Valuing Care

Abstract

In this article, I explore the contradictory demands of ‘participation’ and ‘bureaucratisation’ in Pakistan’s HIV sector. Local models of relatedness, personhood and informal networks, and the particular social and emotional skills of development workers were co-opted under the rubric of ‘participation’ while rolling-out projects for community care, yet the affect, relations of trust and confidence built by community workers during their work were not translated into templates for reporting-up project impact. Technologically less equipped workers were either forced to extend their roles into report-writing, template-filling and indicator-measuring or driven out of the HIV sector altogether during the process of scaling-up. This, I ague, is a form of bureaucratic violence that undermines community care. It draws attention to moving beyond the metrics-driven data determinism of global health.