationally and internationally. 

My research shows melioidosis to be what I call an “enigmatic disease”, which remains difficult to know and control despite first being identified over a century ago. The biology of the disease contributes to its enigmatic character. Melioidosis is caused by bacteria that live in tropical soil and water and can therefore be present in diffuse environments, making its transmission difficult to control. Melioidosis can cause a wide range of symptoms and can mimic tuberculosis, pneumonia, and sepsis. The disease can impact multiple body organs and melioidosis patients can develop co-infection with diabetes or multiple infections of other diseases. Patients treated for melioidosis can develop a relapse or become reinfected with the disease. Furthermore, the nature of the disease-causing microbe makes it challenging to identify, even in spaces like laboratories where multiple tests are performed to make it visible.