Care across Distance: Ethnographic Explorations of Aging and Migration 9781785338014

Table of contents :
CONTENTS
List of Illustrations
Acknowledgments
Introduction: Care across Distance
PART I. Materialities and Technologies of Care across Distance
1. Recalibrating Care: Newly Resettled Nepali-Bhutanese Refugees in Upstate New York
2. Healthy Aging, Middle-Classness, and Transnational Care between Tanzania and the United States
PART II. Spirituality and Intergenerational Care across Distance
3. Intergenerational Relationships and Emergent Notions of Reciprocity, Dependency, Caregiving, and Aging in Tuareg Migration
4. “Old People’s Homes,” Filial Piety, and Transnational Families: Change and Continuity in Elderly Care in the Tibetan Settlements in India
PART III. Communities of Care across Distance
5. Social Embeddedness and Care among Turkish Labor Migrants in Vienna: The Role of Migrant Associations
6. Migrants of Privilege: American Retirees and the Imaginaries of Ecuadorian Care Work
Part IV. Failures of Care across Distance
7. Some Limits of Caring at a Distance: Aging and Transnational Care Arrangements between Suriname and the Netherlands
8. “Where Were They Until Now?” Aging, Care, and Abandonment in a Bosnian Town
Epilogue: Reflections on Care and Virtue
Index

Citation preview

Care across Distance

Life Course, Culture and Aging: Global Transformations General Editor: Jay Sokolovsky, University of South Florida St. Petersburg Published by Berghahn Books under the auspices of the Association for Anthropology and Gerontology (AAGE) and the American Anthropological Association Interest Group on Aging and the Life Course. The consequences of aging will influence most areas of contemporary life around the globe: the makeup of households and communities; systems of care; generational exchange and kinship; the cultural construction of the life cycle; symbolic representations of midlife, elderhood and old age; and attitudes toward health, disability, and life’s end. This series publishes monographs and collected works that examine these widespread transformations with a ­perspective on the entire life course as well as mid/late adulthood. It engages a cross-cultural framework to explore the role of older adults in changing ­cultural spaces and how this evolves in our rapidly globalizing planet. Volume 1 TRANSITIONS AND TRANSFORMATIONS Cultural Perspectives on Aging and the Life Course Edited by Caitrin Lynch and Jason Danely Volume 2 UNFORGOTTEN Love and the Culture of Dementia Care in India Bianca Brijnath Volume 3 AGING AND THE DIGITAL LIFE COURSE Edited by David Prendergast and Chiara Garattini Volume 4 CARE ACROSS DISTANCE Ethnographic Explorations of Aging and Migration Edited by Azra Hromadži´c and Monika Palmberger

CARE ACROSS DISTANCE Ethnographic Explorations of Aging and Migration ijk Edited by

Azra Hromadži´c and Monika Palmberger

berghahn NEW YORK • OXFORD www.berghahnbooks.com

First published in 2018 by Berghahn Books www.berghahnbooks.com © 2018, 2022 Azra Hromadži´c and Monika Palmberger First paperback edition published 2022

All rights reserved. Except for the quotation of short passages for the purposes of criticism and review, no part of this book may be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system now known or to be invented, without written permission of the publisher. Library of Congress Cataloging-in-Publication Data Names: Hromadži´c, Azra, editor. | Palmberger, Monika, editor. Title: Care across distance : ethnographic explorations of aging and migration / edited by Azra Hromadži´c and Monika Palmberger. Description: New York, NY : Berghahn Books, 2018. | Series: Life course, culture and aging ; volume 4 | Includes bibliographical references and index. Identifiers: LCCN 2017053740 (print) | LCCN 2018007332 (ebook) | ISBN 9781785338014 (ebook) | ISBN 9781785338007 (hardback : alk. paper) Subjects: LCSH: Older people--Social conditions--Case studies. | Older people--Care--Social aspects--Case studies. | Aging--Social aspects--Case studies. | Emigration and immigration--Social aspects--Case studies. | Immigrant families--Case studies. Classification: LCC HQ1061 (ebook) | LCC HQ1061 .C336 2018 (print) | DDC 305.26--dc23 LC record available at https://lccn.loc.gov/2017053740

British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library

ISBN 978-1-78533-800-7 hardback ISBN 978-1-80073-439-5 paperback ISBN 978-1-78533-801-4 ebook

ijjjjjjjjjjjjjjk CONTENTSCONTENTS

List of Illustrations

vii

Acknowledgments

viii

Introduction: Care across Distance Monika Palmberger and Azra Hromadži´c

1

PART I.  Materialities and Technologies of Care across Distance 1. Recalibrating Care: Newly Resettled Nepali-Bhutanese Refugees in Upstate New York Retika Desai

13

2. Healthy Aging, Middle-Classness, and Transnational Care between Tanzania and the United States Andrea Patricia Kaiser-Grolimund

32

PART II.  Spirituality and Intergenerational Care across Distance 3. Intergenerational Relationships and Emergent Notions of Reciprocity, Dependency, Caregiving, and Aging in Tuareg Migration Susan Rasmussen 4. “Old People’s Homes,” Filial Piety, and Transnational Families: Change and Continuity in Elderly Care in the Tibetan Settlements in India Namgyal Choedup

55

76

PART III.  Communities of Care across Distance 5. Social Embeddedness and Care among Turkish Labor Migrants in Vienna: The Role of Migrant Associations Monika Palmberger

97

vi 

CONTENTS

6. Migrants of Privilege: American Retirees and the Imaginaries of Ecuadorian Care Work 113 Ann Miles Part IV.  Failures of Care across Distance 7. Some Limits of Caring at a Distance: Aging and Transnational Care Arrangements between Suriname and the Netherlands Yvon van der Pijl

137

8. “Where Were They Until Now?” Aging, Care, and Abandonment in a Bosnian Town Azra Hromadži´c

156

Epilogue: Reflections on Care and Virtue Sarah Lamb

171

Index

181

ijjjjjjjjjjjjjjk ILLUSTRATIONS

Figure 1.1  Dhana and Phul-Maya’s home in Beldangi Refugee Camp, Nepal Figure 1.2 Dhana and Phul-Maya attending their ESL class in Upstate New York Figure 2.1 Hypertension monitoring through an ambulatory blood pressure unit sent from the United States Figure 2.2 The circulation of care shapes new forms of aging: food supplements in the United States Figure 3.1 Musician at the sultan of Aïr’s end-of-Ramadan blessing ceremony Figure 3.2 Young people at car show at end of Ramadan Figure 3.3 Preparations for a baby’s name day Figure 4.1 Elderly Tibetans in Doeguling attending 2011 World AIDS Day community health awareness workshop Figure 4.2 Community prayers, a very important part of appropriate aging in the Tibetan settlements Figure 5.1 Cloakroom at one of the Turkish migrant associations in Vienna decorated with pictures of its members in the years after their arrival in Austria Figure 5.2 Lounge at one of the Turkish migrant associations in Vienna Figure 6.1 Cuenca’s downtown, a UNESCO World Heritage Site with cobblestone streets and traditionally clad cholas, appeals to expats seeking an “authentic” cultural experience Figure 6.2 A billboard in 2008 for a new “state of the art” hospital, Hospital Universitario del Río, now a favorite of expats Figure 8.1 Sitting under an umbrella at Vitalis Figure 8.2 Biha´c church tower and the river Una

17 28 42 46 62 64 65 81 84 101 101

116 122 158 161

ijjjjjjjjjjjjjjk ACKNOWLEDGMENTS

This book is a product of many individuals’ converging intellectual, financial, and professional contributions, encouragement, and support. Still, we owe our greatest gratitude to Jay Sokolovsky, the editor of the Berghahn Books series “Life Course, Culture, and Aging: Global Transformations,” who stood behind our book from the very beginning. With his exceptional forward-looking attitude, restless encouragement, and continuous support, we were able to envision and deliver the book. Jay, we are extremely grateful to you! We also would like to thank Syracuse University’s Aging Studies Institute, and especially Janet Wilmoth, who supported—financially, logistically, and intellectually—a book symposium and workshop at Syracuse University in September 2016. In the course of this event, we received excellent comments on our individual contributions from the discussants—Douglas Wolf, Jay Sokolovsky, and Terese Gagnon. Thank you all for the time you put into the careful and critical reading of our chapters. We are also very grateful to Sarah Lamb, who participated at the Syracuse book symposium and agreed to write the book’s epilogue. In addition, we are very thankful to two more individuals who, at different stages of this process, provided guidance, support, and intellectual stimulation: Bjarke Oxlund and Michele Gamburd, thank you for your commitment, comments, and honesty. Moreover, Monika Palmberger wishes to thank the Austrian Science Fund (FWF T702), the University of Vienna, and the University of Leuven for the generous funding and support she received during the period of accomplishing this book. Azra Hromadži´c is grateful for the generous support from the Fulbright US Scholar Program (Bosnia-Herzegovina 2016-2017), Aging Studies Institute Start-up Grant (Syracuse University 2013-2014), and the Department of Anthropology at Maxwell School, Syracuse University. Finally, a big thank you goes to Berghahn Books and the wonderful team of professionals—including very helpful anonymous reviewers—who helped us develop, polish, and make tangible this volume. We could not ask for a better publishing house and team of people to magically transform our writing into “a real thing.”

ijjjjjjjjjjjjjjk INTRODUCTION Care across Distance Monika Palmberger and Azra Hromadži´c

Many people across the world are aging in places other than those in which they were born, for reasons that are multiple and range from forced migration to lifestyle relocation. In addition, some elderly people age in their countries of origin while their close kin, including children and grandchildren, migrate (by choice or by force) to other geographical locations. When faced with the challenges of aging in the context of migration, elderly people sometimes move back to the country from which they initially migrated, because they long to return to their old home or because they hope to access care offered by their families and/or the state (Ackers 2004). Others, however, decide to migrate in an effort to be close to and receive care from family and friends who have migrated (Deneva 2012; Díaz Gorfinkiel and Escrivá 2012). And there are those who move to faraway places where life and healthcare services are more affordable and where they hope to sustain the standard of living they had prior to retirement, although in a different sociocultural setting (Benson and O’Reilly 2009). These diverse but interrelated experiences of aging and migration generate novel convergences, expectations, and practices of eldercare— processes that are at the heart of this edited volume. By asking questions such as “What does it mean to care at a distance?” and “What does it mean to age abroad?” the contributors to this volume investigate how migration, and the related spatialization and transnationalization of care, produce unprecedented convergences of people (such as relationships between “care receivers” and “care providers”), objects (such as institutions and regimes of care; discourses of morality, responsibility, and spirituality; kinship relations; and material sustenance), and spaces (home and exile; homeland and diaspora; and vacated, transitory, and hybrid spaces of care) that challenge our assumptions about who ought to care, and how and where care ought to happen.

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Thinking Care and Aging across Distance Research on care, aging, and migration has received increased attention in the social sciences since the 1990s. The vast majority of literature originated from migration studies and social gerontology, two areas of study that for a long time had minimal overlap. Only in the early 2000s has a substantial dialogue between migration scholars and social gerontologists started to emerge (see Torres and Karl 2014). One significant research strand therein focuses on the challenging consequences of migration for older migrants, including feelings of isolation and abandonment (Amin and Ingman 2014; Gardner 2009), the high emotional toll, and continual longing for home (Baldassar 2008, 2014; Gardner 2004; Xie et al. 2010). Scholars have shown that this longing for home cannot be simply resolved by migrants returning to their original home after retirement. Rather, returning home at an advanced age, after several years or decades spent abroad, is far more complex than is usually anticipated, especially when social ties with friends and neighbors have weakened over the years (Ciobanu and Ramos 2016). Complementing this focus on experiences of aging abroad and returning to the country of birth in order to age at home, another central research strand explores the experiences of the elderly who stay in place while their children migrate. This literature emphasizes the void that emerges when younger people migrate, and the lack of traditional kin-based care-related services that occur.1 These studies also investigate the rise of novel social networks that are becoming available to the elderly who stay at home (Baldock 2000; Holmén and Furukawa 2002; Lamb 2009). They also address the children’s experience of guilt for not providing care in proximity to their parents; this constant worrying about parents at home is a significant part of a contemporary migrant’s experience (Amin and Ingman 2014). In exploring new ways in which care unfolds across vast spaces of migration, scholars have also focused on the development of new “technologies of care,” including internet-based intimacies (via Skype, for example) (Wilding 2006). New communication technologies generate new possibilities of caring across distance (for example, via webcam, see Miller and Sinanan 2014; see also Kaiser-Grolimund, this volume)—strategies that children employ from afar to preserve and at times deepen contact with their parents as well as with those in the home community who take part in eldercare, such as neighbors, friends, and relatives. These new technologies and communication strategies enable people to provide advice, share stories, and express emotions across physical distance (Mendez-Luck et al. 2009).

INTRODUCTION: CARE ACROSS DISTANCE  

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This scholarship on care, aging, and migration has been enriched by the recent anthropological interest in care. Here care has been approached not only as a subspecies of kinship, as has historically been the case, but also as a subject and set of relations significant enough to be investigated on their own terms. By closely linking care to kinship, anthropologists in the past tended to present care as natural, linked to generational roles and expectations, and closely connected to the pregiven and clearly defined stages in the life course. Feminist and postcolonial critiques within anthropology, and the emerging scholarship on disability, deconstructed such naturalized and flawed understandings of family care by highlighting social inequalities (for example, gendered care labor) and global discrepancies of care (for example, people, mostly women, from the global South providing care to elderly in the global North). These deconstructions, discourses and approaches allow scholars to examine and complicate another widely accepted perception of care: the dichotomy between public/cold care and private/warm care (see Thelen and Coe 2017). While the contributors to this volume, all anthropologists, do not follow a single definition of care, they all understand care as a multifaceted phenomenon that incorporates not only medical but also emotional, social, moral, and economic aspects that may be provided and maintained at proximity or from a geographical distance. The authors acknowledge and investigate different aspects of care that go beyond the division of care as commodity/product and care as relation (see Drotbohm and Alber 2015; Tronto 1993). The authors also adopt a polysemic approach to care that understands it both as a resource and as a relational practice (Buch 2015). In the case of the latter, care practices and evolving care relations are the focus of investigation rather than presupposed relationships (Thelen 2015: 509). Moreover, the roles that institutions and national politics play in care practices and relations are taken into account (Buch 2015). This volume points to the multiple and changing care relations in a migrating world. It analyzes numerous consequences migration may have for aging and eldercare. The chapters investigate how taken-for-granted roles are challenged, intergenerational relationships transformed, and spiritual relations pursued and desired. Furthermore, the care relations that this volume examines go beyond the nuclear and extended family in order to illuminate the roles that friends, neighbors, paid caregivers, fictive kin, state and nonstate institutions, and the wider community play in accommodating care at proximity or at a distance. In order to achieve this, the contributors to this edited volume explore different dimensions and expressions of care across distance, including relations of care and materiality, care and spirituality, and care and community, as well as failures of

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care. In this way, the chapters in this book, individually and collectively, invite the reader to revisit and rethink the familial, spiritual, communal, political and economic relations, practices, and lived effects of care and aging across distance.

Ethnographic Explorations of Care, Aging, and Migration across Distance Various chapters in this edited volume tackle the themes outlined above as they ethnographically explore and untangle the transforming configurations of eldercare in the context of migration, both within and across national borders. The ethnographies that populate this edited volume are not only thick and intimate, but they are also ethnographies on the move and across distance. Several authors literally follow the people they study, as these individuals migrate within and across national boundaries. Consequently, the ethnographic spaces covered in this volume include more traditional anthropological niches, such as homes, community centers, and nursing homes, as well as “non-places” (Augé 2003), such as airports and airplanes, sidewalks, buses, and cyber conversations (see Desai, this volume; Kaiser-Grolimund, this volume). With their fine-grained ethnographies, the contributors to this volume also question the division of “care providers” and “care receivers.” By exploring numerous aspects of eldercare ethnographically in diverse geographic and sociocultural settings, they reveal divergences between selfperceptions and attributions by others concerning the question of who cares for whom. For example, some ethnographic data show different generational perceptions of directions of care, where children perceive themselves as care providers to their elderly parents, while the latter frequently see themselves as caring for their children (see Palmberger, this volume). Other ethnographic contributions show how those elderly people who seek care from non-kin, such as in the case of retiring migrants, are likely to perceive themselves as care providers for the children of those who look after them in the host country (see Miles, this volume). Such ethnographic observations not only question any simple division between care providers and care receivers, but also underpin what anthropologists have for a long time been arguing: namely, that care is tightly interwoven with social understandings of reciprocity (see Rasmussen, this volume; Sokolovsky 2009). By using ethnographic evidence to question this dichotomy between care providers and care receivers, the authors in this book also critically interrogate the idea that those in need of care necessarily find themselves in a passive position (Thelen 2015: 502).

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Using ethnographic fragments and thick description, the contributors show that transnational and migratory settings do not necessarily diminish but rather transform caregiving relationships and practices within and outside of family. In addition, new relations, responsibilities, and expectations of care and intimacy emerge between the family, market, and state. What is more, these novel technologies, arrangements, and modalities of eldercare are tied, in complex and intersecting ways, to gender, generation, migration, and displacement, and geographies of home and exile; their unique, contextual articulations are at the core of this edited volume. The ethnographies that make up this volume span the globe, and they include and compare the following topographies and ethnographic settings: the United States, Tanzania, Bosnia and Herzegovina, Austria, Ecuador, Mali and Niger, Suriname, the Netherlands, Turkey, India, and Nepal. This provides a unique opportunity to acknowledge sociocultural differences and specificities of different locations/politics/regimes of care as well as to recognize similarities of experiences related to aging and care across geographically distant places. For example, several chapters in this book reveal that while for many of the elderly it is important to be part of a community, this community does not necessarily have to be a long-standing, traditional, and rooted one. Rather, materialization of these new, exilic communities in unexpected places (such as in refugee camps or postindustrial cities) prompts us to rethink the imaginaries of care and belonging, and of life and death, that are being generated from novel relations and roles across borders and distances. Other chapters, however, point at the limitations of care across borders and distances—there are documented instances of suffering and “crises of care,” such as visa restrictions that prevent aging parents in need of care from joining their children who have migrated. There are also palpable consequences when migrating family, transforming community, and a shrinking welfare state are unwilling or unable to take care of the elderly in need (see, for example, Hromadži´c, this volume, and Van der Pijl, this volume). Thematically, different chapters explore various confluences of transnational regimes and relations of eldercare in the context of migration. Each chapter offers a detailed discussion of eldercare as it relates to intersectional identities, processes, and experiences—class, kinship, race, ethnicity, citizenship, gender, language, religion/spirituality, violence and exile—and associated inequalities and discrimination, or advantage and privilege, that stem from these convergences. While the authors in this volume draw widely on transdisciplinary research and theory, they offer specific ethnographic approaches and anthropological insights, providing a new angle on, and engagement with, the themes outlined above. Their contributions not only address specific ethnographic cases but also speak to bigger issues

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that go beyond their particular case studies. The themes they address are characterized by the interplay of globality and particularity, as well as by the tension between creative agency and structural constraints (Lamb 2009: 11). This interest in care, aging (and increasingly “good aging”), and migration has received significant scholarly attention, as well as public visibility: these themes are frequently discussed publicly (see the epilogue). And yet, aging migrants have scarcely been included or even represented in these public debates. Scholarly works that illuminate experiences of migration and its transforming impact on care and aging (and vice versa) are vital for widening the public debate on aging in the contemporary moment. Ethnographically grounded studies, such as those presented here, lay the foundation for including the needs and desires of aging migrants and those elderly people whose lives are significantly affected by migration within these public debates.

Care across Distance: An Outline The book is divided into four parts and eight chapters. Part I, titled “Materialities and Technologies of Care across Distance,” examines novel encounters and unexpected directions of care. The two contributions to this part—by Retika Desai and Andrea Kaiser-Grolimund—focus on reconfigurations (mostly material and technological) of intimate family relations of affection and eldercare in the context of contemporary migration and flight. Focusing on the newly resettled Nepali-Bhutanese refugees in Syracuse, New York, Retika Desai explores how care is being discursively, materially, and affectively recalibrated by Syracuse-based refugees, most of whom have several family members in refugee camps in Nepal and who often express their inability to physically provide care to the relatives they have left behind. Andrea Kaiser-Grolimund’s piece explores transnational care practices among middle-class, elderly people in the city of Dar es Salaam, Tanzania, and their children in the United States. The author introduces the notion of the “triangle of care,” which encompasses adult Tanzanians residing in the United States, older people in Tanzania, and their siblings and relatives (“observing eyes”) in Tanzania. The chapter shows how new communication media, such as Skype and smart phones, are essential in creating intimacies at a distance and for upholding the “triangle of care.” Part II, titled “Spirituality and Intergenerational Care across Distance,” explores the role of spirituality, religion, and ritual in the context of caring across distance, both spatial and generational. Susan Rasmussen examines

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the impact of disrupted and transfigured, though not always ruptured, intimate and spiritual ties between elders and youths among the migrating Tuareg (Kel Tamajaq)—a traditionally rural, seminomadic, stratified, and Muslim group—located in northern Niger and Mali. Similarly, Namgyal Choedup investigates the emergence of “old people’s homes” and other forms of community care in one of the largest Tibetan settlements in India. Here he captures both the changes and continuities in practices of eldercare in the context of the settlement’s recent social, cultural, and demographic changes. The author focuses especially on how the elderly in the Tibetan settlements see these spaces of exile not only as proper places to age, but, very importantly, as places where one can die properly; in this settlement, the Buddhist rituals of death and dying are still respected and practiced. Part III, titled “Communities of Care across Distance,” includes chapters by Monika Palmberger and Ann Miles that zoom in on the communal aspect of eldercare. Palmberger’s contribution explores the role of institutions and communities of care among Turkish labor migrants who came to Austria as “guest workers” in the 1960s and 1970s as young adults, and who are now entering retirement age. She discovers that Turkish cultural, political, and religious associations in Vienna provide unique spaces to experience “social embeddedness”—to feel cared about by being part of a diasporic community formed and coalesced around one of the many voluntary associations. Writing about related yet unique phenomena of community care in her contribution to this volume, Ann Miles shows how the US retirement “lifestyle” migrants, or “migrants of privilege,” who move to Ecuador to retain or even increase their standard of living, consume the “good life” and care services in their new locations, while at the same time aiming to create spaces of community and solidarity in their new home. This is achieved by entering and sustaining a community created by and for US lifestyle migrants, as well as by forming personal and family-like relationships with Ecuadorians in their new homes. Finally, Part IV of this volume, titled “Failures of Care across Distance,” examines how the changing relations and configurations of care between individuals and families, the state, and the market sometimes produce failures of care that could have dire consequences. For example, Yvon van der Pijl’s contribution, which builds on her long-term, multisited ethnographic research in Suriname and the Surinamese diaspora in the Netherlands, shows how those who are deprived of their domestic and cultural homes suffer from social-emotional isolation and profound loneliness in old age. Similarly, in her chapter on eldercare in contemporary Bosnia-Herzegovina where postsocialist policies and postwar conditions powerfully converge, Azra Hromadži´c introduces the concept of the “semi-absent” state and family: the state is

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bureaucratically and politically ubiquitous but biopolitically shrinking, and the family is materially present but physically removed, or physically present and materially incapable of providing care. This study shows how elderly people in need of care and assistance sometimes “fall through the cracks” of these shifting topographies and understandings of care and responsibility, which can lead to neglect, abandonment, and, at times, death. The book’s epilogue, which brings together, explores, and further develops the main ideas presented in the individual chapters, is written by Sarah Lamb. By exploring these emerging regimes, processes, and practices of eldercare, as they unfold in multiple contexts and at different junctures of unique migration journeys across societies, this volume also poses questions about ethics of belonging and relations of care in the contemporary world. The assumptions about who ought to care and how and where care ought to happen in the context of migration and changing connections between family, the state, and the market are loaded with sociopolitical dilemmas and ethical idea(l)s about what constitutes good aging and a life worth living (Lamb 2009). Furthermore, we chose not to organize our book around different types of movements, such as forced migration (that is, “ethnic cleansing” and war-flight) and migration “by choice” (that is, economic or lifestyle migration). While taking the different migrants’ trajectories and their specifics seriously, we decided to focus on what is shared and what is surprising and uncertain across these differences. Thus, this volume, with its unique organization and its many and overlapping themes, challenges multiple dichotomies (such as the above-discussed division between care providers and care receivers, and between care as commodity and care as relation) that sometimes saturate the literature as well as popular understandings of eldercare. Finally, the chapters in this volume challenge the dichotomous notions of bifurcated care, which posit private (warm, good, traditional, familial) against public (cold, bad, modern, “institutional”) regimes of care (see Thelen 2015). While this division is not totally absent (see Van der Pijl, this volume), opposing examples and experiences are plentiful, and they invite us to think in a more complex and context-driven way about relations and novel practices of care that materialize from these encounters, assemblages, and convergences of different actors and institutions when care is practiced across distance. Azra Hromadži´c is an associate professor in the Department of Anthropology at Syracuse University. Her areas of interest include political anthropology, violence and reconciliation, youth and education, aging, care and social services, water politics, pedagogies and infrastructures, and the Balkans. She is

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the author of Citizens of an Empty Nation: Youth and State-Making in Postwar Bosnia and Herzegovina (University of Pennsylvania Press, 2015) which was recently translated into Serbian: Samo Bosne nema: Mladi i gradˉ enje države u posleratnoj Bosni i Hercegovini (Belgrade: Biblioteka XX vek, 2017). Monika Palmberger is a research fellow and lecturer in the Department of Social and Cultural Anthropology, University of Vienna, and research fellow in the Interculturalism, Migration and Minorities Research Centre, University of Leuven. Her research interests include aging and migration, (collective) memory, (forced) migration, and postwar societies, as well as qualitative methods. She is author/editor of the books How Generations Remember: Conflicting Histories and Shared Memories in Post-War Bosnia and Herzegovina (Palgrave Macmillan, 2016) and Memories on the Move: Experiencing Mobility, Rethinking the Past (Palgrave Macmillan, 2016, with Jelena Tosic).

Notes We wish to thank the Austrian Science Fund (FWF T702) for funding the open access publication of this chapter. 1. The phenomenon of female migration for paid care work and the resulting care void they leave behind has been discussed under the headings of “care chain” (Hochschild 2000) and “care drain” (Lutz 2012).

References Ackers, Louis. 2004. “Citizenship, Migration and the Valuation of Care in the European Union.” Journal of Ethnic and Migration Studies 30 (2): 373–396. Amin, Iftekhar, and Stan Ingman. 2014. “Eldercare in the Transnational Setting: Insights from Bangladeshi Transnational Families in the United States.” Journal of Cross-Cultural Gerontology 29 (3): 315–328. Augé, Marc. 2009. “Non-Places: An Introduction to Supermodernity.” 2nd edition. London: Verso. Baldassar, Loretta. 2008. “Missing Kin and Longing to Be Together: Emotions and the Construction of Co-Presence in Transnational Relationships.” Journal of Intercultural Studies 29 (3): 247–266. _____ 2014. “Too Sick to Move: Distant ‘Crisis’ Care in Transnational Families.” International Review of Sociology 24 (3): 391–405. Baldock, Cora V. 2000. “Migrants and Their Parents: Caregiving from a Distance.” Journal of Family Issues 21 (2): 205–224. Benson, Michaela, and Karen O’Reilly. 2009. “Migration and the Search for a Better Way of Life: A Critical Exploration of Lifestyle Migration.” The Sociological Review 54: 608–625.

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Buch, Elana D. 2015. “Anthropology of Aging and Care.” Annual Review of Anthropology 44: 277–293. Ciobanu, Ruxandra Oana, Anne Carolina Ramos, Ute Karl, and Sandra Torres. 2016. “Is There a Way Back? A State-of-the-Art Review of the Literature on Retirement Return Migration.” In Aging in Contexts of Migration, edited by Karl Ute and Sandra Torres, 96–107. London: Routledge. Deneva, Neda. 2012. “Transnational Aging Careers: On Transformation of Kinship and Citizenship in the Context of Migration among Bulgarian Muslims in Spain.” Social Politics 19 (1): 105–128. Díaz Gorfinkiel, Magdalen, and Angeles Escrivá. 2012. “Care of Older People in Migration Contexts: Local and Transnational Arrangements between Peru and Spain.” Social Politics 19 (1): 129–141. Drotbohm, Heike, and Erdmute Alber, eds. 2015. Anthropological Perspectives on Care: Work, Kinship, and the Life-Course. New York: Palgrave Macmillan Gardner, Katy. 2009. “Lives in Motion: The Life Course, Movement and Migration in Bangladesh.” Journal of South Asian Development 4: 229–251 _____ 2002. Age, Narrative and Migration: The Life Course and Life Histories of Bengali Elders in London. Oxford: Berg. Hochschild, Arlie. 2000. “Global Care Chains and Emotional Surplus Value.” In On the Edge: Living with Global Capitalism, edited by W. Hutton and A. Giddens, 130–146. London: Jonathan Cape. Holmén, Karen, and Hidetochi Furukawa. 2002. “Loneliness, Health and Social Network among Elderly People—A Follow-Up Study.” Archives of Gerontology and Geriatrics 35 (3): 261–274. Lamb, Sarah. 2009. Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad. Bloomington, IN: Indiana University Press. Lutz, Helma, and Ewa Palenga-Möllenbeck. 2012. “Care Workers, Care Drain, and Care Chains: Reflections on Care, Migration, and Citizenship.” Soc Polit 19 (1): 15–37. Mendez-Luck, Carolyn A., David P. Kennedy, and Steven P. Wallace. 2009. “Guardians of Health: The Dimensions of Elder Caregiving among Women in a Mexico City Neighborhood.” Social Science & Medicine 68 (2): 228–234. Miller, Daniel, and Jolynna Sinanan. 2014. Webcam. Cambridge: Polity Press. Sokolovsky, Jay, ed. 2009. The Cultural Context of Aging: Worldwide Perspectives. Westport, CT: Praeger. Thelen, Tatjana. 2015. “Care as Social Organization: Creating, Maintaining and Dissolving Significant Relationships.” Anthropological Theory 15 (4): 497–515. Thelen, Tatjana and Catie Coe. 2017. “Political Belonging through Elderly Care: Temporalities, Representations and Mutuality.” Anthropological Theory: 1–21. Torres, Sandra, and Karl Ute. 2016. “A Migration Lens on Inquiries into Aging, Old Age and Elderly Care: Carving Out a Space while Assessing the State of Affairs.” In Aging in Contexts of Migration, edited by Karl Ute and Sandra Torres, 1–12. London: Routledge. Tronto, Joan C. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. New York: Routledge. Wilding, Raelene. 2006. “‘Virtual’ Intimacies? Families Communicating across Transnational Contexts.” Global Networks 6 (2): 125–142.

ijjjjjjjjjjjjjjk PART I Materialities and Technologies of Care across Distance

ijjjjjjjjjjjjjjk 1. RECALIBRATING CARE Newly Resettled Nepali-Bhutanese Refugees in Upstate New York Retika Desai

Dhana1 and Phul-Maya were relocated to the United States in February 2015 as part of the United Nations High Commissioner for Refugees’ (UNHCR) resettlement program responsible for resettling approximately 108 thousand Nepali-Bhutanese refugees in eight countries in the global North. In their thirty-two years of marriage, this was the first trip that the couple had taken together. During their harrowing journey from Bhutan to Nepal, when the family moved overnight with their three children and their belongings, the couple traveled from the Indian border to Nepal in two separate trucks. While Phul-Maya was with her children in one truck, Dhana was guarding their belongings inside another. Unable to fathom the situation, I asked how a couple of thirty-two years could possibly have never traveled together anywhere. Dhana laughed and clarified, “If we survived as a couple without traveling together during such a time of crisis, why was there any need to make trips together as a couple as long as we lived?” If the couple had to jointly attend an event or visit relatives in the refugee camp in Eastern Nepal where they lived for almost twenty years, Dhana rode his bicycle. Phul-Maya walked. But since their move to upstate New York (NY), Dhana and Phul-Maya regularly walk together forty minutes back and forth to their state-funded English as a Second Language (ESL) classes. The calculus of being a couple in the US is fundamentally different from the practices Dhana and PhulMaya were accustomed to their entire lives in Bhutan and in the Beldangi refugee camp. From having never made any trips together as a couple to now making a daily mini-trip to their ESL class, the couple spends time with each other whether or not they wish to. A US-funded refugee resettlement project brought them to New York, and ESL classes are mandatory for those refugees whose subsistence depends on New York State’s public assistance. For couples like Dhana and Phul-Maya, who barely know how

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to read and write in their native language (Nepali), the expectation that they will learn English and then find jobs is merely wishful thinking. Aware of this predicament, Dhana aptly equates his need to go to his ESL classes to “chaˉ mal pakaˉ una” (cook rice), in other words, to survive. Regular attendance enables the couple to qualify for a monthly allowance for food, rent, and some disposable cash. As the couple lives with their son and daughterin-law in Syracuse, NY, attending ESL classes becomes a primary means to contribute materially in running the household. By unpacking and carefully untangling the resettlement experiences of this couple, and many similar to them, this chapter explores how the international humanitarian regime of care and biopolitical care of the state coalesces with the care regime of a Nepali-Bhutanese refugee family. I specifically examine how an elder couple who are part of a transnational Nepali-Bhutanese refugee family engages in strategies and practices of care. My examination of transnational care for Nepali-Bhutanese refugees is inspired by Lisa Stevenson’s (2014) exploration of the notion of care with the Inuit community in the Canadian Arctic. She conceives of “care as the way someone comes to matter and the corresponding ethics of attending to the others who matter” (Stevenson 2014: 3). In the case of the Nepali-Bhutanese refugees, I focus on how the refugees come to matter at two levels. First, I examine how caring is produced and consumed at the level of the family. Mining from various ethnographic moments from a twelve-month-long field research in Beldangi refugee camp in Nepal and in Syracuse, New York, between August 2014 and August 2015, I illuminate how care at a distance is shown and experienced materially—fundamentally through discourses around money. I demonstrate that money plays a central role in recalibrating notions of personhood and reconfiguring intimate family relations within Nepali-Bhutanese refugees on the move. Second, I illustrate that care within the family is intricately tied to NepaliBhutanese experiences of the humanitarian care regime that they were exposed to for two decades in the refugee camp as well as new forms of care that the families experience once relocated to the United States. I specifically employ Miriam Ticktin’s (2011: 13) notion of humanitarian care that is based on a “politics of benevolence and compassion for a suffering human” in order to understand how Nepali-Bhutanese refugees navigate the everyday humanitarianism that is at their disposal. I examine this navigation, however, only in conjunction with the idea of “anonymous care” that Stevenson (2014: 5) explores, the idea that “care should be administered indifferently, without it mattering for whom.” I argue that this conception of anonymous care is productive in parsing how the indifferent nature of routine humanitarian care the Nepali-Bhutanese refugee families experience enables them to maneuver humanitarian care to engineer

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new forms of care within the family. In short, the main task of this chapter is to demonstrate that strategies and practices of care for Nepali-Bhutanese refugees, who are straddling spaces of a refugee camp in Nepal and a new neighborhood in which they are resettled in upstate New York, sits at the intersection of monetary care, humanitarian care, and anonymous care.

Historical Background Bhutanese nationals from southern Bhutan who have Nepali ancestry and are native Nepali speakers fled Bhutan in the early 1990s as the Bhutanese government implemented policies to create a homogeneous Bhutan. Specifically, a series of changes in citizenship laws between 1977 and 1985 made it difficult for Nepali-Bhutanese and their families to obtain citizenship in Bhutan (Evans 2013: 122). In addition, the 1989 policy of “one nation, one people” promoted the majoritarian Drukpa-Buddhist culture, Dzongkha language, and a dress code, and indirectly targeted Nepali-Bhutanese to assimilate (Hutt 2003). The Nepali-Bhutanese were forced to flee Bhutan as they refused to conform to these new policies. Once expelled, the Nepali-Bhutanese sought refuge in India, which shares a border with Bhutan, but were denied temporary residence. As a result, the Nepali-Bhutanese crossed the border into Nepal beginning in 1990. Approximately one hundred thousand expelled Nepali-Bhutanese people temporarily settled in seven camps in Eastern Nepal with the hope that they would soon return to Bhutan. But the refugee issue did not receive the needed attention until 2006 because Nepal was embroiled in a decadelong civil war (1996–2006). Meanwhile, Bhutan continued to mislabel majority Nepali-Bhutanese as illegal migrants and refused to repatriate its Nepali-Bhutanese refugees. As a result, Nepali-Bhutanese remained in refugee camps in Nepal for nearly two decades. With relative political stability in the country, Nepal assumed a more proactive role and appealed to the UNHCR in 2006 to facilitate permanent resettlement of Nepali-Bhutanese refugees. The United States, Canada, Australia, New Zealand, and several countries in Europe agreed to take in refugees in limited numbers. The US government initially offered to resettle sixty thousand refugees, but would later offer an unlimited quota for Nepali-Bhutanese refugee resettlement (Banki 2008: 49). The United States, which had been the primary donor to the UNHCR in maintaining the Nepali-Bhutanese camps for two decades, also emerged as the most popular destination for resettlement. The UNHCR subcontracted the International Organization for Migration (IOM) to oversee the resettlement process in 2007, and, since then, 108 thousand refugees continue to be

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resettled in eight countries in the global North. More than eighty thousand of the approximately hundred thousand Nepali-Bhutanese refugees globally are resettled in the US (Shrestha 2015). As a result, the US has witnessed 8,255 percent population growth of Nepali-Bhutanese between 2000 and 2010 (SAALT 2012). The American state provides public assistance to these refugee families from the moment they arrive until families become “self-sufficient.” Depending on a state’s welfare policy, refugees typically get assistance for up to a year after resettlement. It is in this context the dispossessed Nepali-Bhutanese refugee elders, Dhana and PhulMaya, who lived in Beldangi refugee camp in Nepal for twenty-three years, decided to cooperate with the UNHCR, which would resettle them in the US, their potential new home.

The Camp Family Dhana and Phul Maya followed their son and daughter-in-law to the US, but they still have a daughter and her family in the refugee camp. In the camp, up until early December 2014, a total of nine family members lived together in a 6 by 3.5-meter bamboo hut, including the families of the couple’s son and daughter (IOM 2008: 9). It was an overcrowded hut, to say the least, without electricity, but the cool mud floor and a slight breeze that circulated through the holes in the woven bamboo walls made the treacherous post-monsoon heat bearable. Privacy was a tricky concept in the hut that housed not only the elder couple, but also their adult children and their families. The couple’s daughter, Puspa, is married to a Nepali citizen and has two daughters. Puspa’s resettlement process only began in November 2015. The couple’s son, Khem, is married to Sapana, and they have a daughter together. When I first met the family in Beldangi refugee camp in August 2014, Dhana’s son and daughter-in-law, Khem and Sapana, had completed the paperwork and other necessary formalities for their resettlement process.2 They had quit their jobs as primary schoolteachers in order to fully devote their time to completing the necessary bureaucratic requirements of the UNHCR and IOM for their resettlement. It was a general trend among Nepali-Bhutanese families to return from jobs elsewhere in Nepal and temporarily live in the camp to start their resettlement process. Being a UNHCR-managed camp, the residents did not have to fend for basic necessities, and hence quitting a job did not necessarily jeopardize one’s daily subsistence. After finishing their cultural orientation in July 2014, considered the final step before refugees are assigned their departure dates, Sapana and Khem were anxiously waiting for the IOM to give them their final departure date for their relocation to Syracuse,

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FIGURE 1.1  Dhana and Phul-Maya’s home in Beldangi Refugee Camp, Nepal. Photo by Retika Desai.

NY. Khem, Sapana, and their daughter, Lily, flew out of Kathmandu the first week of December 2014. A few months later, Dhana and Phul-Maya ­followed their son and daughter-in-law to the US.

Money Care in the Camp While it made sense to quit their jobs during their process of completing paperwork, interviews, and health assessments, I was puzzled that Sapana and Khem opted not to work between July and December 2014 after completing their bureaucratic preparations for resettlement. Both spent their days playing Ludo in their front porch, a popular board game in Nepal, with their neighbors and relatives, who trickled in and out of their hut throughout the day. Strategically located next to the public water tap, a bare galvanized iron pipe without a faucet that distributed water twice a day to roughly twenty-one surrounding huts, the family hut was always bustling with people who visited the tap for collecting water. Without any access to indoor running water, public taps were the sole source of water

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for most families. Women would start lining up their jerry cans at 1:00 P.M. every day around the tap and play a quick game of Ludo as they waited to fetch their afternoon water, which gushed out of a parched metal pipe at exactly 2:00 P.M. Sapana’s Ludo hours were interrupted not only by water-fetching duties, but also by her daughter, who, between naps, had to be taken out of her hand-crafted swinging bamboo crib hung in the porch. When not sleeping, the daughter was content crawling around the hut with other children covered in mud and dirt. But Khem could afford to play all day with no interruptions of any kind. To my query of whether it would be a productive use of time if Khem took up a temporary job and made some money while he and his family waited for their departure date, Sapana answered that it is embarrassing to work, especially when people are “date waiting,” the last stretch of waiting to hear from the IOM for their date to leave the camp. I found Sapana’s response quite curious. On further probing, Sapana explained, “If people are seen to be working until the final departure date, others will think that no one sends money to those seen working. Others will think that one has no relatives out there [resettled].” Sapana clarified that it is generally assumed that those families getting ready to leave already have family members resettled in the US or elsewhere who are taking care of them. Taking care of those in the refugee camp by those already resettled means sending money for monthly expenses or the costs for preparing for departure, which people generally referred to as “shopping money.” Sapana’s logic is strikingly similar to the logic put forth by Hung Cam Thai (2014: 33) in his brilliant analysis of the role of money among workingclass transnational Vietnamese families for whom money becomes a clear “currency of care.” Thai’s interlocutors in Vietnam state that to take good care of those left behind is to provide money regularly. Families in Vietnam who have family members in the US felt embarrassed in their community if they did not have anything material to show for their transnational membership (Thai 2014: 45). Akin to transnational Vietnamese families, for Nepali-Bhutanese refugees in the camp, money is the cardinal form of care. However, in this instance, it is a perverted logic in which working is directly proportional to experiencing shame. In other words, the more one works, the more embarrassed one feels, for work becomes an ultimate indicator of lack of affection from those relatives already resettled. On the other hand, shame is indirectly proportional to amount of money one receives from abroad. The more money one receives, the less shame one experiences in the community, avoiding any possible social stigma (Thai 2014: 45). Even though Sapana and Khem did not regularly get money from their relatives abroad, Sapana relentlessly tried to maintain the façade that she was indeed being cared for by her relatives even if that meant she spent

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her own savings. Being an excellent knitter and crotcheter, Sapana’s skills were always in demand, and she had saved a decent amount during her pregnancy, a year before I met her, from knitting lace for window and door decorations, as requested by resettling families to bring to their new homes in the US and Canada. In contrast to Sapana and Khem, who were embarrassed to work, Dhana, the father, worked as a construction worker until the last month of departure. During the period of my research in the camp, although there were several working adults in the household, Dhana was the only family member earning. Dhana was clearly the family patriarch and played the primary role of a breadwinner. He quit exactly a month before leaving for the US because he wanted to give his body some rest so that he could smoothly pass his final health assessment conducted by the IOM a few days before departure. Dhana’s daughter and son-in-law ran a corner shop next to their house, but did not have any other source of income. Even though financially Dhana ran the house single-handedly, there were other rules put in place for smooth functioning of the household. As the family was large, there was an equal division of labor for kitchen work. Dhana’s son and daughter-in-law were responsible for making lunch in the morning, whereas the daughter and son-in-law were responsible for dinner. Dhana gave both couples an equal amount of money per week for grocery expenses. In addition, he would buy meat, mainly pork, whenever he wanted to eat meat, and, depending on whose turn it was to cook, the meat would be prepared and served to the whole house. It was clear that Dhana was the economic caretaker and that he did not have any qualms about asking his children to cook what he wanted to eat. If Dhana was spending his money buying food, it was only natural he should be able to eat what he liked.

Divorce: A New Shade of Care Dhana’s role as a caregiver for his household went beyond providing money for food. He also had to fund his daughter Puspa’s legal divorce. Puspa’s resettlement process could not start along with her parents because she had a typical case of a “mixed marriage,” a UNHCR term that describes exiled Nepali-Bhutanese married to a non-Nepali-Bhutanese. Puspa is married to Bhim, a Nepali citizen. Marriage, as per the Nepali Constitution,3 allows non-Nepali women to become Nepali citizens if they wish. In accordance with the Nepali law, the UNHCR also states that “a refugee woman married to a Nepali man may not be eligible for resettlement because she is able to naturalize in Nepal. . . . She would therefore

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no longer be a refugee” (“UNHCR Says Mixed”). Becoming Nepali citizens means Nepali-Bhutanese refugee women lose their refugee status and are automatically disqualified for the UN-facilitated resettlement. Both the Nepali state and the UNHCR assume that with marriage, Nepali-Bhutanese women are adequately settled in Nepal with their husbands. The limit of humanitarian care is evident since Puspa does not fit the category of a dispossessed, suffering refugee. This is where humanitarianism’s insistence on suffering in order to be cared for is rendered visible. Puspa’s eligibility for Nepali citizenship overshadows her lifelong existence as a refugee. The humanitarian care that the Nepali-Bhutanese receive is located within the larger transnational regime of care that is “grounded in a moral imperative” (Ticktin 2011: 12). In her work with undocumented immigrants in France, Miriam Ticktin discusses how a particular notion of care is incorporated into governing immigrants in France. She argues that this form of humanitarian care is premised on the idea of a suffering body, which evokes the moral goodness of people and is fundamentally a “politics of benevolence and compassion for a suffering human” (Ticktin 2011: 12). Being refugees, by definition, Nepali-Bhutanese are suffering beings and disenfranchised noncitizens outside the national order (Malkki 1995). However, unlike Ticktin’s noncitizen interlocutors, the suffering of Nepali-Bhutanese does not need to “be configured as a particular biological form with affective resonance” (Ticktin 2011: 13). As refugee subjects who have been dispossessed for two decades and lived in refugee camps, the Nepali-Bhutanese do not have to reconstitute themselves as Ticktin’s sick subjects in order to become political subjects who can then make a claim in the context of the French nation-state (Ticktin 2011: 12). Nepali-Bhutanese refugee subjectivity is already constitutive of their suffering, but only as long as one actively remains a refugee. If humanitarian government is “deployment of moral sentiments in contemporary politics,” it is all the more urgent for Nepali-Bhutanese refugees to present themselves as authentic suffering refugees worthy of being “saved” (Fassin 2012: 1). In this case, to be saved is to be resettled. Those Nepali-Bhutanese refugee women married to Nepali men who no longer seem to evoke compassion because of their marital status must keep their refugee-ness intact in order to qualify for the American benevolence of resettlement. To be eligible for this humanitarian care, Puspa and Bhim have to recalibrate their own relationship. Puspa and Bhim have to officially get divorced. In Bhim’s words, “I have agreed to this divorce because in the future I don’t want my children to think that they could not go to the US when they had a chance because of their father.” Legally divorcing Bhim keeps Puspa’s refugee status intact. Once divorced, in the eyes of the

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humanitarian institution that fundamentally operates by ranking human lives, Puspa’s life is valued more because now not only is she a suffering refugee but also a doubly vulnerable single refugee mother of two girls (Fassin 2007). Divorce becomes a tool with which resettling families can manipulate the humanitarian care regime, which categorically states that Nepali-Bhutanese refugee women married to Nepali citizens are no longer refugees and, hence, cannot be resettled. Getting a divorce, then, I argue, becomes a novel form of care engineered by the family, but, crucially, this form of care can only materialize as care because the regime of humanitarian care is situated within Stevenson’s (2014) notion of “anonymous care.” Anonymous care is a specific type of biopolitical care by the state that only comes to fruition when it no longer matters what the identity of an individual is—that is, “when life becomes an indifferent value” and one’s focus is only to “cooperate in the project of staying alive” (Stevenson 2014: 82). According to Weber, the idea of maintaining a neutral relationship and treating everyone with indifference is a standard bureaucratic maneuver (in Stevenson 2014: 76). The UNHCR and IOM in Nepal are not immune to it. During my research in Beldangi refugee camp, I often heard IOM staff members say that the IOM discourages their staff from visiting refugee homes. In an interview with an IOM staff member, I was told that the IOM regularly sends out email circulars announcing that they would take severe action against those staff found to be developing any kind of relationship with refugees or visiting their homes. The staff went on to say that since early 2014, the IOM surveillance of their staffs has become tighter.4 Staffs who were openly visiting refugee homes out of courtesy had stopped altogether. When the resettlement process began in 2007, it was a normal practice for refugee families to invite certain IOM staff members for dinner. Such invitations can be considered a natural unfolding of newly forged relationships. Informal exchanges about families and life happen over food.5 Important here is that the majority of institutional interactions refugee families have with the IOM/UNHCR is through their national staff—Nepali speakers—many of whom share similar economic, rural, and cultural backgrounds as the refugees themselves. Extending a dinner invitation to staff members who are similar to one’s family members or relatives and accepting it out of courtesy does not appear to be scandalous behavior according to the staff members whom I interviewed. Nevertheless, just as “personal connections are supposed to be suppressed in anonymous care” (Stevenson 2014: 85), building personal relationship with resettling refugees is considered a serious breach of the IOM’s code of conduct and thus punishable. The IOM in Nepal is invested in a rational goal of actively cultivating a very professional environment, at the base of

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which was this idea of unbiased treatment of refugees—that is, treating all of them with indifference. In the regime of humanitarian care as executed by the UNHCR, as long as Nepali-Bhutanese refugees are generally resettled and agency workers maintain a distance from the refugees they work for, it does not matter who is resettled or, in this instance, how the resettlement is achieved. Similar to how bureaucratic care in the Canadian Arctic is “hinged on the conception of the Inuit as so many serialized bodies that needed to be brought back to health” (Stevenson 2014:6), Nepali-Bhutanese refugee resettlement is dependent on the number of successfully resettled cases. The language used by the UNHCR indexes the importance they give to the “success” of resettlement. The Nepali-Bhutanese refugee resettlement project is considered one of the most successful projects in the world. It is considered successful primarily because “the acceptance rate of UNHCR’s referrals in Nepal by resettlement countries is the highest in the world—at 99.4 percent of total submissions” (Gurung 2013). As numbers become important, one can turn a blind eye to how those numbers are achieved. This turning a blind eye works toward the advantage of Nepali-Bhutanese refugees, for the authorities within the refugee camp, as well as Nepali lawyers who get paid hefty amounts to facilitate these divorce cases, are well aware that the refugee women opting for divorce consider it a temporary measure deployed to facilitate their resettlement process. This became especially clear to me one afternoon as we waited for the judge’s verdict on Puspa’s divorce at the district court in Chandragadi, Jhapa, when the lawyer, who charged NPR10,000 (Nepalese rupees; approximately US $100) to represent Puspa’s case, explained, “It is not even a real [divorce] case. A day is enough for it.” As a mutually agreed divorce that does not call for divisions of property or alimony, the lawyer added, the process of getting a divorce is fairly simple. Nevertheless, what one finally obtains from the district court signed by a district judge is a legal authentic paper of divorce. Puspa was introduced to the lawyer by a refugee camp representative who received NPR5000 (US $50) for his role as a middleman. The strategy of divorce is an open secret. Even though this form of care as mediated by the act of divorce introduced new forms of uncertainties for Puspa and her children, it still remained a strategy for attempting to secure future-oriented care. A family’s future depended on this legal but temporary “deferral of togetherness” (Kwon 2015: 492). Puspa hopes to migrate with her children to upstate New York where her parents now live, work hard to save money, become a permanent resident, return to Nepal to remarry her former husband, and sponsor his migration. Legally divorced but socially together, Puspa and Bhim also hope to get help from Dhana, who is now in the US.

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Similar to Sapana’s explication of how families in the camp assume that their family members, once resettled, should care by sending money, there was a tacit understanding between Dhana and his daughter’s family that he would indeed take care of them. Time was ripe for this expectation to be fulfilled as Bhim, the son-in-law, was gearing up to build a house in Nepal. Bhim had already intimated that the process had begun. Dhana felt especially obligated to provide financial support for this project, for he was aware that Bhim would reciprocate by providing love and care for Puspa, being her only caretaker in Nepal after Dhana’s departure. Maintaining social relations in the camp by keeping the son-in-law happy was necessary for Dhana to ensure Puspa’s wellbeing during his absence. Even after the mental arrangements Dhana made in which care for Puspa was channeled through Bhim, he still expressed his anxiety about the move primarily as his inability to take care of his daughter. But digging a little deeper, Dhana revealed several other reasons that made him equally ­­anxious about moving to the US.

From the Camp to Syracuse, NY Leaving Beldangi refugee camp was extremely difficult for Dhana. It was not only because he was not keen to leave his daughter behind but also due to his anxiety about starting a new life in the US. Dhana’s conversations in the camp invariably revolved around whether someone like him, who could not speak any English, would ever get a job once in the US. He shared how one of his friends, who was already in Ohio, had found a job at a casino collecting cigarette butts but would not tell his children. Instead the friend concocted a lie that he was going for his daily driving lessons when he was actually going to work. The friend was too humiliated to tell his children that his work was collecting cigarette butts. But my follow-up question— how long can one sustain lying—was left unanswered. Perhaps Dhana wondered that himself. He was more concerned about being a burden to his son and daughter-in-law than about starting a new life. In fact, resettlement to upstate New York for Dhana was more an imposition than a desire. He was merely cooperating with the UN edict of “durable solution,” which called for families to resettle in a third country and permanently close the camps in Nepal. When anxiously waiting for his departure to the US, Dhana would often joke about running away and disappearing from the camp so that he did not have to leave Nepal. While Dhana’s preoccupation was about the bigger existential issues of living with children and becoming a burden without a job, once he arrived in Syracuse, NY, in the deep February winter, his anxieties manifested

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in much smaller forms but had a comparable, if not greater, demoralizing effect on Dhana. Syracuse was covered in snow the day Dhana and Phul-Maya arrived. A couple who had never seen snow in their lives were now compelled to walk on it. After his first few baby steps on the snow, Dhana told me, “It is too difficult to walk on the snow. I slipped and fell after two steps. The shoes I have do not work.” Indeed, one can imagine Dhana’s steps as baby steps, those first few steps that we witness of our children or young siblings and capture those memories on camera and cherish for life as happy moments, as moments of progress and beginning of independence. But the irony here for Dhana is that those baby steps seem regressive. Anything but positive, these steps result in confinement to a two-bedroom apartment. From mid-February to mid-April, Dhana and Phul-Maya barely left the apartment. For these two, Syracuse was as vast as their apartment’s sliding door and the view of a snow-covered side street—a couple houses, a church, and the intermittent movement of cars—that the door accommodated. For elders like Dhana and Phul-Maya, who spent time working, socializing with friends and family, and being outdoors, confinement to a tiny apartment felt like imprisonment. The freedom that resettlement supposedly provides Nepali-Bhutanese refugees seemed questionable in the elders’ view.

Shifting Position of a Caregiver Patriarch If Dhana’s authority in the camp primarily came with becoming a caregiver, it was quickly unsettled once Dhana and Phul-Maya moved to Syracuse, NY. Dhana’s position within the household shifted overnight from being a caregiver to a care receiver. Dhana is now a family elder who does not understand English, who is nervous about leaving the house, and who remains confined within the four walls of his two-bedroom apartment in the Northside neighborhood of Syracuse. He requires care of various forms. Not only is he a welfare recipient dependent on the state of New York, but also dependent on his son and daughter-in-law, who are better able to read and write in English. The roles have reversed: now his son, Khem, is the primary breadwinner, and his daughter-in-law is the main kitchen manager. Sapana cooks what she deems fit for the family. Dhana did not openly articulate his discontent about what is cooked but it became apparent in his subtle comments about his changed food habits. Back in the camp, Dhana did not eat beef even though other family members did. During one of my visits to their home in Syracuse, I noticed Dhana eating rice with beef curry. A little puzzled, I commented that my understanding was Dhana did not like beef. He agreed, but went on to say that he is at the

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mercy of his daughter-in-law’s kitchen and has to abide by what is cooked. Dhana stated that it is no longer like those days in Nepal where he had an income and bought what he wanted to eat with his money. Now dependent on his son and daughter-in-law, he just had to consume what was given. This instance of Dhana’s changed food habit signals how he is rendered illegitimate as a caregiver, even though he is rerouting the care he receives in the form of welfare support from the state of New York to the kitchen and other household needs. In order to subsist in Syracuse, Dhana and PhulMaya together receive $357 as food allowance, $260 as cash allowance, and $260 for rent. Because they live with their son and daughter-in-law, the rent allowance goes toward the overall rent of the apartment, which is a direct benefit for Khem, who earns to provide for the entire household. On the one hand, such rerouting of resources indicates that the family model of the resettled Nepali-Bhutanese refugees incorporates a wider kin network, making visible the limits of the nuclear family model (only parents and children) of the American welfare system (Ong 2003: 134). On the other hand, elders like Dhana and Phul-Maya who are on welfare have no choice but to share their public assistance with their children and grandchildren. Dhana’s limited linguistic ability acts as a deterrent when he wishes to use his food stamp card at grocery stores. The process of having to swipe the card, punch in the pin number, and exchange greetings with the cashier, all of which takes place in English, is too much for Dhana. Because of Dhana’s lack of confidence in being able to use the food stamp card and the navigation that follows it, Sapana manages the elder couple’s food stamp allowance and uses it to buy food for the whole family. The remaining $260 cash allowance is what Dhana gets to keep for himself and his extra expenses. His extra expenses appear to be what he wishes to send to his daughter who is still in Nepal. No longer a figure of authority, it becomes all the more important for Dhana to maintain his integrity by trying to care for his daughter by sending money. Although Dhana expresses his love and care for his daughter through regular phone conversations, what he desires is to play a significant role in expediting the process of Puspa’s migration to the US. However, the resettlement process is beyond his control and dependent on the international humanitarian regime of the UNHCR and the immigration regime of the United States. Aware of his limited role in physically bringing his daughter to the US, Dhana attempts to aid the process of movement for his daughter by providing “shopping money,” a generous gesture of love that he considers is within his control. But ironically for Dhana, this gesture of monetary support can only come to fruition by attending ESL classes that are mandatory for him to receive public assistance. Puspa becomes a conduit through which Dhana is able to connect the biopolitical care he

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receives as a result of resettlement with monetary care he extends to his daughter in the camp in Nepal.

ESL Classes: A Chore for Survival The overlap between humanitarian care in the camp in Nepal and care offered through a resettlement package once in the US is remarkable for Dhana’s family and is largely hinged on the idea of bureaucratic indifference. I argue that humanitarian care in the camp and postresettlement state care once in the US are two versions of biopolitical care. Stevenson (2014: 3) states that biopolitical care is “a form of care and governance that is primarily concerned with the maintenance of life itself, and is directed at population rather than individuals.” Although there are several elements in this form of resettlement care package, I want to specifically focus on the ESL classes that are mandatory for resettled refugees as a type of resettlement care. The state considers ESL classes absolutely essential for survival, and hence both Dhana and Phul-Maya must attend them to be eligible for public assistance from the state of New York. However, a visit to the couple’s ESL class reveals that for couples like Dhana and Phul-Maya, who are not even literate in their native language, learning English is next to impossible. When Dhana was introduced to the English alphabet for the first time in his ESL class, he was baffled to discover that there are two cases in English. It was too confusing for him to remember the letters in both upper and lower cases. Once he was able to identify the letters and was feeling proud of his accomplishment, a new confusion surfaced: sentences in English are written in a mixture of both upper and lower case! Not only did Dhana have to learn to read and write a language he is unfamiliar with at age fifty-nine, but also essentially learn two scripts at once. The concept of case differentiation was as new to Dhana as the language itself and had to be consciously internalized. If the technicalities of learning to read and write in English seemed daunting for Dhana, speaking English to make friends was similarly challenging. As we entered their ESL classroom, Dhana pointed to a fellow classmate, a Somali refugee, as his new friend. I was excited to see how the interaction between two similarly aged men from two different corners of the world would unfold. But an hour into the classroom, I realized that besides exchanging cordial courtesy greetings, the two could not understand each other. They sat next to each other in the class but remained quiet the entire time. Both rushed to leave the classroom as soon as the class was over, and made their way home. Similarly, Phul-Maya sat next to another Nepali-Bhutanese woman who was next to an elderly Somali

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woman. Besides general exchange of greetings among the students, the largest amount of exchange that took place was between Phul-Maya and another Nepali speaker. Even though the class was extremely diverse with refugee students from Burma, Congo, Somalia, and Bhutan, the exchange among students was limited to their own community members. The exchanges between the ESL teacher and the students were even more constrained. In one instance, the ESL teacher repeated Phul-Maya’s name three times before she responded to him. Given how silent PhulMaya generally is at home, I initially assumed she was shy and hence slow in responding to the teacher. However, after being in the classroom with the couple for a week, it dawned on me that Phul-Maya’s awkward and slow response was not only because of the teacher’s accent, which Phul-Maya’s ears were not trained to hear, but also because of the way in which her name was uttered, which was unlike a Nepali name. The teacher dropped the Maya part of the name, thinking it was a middle name. But with Nepali names such as Phul-Maya, the first and middle names are combined and uttered together as one name. Phul-Maya, who was used to her longer version of the name in Bhutan and Nepal, had to now adjust her ears to her shortened name, Phul, which she thinks sounds awkward, and which means a flower in Nepali but not a person’s name. By reducing her name from Phul-Maya to Phul the teacher was also, symbolically and unintentionally, reducing Phul’s historically and linguistically rooted personhood and self-recognition. Furthermore, as the class was entirely conducted in English, which is the standard practice of running an ESL class, Dhana and Phul-Maya barely understood the class conversation. Their ESL teacher acknowledged that the classroom catered to a wide refugee population with a diverse level of linguistic competency and was well aware that the Nepali-Bhutanese couple did not understand much of the conversation. Further, the teacher explained that many refugees attend ESL classes because the classes provide them with some disposable cash.6 Dhana could not agree more with the teacher, for Dhana himself considers these classes to be “jhinjhat,” (a nuisance) but attends regularly in order to “chaˉ mal pakaˉ una” (cook rice). “Chaˉ mal pakaˉ una” is at once a metaphor and a reality. It is a reality in that the cash the couple gets from attending the class contributes to running the family’s kitchen, and a metaphor because rice is a Nepali-Bhutanese staple for survival. Although a chore, Dhana and Phul-Maya are forced to acclimate themselves into a new routine of attending the ESL class regularly. For those whose lives have continuously been structured by humanitarian interventions, there is little qualm in having to yet again adjust to newer interventions, even if that may mean getting a divorce or attending ESL classes. Adjustments that Nepali-Bhutanese refugees engage in

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FIGURE 1.2  Dhana and Phul-Maya attending their ESL class in Upstate New York. Photo by Retika Desai.

are reminiscent of what Stevenson (2014) calls “cooperation.” Like the Inuit who are asked to cooperate with a regime of life and thereby foster the expansion of the Canadian state, the resettling refugees are asked to cooperate with the humanitarian regime of care to reinforce the idea of a benevolent American state. As Stevenson (2014: 68) states, “A regime of life is a political system . . . in which keeping people alive has become the primary goal.” Since 2007, the humanitarian goal in the camp may have been to ensure a successful resettlement of Nepali-Bhutanese refugees, but once in the US, the goal is the maintenance of refugee lives. Dhana, who is barely present in the ESL classes, is exactly an example of this maintenance of life. The class enables Dhana and Phul-Maya to continue to contribute some form of subsistence to the family, but does little to aid the newcomer refugees in overcoming linguistic barriers: the assumption that older couples like Dhana and Phul-Maya will get jobs once their English skills improve is false at best. A stellar performance by the couple might fetch one a job where basic to no English is required, whether collecting cigarette butts like Dhana’s friend in Ohio or loading and unloading produce at a grocery store. Yet these classes are a means for survival, for

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maintaining life. In short, ESL classes become a form of biopolitical care that the state of New York provides. For those without other marketable skills, there is an advantage in agreeing to be disciplined by this form of care. For Dhana, it is especially urgent to cooperate with this regime of life so that the cash he gets can be used toward fulfilling his role as a caregiver of his daughter back in Nepal.

Conclusion Since 2007, the process of resettlement has been reshaping intimate family relations and reconfiguring notions of personhood within the NepaliBhutanese refugees, which is evident in the ways these families engage in strategies and practices of care. As emerging transnational families who still have family members back in the camp, care at a distance is shown and experienced fundamentally through discourses around money. As I have shown, those in the camp waiting to be resettled expect money from family members and relatives already resettled abroad. Giving money becomes a central indicator of affection within the family, and recently resettled Nepali-Bhutanese come up with creative strategies to attempt to keep this structure of monetary care intact. These resourceful strategies and practices of care at home are intertwined with the humanitarian care regime of the refugee camp as well as the biopolitical care the families are exposed to once they are relocated to the US. The Nepali-Bhutanese refugees featured in this chapter, then, are neither simply suffering subjects nor haunted by their inability to care. Instead, individuals like Dhana and Puspa work in tandem with regimes of family care and humanitarian care to craft their own versions of care in order to assuage the anxieties of resettlement. At the level of the family, the divorce that Dhana agrees to sponsor so his daughter Puspa can start her resettlement process is an instance of family care that is seemingly nonnormative but fully in line with the logic of a family patriarch attempting to keep his family together. Not only does this strategy signal how families care for each other, but also how families cooperate with the humanitarian care regime in order to be resettled. Divorce as a form of care is marred with uncertainties, and yet individuals like Puspa resort to it because it keeps her status of a dispossessed, suffering refugee intact. Further, only by actively maintaining herself as a refugee can Puspa secure some form of future-oriented care for her family. Dhana’s support for his daughter’s divorce is also a way for him to not only reunite with his daughter, but also to keep his self-worth intact in a vulnerable time of shifting authorities within the family.

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Furthermore, elders such as Dhana and Phul-Maya, who have a different set of skills from what is needed for the American job market, are forced to hold on to public assistance for everyday survival. Although a nuisance, regularly attending ESL classes enables Dhana to save face and maintain some semblance of being an active caregiver. Whether he sends money to his daughter in Nepal or shares rent with his son in Syracuse, the welfare support he receives as a result of attending ESL classes becomes the basis of monetary care he extends to his family members. As recently resettled subjects, the Nepali-Bhutanese navigate the deep waters of the humanitarian care regime in unique ways to craft intimate practices of care that attempt to maintain the tight-knit structure of their families disrupted by relocation. Retika Desai is a Ph.D. candidate in the Department of Anthropology, Syracuse University. Currently she is finishing her dissertation, titled “Refugee Crossings: Everyday Geographies of Nepali-Bhutanese Encampment and Resettlement,” which traces the everyday practices by which Nepali-Bhutanese refugees respond to both state-led dislocation from Bhutan to Nepal and United Nations–led relocation to the US. By studying refugee camps and resettlement sites together, her work illustrates how refugee life in camps in Nepal informs Nepali-Bhutanese narratives of arrival and negotiations of belonging once relocated in various cities in the US. Her work is centered on the anthropology of migration, humanitarianism, development, and critical refugee studies.

Notes 1. All personal names are pseudonyms. 2. The IOM resettlement formalities include conducting interviews with refugees to prepare their narrative of flight, facilitating refugee interviews with the US Department of Homeland Security in the IOM office in Nepal, thorough health examinations, conducting cultural orientation for those refugees ready for departure, obtaining no-objection letters from the government of Nepal for their departure, and, finally, the physical movement of refugees from the camp to various resettlement destinations. 3. The Constitution of Nepal, 2015, states that “a foreign woman who has a matrimonial relationship with a citizen of Nepal may, if she so wishes, acquire the naturalized citizenship of Nepal as provided for in the Federal law.” 4. Interview with an IOM staff member, 19 September 2014. 5. During my field research in 2013, I had attended one of those dinners with an IOM staff at the home of a refugee whose resettlement process to Syracuse was ongo-

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ing. But the same staff quickly intimated to me during my 2014 research that such ­practice had been completely halted. 6. Interview with the ESL teacher, 23 July 2015.

References Banki, Susan. 2008. “Resettlement of the Bhutanese from Nepal: The Durable Solution Discourse.” In Protracted Displacement in Asia: No Place to Call Home, edited by Howard Adelman, 29–58. Hampshire: Ashgate Publishing. “UNHCR Says Mixed Marriage Cases Unlikely for TCR.” 2008. Durable Solution to Bhutanese Refugee Problem, blog, 24 Sept. Accessed 29 November 2015, http:// durablesolution.blogspot.com/2008/09/unhcr-says-mixed-marriage-cases.html. Evans, Rosalind. 2013. “The Perils of Being a Borderland People: On the Lhotshampas of Bhutan.” In Borderland Lives in Northern South Asia, edited by David Gellner, 117–140. Durham, NC: Duke University Press. Fassin, Didier. 2012. The Humanitarian Reason: A Moral History of the Present. Berkeley, CA: University of California Press. _____ 2007. “Humanitarianism as Politics of Life.” Public Culture 19: 499–520. Gurung, Nini (edited by Vivian Tan and Leo Dobbs). 2013. “Refugee Resettlement Referral from Nepal Reaches Six-Figure Mark.” UNHCR: The UN Refugee Agency. 26 April. Accessed 20 November 2015, http://www.unhcr.org/517a77df9.html. Hutt, Michael. 2003. Unbecoming Citizens: Culture, Nationhood, and the Flight of Refugees from Bhutan. Delhi: Oxford University Press. International Organization for Migration (IOM). 2008. Cultural Profile: The Bhutanese Refugees in Nepal, a Tool for Settlement Workers and Sponsors. Damak, Nepal: IOM. Kwon, June Hee. 2015. “The Work of Waiting: Love and Money in Korean Chinese Transnational Migration,” Cultural Anthropology 30: 477–500. Accessed 20 December 2015, doi: http://dx.doi.org/10.14506/ca30.3.06. Malkki, Liisa. 1995. “Refugees and Exile: From “Refugee Studies” to the National Order of Things,” Annual Review of Anthropology 24: 495–523. Accessed 21 January 2015, doi: 10.1146/annurev.an.24.100195.002431. Ong, Aihwa. 2003. Buddha is Hiding: Refugees, Citizenship, The New America. Berkeley, CA: University of California Press. SAALT. 2012. “A Demographic Snapshot of South Asians in the United States: July 2012 Update.” Asian American Federation. Accessed 9 November 2015, http://saalt.org/wp-content/uploads/2012/09/Demographic-Snapshot-AsianAmerican-Foundation-2012.pdf. Shrestha, Deepesh Das (edited by Tim Gaynor). 2015. “Resettlement of Bhutanese Refugees Surpasses 100,000 Mark.” UNHCR: The UN Refugee Agency. 19 November. Accessed 20 November 2015, http://www.unhcr.org/564dded46.html. Stevenson, Lisa. 2014. Life Beside Itself: Imagining Care in the Canadian Arctic. Berkeley, CA: University of California Press. Ticktin, Miriam. 2011. Casualties of Care: Immigration and the Politics of Humanitarianism in France. Berkeley, CA: University of California Press. Thai, Hung Cam. 2014. Insufficient Funds: The Culture of Money in Low-Wage Transnational Families. Stanford, CA: Stanford University Press.

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2. HEALTHY AGING, MIDDLE-CLASSNESS, AND TRANSNATIONAL CARE BETWEEN TANZANIA AND THE UNITED STATES Andrea Patricia Kaiser-Grolimund

Introduction The topic of aging and caring for elderly people is gaining increasing attention in Tanzania as Tanzanians are living longer than ever before. In 2012, the Tanzanian National Bureau of Statistics estimated that 5.6 percent of the country’s population was age sixty and above (URT National Bureau of Statistics 2013).1 During the last decade, Tanzanians’ life expectancy at birth increased drastically from 50.9 years in 2002 to 61.8 in 2012 (URT National Bureau of Statistics 2015). While most people over sixty live in rural areas, the growth of elderly populations in cities calls for new and innovative solutions to an increasing burden of care. Many Tanzanians migrate from rural to urban areas or travel abroad and leave their aging parents behind. How do older people thrive in a country where only an estimated 4.4 percent benefit from a pension from a former employer (Mboghoina and Olsberg 2010: 5), and where the National Aging Policy stipulates that the family is responsible for its elders (URT Ministry of Labour 2003)? Who actually takes care of them? And how is their care organized from a distance? This chapter explores Tanzania’s urban middle class, particularly those belonging to the minority of older civil servants who benefit from amenities like pensions and health insurance, many of whom had sent their children abroad for further education. Using a multisite approach, this study focuses not only on elderly care-receivers in Tanzania but also on their children who migrated to the United States. The study is based on fifteen months of intimate, complex, and multisited ethnographic fieldwork in Tanzania and the United States between 2012 and 2015.2 In Tanzania, I focused on people above sixty years of age and their family members in a

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middle-class milieu of Dar es Salaam.3 In addition, in order to find out more about ideas on aging, as well as practices of caregiving from a distance, I followed children of older people in Tanzania to the United States and conducted research in four Tanzanian communities in cities and suburbs of Massachusetts, New York, Maryland, and Ohio.4 The old-age care that Tanzanian children in the United States provide for their aging parents in Tanzania takes place within transnational social fields that connect individuals, families, and communities across national borders (Yeates 2011: 1125). Traditionally, many authors have examined transnational care via “global care chains,” focusing on care given in exchange for financial returns from one country to the other (Hochschild 2000). While studies of care chains have been focused on aspects of childcare, the literature on care circulations as proposed by Baldassar and Merla (2014a) broadens the scope to include other aspects of care as well. However, support and care provided for older people from a distance has been widely underexplored, especially in African contexts.5 Looking at eldercare contributes to a more complete understanding of “transnational care” by taking into account not only childcare, but also the dimension of care provided by and for older people. By looking at eldercare provided from a distance, this chapter contributes to a rethinking of relational care practices when care cannot be provided through physical proximity and conventional practices. Migrants thus seek other ways to fulfill their duties as children and to show their parents love and affection in old age. As the findings of this study show, migrants abroad apply virtual forms of care by using new communication technologies and rely heavily on siblings or other members of their kin network in Tanzania, whom this study describes as the “observing eyes” of their siblings abroad. These observing eyes organize and provide the care that the migrants cannot at a distance. Based on these findings, this study proposes the spatializing image of a transnational triangle of care that involves not only older people and their relatives abroad in practices around eldercare, but also observing eyes in Tanzania. After an overview of relational care, I present the case of the Mushi family to illustrate how transnational caregiving can help foster novel relationships between emigrated children and aging parents within triangles of care. This relational care over distance is enveloped in multiple discourses, including those that circulate between Tanzania and the United States and create knowledge about how to age in good health. Older Tanzanians belonging to transnational middle-class families are exposed more than other Tanzanians to these discourses, which, as will be explained, become visible in their daily practices.

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Thinking Eldercare in Tanzania and Beyond: Contemporary Investigations Today, we are confronted with what Appadurai (1996: 44) calls “new global realities,” where different parts of the world become increasingly interconnected through flows of people, goods, and ideas. In migration literature, the new connectedness led to a rethinking of migration as a “oneway” process whereby migrants leave one country to settle and assimilate in another. Rather, migrants are embedded in transnational social fields that involve different forms of interaction over national borders.6 Being part of multidimensional transnational social fields, migrants often remain engaged in two or more countries (Mazzucato 2008a: 206). For example, they may provide care for a relative in their country of origin while simultaneously raising their own children in the country of current residence. While migration research mainly focuses on migrants in the current country of residence, the transnational social field approach broadens the view to include those at the “other end” of the field: in this study, the older people who receive transnational care from migrant children and relatives. Without ever having migrated, these older people are actively involved in transnational social fields by virtue of being embedded in such networks. Within these social fields, care does not only flow from migrant children to aging parents but rather circulates among several members of a transnational network of kin. Baldassar and Merla (2014a) therefore propose a concept of care circulations that go beyond the often described processes of “care substitution,” which is mainly concerned with care provided by emigrated mothers who struggle to find a replacement at home (Scott 2012). Instead, Baldassar and Merla (2014a: 8) describe care circulations as informed by “generalised asymmetrical reciprocity,” where care circulates within family networks over distance and time. Care circulations are therefore much more complex than unilinear care chains, which see care as only flowing in one direction. The care that circulates between migrants and aging parents can be described as “relational care,” encompassing a caregiver and a care receiver. Relational care is “an interpersonal experience; it is concern and compassion, and, in a large sense, love” (Kleinman and Geest 2009: 161). De Klerk (2011: 164) describes elderly care as “both the object and subject of social relations.”7 Social relations are formed or reinforced through bodily practices of care that are perceived in Tanzania to be the responsibility and moral duty of children, for example, to provide for their parents, while parents both accept care and provide aspects of care.8 When care relations are not fostered from both sides, they risk breaking in a process of

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de-kinning (Schnegg et al. 2010: 24). Over distance, care can thus become an important means of cultivating relationships, though care relations cannot be reinforced through bodily practices but through other important forms of care that will be looked at in this chapter in more detail. Naturally, over distance, migrants cannot provide the technical or practical aspects of care corresponding to Tronto’s (1993: 106) notion of “taking care of.”9 Such activities include cooking, cleaning, or washing clothes for an older person, or accompanying him or her to the church, hospital, or market. Or “just” being there, being available. In contexts where “being there” becomes impossible, virtual forms of care can be used to maintain relationships and to “care about” an older person (also see Baldassar and Merla 2014a). Technologies that facilitate communication between two countries become important (such as Skype or Whatsapp) in showing concern and care about the older person. Through these virtual forms of care, as opposed to bodily forms of care, Tanzanians in the United States maintain a sense of presence within the kin network (Baldassar and Merla 2014a: 6). They remain present simultaneously in both countries, despite their physical absence in Tanzania.10 In addition to virtual care, practical support can be provided by sending money or goods from one country to the other. Financial resources can serve to support those “at home” taking on the physical care work. Especially in health crisis situations, the availability of funds or medicines is crucial—for example, when a health condition necessitates hospitalization. In Dar es Salaam, hospital visits can become suddenly expensive when not covered by health insurance. In order to accelerate treatment, middle-class older people often use private hospitals where their health insurance does not work. Furthermore, more elaborate cases necessitate expensive trips to India for treatment.11 Flows of goods and money change over time and usually depend on the migrant’s ability to provide resources while at the same time adapting support to the needs of the care receiver(s) in the country of origin. Mobility enables middle-class transnational families, in particular, to be “associated with positive experiences of extended family relationships” as they are able to be involved in family practices not only through care and support from a distance but also through being present from time to time (Baldassar and Wilding 2014: 249). Some middle-class families with legal status in their countries of residence have access to enough capital to facilitate their mobility. Even though virtual care and practical support can be provided from a distance, during a crisis within the family (for example, a health crisis of an older person or the death of a family member), physically “being there” might be valued more highly than virtual or material forms of care (Baldassar and Merla 2014b: 52–53). However, visits require money and

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valid travel documents, and not all migrants are able to travel to respond to difficult moments. These complex experiences of care at a distance will be further explored in the context of the Mushi family.

The Case of the Mushi Family Bibi (grandmother in Swahili12) Veronica Mushi13 was sixty-three years old when I first met her in Dar es Salaam in 2012. She had just lost her husband and appeared rawboned and sad. Her husband had died from cancer. He had been transferred to India for treatment once he became very sick; he did not come back alive. Bibi Veronica was born in the northern Kilimanjaro region of Tanzania and went to a mission school there. She moved to Dar es Salaam in 1968. She taught at a nursery school and trained women at the Tanzanian railway company. After retiring in early 2000, she started to keep poultry in the compound of the house but stopped when her husband fell ill. Due to the state employment of the husband, the couple was able to buy their house in a former civil servants’ area of the city. Contrary to other areas of the city, Bibi Veronica’s house contained several rooms and a built-in kitchen. The compound around the house was big enough to park cars and was bordered by a wall. Since the death of her husband, Bibi Veronica had shared her house with her eldest son, Eric, who returned from the United States to stay with his mother after his father passed away. The son returned to organize the funeral—taking over his responsibilities as eldest son—while he was in the process of getting a green card in the United States. His sudden departure prevented him from legally returning to the United States—although his wife and two children were there. Bibi Veronica also shared her house with a nephew, the son of her late younger brother. Two of her grandchildren also stayed with her and helped her in the household. She cultivated vegetables around the house, and, every time I was there, she was busy preparing food for everyone who might pass by the house. To prepare food, she did not use the built-in kitchen in the house but a fire and charcoal stove outside the house that her children built especially for her. In the built-in kitchen, she only used the microwave to warm up food. When we met in 2012, three of her seven children were living in the United States. Her youngest son returned to Tanzania after some months, upon finishing his medical degree. In addition to the son who shared the house with her, three of her children lived in Dar es Salaam and visited her on a regular basis. Together with the children in the United States, they were in constant communication to decide what would be best for their mother. In August 2013, the wedding of her son (residing in Dar es Salaam)

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was a reason for all sisters and brothers to reunite in Tanzania. In 2014 and again in 2015, Bibi Veronica traveled to the United States, where she stayed for almost three months. While there, the children took her for medical checkups to improve her hypertension regulation and treat her eyes. In the United States, Bibi Veronica stayed in her daughter Maria’s house and helped care for Maria’s two small children during school summer break. Maria’s house was a small townhouse in the suburbs. When we met, Maria was thirty-five years old. She moved to the United States more than ten years ago—with a green card that she won in a lottery. In the United States, she finished her undergraduate studies in social work. She continued her studies and married a Tanzanian man living in the United States. When she first arrived in the United States, three of her brothers were already living there, which, she explained, made it easier for her to settle. However, she felt home sick from the start and made sure to travel back to Dar es Salaam once a year. She explained, To me, it is very important to go there every year. . . . When I go there after three weeks I am like oh my God I need to go back, but at least I went there, I stayed with her [my mother] and . . . so I am [going to] try to keep going there every year. If not every year, maybe every other year, at least to see her once a year, whether we are going or she is coming. And I think that is a part of . . . you know like sometimes getting sick is not a headache, she can be lonely to the extent that she will have a headache, so if I cut down the loneliness and make sure that she gets all her needs, she can be healthy and maybe she won’t even have to go to the hospital.

In the United States, Maria worked night shifts in the nursing sector, caring for disabled people, while she spent the days with her children. Her husband also worked the night shift as a social worker. He also had another job by day and completed a master’s degree part time. Because both worked at night, a nanny from Tanzania cared for the two little children. After the nanny left, Maria and her husband had difficulties finding another woman from Tanzania who was ready to travel to the United States to work for them. Maria explained that, for her, it is very important that her children learn both Swahili and English, therefore she preferred a Tanzanian nanny. Maria communicated several times a week with her mother in Dar es Salaam by calling her on her mobile phone. Because Maria was busy all the time, she usually called by using the headphone while driving her car. Apart from exchanges with her brother Eric, Maria communicated with her sister Amy, who lived in Dar es Salaam, not far from the family house. Together, the two sisters often decided what was best for their mother and then informed their brothers to collect financial support. Maria described their communication:

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Sometimes if she [the mother] needs anything, Amy will call and say, “Hey you need to get this for mom” . . . because it is easier here, and maybe good quality. . . . For example, when she lost weight, I saw the picture and said, “Amy that clothes look big,” and Amy said, “Yes, she lost so much weight, everything is big,” but she is still wearing it. So what we did, I bought like ten clothes like for the church and then I bought the other one for just the household, and Amy has to go home when she is not there and take all the bigger ones and take them away and hang the others. Because if you don’t do it she is still [going to] wear it.

Although they were neighbors in the United States, living in the same suburbs, the sisters and brothers did not talk much about the regular support they were sending to their mother; only in cases of an event for which they needed to collect money for something in particular. Maria explained that she does not want to tell her brothers how much “pocket money” she sends directly to her mother on a monthly basis so that they do not stop doing the same. Maria’s brother, Eric, made sure that his mother had everything she needed. He drove her to church every Sunday and organized, together with his sister Amy, the care she needed. Although far away from his wife and children, Eric felt it was his responsibility to remain with his mother until she completely recovered from the loss of her husband. He said, I am the first-born. Somebody can see that because I have a marriage—a wife and kids—and I need to be with my family. In other words, it’s [for] me to move my family here so I can stay and take care of mother. And mother does not want to go to United States. She wants to stay here and I can’t bring my family here. And . . . I have got them in school, I want them in school in the United States, which is a good school. So I better come and be here and I can go back once she is stabilized. Maybe she finds a business, anything like . . . I can leave her here and go and then my brothers can take care of her, but right now she is not . . . she is doing small things but not something to keep her busy all the time.

When Bibi Veronica needed medical treatment, they called their youngest brother, a medical doctor, to accompany her to the hospital. When the siblings wanted to pass on health advice to Bibi Veronica, they usually relied on their youngest brother, since she only listened to him as a medical doctor. Although their mother did not need more bodily forms of care (she was still capable of doing the more intimate care for herself), Eric was the one “being there.” Together with his sister Amy, they were what I call “observing eyes” of their siblings in the United States. Both communicated regularly with their siblings abroad and reported on their mother’s wellbeing.

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The case of the Mushi family illustrates how eldercare can be organized over national borders. Care circulated not only between Bibi Veronica and her children in the United States but involved siblings in Tanzania too. Especially Amy, but also Eric, had a crucial role when it came to the organization of their mother’s care from abroad.

Care within Transnational Triangles While Tanzanians in the United States are exposed to an American system of welfare that makes provisions for eldercare outside of the family, they are also familiar with the Tanzanian context, where even the country’s National Aging Policy stipulates that eldercare remains the responsibility of the family, while institutional care is described as a last resort (URT Ministry of Labour 2003).14 Most migrants feel responsible for the care of their parents and base their responsibility on organizing principles of kinship. As with Maria and Eric, parents in many middle-class families in Dar es Salaam supported their children’s traveling abroad for studies, but would prefer that they return at some point to take care of them. Eric explains his mother’s wishes: “So mom was happy for us to go but now she is not happy because we stayed there . . . that will happen to any mother because you have your parents, but you have to move out to find your own life and then bring something home.” Lamb (2009a: 187) observed the same idea among older Indians whose children traveled abroad for studies: the parents wanted to invest in a good education abroad, but they also wanted their children around when they became old, since serving parents in old age in the Indian context constitutes more than just sending money. Like Maria, many migrants tried to make up for not physically being with their older relatives through regular phone calls or by sending money or goods. What became evident in this study was that the degree and nature of transnational care provided by Tanzanian children for their parents strongly depended on their legal status in the country of residence.15 For Tanzanians without legal permission to stay in the United States, it was more difficult to acquire the means to send regular support. Due to the United States’ restrictive immigration policies, many of this study’s participants resided illegally in the United States upon arrival, and not all managed to legalize their status during their stay.16 Migrants from middle-class families usually had few difficulties due to scholarships and higher education that facilitated their access to employment to legalize their status in the country. For these “well-established” Tanzanians, providing regular financial and material support for the parents was common.17

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Without legal status, few Tanzanians could travel back home, even when a parent or relative died, because they would not be able to reenter the United States at a later date. With a green card or American citizenship, migrants are more mobile and thus able to travel home. The importance of such visits was underscored by Maria, who explained that these visits contributed to her mother’s wellbeing just by allowing her to be with her. Through the flow of people traveling in both directions, the social field is “active and activated” (Baldassar and Wilding 2014: 248). Some children, however, also decided not to travel to Tanzania for a longer period of time. They did so for several reasons, mostly to save costs and time. Similarly, the ability to invite parents to visit the United States depends on the migrant’s legal permission to reside there. Parental visits to the United States were often linked to the need for medical treatment, either in emergency situations or for regular checkups. Checkups were sometimes tagged on to parental visits to the United States for events such as weddings, childbirths, or graduations. In Bibi Veronica’s case, the children made her visit the United States on a regular base. Her children had to persuade her each time to travel to the United States as she preferred to remain in Dar es Salaam. While being in the United States, her body became a “project” when taking her from one medical doctor to the next in order to improve her health condition. Maria and her siblings took Bibi Veronica to the medical doctor in order to adjust her hypertension medication. The medication was changed and Bibi Veronica’s body reacted strongly to the change so that she had to be admitted to a hospital for a short period of time. Monica, another research participant, arranged for her father a trip to the United States when the doctors in Dar es Salaam discovered water in his lungs but sent him home without further treatment. He almost died on the airplane and was collected by ambulance upon landing at the US airport. The American medical doctors found that he had cancer that had already spread widely, though it had remained undiscovered in Tanzania. Generally, other Tanzanians “flew in” their parents less regularly than did the Mushi family, as it involved not only high medical costs but additional expenses to maintain their parents while in the United States. In addition, most elderly parents of migrants would rather have their children visit them in Tanzania instead of enduring travel to the United States, as they usually described feeling lonely and isolated while there. Most of this study’s research participants resided in suburbs of larger cities, where, without cars or knowledge of the transport system, mobility was limited for older visitors. The most common element of transnational care found in this study was financial support. While well-established Tanzanians sent money on a

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monthly basis (the amounts averaged from US$100 to US$300) or through a rotation system among siblings, less well-established Tanzanians sent money only when available or when asked in emergency cases. Angela, who was in her mid-thirties when we met, normally received text messages when her mother needed support. With a gentle smile on her face she explained, “I send [money] if it’s needed, [I do] not send every month, yah. When she [my mother] needs money she just texts me ‘am broke’ . . . hahaha! That’s her text, ‘Angela I am broke.’” Angela lived in the United States with her youngest son and her husband, while her two daughters stayed with her husband’s parents in Dar es Salaam. Money was sent for festivities such as Christmas or during the end of Ramadan, but also for important events such as funerals and weddings. Some Tanzanian research participants also sent regular amounts to finance the building of a house or houses in Tanzania, either for themselves or for their parents. Others invested in solar panels for electricity or in a water tap in their parents’ or a relative’s house. Some contributions paid for water or electricity bills. Furthermore, migrants paid school fees for extended family members. Referring back to the care circulation concept, financial care provided by Tanzanian children abroad not only flowed directly to parents but circulated among different members of the extended network of kin, thus creating intimacy, enforcing responsibility and multiple networks of engagement. Often, the “observing eyes,” the relatives responsible for the care of the older person, were involved in organizing the flow of remittances, as somebody trustworthy was needed to withdraw the money sent through Western Union to a bank account, or make arrangements with traveling relatives or friends.18 Material support, or sending goods, was another way that children in the United States actively engaged in caring for their parents as they got older. Depending on their parents’ health condition and needs, they sent different kinds of medical equipment (such as insulin injections or ambulatory blood pressure units) or health-related support in general (such as medication or sanitary napkins). However, medical equipment or other goods only arrived at the destination when taken there by a person.19 The public post transport was unreliable. For this reason, sending goods was much easier for well-established Tanzanians, with legal permissions that allowed them to travel. Furthermore, it was easier to send goods to the city than to remote rural areas. When Maria traveled to Tanzania for visits, her luggage was usually full of gifts for her mother and other relatives. Apart from new curtains for the living room and other gifts, she also carried food supplements for her mother.20 Together with her brothers, Maria invested in a blood pressure monitor so that their mother could supervise her hypertension. This medical equipment sent to Tanzania not only affected the

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FIGURE 2.1  Hypertension monitoring through an ambulatory blood pressure unit sent from the United States. Photo by Andrea Kaiser-Grolimund.

recipient’s health condition but also shaped how these older parents perceived their own health and aging process (see fig.2.1). Transferring technical devices such as laptops or mobile phones was also very common. The devices helped to facilitate communication with relatives in the United States and also supported school-aged children. Yacinta, when asked about what she sends back home, replied, “I sent them phones to use WhatsApp; a good phone, so that they can have WhatsApp. Also, I sent them laptops so that we can talk on Skype, so sometimes we talk on Skype.” Yacinta worked for a fast food chain without papers and was not able to travel to Tanzania due to her illegal status. Great emphasis was placed on ensuring smooth communication with parents and those responsible for the parents in Tanzania. The most important means of direct communication between migrants and their parents were regular phone calls. The phone calls to parents can be described as an element of virtual caregiving in order to “be together” and to cultivate the relationship between parents and children abroad. In this connection, normative understandings of migration have to be revisited, since it is not always the distance and absence that have a negative impact on “being together” (Baldassar and Merla 2014b: 40). Direct phone conversations with parents were sometimes challenging because of the time difference. Chat communications, however, mostly with younger relatives through

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instant messengers or Skype, helped provide information quickly at any time. Hindered communication between parents and children across continents made migrants value the role of the observing eyes back home. Normally, the communication between siblings was more fluent and regular through the use of social media. In contrast, monthly or weekly phone calls with parents were rather short due to costs. In addition, the conversations were said to remain at a superficial level, since the older person felt compelled to assure the caller that he or she was well. In this respect, children abroad gave more credibility to reports of an older persons’ health condition narrated by a sibling who was able to see the older person and make a judgment about his or her (health) condition by observing the older parent on a daily base. Similarly, health advice for parents, offered by emigrated children based on their experiences in the American context, was more successfully transmitted to the observing eye than to the older person herself. Interestingly enough, in contrast to their parents, who emphasized the importance of the support coming from overseas, children abroad estimated their involvement in care, mainly through financial means or sending goods, as marginal. The children abroad perceived the role of siblings or relatives physically present in Tanzania to be much more important, and valued them highly as the observing eyes back home. When I asked Goodluck about staying in the same compound with his aging parents while three of his siblings live abroad, he replied, “I am the eye of my brothers in America here in Tanzania; we often communicate through phone, WhatsApp, and Facebook.” Goodluck was invited by his parents to build his house right next to the parents’ place, within the same walls of the compound in the former civil servants’ area of Dar es Salaam. As a youngest son, he was expected to take care of his parents. He explained this expectation with organizing principles of his ethnic group of Chagga. The observing eyes in Tanzania who stayed close to the older person and communicated with children abroad were thus the “nodes” through which information about the older person usually passed (Levitt and Glick Schiller 2004: 1009). Those nodes were involved in daily care activities with the older person and closely monitored the older person’s health. Ali, who was in his mid-forties when we met, described the importance of his siblings in Tanzania to the care of his mother as follows: I could say, because I am in America, I can send a lot of money there, but I am not the most important [caregiver] because others are there physically so probably they contribute more than I do, but when they need a push, a financial push, then my money makes a difference. But in terms of personal

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attachment, more support I think [comes from] my sisters and my brothers. They do a wonderful job so it’s . . . it’s not somebody doing the most but something we do it collectively together.

Observing eyes stayed either in the same household as the older person, or at least in the same city or area of the country. Describing themselves as eyes of their siblings abroad, they emphasized the importance of being related to the older person through kinship. In Tanzania, the provision of more intimate forms of care is only acceptable among kin. Furthermore, they are gendered. Hence, an elderly woman needing assistance to shower or to go to the toilet can only rely on a female family member, while an elderly man must depend on male kin or his spouse. Observing eyes were mostly siblings or relatives of the emigrated child abroad. In contrast to what the literature describes in many other contexts, in this study it was only in very rare cases that all siblings resided abroad, leaving no one present to manage practical care activities in Tanzania. Christian, for example, has a sister in the UK and another sister in Denmark. His parents did not have another child in Tanzania, but shared their house with members of the extended kin. These co-residing members, however, changed from time to time, so that Christian never knew whom his parents were sharing their house with. In Lamb’s (2009) research on Indians residing alone in Kolkata, very few had a child living with them or in a different household in the same city. Most had all of their children either living abroad or in other cities in India (Lamb 2009a: 178–179). The loneliness connected to living alone that Lamb describes was not so evident when talking to older people in Tanzania and to children in the United States as it was usually only one of many children who resided abroad (the Mushi family depicts a rather exceptional case for this study, with more than one sibling residing abroad). Due to the highly valued involvement of a sibling or relative in Tanzania in most of the observed cases, this study’s findings agree with other scholars who assert that we cannot assume a care chain exchange between just two people—in this case, the older person and the child abroad. Rather, I argue that we have to look at a “triangle of care,” where involvement and care practices change over time and according to the abilities and health conditions of those involved in Tanzania and abroad. By using the image of a triangle, I want to emphasize the crucial role of the observing eyes.21 Within these triangles of care, the older people are by no means passive, but engage in the exchanges about improving their health and wellbeing. Like Bibi Veronica, many older parents offer healthcare or lifestyle advice to their children by phone—for example, on how to raise children. Older people also sent antibiotics that were not easily accessible in the

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United States without prescription from an American medical doctor. Financial support, advice, and material thus circulated between countries in both directions and between several people. Hence, many older persons in Tanzania were actively engaging in the transnational networks that, according to Yeates (2011: 1126), act as conduits where “orientations, ideas and ideologies of care” circulate. With a family member abroad, older people in Tanzania take part in exchanges within transnational social fields although remaining where they are (Levitt and Glick Schiller 2004: 1010). In India, Lamb (2009b: 419) found that older people live and shape new forms of aging by facing processes of “global” or “modern” living and aging while being part of transnational families. Comparably, in Tanzania, older people took up ideas deriving from exchanges with their children. As with Maria, many Tanzanian migrants of this study worked in the nursing sector, taking care of somebody else’s parents while their own elders were far away. Thus, they were engaged in “care substitution” (Scott 2012: 144). Through their exposure to the American welfare system, they were confronted with American gerontological discourses, such as the current concepts of “healthy aging” or “successful aging” that create new ways of experiencing old age (Sokolovsky 2009: xviii).22 The experiences and reflections on care within institutionalized eldercare in the United States consequently shaped the children’s care provision to their own aging parents in Tanzania. Older parents received information from other sources in Tanzania (i.e., medical doctors, media,23 or social environments), tried to make sense of what they were told, and incorporated aspects into their daily healthcare practices.24 While Bibi Veronica makes sure that she eats “good food” by following a balanced diet, Mzee (elderly man in Swahili) Dunford from Dar es Salaam walks every second day for exercise. Many older people in this study, belonging to these transnational middle-class families, generally aspired to take good care of their own health, so as to retain strength in old age—drawing implicitly or explicitly on global aging discourses. At the same time, however, they prepared for old age by offering a “good” education to their own children in Tanzania or abroad. These new imaginaries of aging and care highlight ideas and ideologies as they circulate through triangles of care (see fig. 2.2).

Conclusion This chapter has sought to challenge narrow concepts of relational care that miss out on important aspects of care provided over distance. The transnational care practices of Tanzanian children in this study show

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FIGURE 2.2  The circulation of care shapes new forms of aging: food supplements in the United States. Photo by Andrea Kaiser-Grolimund.

that there are elements of care that create closeness although provided over distance. These elements do not rely on physical proximity or bodily elements of care but show emotional and moral concern; through phone calls or through sending money, gifts, or medical equipment; and through cooperating closely with a sibling or other kin who live close and keep an “observing eye” on the older parent. Nonetheless, this study reveals that middle-class transnational families, in particular, use their ability to travel from one continent to the other to strengthen bonds of kinship through physical proximity—at least for short periods of time. These visits, however, necessitate a legal status of the migrant as well as sufficient means to either travel themselves or to invite their parents or other relatives to do so. In most middle-class families participating in this study, the visits were less frequent than in the case of the Mushi family. By using the concept of care circulations as developed by Baldassar and Merla (2014a), this chapter argues that the idea of asymmetrical circulations of care between different localities suits transnational care practices in old age much better than unilinear notions of care chains. This study goes even further and proposes the spatializing image of a transnational triangle of care in order to illustrate the tridirectional networks of contact

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between the older people and their relatives abroad and in Tanzania who are involved in different care practices around eldercare. The triangle was developed based on the findings of this multisited ethnography that revealed the importance of an observing eye in the country of origin who takes over the practical and technical aspects of care. Neglected by the literature until now, these observing eyes play a major role when it comes to transnational care provided by Tanzanians in the United States for their elders in Tanzania. Interestingly enough, these observing eyes and their involvement in care practices were much more appreciated by the migrants in the United States than by the older people as the main receivers of their care. Observing eyes do not necessarily have to be children of older people; in many cases, nieces or nephews took over these care tasks. This study not only observed these triangles of care over national borders but also when caregivers were dispersed in different localities within the same country. The focus on older people within the triangles revealed that their experiences and practices of aging were strongly influenced by their involvement in transnational care relations. More than others, they seemed to be exposed to the prevalent international discourses that promote concepts around healthy aging. Children in the United States who are constantly exposed to American discourses and practices of old-age care, especially those employed in the nursing sector, advised their parents to exercise and organized regular medical checkups for them, together with the assistance of the observing eyes. When taken to the United States for treatment, the elderly people’s bodies became “playgrounds” for healthy-aging interventions. Therefore, this study argues that, with the circulation of care, ideas and ideologies also flow from one (cultural) context to the other and shape new images of aging and care in urban Tanzania and beyond. While this study was only able to provide a snapshot over a few years, it was evident that distance-based care practices changed over time and constantly adapted to the needs and abilities of the people involved. The migrants interviewed for the study belonged to a first generation of Tanzanians in the United States. While they raised their children in the American context, many expected to go back to Tanzania in old age—­ however, without anticipating much care from their own children. It would be telling to follow them over a longer period of time to observe how they organize their aging and care when old and frail themselves.

Acknowledgements The author wishes to thank Amena Briët for her English proofreading, and Sandra Staudacher and Peter van Eeuwijk for their valuable comments.

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Andrea Patricia Kaiser-Grolimund is an academic assistant, lecturer, and Ph.D. candidate at the Institute of Social Anthropology at the University of Basel in Switzerland. In her Ph.D. thesis, she explores how people at the age of sixty years and above experience aging and health as expressed, for instance, in living and care arrangements created in changing urban and transnational contexts of Tanzania and the United States. Her multisited ethnographic fieldwork was carried out in the context of the Swiss National Science–founded research project on Aging, Agency and Health in Urbanizing Tanzania (headed by Prof. Dr Brigit Obrist).

Notes   1. The next Population and Housing Census of the National Bureau of Statistics in Tanzania is announced for 2022, therefore this chapter is based on the data available from 2012.   2. This study was conducted as part of a comparative research project, Aging, Agency and Health in Urbanizing Tanzania (http://socialresilience.ch/old-ageagency/), funded by the Swiss National Science Foundation [Nr. 140425 and Nr. 152694] and in collaboration with the University of Dar es Salaam and the State University of Zanzibar in Tanzania. The project was led by Prof. Dr Brigit Obrist, and supervised by Dr Peter van Eeuwijk, both from the University of Basel in Switzerland. My co-researcher, Sandra Staudacher, conducted a similar study in the city of Zanzibar with transnational care relations to Oman. The National Institute for Medical Research (NIMR/HQ/R.8a/Vol.IX/1376 and NIMR/ HQ/R.8a/Vol.II/266) in Tanzania and the Tanzania Commission for Science and Technology (COSTECH No. 2012-386-NA-2012-125 and No. 2013-305-NA2013-81) supported the conduct of qualitative research in Tanzania, while Prof. Dr Sarah Lamb from Brandeis University supervised the research in the United States.   3. The milieu stands out by its particular historical development as a former civil servants’ area and has a low density of 2,821 inhabitants, with a rather high number (4.5 percent) of people above sixty years of age (Census data from 2012, information derives from an interview with the sub-ward leader on 18 March 2013).   4. All participants in Tanzania and the United States consented either orally or in written form to take part in the research. The in-depth interviews with fifty older people and their caregivers in Tanzania, as well as the twenty-seven interviews with relatives in the United States were audio recorded, transcribed, and analyzed with the qualitative data analysis software MaxQDA. Data was coded and analyzed following a further-developed grounded theory approach by Charmaz (2006).   5. Authors who have looked at transnational eldercare are, for example, Mazzucato (2008b) for Ghana and the Netherlands; van der Geest, Mul, and Vermeulen (2004) for Greece, Ghana, and the Netherlands; and Staudacher (2018) for Tanzania and Oman (Staudacher’s research belongs to the same research project as this contribution).

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  6. Levitt and Glick Schiller (2004: 1009) define social fields as “a set of multiple interlocking networks of social relationships through which ideas, practices, and resources are unequally exchanged, organized, and transformed.” The authors base their description of social fields on Basch, Glick Schiller, and Szanton Blanc (1994).   7. The author emphasizes that care is provided through social relations while, likewise, it is care that creates these social relations.   8. This chapter is mainly concerned with parent-child care relations, although I am aware of transnational care that is provided for older people through other members of a social network.   9. Tronto (1993: 106), distinguishes between “caring about” and “taking care of.” She points to the fact that the person who cares about somebody is not necessarily the same person involved in the actual caregiving. 10. In this way, calling a parent to ask about his or her wellbeing becomes an important part of showing love and affection, while calling or chatting with a sibling is used to organize practical support and physical care for the older person. 11. When Tanzanian doctors lack infrastructure or knowledge to treat a particular health problem, in many cases Tanzanians are referred to India for treatment. 12. Swahili is one of Tanzania’s national languages. 13. All names of the research participants presented in this chapter have been changed in order to protect their privacy. Due to the illegal status of some research participants residing in the United States, I decided to omit information about migrants’ places of residence in the United States. 14. The family constitutes only one important care provider within the global political economies of care. This contribution mainly focuses on care provided through relatives while being aware of the fact that care does not take place in a vacuum. 15. Mazzucato (2008b) observed similar tendencies when studying Ghanaian migrants in the Netherlands and their involvement in organizing care for their parents at home. The Ghanaian’s legal status greatly influenced the support they sent from abroad. 16. Currently, Tanzania does not accept dual citizenship. Therefore, migrants have to decide in favor of either the Tanzanian or the US passport, once they are able to apply for US citizenship. 17. This study distinguishes three groups of Tanzanian migrants in the United States: the group of “well-established” Tanzanians, the group of “over stayers” and the group of “temporarily employed” Tanzanians. For this chapter, the main focus is on the well-established migrants, mostly belonging to Tanzanian middle-class families (Kaiser-Grolimund 2017). 18. However, not all cases reported a successful circulation of money. Abou could not send money to his brother who was living close to his mother. Because of the brother’s drug addiction and need for money, the financial aid never arrived at the mothers’ place. 19. Many US states have an organized Tanzanian community. People belonging to the biggest Tanzanian community of Washington, D.C., Maryland, and Virginia (DMV), for example, met for barbeques or celebrated Tanzanian and US holidays together. Usually people knew each other’s travel plans and sent material with other members of the community.

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20. Intake of “Centrum Silver Adults 50+” vitamin pills sent from the United States to Tanzania was very common among older parents of migrated Tanzanians. Some older research participants reported that the pills were usually not taken on a regular basis for prevention, but only when feeling weak or sick. 21. This chapter mainly focuses on care provided between parents and Tanzanian children residing in the United States. Other flows of care within the triangle (i.e., between elderly people and observing eyes and between observing eyes and children in the United States) are explored to a lesser extent. 22. The United States was at the forefront of emphasizing the core values of activity, future orientation, and autonomy in connection to aging (Rowe and Kahn 1997). Of course, not every corner of the world perceives aging as an individual project of the empowered individual. We therefore have to critically reflect on the ways in which culture and ideology silently coin these discourses (Lamb 2014: 42). Only recently the World Health Organization published its World Report on Ageing and Health, in which they revised their initially promoted concept of “active ageing” (WHO 2002) and now opt for a “healthy ageing” that is adapted to local environments. They define healthy aging as the “process of developing and maintaining the functional ability that enables well-being in older age.” By functional ability they mean “health-related attributes that enable people to be and to do what they have reason to value” (WHO 2015: 28). 23. Local TV channels in Tanzania offer aerobic lessons, while some local newspapers inform readers about healthy living in their health sections. 24. It is important to note that children in the United States constitute only one source of information for their parents on how to age well, among from several others.

References Appadurai, Arjun. 1996. Modernity at Large: Cultural Dimensions of Globalization. Minneapolis, MN: University of Minnesota Press. Baldassar, Loretta, and Laura Merla. 2014a. “Introduction: Transnational Family Caregiving through the Lens of Circulation.” In Transnational Families, Migration and the Circulation of Care: Understanding Mobility and Absence of Family Life, edited by Loretta Baldassar and Laura Merla, 3–24. New York: Routledge. _____ 2014b. “Locating Transnational Care Circulation in Migration and Family Studies.” In Transnational Families, Migration and the Circulation of Care: Understanding Mobility and Absence of Family Life, edited by Loretta Baldassar and Laura Merla, 25–58. New York: Routledge. Baldassar, Loretta, and Raelene Wilding. 2014. “Middle-Class Transnational Caregiving: The Circulation of Care between Family and Extended Kin Networks in the Global North.” In Transnational Families, Migration and the Circulation of Care: Understanding Mobility and Absence of Family Life, edited by Loretta Baldassar and Laura Merla, 235–251. New York: Routledge. Basch, Linda, Nina Glick Schiller, and Christina Szanton Blanc. 1994. Nations Unbound: Transnational Projects, Postcolonial Predicaments, and Deterritorialized Nation-States. Langhorne, PA: Gordon and Breach.

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Charmaz, Kathy. 2006. Constructing Grounded Theory: A Practical Guide through Qualitative Analysis. London: SAGE. Geest, Sjaak van der, Anke Mul, and Hans Vermeulen. 2004. “Linkages between Migration and the Care of Frail Older People: Observations from Greece, Ghana and The Netherlands.” Ageing and Society 24: 431–450. Hochschild, Arlie. 2000. “The Nanny Chain.” The American Prospect 11 (4): 32–36. Kaiser-Grolimund, Andrea Patricia. 2017. “The New Old Urbanites: Care and Transnational Aging in Dar es Salaam.” Ph.D. diss., University of Basel. Kleinman, Arthur, and Sjaak van der Geest. 2009. “‘Care’ in Health Care.” Medische Anthropologie 21 (1): 159–168. Klerk, Josien de. 2011. “Being Old in Times of AIDS: Aging, Caring and Relating in Northwest Tanzania.” Ph.D. diss., African Studies Centre, Leiden. Lamb, Sarah. 2009a. Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad. Bloomington, IN: Indiana University Press. _____ 2009b. “Elder Residences and Outsourced Sons: Remaking Aging in Cosmopolitan India.” In The Cultural Context of Aging, edited by Jay Sokolovsky, 418–440. Westport, CT: Praeger. _____ 2014. “Permanent Personhood or Meaningful Decline? Toward a Critical Anthropology of Successful Aging.” Journal of Aging Studies 29: 41–52. Levitt, Peggy, and Nina Glick Schiller. 2004. “Conceptualizing Simultaneity: A Transnational Social Field Perspective on Society.” International Migration Review 38 (3): 1002–1039. Mazzucato, Valentina. 2008a. “The Double Engagement: Transnationalism and Integration: Ghanaian Migrants’ Lives between Ghana and the Netherlands.” Journal of Ethnic and Migration Studies 34 (2): 199–216. _____ 2008b. “Transnational Reciprocity: Ghanaian Migrants and the Care of Their Parents Back Home.” In Generations in Africa, edited by Erdmute Alber, Sjaak van der Geest, and Susan Reynolds Whyte, 91–112. Berlin: Lit. Mboghoina, Thadeus, and Lars Osberg. 2010. “Social Protection of the Elderly in Tanzania: Current Status and Future Possibilities.” In Special Paper 10/5. Dar es Salaam: REPOA. Rowe, John, and Robert Kahn. 1997. “Successful Aging.” The Gerontologist 37 (4): 433–440. Schnegg, Michael, Julia Pauli, Bettina Beer, and Erdmute Alber. 2010. “Verwandtschaft heute: Positionen, Ergebnisse und Forschungsperspektiven.” In Verwandtschaft heute: Positionen, Ergebnisse and Perspektiven, edited by Erdmute Alber, Bettina Beer, Julia Pauli, and Michael Schnegg, 7–44. Berlin: Reimer. Scott, Mary Alice. 2012. “Paying Down the Care Deficit.” Anthropology & Aging Quarterly 33 (4): 142–151. Sokolovsky, Jay. 2009. “Introduction: Human Maturity and Global Aging in Cultural Context.” In The Cultural Context of Aging: Worldwide Perspectives, edited by Jay Sokolovsky, xv–xxxv. Westport, CT: Praeger. Staudacher, Sandra. Forthcoming. “Cosmopolitan Aging in Zanzibar: Elderhood, Health and  Transnational Care from Oman.” Ph.D. diss., University of Basel. Tronto, Joan C. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. London: Routledge.

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URT Ministry of Labour, Youth Development and Sports. 2003. National Ageing Policy. Dar es Salaam, Tanzania: Ministry of Labour, Youth Development and Sports. URT National Bureau of Statistics. 2013. 2012 Population and Housing Census: Population Distribution by Age and Sex. Dar es Salaam, Tanzania: National Bureau of Statistics. _____ 2015. Mortality and Health. Dar es Salaam, Tanzania: National Bureau of Statistics. WHO. 2002. Active Ageing: A Policy Framework. Geneva: World Health Organization. _____ 2015. World Report on Ageing and Health. Geneva: World Health Organization. Yeates, Nicola. 2011. “Going Global: The Transnationalization of Care.” Development and Change 42 (4): 1109–1130.

ijjjjjjjjjjjjjjk PART II Spirituality and Intergenerational Care across Distance

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3. INTERGENERATIONAL RELATIONSHIPS AND EMERGENT NOTIONS OF RECIPROCITY, DEPENDENCY, CAREGIVING, AND AGING IN TUAREG MIGRATION Susan Rasmussen

Introduction Numerous anthropological studies of aging have examined how reciprocity, dependency, and concept of person are negotiated in caregiving practices between the generations (Lamb 2000; Rasmussen 1997, 2012; Sokolovsky 2009; Vatuk 1981, 1990). Additional studies (Cole and Durham 2007; Lamb 2009; Vesperi 1985) have examined the impact of migration on intergenerational relationships. Building on this scholarship, here I explore caregiving between elders and youths in the context of urban migration among the Tamajaq-speaking Tuareg. Tuareg are traditionally rural, seminomadic, stratified, and Muslim people living in northern Niger and Mali. There, several forms of migration profoundly affect ideals and practices surrounding relationships between the generations and aging—namely, moves from nomadic rural to sedentarized urban communities; refugee flights from droughts and political violence; and transnational labor migration. In these voluntary and forced migrations, ideals of three modalities of care at a distance—spatial, spiritual, and material—­ alternately intersect and diverge. The main focus in this chapter is on the transformation from seminomadic rural to sedentarized urban living, and the impact of these transformed ties on relations and practices of care. For example, I ask what direction does care take in the experiences of families impacted by migrations of predominantly younger kin? Looking at ritual and sociability in the economic context of urban spaces illuminates the emergent, disputed meanings of longstanding Tuareg caregiving practices, suggesting that the relative powers of spirituality and economics in shaping elder personhood and relations to youth shift in different migration predicaments and

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contexts. Therefore, in this context, “migration” is not understood solely as literal travel; rather, it also incorporates nonliteral psychosocial and ritual-symbolic expressions of cultural memory. Spirituality is relevant here because it is a core ideal characteristic that many rural Tuareg attribute to elderly persons, whose lives should become increasingly focused on prayer and ritual. How does spirituality play into caregiving and intergenerational relationships as these are redefined by migration in new ­­socioeconomic conditions in town? The method here is to analyze selections from several longitudinal case studies, social vignettes, and examples I collected of rural-to-urban migrations, predominantly (though not exclusively) to towns in Niger and Mali. These “within the nation-state migrations” coexist with other, more distant transnational and intercontinental migrations. These migrations are fluid rather than fixed or involving permanent moves, for some persons alternate back and forth between different locations over time. The primary focus here is on the experiences and perspectives of long-term migrants originally from the Saharan countryside to nearby towns. There, with few exceptions, rural Tuareg elders and their urban children and grandchildren remain dependent on each other, albeit in different ways and for different reasons than in the countryside. Many rural-based elderly relatives of recent urban migrants remain in the countryside, but visit their children in towns for rites of passage and healthcare. To the larger context of these practices we now turn.

Ethnographic Context: Meet the Tuareg Many Tuareg reside in rural regions of Algeria, Libya, Niger, Mali, and Burkina Faso. Prior to the late 1960s, aristocratic elites who in the precolonial ranked system controlled the caravans and monopolized weapons and large livestock, entered towns only temporarily to trade in markets, staying with business partners, clients, and subordinates there.1 Droughts have diminished livestock, however, and trucks compete with camel caravans. More recently, herd loss, Tuareg nationalist rebellions, violence by outside Islamist-reformist militants and state armies, and widespread unemployment in Niger and Mali have compelled many to alternately flee from their regions and return home. Additional tensions derive from historic differences in regional development. Until recently, the northern Saharan regions of Niger and Mali were much poorer economically than the more fertile and populous southern farming regions, and Tuareg were initially underrepresented in national armies, civil service, and higher education following independence from France. In peaceful intervals, many rural

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parents send their older sons on labor migration and itinerant trade, while sending others on dwindling camel caravans with elders or with relatives’ increasingly frequent truck trips across the Sahara. Usually they keep some younger sons and daughters at home to watch herds and work in familyowned oasis gardens. Although recently many African women and men have embarked on very dangerous crossings of the Mediterranean in boats, seeking asylum and work in Europe, not all African migrants travel beyond Africa; the majority migrate to and settle in towns near their rural communities. Tuareg migrations have occurred in several waves. Some rural families moved to towns several generations ago, when many nomads first fled the 1969-74 droughts in Niger and Mali and the 1963 armed conflict with central government armies in Mali. Thus far, few young rural Tuareg women willingly depart alone on urban, transnational, or transcontinental labor migrations, but both sexes often flee as refugees from recurrent droughts and several sporadic rebellions and other political violence in the northern regions of both these countries.2 Later migrants, predominantly adolescent males and those considered “young” (i.e., physically mature but not yet economically independent or married), have sought jobs first in Nigeria, Libya, and Algeria, and more recently in France and Germany (Kohl 2009), but a substantial number migrate to Saharan towns near their rural homes. In rural-to-urban migration within northern Niger and Mali, many men have moved to towns such as Agadez and Kidal to work ahead of their families and, later, when economically established, have brought their wives and some children with them. But most older rural relatives of these recent town migrants—parents included—prefer to reside in the countryside and to visit their children in nearby towns. Although some migrants alternate between town and countryside, even long-term town migrants that I befriended frequently yearn nostalgically for their rural desert homes. Many still hope to return to rural pastoral nomadism, but most now combine diverse occupations. Cultural memory-making is therefore important in the context of migration, and many (though not all) urban migrants turn to elders for inspiration in this. Relevant here are constructions of unofficial, not solely official, histories (Connerton 1989), though both are selective as they reimagine and rework idealized rural society rather than exactly reproduce it. There is a dialogue between youths and elders in constructing this memory, though this process is not always exactly reciprocated or consensual. In towns, Tuareg elders seek to “anchor” widely experienced cultural nostalgia for a more rural and nomadic lifestyle, with its attendant ideal intergenerational expectations. Specifically, elders attempt to reenact their longstanding pre-ancestral position—centrally important

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in the countryside (Rasmussen 1997, 2012)—conveying older spiritual and social relations that once facilitated age-related economic practices. Ritually, symbolically, and socially, elders “reach” across rural-urban spaces and evoke parent-child and grandparent-grandchild ties. An important vernacular concept, essuf—meaning nostalgia, solitude and “the wild”—is frequently used here, elaborated in local poetry, song, ritual, and conversations concerning one’s past life or distant loved ones (Rasmussen 1995, 2008, 2016). Among recent migrants from countryside to town, this idea of essuf reverberates in appeals to longstanding cultural ideals of mutual and reciprocal caregiving between the generations. In what follows I analyze different forms this process takes in spatial, spiritual, and material contexts, and I assess its efficacy in a range of migrant perspectives and experiences.

Spatial and Spiritual Aspects of Elder-Youth Relationships First, what precisely is meant here by “elders” and “youths”? Many rural residents define age not strictly according to biological or chronological markings, but rather use social and ritual criteria: one is defined as “old” or “elderly” (in Tamajaq, amghar, feminine tamghart, also “chief”) when one’s children are ready to marry or are married (Rasmussen 1997, 2000). Prior to this, one has ideally acquired skills, property, a reputation for respectful and respected personal conduct, and religious devotion. In advancing age, many increase their participation in both Islamic and pre-Islamic rituals. Eventually, they enter another “age category”—wa wachere (feminine ta wacheret), meaning “old old,” which approximates the Western academic category of the frail elderly. In transition from still-vigorous to frail older statuses (not rigidly institutionalized age grades or sets), elders are encouraged to gradually cede official duties and property to sons, maternal nephews, or daughters (for example, in apprenticeships to healing, artisan, herding, and Qur’anic scholarship occupations and in political leadership positions) (Rasmussen 2006, 2013), and to gradually give preinheritance gifts. A few attempt to control youths’ taking over work until a supervising parent’s death, but others pass their occupations on before death, and enter seclusion, as for example, when traditional chiefs become disabled. In these rural communities (mostly seminomadic today), persons at opposite poles of the life course—frail elders and young children—have a special relationship. Both are economically vulnerable, yet spiritually powerful, and have complementary ritual, social, and mutual caregiving roles. Small children, widely believed to be without sins (ibakaden), often act as

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go-betweens for adults, sometimes in delicate situations such as illness or socially awkward encounters, and participate in caregiving of frail elders of advanced age. For example, Rasmussen (2012) has analyzed declining elders’ spatial isolation—living separately from, but adjacent to, their children. This is not usually indicative of pariah status or neglect, but rather of special liminal status, related to elders’ mediating pre-ancestral position at thresholds and meeting places on the borders of life and death. As elders and youths “reach out” to one another, the chasm between life and death lessens. Spatial and spiritual aspects of elders’ caregiving (as both givers and receivers of care) derive from cosmological and domestic forces: social and symbolic parallels, and spiritual complementarity, especially between alternate generations. Adjacent generations tend to compete for power. In advancing age, the public face of household authority becomes more difficult to maintain. Rural elders’ declining powers must be hidden or redefined in ritual, since their powers, almost “sacred king-like,” are connected to the fertility of humans, herds, and crops. Their residence is also changed to “a little to one side”—with predominantly small children visiting them and acting as go-betweens. These developments express Tuareg aging constructs. These ideals become modified among migrants in larger-scale, less exclusively kin-based, and more multiethnic town horizons, however. The prevalent rural Tuareg cultural ideal of late-life spirituality and mutual caregiving between parents and children, even more so between grandparents and grandchildren, remain somewhat powerful, though modified, and not always observed perfectly. Efforts at maintaining, reimagining, and reworking these moral and spiritual ties are most striking in Agadez, Niger, among the Kel Ewey, a large descent group around Mount Bagzan in the Aïr Mountains northeast of Agadez within the Kel Aïr regional confederation. Most Kel Ewey residents in Agadez are relatively recent permanent migrants to the town, tend to reside on its east side, and retain many social, economic, and affective ties with rural relatives. Consider the case of one Tuareg man, approximately sixty years of age, a merchant of aristocratic (precolonial elite) background now settled in Agadez with some of his family. He founded a weekly market in his home village, and also conducted wider truck-gardening trade. In his youth he had migrated to Nigeria and worked as a house guard to raise bridewealth for his marriage. Since then, he had raised his standard of living considerably, now owning a house, motorcycle, cell phone, and, in the countryside, a garden, a few animals, and a shop, cared for by some of his children remaining in the countryside. His oldest son had worked in Italy and in Côte d’Ivoire since 2007.

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Yet despite the powerful urban pull of expanded commercial interests, this merchant’s intergenerational spiritual, social, and economic ties to rurality persisted over long-term residence in town. Cell phones permitted calls between town and countryside. His elderly ailing mother stayed in his compound when she came to Agadez for medical treatment. Now a grandfather, he sometimes sent his small four-year-old grandson on errands and messages. On one occasion that I observed, he had his grandson enter a friend’s room before he did, in order to repair a damaged social relationship. This action was effective because the parties involved in a quarrel soon reconciled, facilitated by the presence of the small grandchild on whom everyone doted in a neutral space. The point here is this man’s continuing, if modified, rural pattern of elder kin engaging small children to act as their spiritual and social go-betweens persists as a form of caregiving. Rural-based elders who are not yet too frail to travel continue to often be an important presence in younger relatives’ urban lives, particularly at rites of passage. Just following a baby’s name day, after rural elderly female participants on the mother’s side had left, I heard a young Tuareg woman from the rural Aïr Mountains—now living with her husband who had a business in town—remark sadly, “Now that all the old women (chimghaghen) have gone back to the countryside, we are in the wild (essuf, solitude and nostalgia)” (Hawad 1979; Rasmussen 1995, 2008). She and many other women and their children who followed spouses to town visited elderly rural relatives each year during school vacations. Her husband’s mother always visited Agadez for relatives’ rites of passage and healthcare. Her elderly widowed aunt, also from the countryside, sometimes stayed for several months a year in her son’s urban household compound. These cases, though not unusual, do not represent all Tuareg experiences in urban migration where these reciprocal ties persist, sometimes weakened, sometimes strengthened, in the larger context of reimagining prevalent cultural ideals of complementary spiritual/moral and political/ economic relationships between generations. In some cases, migration affects parent-child relationships differently even within the same family. Some, but not all, children are pulled back toward the parental home. Some elders’ power in property and marriage matters can be weakened. How and why? Consider the case of a smith/artisan whose family had resided in Agadez over several generations since the droughts of the late 1960s. Both gender and distance are significant here. Three of his sons continued work in ­family-owned artisan workshops, one in Agadez; one in Niamey, the capital of Niger; and one in Ouagadougou, the capital of Burkina Faso. A daughter accompanied her husband to Arlit, a large town about a hundred miles away, where he sold jewelry for about ten years, but later returned.

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She explained, “I was in essuf there, since my relatives weren’t in Arlit with us, so we returned to Agadez.” After returning, this couple resided several blocks from her father, who, now retired, was somewhat frailer, but still walked around town, often to attend funerals. This smith/artisan’s retirement from directly supervising his sons as they apprenticed in different localities diminished his authority over them, however. The sons still working in Niger produced different art designs, more for tourists than for traditional noble patrons, and had forgotten the meanings of some older jewelry designs. The son working in Ougadougou settled there and, despite his father’s strong opposition, married a Peul woman there. Many Tuareg parents still attempt to arrange first marriages for their children, preferably with close cousins on the maternal side. This son’s newfound economic independence and his distant residence in a more multiethnic town loosened the father’s influence over this son’s choice of spouse. The daughter, on the other hand, followed prevalent Tuareg cultural ideals of daughters residing closer to home in later life (Nicolaisen and Nicolaisen 1997), reflecting the importance of female matrilineal ancestor themes in mythico-histories.3

Intergenerational Urban Rituals: Attempting to Make the Obligatory Desirable Elders are supposed to not only supervise, but also provide important social and ritual protection. During the most recent war in northern Mali over some Tuaregs’ declaration of an independent Azawad, the elderly Ifoghas amenokal (traditional chief) of the Ifoghas (descent group), also a spiritual power, sheltered rebels in his Kidal palace from an attack by the state army. During my research assistant’s brief absence on travel, which left a temporary gap in his normal guarding of the courtyard while I slept in the home I rented while in Agadez, his two older sisters and elderly uncle spent the night in that courtyard in order to protect me from dangers feared: namely, human bandits and Kel Essuf spirits of the wild. In the popular discourses, these human bandits are labor migrants who returned to their Saharan home communities after Gadhafi’s 2011 fall and the ensuing violence in Libya brought back weapons, and who faced unemployment. Kel Essuf spirits of the wild enter spaces once filled with people but now empty. My assistant’s uncle reinforced his spiritual protection of me and his other relatives each morning at sunrise by reciting the names of deceased persons, chiefly ancestors in the descent group around his village, during his prayers, subtly incorporating ancestral dialogues into his Qur’anic prayers to Allah, thus praying for our safety to both his remembered

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ancestors and the Islamic God. Many elders, in their close association with prayer and ritual, therefore continue to act as human amulets in dangerous situations in towns, as well as in the countryside. Elderly persons’ spiritual roles as intermediaries between humans and ancestors—indeed, as “pre-ancestral” themselves—and the idealized complementary roles between the generations, therefore retain their power in some contexts beyond kin-based rural life. In this enclosed urban space, I was a fictive sister of my assistant, and a fictive grandniece of his uncle.

Changes, Disputes, and Disrupted Meanings There are also changes, disputes, and disrupted meanings—with unintended consequences, negotiations, and “trade-offs”—in these ideals and practices in wider urban spaces. One arena where these occur, ironically, is at urban rituals, precisely the context where elders are most important (recall the earlier comments by the married daughter on her elders’ departure following a name day) and where they metaphorically remind youths of intergenerational complementarity and reciprocity. Illustrative here is the important barka da sallah (prayer day blessing) ceremony held by the sultan (amenokal) of the Aïr regional confederation in his Agadez courtyard at the end of the Ramadan fasting month, when he distributes dates and candy to children from all Agadez neighborhoods, transmitting his al baraka blessing power to them, and also meets with neighborhood leaders,

FIGURE 3.1  Musician at the sultan of Aïr’s end-of-Ramadan blessing ceremony. Photo by Susan Rasmussen.

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who give him cash tributes conveying their gratitude for his generosity and service. Smiths and griots (bards) drum and praise him, and metaphorically compare the sultan to a father: he should be a father to his subjects, who should be like children to him, and he should be generous to them, thereby securing their future (reciprocal) loyalty. Thus, in these urban compounds, the ideal spatial, sociospiritual, and material care and nurturing by elders, transposed onto wider, chiefly political and spiritual leadership in the sultan’s ritual, symbolically conveys both the spiritual and economic obligations from a leader (the term for elder, amghar, also denotes leader of a nomadic camp) to his subjects, using the father-child analogy. Giving and care between children and parents should be mutual and reciprocal. Adults should give alms to small children on Fridays to lessen their own sins. Small grandchildren should bring food to frail grandparents and maintain supplies in their tents adjacent to those of their adult children (Rasmussen 2012). Rural elders both give and receive food alms at rites of passage. Still-vigorous persons should also care for children and grandchildren, in both town and countryside. Some become fictive grandparents (for a similar practice in Ecuador, see Miles, this volume), and there is flexible adoption, as in many African societies. The important point here is that many elders often are caregivers, not solely care-receivers. This ritual feeding of children, however, was characterized by some asymmetry in caregiving roles. Here, the sultan as a symbolic sacred kinglike father figure gave to the children, but the children did not give in return, (except in terms of their hoped-for future loyalty); only the chefs de quartier elderly men did (in tributes). The huge crowd of eager children were at first tenuously restrained by anxious smiths and griots wielding long cowhide camel-whips. During the praise-singing and tribute offerings, however, they scampered over, grabbed the candy and dates, and ran off, laughing raucously. Notably, older adolescents were absent from this ritual, which they considered old-fashioned and for younger children; instead, they attended a competing event called Zero on the outskirts of town: a car show with fancy maneuvers in the sand. Absent here was the spiritual caregiving imagery: there was neither a sacred king-like father figure nor a symbolic connection between the fertility of the land, the ruler, and the ruled. In discussing these post-Ramadan urban celebrations, some ruralbased adults lamented, “Instead of valuing camels and keeping them in the family, youths nowadays want to sell them for cars,” thereby hinting of the increasing pressures of monetization and tempting new consumer goods, and also, on youths’ part, expressing new concerns and eclipsing cultural memory: of ecological disasters and economic uncertainty of livestock

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FIGURE 3.2  Young people at car show at end of Ramadan. Photo by Susan Rasmussen.

property. In other words, cultural memory and its caretakers and caregiving became debated here in competing celebrations; the “battle lines” were drawn between the generations in the urban space. On the other hand, the Zero event continued a respectful tradition of youthful secular celebrations taking place on the outskirts of camps and villages, far from mosques and leaders’ meeting places (Rasmussen 1995, 1997). On one level, therefore, the ritual at the sultan’s palace courtyard was a carnivalesque reversal of roles of children toward elders, not exactly forbidden or discouraged, but nonetheless disapproved by the smiths and griots. On another level, there was a simultaneous ritual spirituality still ­­conveyed, if not completely reciprocated by everyone.

Rites of Passage at a Distance: Gender and Age Transformations Also illustrative of these tensions are rites of passage. On the surface, urban babies’ name days are not markedly different from their rural counterparts, which feature elderly female relatives’ encircling at twilight the mother’s tent inside the maternal grandmother’s compound, where the mother and newborn remain secluded. This phase precedes the official men’s phase of Qur’anic naming the next morning at the mosque by the father and the marabout. In town, this ritual retains these practices, though the women usually encircle a small adobe house inside the compound—both usually owned by the husband/father. At urban name days, however, there occurs

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greater commercial transaction: younger, sometimes unrelated Agadez women bring cloth, incense burners, snack foods, and jewelry to sell for cash during the sociability following the more ritualized phases of these occasions. This provides an important opportunity for informal small-scale trade by younger women guests, although economic exchange is not their sole meaning. Even in rural name days, some exchange takes place (in animals, foods, and jewelry), but the rural exchange is primarily barter conducted by elders. The young women’s sales have become more central to their social interaction at the urban rites of passage, and some guests and politicians criticize them as too commercialized. Moreover, elderly women are no longer always taken seriously or respected in urban spaces as repositories of ritual knowledge. I heard one older woman complain that a younger person at a name day had argued with her over which foods would be served, and had remarked that she “was too old (ta wacheret) and did not know anything anymore.” Therefore, urban migrants face additional transformations and disruptions, as well as continuities, between intergenerational ideals and practices over wider spaces, involving non-kin and multiethnic participation. Yet neither urbanization nor migration per se, but rather duration of absence and extent of distance, combined with migrants’ material circumstances and modes of communication of affective ties, can weaken

FIGURE 3.3  Preparations for a baby’s name day. Photo by Susan Rasmussen.

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caregiving and respect if they are not nurtured by economic success and/or regular close interpersonal contacts. No single cause determines or predicts all patterns of caregiving in urban migration; thus it is more constructive to analyze different contextual conditions and responses to them, as well as the subjectivities of the persons who experience them. More specifically, lengthy and distant migrations do not always diminish attachment, and commercialism is not necessarily the “enemy” of spiritual or social ties. Many children who are economically successful on labor migration send assistance to elderly parents, even over more long-term separations and from great distances. Yet they may resist other parental rules, such as marriage preferences, food choices, which properties to keep and which ones to exchange, and which cultural knowledge and aesthetic and ritual practices to retain and which ones to abandon. Often, important rural Tuareg concepts of intergenerational reciprocity and complementary spiritual/ ritual and economic/material roles endure, but are reworked in “tradeoffs” according to needs and constraints. These complexities are shown in the case of a Tuareg woman, originally from rural northern Mali, now permanently residing in Niamey, the capital of Niger, since migrating there with her younger sister from northern Mali as refugees fleeing ecological disaster and political violence there in the 1960s. Her oldest son, residing and working steadily in Paris, France, for several decades, bought his mother a cell phone and, eventually, a house in Niamey, and sent her handbags to sell for income. She informally adopted his son and also several children of another sister who had married a French soldier and left Africa years earlier, and mother and son assisted them with school fees. These sisters, by 2011 both single (one divorced, one widowed) and in their sixties, remained very close and sometimes resided together. They participated in a revolving credit association (called cotison), which was not exclusively kinship-based but ethnically included predominantly Tuareg women of Malian origin, to which each contributed a sum of money at intervals, used to help each other in business. The sisters also cared for one another when each underwent surgery. In this case, mother and son loved each other, but economics, here the main channel of long-distance intergenerational preoccupation and form of caregiving (see Desai, this volume), involved an unusually successful son who became a permanent resident of France after immigrating there many years earlier, who gave substantial support to his mother and aunt, and frequently communicated via cell phone. His mother reciprocated this in caring for relatives’ children (see also Golimund, this volume). The question raised here is, what happened to the intergenerational spiritual and ritual connections in this case? There was some trade-off.

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Although the two sisters in Niamey remained devout Muslims, praying five times a day, practicing almsgiving, and observing the Ramadan fast and other Islamic ceremonies and holidays, and one of them traveled to Mecca on pilgrimage, the traditional prominence of other formal rituals— in particular, rites of passage—in elders’ spiritual mediation of elder-youth relationships had diminished. Perhaps it was not necessary or simply not feasible over such long distances and lengthy separations. Yet even here, elders continued their longstanding spiritual roles, albeit in modified form. Informal adoption in lengthy and long-distance migration enabled these women to continue unofficial cultural memory-making: in these sisters’ case, done by transmitting Tuareg culture and the Tamajaq language to the next generation in the capital city—a space of endangered local culture and language. In this practice, elders modify, but do not cease, their “pre-ancestral” roles in preserving their cultural/ethnic identity. In effect, there can still be a bridging of living human-deceased ancestral distance and an activating of cultural memory here. Rituals in this context are more diffuse, but equally powerful in giving voice to elders. As noted by Rosaldo (1989), rituals must be seen as a “busy intersection” rather than neatly contained or formalized events. But rituals are not sufficient to guarantee reciprocal intergenerational relationships; rather, they usually express and remind others of already-secure political and economic ­relationships, rather than enforce them.

Economic Transformations and Age-Related Effects on Rural-tourban Migration As noted, material caregiving, in prevalent viewpoints, should be a twoway reciprocal process between the generations—in this respect, similar to the complementarity valued between the generations in Bengali society reported by Lamb (2000), though among Tuareg, the specific roles of adult children and small grandchildren may take different forms. As they weaken physically, rural Tuareg elders should receive and give alms and care—both before death, in gradual preinheritance gifts to children and, following death, in Islamic scholars’ distribution of their remaining property (not already dispersed in gifts or in matrilineal or Qur’anic inheritance) to the poor and in almsgiving at commemorative rituals held at intervals evoking the deceased. In most rural Tuareg groups, much property is controlled by living elders through apprenticeships, preinheritance gifts, endowments, and bridewealth, in the past primarily livestock. Given the diminished (though not completely destroyed) herds, these must be replaced with alternative

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resources and skills: gardening, literacy, and new occupations such as tailoring. Acquiring them sometimes separates households over great distances, thereby threatening sibling and intergenerational relationships. Brother-sister relationships are supposed to endure into late life. Sisters, daughters, and mothers usually attempt to reside near each other, but some now follow husbands to their distant work sites, thereby curtailing the traditional authority of parents over children in marriage choice and that of parents-in-law over children’s spouse in groom-service and gifts. New communication technologies have recently bridged these distances somewhat, with varying affective and economic consequences for intergenerational caregiving. Most men still respect their wife’s mother, and many migrants send monetary remittances to the latter via Western Union. Indeed, communication technologies can greatly facilitate economic support (or at least the requests for it) between generations separated by urban migration, but have both positive and negative consequences for each generation. In cell phone conversations, rural parents-in-law can more easily ask for money from sons-in-law. On the other hand, youths can use cell phones to resist or circumvent parental authority. As one young man explained, “Whereas in the past, a suitor needed to first approach a girl in person in her parents’ household with her father present, now the girl and her suitor can call each other on cell phones to arrange a meeting.” Through new technologies available in rural-to-urban migration, efforts at elder-youth connections and interdependent caregiving persist, but with varying success. In some cases, elders’ ritual actions enacted to “remind” youths of mutual caregiving sometimes become mere formalities, no longer backed up by infrastructural or material conditions. Many youths have difficulty raising bridewealth, now monetized, because of national unemployment and trading disruptions from regional wars, but when they succeed in raising it on distant labor migration, they can resist arranged marriages. Many also skip important socialization conveyed at rites of passage, such as the men’s turban-wrapping by an Islamic scholar or marabout; occupational apprenticeships, such as artisanry; and the now-rare salt and date camel caravans, presided over by older relatives. Even in cases of successfully arranged marriages, urban migration of relatives has created new economic burdens on some parents of marrying couples. Between 2002 and 2005, in Agadez, in addition to the longstanding bridewealth, a very expensive additional marriage gift from the groom gained favor: a requirement of furniture (ornate bed and cabinet for displaying chinaware) made by unrelated Hausa male carpenters. This is a marked departure from the rural Tuareg dowry: the bride’s nomadic nuptial tent, built and provided by her older female relatives, which becomes the married woman’s property and basic unit of society, defining a rural

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household, and the centerpiece at rites of passage (Brett and Fentress 1997: 210; Rasmussen 1996, 1997). The rural Tuareg tent dowry and matrilineally inherited herds enable women of all ages to make important contributions to subsistence, in effect an investment in their future reciprocal and complementary intergenerational caregiving: they gather plants, herd small livestock and control their products, and tan hides. Elderly women dominate the herbal healing profession (Rasmussen 2006). In town, resources for these occupations are distant and/or must be purchased in markets, thus far dominated by men. Only a few Tuareg women are beginning to open small shops. These longstanding sources of prestige and independence must be replaced, or older persons risk economic dispossession and social disaffiliation, thereby disrupting potential mutual caregiving between generations, a danger faced by some refugees in towns, particularly in regions devastated by wars. This predicament was shown in the case of an older woman residing in Kidal, Mali, about fifty years old, of rural origins, who had repeatedly fled sporadic armed conflicts there. Her flights to refugee camps and returns home took a toll on her property ownership (much looting had taken place during the fighting), her kin relationships (many relatives remained dispersed, and her only son was killed in a car accident in Bamako), and her mental health. She became alienated from her aunt and brother in a dispute over what to do with their remaining livestock property. Her brother’s small children did not receive an education inside her tent, and tended to disobey and disrespect her—very unusual for nephews. Her role in conveying cultural memory to youths was consequently curtailed, as was her access to affection and material wealth. Her urban compound, neglected, became defined by some as essuf or “the wild”; in effect, this older woman’s ideal positive spirituality became transformed into negative affliction by evil spirits, the idiom used to describe mental (nonorganic) illnesses “of the heart and soul” (Rasmussen 1995). In town, moreover, she lacked access to medico-ritual healing usually available to treat such afflictions: spirit possession rituals featuring group support and musical therapy had been banned in Kidal. Even in peaceful times with fewer household upheavals, urban migration produces mixed results for the ideally reciprocal and complementary economic and spiritual caregiving between the generations. Urban grandchildren enrolled in “modern” secular schools who still assist with older relatives’ oasis gardening do so only between June and October, sowing and harvesting times, but most of the year remain distant from elders’ direct social influence. In cases of youthful economic success, older relatives in both rural and urban areas tend to become more dependent on children’s monetary support than previously, when elders, as noted, controlled most

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wealth in the form of herds, thereby inverting some economic roles. The symbolism in the baby’s name day and the sultan’s end-of-Ramadan ritual attempted to remind youths of elders’ spiritual powers as pre-ancestral and also as a source of abundance (in the dates and candy), partly in order to counterbalance economic pressures (unemployment, droughts, and political violence) challenging this status, but was only partly successful. Many youths love and attempt to support their older relatives, and contrary to some stereotypes, also attempt to preserve their culture. But in urban migration, ritual alone, directed by elders, is not sufficient to make the obligatory desirable or effective, contrary to what Turner (1967, 1968) argued. Rather, I argue, ritual expresses and instantiates social relationships whose persistence is enabled by an intertwining of economic/ material and spiritual/moral conditions, which in urban migration face conditions that are not always of one’s choosing. Many urban play plots illustrate this predicament, and critically reflect on elders and youths by portraying them in contrasting relationships, thereby reflecting dilemmas and contradictions. Some feature children rebelling against parents’ authority and consequent harming of the parent and shaming of the child; others feature youths enlightening parents, even lecturing them (traditionally taboo) about the advantages of secular schooling and literacy. These performances, like rituals, also convey moral commentary and cultural memory, but most nowadays are directed by youths, NGOs, and state agencies, rather than by local elders. Thus, notwithstanding the powerful evocation of mutual caregiving between the generations in rural elders’ continuing ritual participation in towns, these attempts have uneven success.

Conclusion The foregoing cases and examples reveal a range of outcomes within Tuareg rural-to-urban migrating households, and suggest the broader need, in anthropology, to interrogate some key concepts in current theories of cultural borderlands when these are transposed onto studies of aging, migration, and intergenerational relationships. First, the concept of migration is complex, and requires nuanced analysis. Rich in potential insights, the term “migration” is fraught with analytic challenges in its increasingly broad uses and meanings, unless carefully deconstructed and contextualized. Like globalization, migration can be represented as too static a concept, caught up in dualistic binaries of “home” and “exile.” Among the Tuareg, migration can be rural to urban and transnational sequentially for an individual or simultaneously

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for several persons within the same household, and is sometimes voluntary and sometimes forced, over the same person’s life course. Studies of aging and intergenerational relationships facilitate, indeed require, viewing even large-scale migrations in more intimate terms. Viewed contextually and dynamically as a subjectively experienced process, both literal and symbolic, “migration” reveals psychosocial and ritual expressions of cultural memory that sometimes themselves “migrate” in ways not neatly predictable. Whether involving transnational or national rural-to-urban destinations, migration can require drawing on cross-cutting ties to avoid ruptures of mutual care for elders and youths in similar geographic localities, but in different psychosocial and economic predicaments. Here I wish to avoid a “Durkheimian lament”; the spiritual need not be opposed to the commercial or the bureaucratic, but the Tuareg data show that their ideal compatibility can be challenged, needs continual negotiation and ­­reinforcement, and can produce trade-offs for elders and youths. The concept of caregiving, an important concern and recurrent term in anthropology of aging, may similarly convey a variety of meanings across cultural settings and may become modified in meanings over time, place, and the life course. In Tuareg communities, caregiving is very broad in its significance, and no single person decides on this matter, since rural residential patterns largely have shaped where one resides over time. But in urban spaces, there is a trade-off: greater independence for youth who become economically successful can bring abandonment, disobedience, respect, or devoted care, depending on specific contexts, despite the generalized, still widely held cultural ideals of respect for elders. For anthropologists and others concerned with aging, the Tuareg case suggests constructive ways to conceive of caregiving, very broadly, as taking diverse forms. Finally, the concept of reciprocity has a very long history in economic anthropology, but needs to be resituated and reanalyzed in spiritual, social, and spatial contexts of aging and caregiving. The Tuareg data on spatiality, economics, sociality, and ritual symbolism in rural-to-urban migration reveal some persisting ideals of mutual caregiving—spiritual and ­­material—that become alternately highlighted and submerged in ­­negotiations between the generations. But these effects, though subjectively experienced and best revealed through a culturally intimate analysis, are not merely the sum total of individual choices; rather, they are responses to larger political and economic constraints. The data also show disagreement, trial and error, modification, and variation of expected intergenerational relationships in different migration situations: varying degrees of stability, ambiguity, uncertainty, and upheaval. Older women’s and men’s experiences in urban migration are somewhat distinct economically, and change differently in response to wider political events, but even

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men’s strength and authority also eventually decline. Thus while gender is in some contexts salient here, all elders must work harder to “archive” spiritual cultural memory in towns. Fundamental to understanding the effects of urban migration on intergenerational relationships, in particular on caregiving, is careful contextualization of the foregoing concepts as dynamic processes in relation to each other and to other processes: intimate cultural knowledge and spiritual roles conveyed by elders in rituals may reverberate or may fall on “deaf ears.” Spirituality so central to Tuareg intergenerational relationships, particularly between alternate generations and between elders and small children, becomes redefined, not always obliterated, as circumstances change. Commercialization and spirituality are not mutually exclusive in urban migration. In contexts of correspondences between ritual and economic roles, migrants live simultaneously across two overlapping worlds, transforming each cultural system, themselves, and caregiving. In more fragmented and dispersed contexts, however, they experience these worlds as opposed and separate. Local concepts of dependency, reciprocity, and aging personhood in some respects approach, but do not coincide exactly with, prevalent EuroAmerican expectations that elders live “independently” as long as possible, and also contradict widely held Euro-American rigid cultural dichotomies between “active” and “passive” aging (Fry 1981; Gullette 2004; Neugarten 1996), which tend to reproduce more individualistic Western concepts of person/self in situating activity or passivity within the aging/aged person.

Acknowledgments This essay is based on longitudinal data I collected during over thirty years of ethnographic research in rural and urban Tuareg communities in Niger, Mali, and more briefly, among Tuareg and other Amazigh (Berber) expatriates and travelers in the United States and France. In projects on spirit possession, aging, the life course, gender, medico-ritual healing specialists, smith/artisans, verbal art performance, and youth cultures, I gratefully acknowledge support from Fulbright-Hays, C.I.E.S., Wenner-Gren Foundation, National Geographic Committee for Research and Exploration, Social Science Research Council, Indiana University, and the University of Houston. Susan Rasmussen, professor of anthropology within the Department of Comparative Cultural Studies at the University of Houston, is interested in

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anthropology of religion, medico-ritual healing and healers, the life course and aging, gender, verbal art performance, ethnographic analysis, and African humanities. The author of five books and numerous articles, she has conducted extensive field research in rural and urban Tuareg communities of Niger and Mali on spirit possession, aging, herbal medicine women, smith/artisans, changing gender constructs, and youth cultures, and briefer research among Tuareg and other Berber peoples in diaspora, including religion and identity among Kabyle immigrants in France.

Notes 1. Precolonial society was ranked and endogamous, comprised of elite aristocrats (imajeghen) in descent groups in each regional confederation who elected an amenokal or “sultan,” and until approximately the late nineteenth century, dominated groups of varying client and servile statuses with distinct occupational specialties based on descent: namely, tributaries (imghad), who raided and traded for noble overlords; settled client and servile strata (ighawalen and iklan), who owed agricultural tribute and/or were owned and performed domestic, herding, caravanning and oasis labor, respectively; Islamic scholars, who interpreted the Qur’an (ineslemen); and smith/ artisans (inaden), who manufactured tools, jewelry, and weapons, and also acted as political go-betweens, oral historians, and ritual specialists for imajeghen patrons. 2. Tensions between the northern regions and the central state governments have culminated in four Tuareg rebellions in Mali and two in Niger over issues of regional disparities in development and, until recently, underrepresentation of Tuareg in universities, jobs, and armies: in 1963 in the Kidal region of Mali; from 1990 to 1996 in Niger and Mali; in 2006 with some post–peace accord dissidents in Mali; in 2007 in Niger over international mining contract disputes around the northern town of Arlit; and, most recently, the civil war in Mali involving Tuareg nationalist/ separatists, Islamist-reformist militants, Al Qaida of the Maghreb, and the Malian and French armies in the Kidal region, erupting in 2012 on Tuareg rebels’ declaring of an independent state of Azawad there. For background to these conflicts, see Anselin 2015; Boilley 1999; Dayak (1984) 1992; and Kohl 2009. 3. Most Tuareg combine Qur’anic and non-Qur’anic spirit and ancestor-related beliefs in their cosmology, ritual, and mythology, and interweave Arabic, Qur’anic, and state patrilineal influences with local matrilineal property arrangements practiced prior to their conversion to Islam between the eighth and eleventh centuries C.E., to their exposure to French colonial policies in the early twentieth century, and to independent state laws around the mid-twentieth century (Bernus [1981] 1993; Claudot-Hawad 1993; Nicolaisen 1997). Most women enjoy high social prestige and independent property rights, and there is much free sociability between the sexes. Sibling ties often compete with husband-wife ties over the life course. There are some regional variations on these patterns, but, in general, many women enjoy alternatives to Qur’anic inheritance, may represent themselves in legal cases, initiate divorce, travel independently, and may visit and receive visits from unrelated males, even after marriage, Recently, there have been some debates over proper

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conduct of women and relations between the sexes in communities more influenced by Islamist-reformist piety movements, but most Tuareg are cool toward these movements.

References Anselin, Paul. 2015. La France et les Touaregs: De la colonisation a la 3eme guerre mondiale. Paris: Temporis editions. Bernus, Edmond. (1981) 1993. Touaregs Nigeriens: Unite culturelle et diversite regionale d’un people Pasteur. Paris: Editions ORSTOM. Bouilley, Pierre. 1999. Les Touareg Kel Adagh. Paris: Khartala. Brett, Michael, and Elizabeth Fentress. 1997. The Berbers. New York: Basil Blackwell Press. Clark, M. 1972. “Cultural Values and Dependency in Later Life.” In Aging and Modernization, edited by D. Cowgill and L. Holmes, 263–274. New York: Appleton-Century-Crofts. Claudot-Hawad, Helene. 1993. Les Touaregs: Portrait en fragments. Aix-en-Provence: Edisud. Cole, Jennifer, and Deborah Durham, eds. 2007. Generations and Globalization. Bloomington, IN: Indiana University Press. Connerton, Paul. 1989. How Societies Remember. Cambridge: Cambridge University Press. Dayak, Mano. (1984) 1992. Touaregs: La Tragedie. Paris: Editions Jean-Claude Lattes. Fry, Christine. 1981. Dimensions: Aging, Culture, and Health. New York: Praeger. Gullette, Margaret. 2004. Aged by Culture. Chicago, IL: University of Chicago Press. Hawad, Makhmoudan. 1979. “La Tagdudt.” Tisuruf: Groupe d’etudes berberes 8 (3): 79–82. Kohl, Ines. 2009. Beautiful Modern Nomads. Berlin: Reimer Verlag. Lamb, Sarah. 2000. White Saris and Sweet Mangoes: Aging, Gender, and Body in North India. Berkeley, CA: University of California Press. _____ 2009. Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad. Bloomington, IN: Indiana University Press. Neugarten, Bernice. 1996. The Meanings of Age. Chicago, IL: University of Chicago Press. Nicolaisen, Ida, and Johannes Nicolaisen. 1997. The Pastoral Tuareg. Copenhagen: Rhodos. Rasmussen, Susan. 1995. Spirit Possession and Personhood among the Kel Ewey Tuareg. Cambridge: Cambridge University Press. _____ 1997. The Poetics and Politics of Tuareg Aging: Life Course and Destiny in Niger. DeKalb, IL: Northern Illinois University Press. _____ 2000. “Between Several Worlds.” Anthropological Quarterly 73 (3): 133–145. _____ 2004. “These Are Dirty Times!” Journal of Ritual Studies 18 (2): 43–60. _____ 2006. Those Who Touch: Tuareg Medicine Women in Anthropological Perspective. DeKalb, IL: Northern Illinois University Press. _____ 2008. “The People of Solitude.” Journal of the Royal Anthropological Institute 14: 609–627.

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_____ 2012. “A Little to One Side: Caregiving, Spatial Seclusion, and Spiritual BorderCrossing in Frail Old Age among the Tuareg (Kel Tamajaq).” Anthropology and Aging Quarterly 33 (4): 130–141. _____ 2013. Neighbors, Strangers, Witches, and Culture-Heroes: Ritual Powers of Smith/ Artisans in Tuareg Society and Beyond. Lanham, MD: Rowman & Littlefield/ University Press of America. Rosaldo, Renato. Culture and Truth. Boston, MA: Beacon Press, 1989. Simic, A. 1990. “Aging, World View, and Intergenerational Relationships in America and Yugoslavia.” In The Cultural Context of Aging, edited by Jay Sokolovsky, 89–107. Westport, CT: Bergin & Garvey. Sokolovsky, Jay, ed. 2009. The Cultural Context of Aging. Westport, CT: Bergin & Garvey. Turner, Victor 1967. The Forest of Symbols. Ithaca, NY: Cornell University Press. _____ 1968. The Drums of Affliction. Chicago, IL: University of Chicago Press. Vatuk, Sylvia. 1981. “Withdrawal and Disengagement as a Cultural Response in Aging in India.” In Aging in Culture and Society: Comparative Viewpoints and Strategies, edited by Christine Fry, 126–148. New York: Praeger. _____ 1990. “To Be a Burden on Others: Dependency Anxiety among the Elderly in India.” In Divine Passions: The Social Construction of Emotion in India, edited by O. Lynch, 64–88. Berkeley, CA: University of California Press. Vesperi, Maria. 1985. City of Green Benches: Growing Old in a New Downtown. Ithaca, NY: Cornell University Press.

ijjjjjjjjjjjjjjk 4. “OLD PEOPLE’S HOMES,” FILIAL PIETY, AND TRANSNATIONAL FAMILIES Change and Continuity in Elderly Care in the Tibetan Settlements in India “old people’s homes” Namgyal Choedup

Early into my fieldwork, I met Penpa,1 a sixty-year-old organic farmer and sweater seller, while we were waiting to see the settlement officer in Doeguling Tibetan Settlement. We ended up chatting, and he asked me where I lived. When I said, “Ari” (colloquial for USA), his eyes lit up and he said in jest, “Oh really! So you have attained enlightenment (or Buddhahood).” I was a bit taken aback by his comment. He gave me a surprised look and said, “Don’t you know everyone wants to go abroad these days? It has become the ultimate goal in one’s life.” Despite the irreverent nature of his comment, it encapsulates the widespread notion in the Tibetan exile society today that “everyone wants to go abroad.” It is very common to hear people use the term heb or heb langs (literally arising of desire and greed) to describe what is prompting particularly the younger generation of Tibetan exiles to go Westward.2 In my later interviews with him, I learned that Penpa, who has nine children, was selected in the lottery for the US Tibetan Resettlement Project in 1992. He decided not to go to the US because his ailing mother made him promise that he would never leave her and go into what she called “second exile.” As I learned in the course of our conversation, his mother was strongly against the idea of going to a foreign country, and Penpa used the Tibetan phrase mi yul sa mtha’ to refer to the West, implying a place without religion.3 A former CTA (Central Tibetan Administration, popularly referred to as the Tibetan government in exile) official who served in the Tibetan settlements for over twenty-five years recalled that when the CTA first announced the resettlement of a thousand Tibetan exiles from India and Nepal to the United States, many older Tibetans were very critical of the idea because in their opinion the CTA had given up hope of returning to Tibet. They further expressed fear that going to the West would lead to the loss of Tibetan culture and identity primarily because they saw it as a

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place without the opportunity of practicing religion, meaning Buddhism (Dalai Lama 2008: 50–51).4 When I asked Penpa if he has any regrets about not moving to the US, he said that he has none. He said he would have regrets, however, if he had disobeyed his mother, and takes pride in the fact that he performed his filial duty. However, Penpa is not against the idea of people going abroad. Like other Tibetans in Doeguling who do not have any family members abroad, Penpa says, “It would be very beneficial if the Tibetan government sends one person from each family [abroad] so that it would uplift the economic situation of Tibetan families but not destroy the foundation of society.” Penpa’s (and others’) sentiments highlight not only the precarious relationship between aging and migration, but they also encapsulate the tension between settlement and mobility in the Tibetan exilic ­community— tension that is at the heart of this chapter.5 This tension arises from cultural ideals that suggest that old age should be devoted to spiritual activities, including doing pilgrimages and receiving religious teachings so as to prepare for a better after life. Providing care for parents in old age is therefore seen as an important filial and religious duty. Family-based and religion-oriented care for the elderly as a cultural expectation is still very strong in contemporary Tibetan societies (Childs et al. 2011; Wangmo and Teaster 2009). Many Tibetans in exile say that the settlement is an ideal place for elderly Tibetans to retire because they can live in a Buddhist social environment where they can devote their life fully toward religious practice. As a result, there exist compelling social, cultural, and religious reasons for a return migration for retirement and, simultaneously, to care for aging parents. In this chapter, I draw upon my ethnographic data from Doeguling, one of the largest Tibetan settlements in India, to document the impacts of transnational migration on elderly care. I do this by exploring the intersection of forced/voluntary migration, local ideas about aging and care, and community care/old people’s homes. In order to do so, I explain the unique nature of Tibetan exile society, which underwent several major transformations, including transition from forced exile to the current voluntary and economically driven migration and a “fertility transition” that has resulted in a small-family norm and significant investment in children’s education, which then fuel an economically driven youth migration. These transitions are intimately linked to the prevalent forms of elderly care in Doeguling, including the institutionalized care for childless and destitute elderlies at “old people’s homes,” the traditional norm of family-based caretaking, and the emerging practice of hiring domestic help to provide elderly care. By following and unpacking these entanglements of migration and elder care, in this chapter I show the impact of migration on the

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traditional norm of family-based caretaking. In the process, I tease out how discourses and embodied experiences of migration, aging, and elder- care are intimately ­­ intermingled in the shifting context of Tibetan life in exile.

Thinking Migration in Tibetan Exile and Beyond Castles and Miller (2003: 5) observe, “There can be few people in either industrialized or less-developed countries today who do not have personal experience of migration and its effects: this universal experience has become the hallmark of the age of migration.”6 This is certainly the case in Doeguling, established in 1967 as resettlement camp, where every family has at least one member living elsewhere. External/transnational migration takes place at significant financial and psychological costs not only to the individual but also to the household and its social networks. Social networks operate as a powerful form of social capital, defined as “the capacity of individuals to command scare resources by the virtue of their membership in networks or broader social structure” (Portes 1995: 2). These networks primarily help to reduce risks and costs associated with migration as well as mediate and perpetuate migration streams. The “new economics of migration” perspective prioritizes the household as the decision-making unit of analysis (Massey 1990; Massey et al. 1993; Stark and Bloom 1985). This is logical since the household mediates between the individual and the outside world, so a focus on the household allows one to better understand how migration decision-making considers economic, political, and social conditions, as well as cultural norms (Brettell 2000: 107). Commenting on these trends, Massey and others have integrated network theory with the micro and macroeconomic migration perspectives, formulating the concept of “cumulative causation” (Bohra and Massey 2006; Massey et al. 1993). They use this concept to explain the feedback mechanisms that contribute to the self-perpetuation of migration streams, and that create a “culture of migration” as well. This culture of migration refers to the fact that the aspiration to migrate is transmitted across generations and between people through social networks (Kandel and Massey 2002). This accounts for the cultural beliefs and social patterns that influence people to move—or to remain at home (Cohen and Sirkeci 2011). I build on this scholarship to show the intricate nature of transnational migration in the Tibetan exile, which is grounded in the fact that a second homeland has been established for Tibetans in India. This process is informed by the idea of cultural resistance and revitalization in opposition to the continuing occupation of Tibet by China. In a sense, the Tibetan settlements in India could be viewed as a form of cultural migration that

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produces “intentional community” (Brown 2002; Pitzer 1997), or a site where Tibetan exiles in India experiment with a form of Tibetan culture that is in dialectic relationship with the perceived “taintedness” of culture inside Tibet due to the alleged “cultural genocide” perpetrated by the Chinese state.7 In the span of over five decades of exile in India, subsequent socioeconomic transformations triggered by fertility decline and outmigration are seen by many Tibetan exile leaders as a threat to the viability of the settlements, thereby bringing individuals’ desires to migrate into direct conflict with political and collective desires to maintain cultural continuity (Choedup 2015). The US Immigration Act of 1990 started the major immigration stream from exile settlements in India to North America by granting immigrant visas to one thousand Tibetan exiles, mainly young and economically active individuals, who have acted as a bridgehead for ­­subsequent migrants. As a result, population mobility has become an important feature of the Tibetan settlements, which have transformed into “lifephase spaces” rather than “lifecourse spaces” (Knight 2002: 121). These “lifephase spaces” are sites of enculturation wherein people are born and raised in a Tibetan cultural milieu but from where many ultimately leave seeking higher education, employment, and upward mobility through migration. At the same time, however, the settlements are facing intensive pressure to maintain themselves as sites of cultural continuity through “integrated development” projects that seek to ensure their economic viability and ability to maintain their central role as places of enculturation (Choedup 2015). In what follows—using the intersection of migration, local ideas about aging and care, and cultural/religious identity—I explore one important aspect of the aforementioned tension: the impacts of transnational migration on the exile society and elder care.

Zooming in: Doeguling Tibetan Settlement Tibetans received preferential treatment from the Indian state in part because they have a very strong collective organization, popularly referred to as government in exile, under the Dalai Lama’s leadership. India’s policy on the Tibetans includes two important features: first, not exerting pressure on the Tibetans to become Indian citizens or be repatriated, and, second, minimal interference in the internal matters of the Tibetans. In a sense, the treatment of Tibetans in India fits very well with the normative anti-assimilation model of India’s “multicultural democracy,” which gives explicit state recognition and protection to religious, linguistic, and cultural diversities (Mahajan 2005). Between 1960 and 1975, wide tracts of

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uninhabited forestlands in Karnataka State were made available to Tibetan refugees for resettlement, which led to four major settlements: Doeguling near Mundgod, Dickey Larsoe near Bylakuppe, Rabgyaling near Hunsur, and Dhondenling near Kollegal. Today, these settlements form the largest cluster of the Tibetan exile population in India, places where Tibetan language, culture, and religion are practiced and maintained in everyday life.8 On 6 June 1966, at a meeting in Bangalore, the capital of Karnataka, a detailed plan was laid out on the implementation of the second Tibetan settlement in Karnataka through what was called the Tibetan Refugee Rehabilitation Scheme II (TRRSII). Karnataka State granted four thousand acres of land in Malnad region in northern Karnataka to accommodate four thousand people in a farming settlement. It was officially named the Tibetan name, Doeguling (‘dod rgu gling or wish-fulfilling place). The official settlement records show the original population of 4,306 in 1967 increased to 15,947 in 2009. The CTA’s 2009 census listed Doeguling’s population as 9,754 (this, however, does not include monk residents from the Himalayan region of India, Nepal, Bhutan, and other parts of the world). My 2010 survey data show that the population is closer to around thirteen thousand after accounting for the monks from the Himalayan region. Although the outmigration of young people is a strong feature of Doeguling, there has been significant in-migration, mainly of monks, from Tibet until the early 2000s, and from the Himalayan region since then. Many older Tibetans remember the early days as a very difficult period. At the same time, they say people were happy-go-lucky, and most believed that they would return to Tibet after a few years. They remember nostalgically the communitarian spirit of the early years—how after a day of hard manual work, bonfires would be made and everyone would participate in folk dancing (sgor gzhas) and singing late into the night. In the beginning, for many former nomads, growing crops and leading a settled farming life was a new experience. Tibetan farmers were more familiar with growing only highland crops, like barley and pulses. The older refugees recall how it was a period of learning everything new. While the Swiss agricultural experts trained them in growing maize, they learned how to grow rice from the local Indian farmers. The Tibetans learned how to make their traditional staples like tsampa (roasted flour) from white hybrid maize, and sran (porridge) from flour made out of yellow maize. Today, the majority of Tibetan farmers grow maize and rice as cash crops. Only a few older Tibetans still consume the maize and rice they produce. Many older Tibetans still farm and raise livestock and take pride in their livelihood because they view it as following the advice of the Dalai Lama in maintaining the settlement as a farming community. Originally intended as a farming settlement, Tibetans have since engaged in a diverse range of livelihood strategies. For example,

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FIGURE 4.1  Elderly Tibetans in Doeguling attending 2011 World AIDS Day community health awareness workshop. Photo by Namgyal Choedup.

farming is not seen as a viable economic strategy by the younger generations, who are increasingly looking at options beyond the settlement for their future. When the settlement was established, a separate residence for the elderly and infirm, called Old People’s Home, was founded. There were originally six hundred residents, most of them single elderly, infirm, and disabled persons. Today, there are 134 residents,9 and the home serves any Tibetan who has no dependents. The regional chapters of the two largest NGOs in exile, Tibetan Youth Congress (TYC) and Tibetan Women’s Association (TWA), provide social services (see Figure 4.1) to the elderly residents in the form of the local women’s chapter visiting twice every month to bathe the elderly people and wash their clothes, and the local youth’s chapters providing funerary services whenever elderly residents pass away. These novel arrangements of eldercare through community care should be understood in the shifting context of life in exile, to which I now turn.

Aging and Elderly Care in the Shifting Context of Life in Exile In the Tibetan exile society, strong emphasis on modern education means that today all children receive free education up to high school and considerable scholarship opportunities for further studies. The success in education is one of the main contributing factors to the out-migration

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of young Tibetans, who no longer see farming as a viable option. In the recent years, the CTA has invested significant resources in reviving the farming settlements through projects like soil and water conservation, organic farming, and strengthening of farming cooperatives. However, it is common knowledge that farming does not have the potential to revitalize the settlement. For example, in my survey, out of about 940 households, there are fewer than thirty households that are dependent solely on farming. One Tibetan sweater seller, whose elderly father still farms, said, “It is my parents’ hobby. We don’t make any profits. It is great if it breaks even. I let them farm because it keeps them occupied. They also feel very strongly about following the advice of the Dalai Lama and Tibetan government in exile.” One elderly couple, whose only son is married and working in Dharamsala, farm and raise three cows. The husband, Nyima, is seventythree years old, and his wife, Tsering, is seventy-one. They say that they will farm as long as they can. Nyima said, I am from a nomadic family in Tibet. After I came to India, I engaged in road construction for a few years before coming to this settlement in 1966. Since then, I have farmed and raised cows. Except for one time when I felt ill from high fever and had to rest for a week or so, I have never felt sick. Working makes you fit and healthy. These days, many people my age, whose children are abroad, are told by their children to stop farming and raising livestock because these are viewed as difficult and backward. Once they stopped farming and raising livestock, they tend to get more health problems like high blood pressure, diabetes and heart problems. So, you see if you work, it keeps you occupied and healthy as well.

The couple’s son, Urgyen, moved out of the settlement at the age of eighteen for college education. Later, he joined the Tibetan administration in Dharamsala, where he met his wife, and his two children were born. Urgyen and his family visit once every two years or so for a month vacation during the Tibetan New Year. When I asked Nyima and his wife what would they do if they become too old and unable to work, or whether they would go to live with their son, Nyima said, “My son will definitely come and visit us during our hard times, but we don’t expect him to be there all the time since he has his job and family to take care of. We will live in this house as long as we are healthy and are able to take care of ourselves. If we get too sick and need help for care, then we might end up going to the Old People’s Home.” Nyima gave me a mischievous laugh when he mentioned going to the Old People’s Home because it is commonly regarded that going to the elderly home is the last resort. For someone who has children of his own, going to the elderly home in old age is unthinkable and would be

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considered a form of “social suicide” because it would reflect very poorly on one’s children and it would be the talk of the community. For instance, I heard many people express fear that the intense desire to go abroad among young people leads to neglect of old parents. To prove this point, they often mentioned the case of one elderly widow who ended up in the Old People’s Home in a nearby Tibetan settlement. The fact that her two children were settled abroad in North America while the unfortunate woman was bound to a rusty wheel chair in the elderly home became a hot topic for gossip and social commentary. In general, only those elderlies whose children are too poor or disabled would end up in the elderly home.10 In fact, I came across a few elderly people who were childless, living on their own in their homes. For instance, I came to know Tashi, peon of an office where I carried out some archival research. Tashi is sixty-seven years old, and his wife is sixty-eight: their only child died at a very young age. When I asked Tashi about his ­­retirement from the office and future, he said, After coming to the settlement in 1967, my wife and I farmed our whole life and raised livestock. A few years ago, we had to give up farming and raising livestock because it was too hard due to my wife’s failing health. We still have two cows. We have been receiving welfare benefits from the settlement office and we were advised to go to the Old People’s Home. But we didn’t want to go, so I requested the village leader and settlement office to give me some job so that I could support myself and stay in the village. That is how I got this office job. So I get some monthly salary but there are no other benefits like pension. We have decided that we would live in the village and die in the same place that has been our home since we came here.

In short, some elderly people who are childless and single resist going to the elderly home for variety of reasons. One commonly cited reason is that such a move is viewed as losing one’s independence and becoming dependent on charity.11 Another very important factor is that it is also viewed as leaving the comforts of a close-knit community (see figure 4.2). For instance, during my household survey, I came across Choezom, an elderly woman in her eighties living on her own and in relatively poor housing conditions. I asked the camp leader, also her neighbor, why she is not in the elderly home. He responded, She is a very happy-go-lucky person (snang pa skyid po) and independentminded too. Her husband died a few years ago and they didn’t have any children or close relatives. She has been very nice to my children, who regard her like their grandmother. So, I look after her whenever she needs help. She is like a family member now and eats with us anytime she feels like. She is adamant that she does not want to go to the elderly home.

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FIGURE 4.2  Community prayers, a very important part of appropriate aging in the Tibetan settlements. Photo by Namgyal Choedup.

When I tried to interview her, I found that she was very hard of hearing and would give me some flippant one-liners to my questions. I told her that I had interviewed the director and residents of the elderly home and found out that the home takes very good care of elderly people. She responded, “I have lived all my life on my own and have made this village my home. So, I won’t leave this place for anything, even if it is like heaven.” The above examples demonstrate how people who are childless/­ destitute resist going into the old people’s home. In this unique context of aging in exile, this resistance is a product of converging forces of culture, subsistence, and (youth) migration. In the next section I will focus even more specifically on how decisions/resentments concerning migration are entangled with the ideas and cultural/moral claims regarding elderly care in the Tibetan settlements.

Ambivalent Migration: On Aging and Dying Rituals Abroad The older Tibetans are understandably more reserved toward the idea of going abroad; they view it as detrimental to the goal of returning to Tibet, which is articulated in the exile discourse that India is just a temporary abode. Many still harbor a hope of going back to either a free Tibet or a Tibet where the Dalai Lama and the Tibetan people would enjoy a certain degree of freedom. At the same time, there is a growing realization that the

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dream of returning to Tibet is unrealistic. For example, Dolma, sixty-two, whose daughter went to Belgium in 2005 and had yet to receive political asylum, expressed strong negative views on going abroad. She said, People go to die in the West. Going abroad breaks up families. I think that people can make enough money in the settlement. Look at people driving taxis to make a living in the settlement. One brother of our neighbor [who was adopted by a foreign couple when very young] came once to visit his old parents, and lamented how dirty his parents and the settlement were. He never visited after that. My own daughter calls me and complains about not finding a job. I say to her, “rkyag pa za ga phyin pas” [literally, did you go to eat shit?].

Dolma lives with her married son, who sells sweaters, and one of her married daughters is actively in the process of migration. Later, I learned that her older son went to the United States in 1993 as part of the US resettlement project and passed away in 2000 due to tuberculosis and chronic hepatitis. Her strong opinion on going abroad should not be linked to this unfortunate experience only, but should also take into consideration that for older Tibetans it is culturally and spiritually very important to have one’s family members around at the time of death to perform all the proper religious rites for a smooth passage into the next life. Through migration, many elderly Tibetans are becoming de facto “childless” (in terms of not having in situ caretakers), and this fact, when combined with religious beliefs about life and death rituals, significantly deepens the already existing anxieties about aging in exile. Dolma’s friend, another elderly woman, expressed similar views about life in the West as a place where it is difficult to practice religion and where there is no strong sense of community. She further cites what she heard about the West during a religious teaching in the village, “A Geshe (honorific title for highly learned Buddhist monks) from Drepung monastery said that there is nothing to envy about life in the West. He said that even family members don’t have time for each other.” Sithar’s case nicely demonstrates these complexities. At age fifty-six, this woman who farms and raises cows also has a very strong opinion about going abroad. She received some schooling and worked in a nursery for seventeen years. Her husband is a former member of the disbanded Tibetan guerilla group Lho Dritsug based at Mustang, Nepal, and is now retired from the army. Her elder son passed away in 2002 at the age of twenty due to cancer. Her younger son, a former monk, later defrocked and now lives with Sithar and her husband. He is married and has a oneyear-old son. Sithar’s uncle went to the US under the resettlement project in 1993, and all but one of his immediate family members later moved through

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family reunion. The only exception was his brother, the second husband in their fraternal polyandrous marriage.12 Sithar narrated her opinion about going abroad, and here I include her long answer intact: Ideally, if the whole family can go, it is good. Otherwise, there are many instances where either the husband or the wife is able to go abroad, but the rest of the family is stuck here. For such families, I don’t see any benefits coming from going abroad. The West has been very kind to us and provided us lots of aid. However, I feel that in the West, religion is not very strong . . . I have strong opinions due to my own personal experience. One of my uncles could not move to the US with his family because it is a polyandrous marriage. When he passed away here in the village, my other uncle came to India after many years. He came only once for vacation in 1995 during the Kalachakra teaching here. His brother died in 2005; my husband and I took care of him during his brief illness. I did not phone them until the very end because I did not know my uncle would pass away. When I called my younger uncle in the US about his brother’s death, he had already left for India to see his elder brother. He died all of sudden; he used to drink and his liver was damaged. He died in the night at the DTR hospital (in the settlement). I called my uncle in the US right away to tell him not to come because his brother has passed away. It was daytime in the US, and his children told me that he had just left on his flight. They called back a few times and told me not to cremate the body until my uncle arrives. So I took the necessary arrangements to keep the body. . . . Then, my uncle arrived here. On the fourth day of mourning we performed the necessary rites and cremated the body. My uncle did not show any interest in the religious rites during death. It was his own brother who had passed away but he did not know the religious rituals that needed to be performed. For instance, when I told my uncle about offering the gsur,13 he did not show any interest in doing it himself. He told me to go ahead and do it if I want to. As I observed, he was not reciting mani, let alone reciting other prayers for his brother. I don’t know if all the Tibetans in the West have become like him. So, I think going abroad might lead to a better life, but when it comes to Tibetan customs and traditions, I don’t know if it is a place to go. I don’t think highly of going abroad in that sense.

For Sithar and many older Tibetans, the settlement has become a place where there is a strong sense of Tibetanness, manifested in the material and spiritual aspects of Tibetan Buddhism practiced in the Tibetan settlements. Importantly, this context is necessary for aging and dying “appropriately.” Relatedly, migration presents a rupture in religious fluency, and it becomes especially apparent via processes of aging and cultural practices associated with death. For Tibetans, it is not only living properly at the end of life (prayer, circumambulation, hearing religious sermons and teachings), but also having proper rites performed by knowledgeable family members

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after death. Migration—with a related perceived loss of cultural/religious fluency—presents a significant threat to this order. To further emphasize elderly Tibetans’ perception of the importance of aging and dying in the Tibetan settlements, Ama Tsamchoe, age seventynine and a childless woman, explained, On the one hand, it is my misfortune that I had to leave everything behind, including my home, parents, and country. On the other hand, I think I am very fortunate that I am here (in India) where I can see and hear the Buddha (meaning the Dalai Lama).14 It is pity that people inside Tibet can neither see nor hear the Buddha. In that sense, I feel I am very lucky. I don’t think I will ever see Tibet again. I am waiting for my death. It would be great to see and hear from the Buddha one last time before I die.

Ama’s words suggest that it is exactly the life in Tibetan exile that becomes the essence of Tibetanness; it is in this context that one can see and hear Buddha. I conducted the above interview in November 2010, and like many other older Tibetans, Ama Tsamchoe was expectantly waiting to have another special blessing from the Dalai Lama, who visited the settlement in February 2011. The Dalai Lama, whenever he visits the Tibetan settlements these days, makes it a point to meet and give a special audience to the elderly Tibetans, normally those above the age of seventy. After the special audience during the visit, I heard many older Tibetans express that they feel so blessed that they can die happily now. Some say that their only goal now is to prepare for the next life, and pray that they will be born as a human, ideally a Tibetan, in a place where religion (meaning Buddhism) is practiced. During these special audiences, some elderly Tibetans offer their precious possessions, such as jewelry, to the Dalai Lama as a form of bsngo rten, a traditional Tibetan practice of offering money and personal valuables on the behalf of a dead person to high lamas as a dedication toward accumulating merits for better rebirth. These examples highlight the intricate relationship between aging, elderly care, religion and culture, and migration since migration increases the number of people who do not have adult children as caretakers. Transnationally, common anxiety and reluctance to enter institutional care because of an associated stigma (“family not doing their job”) is in the case of Tibetans in exile deepened by spiritual and religious expectations that paint settlements as appropriate places to age. This belief rests on the idea that one needs to die properly, meaning in proximity to Buddhist institutions and the community of Buddhist practitioners, and, importantly, close to family members who know how to conduct funeral rites. Migration is challenging these religious and spiritual expectations since it fragments communities and restricts transmission of knowledge about ritual rites and

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rites of passage related to death and dying. I will now turn to one household case study to provide a more detailed account of these processes and their effects on “ordinary” people.

A Case Study: De Facto Childless Couple Gonpo is eighty-five years old, and his wife, Jampa, is seventy-three years old. After moving to Doeguling in 1967, they engaged in farming and raising livestock. Gonpo also learned masonry, while Jama learned carpet weaving to supplement their incomes from farming and animal husbandry. They raised six children. Only their eldest fifty-year-old daughter is married. She lives more than two thousand kilometers away with her husband and three children in Dharamsala. When I first visited the settlement in December 2009, their son Tenzin, age thirty-nine, was living with them and working in the settlement office. When I returned in October 2010, he had already moved to the US. The couple now have three unmarried children (two sons and one daughter) in the US; one is a former monk. Another son is a monk at a monastery in another Tibetan Settlement in South India, and a daughter is a nun at the nunnery in Doeguling. To my queries about how his children went abroad, he told me that his son Legdup, age forty-two, was a senior monk at a monastery who went abroad a few times as part of the official monastic tours, mainly for fundraising. During these tours, groups of monks would perform sacred rituals, like building sand mandalas and performing religious dances (‘cham). After a few such tours, Legdup decided to stay back in the US and applied for political asylum. He later defrocked and helped in arranging an invitation for his sister who had been in the army. In 2011, Tenzin moved to the US after his sister and brother arranged all the paperwork for immigration. Gonpo wanted his son Tenzin to marry and settle down in the settlement, but Tenzin had other plans. Gonpo says, “Children of today are so hot-headed and they don’t listen to us anymore. They see us as old brains who don’t know anything about the modern world.” In 2009, through remittances from the children in the US, a new house was built opposite the old tiledroof house. The children insisted on building the new house, but Gonpo now complains about the additional chores of maintaining the new house: We are only two old people who live here. We were just happy with our old house. Now, we have to take care of the new house as well. You know there are so many community obligations in the village like attending meetings, prayers, and mnyam las (communal labor). Sweeping the houses alone is a task. Every morning, I would do the morning rituals at the altar and clean the courtyard while my wife cleans the rest of the house. Most of the time she

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is busy with one community obligation or another, like attending meetings, prayers, and other tasks.

Gonpo and his wife, very healthy for their age, can take care of themselves. In fact, Jama is very active in the community religious activities, while Gonpo prefers to stay home to take care of the houses. I would occasionally see him walk two miles to visit the traditional Tibetan medicine clinic to get his herbal medicines. Nevertheless, they are getting quite old and will soon need assistance. Their nun daughter lives in a nunnery in the settlement and frequently visits them. She is the child who is most likely to take care of them when they need it. Gonpo further narrated his distant dream of seeing Tibet and his twilight years: So, what is the point of my going to Tibet? I have lived in this village my whole life and the village people will be here for me till the end. I even tell my children that for me, this village is everything and they [the village people] will take care of me in times of need and difficulty. The village people will be here for me when I die. But my children won’t be around to take care of me when I die.

In the case of this household, the move abroad of several siblings was initiated by the monk son who first traveled internationally as part of his monastic training. By staying in the United States, he created a social connection abroad for his siblings, two of whom are now there as well. For the parents, like many older Tibetans, the settlement is their cherished home and their intimate community of care, a place where they have lived most of their lives, raised family, developed deep social relationships with neighbors, and forged spiritual and religious connections to their root lamas and monasteries in the settlement. In addition, Gonpo’s last sentence, “But my children won’t be around to take care of me when I die,” because it hints at a different temporality of care, illuminates the core of anxiety surrounding aging in the Tibetan exile. It is not that Gonpo worries about his children not caring for him here and now, while he is alive; it is the proper departure from this world that he is concerned with and that constitutes the core of proper eldercare. With his children far away, he is worried that no one will be there and/or knowledgeable enough to help him die in a way that is culturally dignified and religiously appropriate.

Conclusion For older Tibetans, the loss of homeland is personal, deep, and perpetual. At the same time, their protracted stay in exile has led to a sense of settlement

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in India. In contrast, the younger Tibetans who never experienced life in Tibet, but were born as exiles in India, are becoming very much part of the global flow of migrants and a transnational global economy because migration provides opportunities for upward economic mobility. The Tibetan settlements in India are thereby caught in a bind: on the one hand, they have achieved much success in maintaining cohesive Tibetan communities that have access to schools that teach Tibetan language and history, and monasteries that cater to Buddhist religious needs. At the same time, the very success of the settlements in terms of livelihood, health, and education has contributed to a fertility decline, high levels of education, and mobility among the youth. In paying attention to the precarious relationship between aging and migration in the context of tension between settlement and mobility in the Tibetan exile settlements, I document how migration transforms traditional norms of family-based elderly care in the Tibetan exile context. Migration increases the number of elderly people who do not have adult children as caretakers, and therefore decreases the number of persons who can help old people die in a religiously and culturally appropriate way. Although the alternative is to put the elderly into institutionalized care, such as Old People’s Homes, there is reluctance to enter institutional care because of associated stigma. Moreover, what makes Tibetan settlements even more crucial for thinking about what it means to be Tibetan and age appropriately in the contemporary world is the link between settlements and Buddhist religion. According to the local beliefs, settlements remain culturally appropriate places to age and die because of proximity to Buddhist institutions, a dense community of Buddhist practitioners, and knowledgeable family members or neighbors who know how to conduct funeral rites. Namgyal Choedup received a Ph.D. in cultural anthropology from Washington University in St. Louis in 2015. He conducted his dissertation fieldwork in one of the largest Tibetan refugee settlements in India to study the tension between the collective desire to maintain cultural continuity and the individual desire to achieve upward mobility through migration. He is currently conducting research on population mobility and social change among ethnic Tibetans in the highlands of Nepal. In addition to publishing several articles on Tibetan diaspora, he is currently working on a coauthored book project that discusses the mass out-migration of young children from Nubri, Nepal.

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Notes   1. All the names of research informants throughout the chapter are pseudonyms so as to ensure their anonymity. However, in the case of exile leaders and leaders and their interviews, real names and their official positions and roles are explicitly mentioned.   2. Reflecting on the same sentiment, Hess (2009: 134) applies the term “occidental longing” to describe this strong desire to move to the West among the Tibetan exiles.   3. The Tibetan term sa mtha’ refers generally to a place or region that is remote, a border, or a faraway region. In the religious and cultural contexts, it can have the connotation of a region that has not been touched by the reach of religion, synonymous with Buddhism for many older Tibetans.   4. In Doeguling, I came across only three other Tibetans who moved abroad but later returned to India. One is Sonam, age fifty-eight, who went to the United States in 1993 as part of the resettlement project. After two years, he came for a vacation and stayed because his elderly mother, now eighty-seven years old, asked him to. Among his three children, two daughters are married and settled in Canada and England, while his son lives with him and goes for seasonal sweater selling. Another US returnee is Tsering, age fifty-five, who stayed in the US for two years and returned to take care of her elderly father, who is now eighty-four years old. She has a very good job in an Indian bank in the settlement and had taken leave of absence for two years to go to the US, where her husband and four children are all settled. I also came across a seventy-two-year-old Tibetan retiree who returned from Switzerland and now lives with his nephew. Stories of such return, however, are very rare in the Tibetan settlements in India.   5. This chapter is based on my primary dissertation research investigating the tension between the collective desire to achieve cultural continuity and the individual desire to achieve upward socioeconomic mobility in the Tibetan exile settlements in India.   6. Migration defined most broadly is “a change in residence across some geopolitical boundary.” Such a change can be temporary or permanent, and the geopolitical boundary can be anything from a county to an international border depending on the nature of one’s study.   7. The political context is crucial to note here: for decades, Tibetan exile leaders have projected a vision of a Tibetan population facing the threat of genocide (Klieger 1992), and the exile settlements as the means to counter this threat by maintaining them as centers of cultural preservation.   8. These India-based settlements are part of the larger network of fifty-eight Tibetan settlements administered by the CTA in India, Nepal, and Bhutan.   9. This elderly home, intended to house the elderly and disabled persons who had no dependents among the Tibetan refugees, is administered by the CTA since its inception and is dependent on funding from NGOs and Tibetan patrons. The stark decline in the number of residents is due to the minimal number of new admissions because the elderly home carries a strong social perception of being a place for the destitute, thus carrying an implicit sense of social stigma for the children and ­­relatives of any elderly who end up there.

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10. I did come across three cases of elderly home residents whose children are living in the settlement. First is Metok, a widow, age seventy-nine, who occasionally visits her widowed daughter to babysit her six grandchildren. She has two married sons who moved out of the natal home a long time ago. Second, I met an elderly couple, both in their late seventies during my survey, and they were taking care of their son’s home. They told me that their son had suffered so many misfortunes despite his hard work at making a living in the settlement. The son had temporarily moved his family to a place in North India to make a roadside food stall. The third case is that of a widowed mother and her son in the elderly home; the mother is paralyzed, and her son, age forty-five, is disabled. The woman’s sister had taken care of them for many years but was advised by everyone, including the village leader, the settlement officer, and the foreign NGO helping the family, to send the mother and her son to the elderly home. 11. The cultural ideal for an elderly Tibetan is to prepare for the next life; giving charity instead of receiving it is one way of gaining merit for better rebirth. Therefore, for many elderly Tibetans, it is socially undesirable to go to the elderly home because it is primarily funded by foreign and Tibetan sponsors and thus dependent on charity. 12. I found four such cases in Doeguling where the second husband in the polyandrous marriage was separated from his family because of not being legally recognized as a member of the family in the US immigration system. 13. A Tibetan custom of offering burnt roasted flour for the dead person, whose consciousness is believed to remain around in the intermediate realm between death and rebirth. 14. In addition to the common belief among the Tibetans that the Dalai Lama is a reincarnation of Chenrezig, it is common to hear many Tibetans to refer to the Dalai Lama as a Buddha in human form.

References Bohra, Pratikshya, and Douglas S. Massey. 2006. “Process of Internal and International Migration from Chitwan, Nepal.” International Migration Review 47 (3): 621–651. Brettell, Caroline. 2000. “Theorizing Migration in Anthropology: The Social Construction of Networks, Identities, Communities, and Globalscapes.” In Migration Theory: Talking Across Disciplines, edited by Caroline Brettell and James F. Hollifield, 97–113. New York: Routledge. _____ 2003. Anthropology and Migration: Essays on Transnationalism, Ethnicity, and Identity. New York: Altamira Press. Brown, Susan Love. 2002. Intentional Community: An Anthropology Perspective. Albany, NY: Sunny Press. Castles, Stephen, and Mark Miller. 2003. The Age of Migration: International Population Movements in the Modern World. New York: Guilford. Choedup, Namgyal. 2015. “From Tibetan Refugees to Transmigrants: Negotiating Cultural Continuity and Economic Mobility through Migration.” Ph.D. diss. St. Louis: Washington University.

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Childs, Geoff. 2008. Tibetan Transitions: Historical and Contemporary Perspectives on Fertility, Family Planning, and Demographic Change. Boston, MA: Brill. Childs, Geoff, Melvyn C. Goldstein, and Puchung Wangdui. 2011. “Externally-Resident Daughters, Social Capital, and Support for the Elderly in Rural Tibet.” Journal of Cross-Cultural Gerontology 26 (1): 1–22. Cohen, Jeffery H., and Ibrahim Sirkeci. 2011. Cultures of Migration. Austin, TX: University of Texas Press. Dalai Lama. 2008. Awakening the Mind, Lightening the Heart, edited by Donald S. Lopez. Dharamsala, India: Library of Tibetan Works and Archives. De Haas, Hein. 2007. “Remittances, Migration and Social Development: A Conceptual Review of the Literature.” Social Policy and Development Programme Paper Number 34. Geneva: United Nations Research Institute for Social Development. Hess, Julia M. 2009. Immigrant Ambassadors: Citizenship and Belonging in the Tibetan Diaspora. Stanford, CA: Stanford University Press. Kandel, William, and Douglas S. Massey. 2002. “The Culture of Mexican Migration: A Theoretical and Empirical Analysis.” Social Forces 80 (3): 981–1004. Klieger, P. Christiaan.1992. Tibetan Nationalism: The Role of Patronage in the Accomplishment of National Identity. Meerut: Archana Publications. Knight, John. 2002. “Repopulating the Village?” In Demographic Change and the Family in Japan’s Aging Society, edited by John W. Traphagan and John Knight, 107–124. New York: State University of New York. Levitt, Peggy. 2001. The Transnational Villagers. Berkeley, CA: University of California Press. Magnusson, Jan S. 2002. “A Myth of Tibet: Reverse Orientalism and Soft Power.” In Tibet, Self and the Diaspora: Voices of Difference, edited by P. Christiaan Kleiger, 195–212. Boston, MA: Brill. Magnusson, Jan, S. Nagarajao, and Geoff Childs. 2008. “South Indian Tibetans: Development Dynamics in the Early Stages of the Refugee Settlement Lugs zung bsam grub gling, Bylakuppe.” Journal of the International Association of Tibetan Studies 4: 1–31. Mahajan, Gurpreet. 2005. “Indian Exceptionalism or Indian Model: Negotiating Cultural Diversity and Minority Rights in a Democratic Nation-State.” In Multiculturalism in Asia, edited by Will Kymlicka and Baogang He, 288–312. New York: Oxford University Press. Massey, Douglas S. 1990. “Social Structure, Household Strategies, and the Cumulative Causation of Migration.” Population Index 56 (1): 3–26. Massey, Douglas S., Joaquin Arango, Graeme Hugo, Ali Kouaouci, Adela Pelegrino, and J. Edward Taylor. 1993. “Theories of International Migration: A Review and Appraisal.” Population Development Review 19 (3): 431–466. _____ 1998. Worlds in Motion: Understanding International Migration at the End of the Millennium. Oxford: Clarendon Press. Pitzer, Donald. 1997. America’s Communal Utopias. Chapel Hill: University of North Carolina. Portes, Alejandro 1995. “Economic Sociology and the Sociology of Immigration: A Conceptual Overview.” In The Economic Sociology of Immigration: Essays on Networks, Ethnicity, and Entrepreneurship, edited by Alejandro Portes, 1–41. New York: Russell Sage Foundation.

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Stark, Oded, and David E. Bloom. 1985. “The New Economics of Labor Migration.” American Economic Review 75: 173–78. Wangmo, Tenzin, and P. B. Teaster. 2009. “The Bridge from Now to Then: Tibetan Elders Living in Diaspora.” Journal of Applied Gerontology 29 (4): 434–454.

ijjjjjjjjjjjjjjk PART III Communities of Care across Distance

ijjjjjjjjjjjjjjk 5. SOCIAL EMBEDDEDNESS AND CARE AMONG TURKISH LABOR MIGRANTS IN VIENNA The Role of Migrant Associations Monika Palmberger

Introduction: Care and Social Embeddedness Stepping off a busy multilane street into the Turkish cultural association— located on the outskirts of Vienna in a traditional commercial district—feels like escaping a hostile industrial environment, heavy with traffic, into a hospitable and intimate place. Upon entering, I see elderly men sitting around tables in small groups, talking to each other. On the walls pictures in cheaplooking golden frames show Turkish landscapes. At the back of the room, on one of the walls there is a picture of the Austrian president, next to a picture of the Turkish president. While taking in this welcoming and complex setting, I am invited to join six elderly women who are preparing Gözleme (a traditional Turkish pastry dish) for today’s celebration in a small back room. The women sit on the carpet, chatting; one of them cuts the dough into small pieces, two others have a big round board and a wooden stick to roll out the dough, and the rest fill the dough. This collective, seemingly easy, gendered work is done while chatting and exchanging news and gossip. It is an exceptionally hot summer day and the heat is almost unbearable in this small room. The women lift their headscarves from time to time to get some air. It is a nice, intimate atmosphere in the room and, when I join them, a conversation quickly gets off the ground. —Field notes, 15 June 2013

This ethnographic vignette reflects some of my first impressions when entering one of the several Turkish voluntary associations in Vienna. When I sat together with the women in the back room where they prepared food, I learned that they not only met each other at the association but they also met on a weekly basis in one of their homes, mostly for Qur’an reading. Their husbands came to the associations even more frequently,

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some on a daily basis, to chat and play cards together. When I asked the women preparing Gözleme who they consult if they need advice or help, two of them answered without hesitation: “We ask each other for advice when something comes up” (Hülya). “When something happens, all of us are there to help!” (Ayse). For many other aging labor migrants I talked to, just as for Hülya and Ayse, one of the cultural, political, or religious voluntary associations held a central position in their lives. Although very different in nature, these associations were important places to socialize and to experience social embeddedness outside of the family and with others who had a similar migration history and a shared stage of life (in the sense of a particular “life situation”). Importantly, these people also shared a transnational outlook on aging. In this chapter, I illustrate and discuss how migrant associations become “places of caring.” I also show how novel, transnational understandings of aging and care are negotiated among older migrants in Vienna.

Care and Social Embeddedness in the Context of Migration Care is a difficult concept to grasp; it entails various aspects and involves multiple actors. In the current social science literature, care is most often discussed as a relational concept (see Korinek, Entwisle, and Jampaklay 2005). In the existing literature on care, different foci can be distinguished corresponding to the interest in different care “providers.” These include state-organized and institutionalized care, often linked to citizenship debates, and family-based care, frequently related to kinship debates. In this literature, there is a rather strict and problematic dichotomy between the public (formal) and the private (informal) domains of care. Some scholars, however, have challenged this dichotomy and have highlighted the enduring bias that care provided by family members is based on “good” emotions, while care by professional care workers is based on “fake” emotions or is completely lacking in feeling (Thelen 2015a). In the literature on migrants’ care relationships (as in the anthropological literature more generally), care has long been discussed primarily within the context of kin relationships, with the family often identified as the prime care provider. At the same time, the state has been criticized for failing to fulfill its care responsibilities toward migrants (Buch 2015; England and Dyck 2016; Walsh and Näre 2016). In the discussion of the failure of the state to care for its migrant population and the focus on care relations within migrant families as compensating for the lack of state care, the role communities play when it comes to care remains widely

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unexplored. In addition, even though there has been an increasing interest in questions of aging and migration, there are still only a few studies on this topic concerning Austria (see Reinprecht 2006). Migrant associations, which prove to be vital in the lives of aging labor migrants and which are central in the discussion of this chapter, are another under-researched subject in migration studies, particularly in Europe (Caglar 2006). Migrants who have reached retirement age and whose children have moved out from their parental home are key actors in community building around these associations, and they are the main focus of this chapter. Care is understood here in a broad sense, with a particular focus on its relational and discursive (negotiable) dimensions (see Brown 2002; Korinek et al. 2005). Experiences of social embeddedness are understood as a fundamental element of a sense of being cared about. Regarding the distinction by Grant and colleagues (2004) between “caring for” (referring to concrete labor/services provided) and “caring about” (referring to relational and emotional aspects of care), this chapter primarily focuses on the latter. Social embeddedness nurtures feelings of belonging and security in the sense that one feels “cared about.” I understand social embeddedness in a relational sense: that is, social relations that foster a sense of “rootedness” and belonging, not in a geographically binding way, but more in the form of social ties (see Brown 2002; Korinek et al. 2005). Such an understanding of social embeddedness takes account of transnational ties and does not restrict a sense of embeddedness to a geographically defined place (for example, Austria versus Turkey). Social ties important for my interlocutors’ sense of social embeddedness, however, were closely linked to their everyday lives and daily routines, which included regular visits to one of the voluntary migrant associations. These associations will be the focus of this chapter when investigating the multiple but specific experiences of aging and relations of care among older labor migrants in Vienna. That said, the other two care “providers”—the state and the family—are not omitted from the discussion; rather, the three are assumed to be ­interrelated and are discussed in relation to one another.

Research Contextualization Aging migrants are a very diverse group, as this edited volume clearly shows. It is particularly important to take into account the specific migrant trajectories—including the stage of life when people migrate and the individual reasons behind the decision to migrate—as well as the specific legal and structural constraints aging migrants face. In what follows, I briefly carve out and contextualize the specific histories of Austria’s Gastarbeiter

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(guest workers) and the specific challenges they have faced historically and continue to face today. The first guest worker contracts between Austria and Turkey were signed in 1964. The majority of Turkish labor migrants were young men who worked under precarious conditions as unskilled workers, mainly in the construction industry but also in other industries, including textile and paper factories, as well as in tourism-related business (see Fassmann and Lichtenberger 1987). While some women entered alone as guest workers (see Lorber 2017), the majority either moved with their husbands to Austria or followed somewhat later (with their children, or sometimes children followed at an even later stage). Regardless of the fact that guest worker contracts did not foresee labor migrants remaining in Austria for more than a limited period of time, a significant number settled down and stayed. When the idea of recruiting guest workers was first put forward in the early 1960s, no plans for integration measures, such as language courses, were included. The establishment of migrant associations, however, was supported by the authorities in the belief that these associations would be temporary and help guest workers to socialize among themselves in their new environment. However, these associations are still active throughout Vienna, and in 2004 there were 728 migrant associations registered in the city (Sohler 2007: 379), 109 of which were organized by the Turkish migrants (see figures 5.1 and 5.2). Regardless of this specific history of Austria’s migrant associations, it would be incorrect to characterize them as ethnically defined. In fact, political and religious affiliations were most influential when choosing a particular association, although the Turkish language dominated and thus was more or less a prerequisite for becoming part of the community (only in mosques, which non-Turkish visitors sometimes attended, did language play a somewhat lesser role). Rather than ethnicity, different associations reflect the diversity among the older Turkish labor migrants, suggesting that we take seriously “migrant’s agency beyond ethnic subjects” (Caglar 2013: 407). Between 2013 and 2016, I visited twelve Turkish cultural, political, and religious voluntary associations (including small mosques). The associations I visited differed greatly from one another. However, a common factor was that they were places with a strong sense of community and plenty of room for socializing. Among them were Turkish cultural centers, often also used as mosques, an Islamic-Alevi association,1 and a Turkish democratic labor association. The last two were particularly politically active among the centers I visited (for example, they were used for discussion rounds and organizing demonstrations). In these voluntary associations, members

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FIGURE 5.1  Cloakroom at one of the Turkish migrant associations in Vienna decorated with pictures of its members in the years after their arrival in Austria. Photo by Ogül Büber.

FIGURE 5.2  Lounge at one of the Turkish migrant associations in Vienna. Photo by Ogül Büber.

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who were fifty years and older took on a central role in community building. During weekdays, the great majority of visitors were pensioners (particularly male pensioners), but on weekends and for religious festivities, the associations hosted people of all ages and entire families. I participated in activities at the associations and conducted semistructured narrative interviews there. In addition, I visited people in their homes, where I also conducted interviews. Between 2013 and 2016, I conducted twenty-five semistructured narrative interviews with twenty-five men and women who themselves (or their spouses) entered Austria as “guest workers.” In these interviews, which lasted between forty-five minutes and two hours, I asked questions that invited my interlocutors to examine their present lives by connecting them to past experiences and future aspirations. The interviews thus give insight into past decisions and present life strategies and concerns, as well as into hopes and fears regarding the future. Additionally, I conducted about thirty informal interviews, and with my key informants I conducted a second interview round. While this chapter shows how greatly research participants valued the community around these associations, which was central to their sense of social embeddedness, it does not claim that all older Turkish labor migrants and their spouses are socially well-embedded. Two of my interviewees were not able to visit any of the associations on a regular basis because they had to look after a sick or handicapped adult child. Furthermore, the location of this study is of relevance: Vienna, with its historical particularities, including its long history of immigration, marks itself off from other places in Austria in terms of migrant-friendly infrastructure. The same can be said with regard to access to migrant associations, which are more numerous and more easily established in Vienna than in some other places in the country. These territorial discrepancies and different opportunity structures across a national territory need to be considered (Caglar 2013). Due to the many different associations I include in my analysis here, it is not possible to discuss the specific histories, outlooks, and political aspirations of each.2 It would also go beyond the scope of this chapter to discuss the meaning of voluntary associations for migrants more generally (see Moya 2005). The focus thus remains on the meaning of such associations for older migrants and the migrants’ experiences of social embeddedness and care in these associations and beyond.

Places of Social Embeddedness and Caring Entering retirement for many of my interlocutors ended a phase of hard work as unskilled laborers and often coincided with their children moving

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out. This stage of life was also unique in the sense that it opened up new possibilities, especially for transnational living arrangements. Retirement was an important time when spouses renegotiated where they wished to live and how they wanted to divide their time between Turkey and Austria (Palmberger 2016; Palmberger forthcoming). Despite gender differences, most couples in the end opted for one extended stay in Turkey, from one to three months (preferably during/including summertime) and spending the rest of the year with their children (and grandchildren) in Vienna. These individual preferences regarding mobility were central to their understandings of a satisfactory old age but were also significantly restricted by existing mobility regimes (Glick Schiller and Salazar 2013). Especially when their retirement benefits were below the guaranteed minimum, they risked losing compensation payments if they spent more than two months a year outside Austria. The everyday lives of my research participants consisted of daily routines, which often included a visit to one of the cultural, political, or religious associations, as well as more exceptional but periodic activities, such as religious holidays celebrated with family and repeated commutes between Austria and Turkey. Everyday life may be characterized as “what happens every day, the routine, repetitive taken-for-granted experiences, beliefs and practices; the mundane ordinary world, untouched by great events and the extraordinary” (Featherstone 1992: 160–161). Everyday life is practiced, rather than reflected upon, and this becomes most apparent when asking people about it. Crucial for understanding my interlocutors’ everyday lives was the fact that they did not divide their activities into daily routines and leisure time. When asked about what they did for recreation, they referred back to their daily routines, which they sincerely hoped to keep up for as long as they were able. While daily routines differed between men and women, for many of both groups these routines included visits to one of the Turkish associations or meeting other members of one of the associations. Besides visiting family members, an integral part of everyday life for most of the older generation I talked to were the visits to a cultural, religious, or political association in which they actively participated. The associations, which they visited on a regular basis, took center stage in their lives and provided an important place for them to socialize and to experience social embeddedness outside of the family. The atmosphere in these associations was rather informal, and people knew each other well. There they socialized, but also shared information and helped each other out with advice. Some described the association as their second home. The associations greatly differed in nature, particularly with regard to their religious and political orientation, and thus people purposely chose one over the other.

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Most of the associations and mosques I visited during my fieldwork were rather invisible from the outside, often being located in basements. When they also hosted a mosque, there was a big area reserved for praying that was decorated with carpets and pictures. The remaining space was set aside for socializing and meetings and for different activities (e.g., music classes); furnished with tables and chairs, it most often included a small bar where tea/soft drinks and snacks could be consumed. This was also the case in the Turkish Islamic cultural association, located in a traditional working-class district that Hasan, age sixty-four, visits on a daily basis. This association has become a second home to him, and he spends most of his day there. Hasan comes to the center every day to socialize and to join shared prayers. When asked to describe a typical day, Hasan answered, “When I wake up in the morning I pray and then go to bed again, for two more hours. Afterwards I come here. I stay here until the evening prayer, and then I go home.” Hasan’s children at the time of the interview studied in Turkey, and his wife had moved to Turkey to support them. Hasan visits them regularly and each time stays for several weeks before returning to Austria. For ten years, Hasan has been receiving an invalidity pension, which at the time we spoke was 760 euros a month.3 Hasan told me how difficult it is to live on such a small pension. The Turkish Islamic cultural association provides him with a place where he can spend his days, socializing and engaging in the association’s activities regardless of his limited budget. He can even enjoy a warm lunch there for only a small financial contribution. There he meets other men of similar age and with a similar migration history—men who came to Vienna during young adulthood as labor migrants and who have now entered retirement. On warm days, Hasan meets his friends from the Turkish cultural association at different public places in the neighborhood, in a particular park, or on a particular park bench. He said he knows where to find them without agreeing on a date and time to meet in advance. While Hasan goes to the association first and foremost to socialize, many of my research participants take an active part in the organization of their association, as is the case with Mehmet, who is politically engaged and an active member of an Islamic-Alevi association. The following quotation from an interview I conducted with Mehmet describes how, besides family and household duties, active participation in the community life takes center stage in his everyday life: Well, before retirement we had time but now I am a pensioner and I do not have time anymore [laughs]. I have built a house with a garden and a garage; I just planted five or six fruit and vegetable plants. I work in the garden and mow the lawn. When I find time during the week I come here to

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the association [Islamic-Alevi association]. I have to come here at least twice a week. I help out here as much as I can.

Mehmet is involved in the organization of various cultural and political activities. He also arranges a communal breakfast that takes place once a month. Mehmet described the relationship between the members of the association as very intimate, even family-like: “We come here and talk like friends. All of the people here are like brothers and sisters to me.” The importance, especially after retirement, of the community around a particular association was stressed by many of my interlocutors. Even for those who had been members of an association for a long time, the meaning of the community around it often changed and increased after retirement, as experienced by another of my key interlocutors, Ada. Ada, a self-declared atheist, described the community around the Turkish democratic labor association where she is an active member as extremely important for her wellbeing and sense of social embeddedness. Ada was forced into invalidity retirement in her mid-forties due to bad health. Before she retired, she worked for different cleaning companies and in the home care service sector. Since her husband died, Ada has experienced great loneliness and financial hardship. The only place where she finds some respite is at the political association of which she is an active member.4 She told me, I had to claim an invalidity pension due to my illness. I would have preferred to work longer because when you work you also socialize. Now, the only thing I have is the association; there, at least, I have something to do. Otherwise I would only sit at home alone or visit my sisters. But I also have financial difficulties, great financial difficulties! . . . I have nothing left to hold on to since my husband died. But at least there [in the association] I feel good. When I am at the association, I am relieved and find distractions. There I can forget everything and put everything aside.

Even though Ada is only in her mid-fifties, she has been an active member of her association for decades already. She, so to speak, grew old together with the association and with the other founding members. While the association has always been an important place for Ada, its importance increased drastically after her early retirement and the death of her husband.

Outlooks on Late-Life Care Late-life care was not an easy topic for my interlocutors to talk about and was most often not openly discussed within families. This became

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especially clear when the children were present. While many were aware of the difficulties of home-based family care and knew that their children were busy with their own lives (jobs and children), this subject was generally avoided. Many of the aging migrants, it has to be added, still perceived themselves as care “providers” since they took on a great share of daily care activities, including not only caring for grandchildren but also looking after adult children with a disability or chronic illness, and it was not unusual for mothers to still cook for their adult children when the latter had busy working lives. Even if this care work was not evenly distributed between men and women, with women clearly playing a greater part in care activities, after retirement men became increasingly involved. This was the case with Erin, a man I met at a Turkish cultural association. Since his retirement, Erin had volunteered to care for two small children. He had two children of his own, twins, who were already grown up, but he had no grandchildren yet. The two small children Erin cared for, and to whom he often referred affectionately as his “two little Austrians,” were the children of his daughter’s Austrian friend who had fallen seriously ill. When Erin’s employer fired him at the age of only fifty, the older of the two children was only about forty days old. For Erin, this was no coincidence, and he told me that “this is a grace but also a test from Allah.” This example nicely shows how care relationships are more manifold and rarely one-directional. For Erin, retirement provided this particular window of opportunity to care for the two children. Regardless of his “duties” looking after his “little Austrians,” Erin tries to visit the cultural association as much as possible. Similar to the other older migrants introduced above, Erin described the community around the association he regularly visits as essential to his wellbeing. When, however, I asked Erin where and from whom he would seek help if and when he is in need of care, he referred to his family and not to the association. Erin, like most of my other interlocutors, hoped that his children would take care of him and his wife when in need. At the same time, like many of the older generation, he was aware that he could not take his children’s help for granted and knew that “times have changed.” Therefore, many in the end added that they would seek institutional care if they needed to. Even if there is a strong network and people help each other out, the community is only accessible as long as people are mobile enough to come on a regular basis to one of the associations. Places offering late-life care, such as nursing homes, seemed very inaccessible to aging Turkish migrants. This also became clear when talking to the women I met in the first of the voluntary associations described in this chapter, to whom I talked while they prepared traditional Turkish pastry in the little backroom. Hülya and Ayse started the following conversation when I asked them where they

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would seek help and whether they would consider moving to a nursing home at an advanced age: Hülya: I haven’t given it much thought yet, I don’t know; only Allah knows. We indeed hope that our children can take care of us. I don’t know, I only hope that our children don’t sell us out. Ayse: If our children don’t take care of us . . . Hülya: Then we would go to a nursing home. But if my children don’t take care of me I can’t force them to. . . . We have not visited a nursing home yet nor has anyone from among our family or friends. Therefore, we don’t know anything about them—neither good things nor bad. . . . We would need to know whether we could practice our religion freely there. They are Christians; I am Muslim. I don’t know whether they would give me a place to pray there . . . or if they would give me a place to read the Qur’an; nobody knows.

Besides questions of faith (for example, prayer rooms) and halal food, research participants raised language difficulties as an issue when considering a nursing home in Vienna. Skepticism toward Austrian nursing homes was common not only among Muslims but also among those describing themselves as atheists, as was the case with Ada introduced above. Important to note in Hülya’s explanations, however, is the fact that she did not prioritize family care over institutionalized care. Hülya thus did not join the discourse that juxtaposes “true care” (which is attributed qualities of love and intimacy) to “institutionalized care” (see Thelen 2015b). In this discourse, home-based care is depicted as “warm” and done by relatives, and care provided by institutions is seen as “cold” (Hochschild 2003). Hülya, however, made it clear that one can be treated badly by a family member in the same way that one can be treated exceptionally well by a professional nurse: And I would like to add that one can never foresee how things will go. You can remain in your own home or with your child and you don’t know how it will be. The same is the case when you go to a nursing home. The Austrian nurse, who you don’t know . . . there are good people and bad people. She can treat you badly or well, you don’t know. But there are also really good people, people who even may treat you better than your own child does. We have been to hospitals and know that they can be so different; some really insult you and treat you badly.

Even if Hülya was aware that it is not always possible to predict where one would be treated best, she was still skeptical toward Austria’s health institutions and was in favor of opening a Turkish (Muslim) hospital and nursing home. She said that her mosque already had plans to back such

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efforts but that there was no state support and it would be hard to fulfill this dream with donations only. Hülya was convinced that the lack of suitable nursing homes is a big problem for Vienna’s aging Turkish migrants. Looking closer at the relation labor migrants have with the state when it comes to questions of institutionalized care, it becomes clear that it is an ambivalent one. Some of my interlocutors did not or could not describe where their negative attitude came from, and they admitted that they had never been to a nursing home and did not know anyone who had visited one and who thus could share their impressions of it. However, most of the people I talked to had been hospitalized and some shared with me their experiences of discrimination there. In an interview I conducted with Alev, a woman in her mid-fifties who followed her husband, a labor migrant, to Vienna almost thirty years ago, she told me how she was discriminated against when she was treated in a health resort and in a hospital: I had knee surgery, my kneepans are in a very bad condition. . . . My health insurance paid for treatment at a health resort. . . . But, believe it or not, they would not let us [her and other Muslim women] go in the water at that health resort because we were wearing headscarves. . . . Nor was I allowed to use the sauna. They did not let us in with our swimsuits, which completely covered our bodies. . . . I also had bad experiences in the hospital when I could not express myself because of language problems. They performed surgery on my knees four times! And at the last surgery they let an intern treat me. They took a blood sample, four tubes of blood . . . I was already suffering from anemia. They took my blood and threw it in the rubbish bin. And then the intern came and again took another blood sample from me.

Alev sensed discrimination in the way she was treated in the hospital and thought that the intern was allowed to “experiment” on her because she was originally from Turkey. She also felt defenseless since she was not capable of expressing herself in German. Such experiences in hospitals and other health institutions certainly do not counter skepticism toward nursing homes. Moreover, even if some of my interlocutors admitted that they would seek institutional care if they needed to, they had no information about how to secure a place in a nursing home nor did they have a clear idea of how these homes were run.

Conclusion In this chapter I drew attention to the importance of voluntary associations in the lives of aging Turkish labor migrants in Vienna. Cultural, political, and religious voluntary migrant associations are not only relatively easy

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to access in old age but also provide a social context for the integration of personal histories and transnational life-concepts. The community around such associations was crucial for their wellbeing, as intimate, friendly, family-like places, and as places where they would seek advice and help if needed. The associations’ importance increased even further with retirement and at the phase when children moved out of their parental home. Regular visits to one of the associations and meeting other members of the association in private settings were central to my interlocutors’ everyday routines. It can be said that the sense of social embeddedness they enjoyed in the associations is based on a shared stage of life (in the sense of a particular “life situation”) together with a shared migration history, transnational living arrangements, similar religious, cultural, and/or political ideas, as well as a common mother tongue. As indicated at the beginning of this chapter, eldercare has most often been discussed either on the state (institutionalized) level or as exchanged within families. The latter often has been said to compensate for the lack of state-sponsored care designed for migrants’ needs. In this vein, much has been written on the way care is predominantly accomplished within migrant families. This contributed to a tendency to overestimate familybased care in migrant families, while family-based care relationships among nonmigrant families have been understated (see Baykara-Krumme 2007; Fokkema and Naderi 2013). In this chapter, an additional form of care, found at the community level, has been opened up for discussion and it has been argued that voluntary associations deserve closer attention when researching aging and care in the context of migration. Following the above-introduced broad understanding of care in which social embeddedness constitutes an important element and fosters a feeling of being cared about, the political, cultural, and religious associations that older Turkish migrants were members of may well be referred to as “places of caring.” While I wish to highlight the potential of voluntary associations to become places of caring for aging migrants, I do not wish to hide their limitations either. This concerns first and foremost the fact that the associations constitute places of caring only for those who are (still) mobile enough to visit them and their members on a more or less regular basis and excludes those who are restricted in doing so. My interlocutors were well aware of this fact and never pictured the association as a provider of latelife care but rather referred to their family as the first choice in this matter. Even if family-based eldercare was the preferred option of the great majority of my interlocutors, the presumption that family-based care was necessarily “warm” care and its counterpart, institutionalized care, “cold” did not remain unquestioned. Regardless of the fact that most of the men and women I spoke to said that they would prefer their children to look

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after them when they needed it, they also articulated the wish for institutionalized eldercare that would cater to their particular needs and desires. Besides questions of faith (for example, prayer rooms), my interlocutors raised language difficulties as an issue when considering a nursing home in Vienna. Also halal food was an important topic. There was clearly a wish to spend late life among people with a similar migration background, with shared political ideas and/or faith. By articulating the wish for a Turkish nursing home, the desire for social embeddedness within a community (as experienced in the voluntary associations illustrated above) was voiced. This again supports the argument that social embeddedness is an essential basis for the experience of feeling cared about, which needs to be accounted for in debates on late-life care in the context of migration and transnational life-concepts. Monika Palmberger is a research fellow and lecturer in the Department of Social and Cultural Anthropology, University of Vienna, and research fellow in the Interculturalism, Migration and Minorities Research Centre, University of Leuven. Her research interests include aging and migration, (collective) memory, (forced) migration, and postwar societies, as well as qualitative methods. She is author/editor of the books How Generations Remember: Conflicting Histories and Shared Memories in Post-War Bosnia and Herzegovina (Palgrave Macmillan, 2016) and Memories on the Move: Experiencing Mobility, Rethinking the Past (Palgrave Macmillan, 2016, with Jelena Tosic).

Notes I would like to express my gratitude to the Max Planck Institute for the Study of Religious and Ethnic Diversity and the Austrian Science Fund (FWF T702-G18) for funding the research on which this chapter is based. Parts of this article have been published in Monika Palmberger (2016), “Social Ties and Embeddedness in Old Age: Older Turkish Labour Migrants in Vienna,” Journal of Ethnic and Migration Studies 43 (2): 235–249. 1. Since 2013, Alevis have been a recognized religious group in Austria. 2. Several scholars have critically assessed the historical and political dimensions of migrant associations. Caglar (2006), for example, analyzes how hometown associations have their specific histories and political locations. Yurdakul (2009) analyzes in detail the varying political engagements of different migrant associations in Germany and stresses that they developed their own political agendas and decisions rather than being passive recipients of state politics.

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3. A disproportionately high share of those receiving invalidity pensions in Austria are migrants (Reinprecht 1999). 4. Besides political discussions and political activism (such as demonstrations), the democratic labor association also organizes courses in music and dance and other activities, and Ada sometimes participates in these.

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Moya, Jose C. 2005. “Immigrants and Associations: A Global and Historical Perspective.” Journal of Ethnic and Migration Studies 31 (5): 833–864. doi: 10.1080/13691​​ 830500178147. Palmberger, Monika. 2016. “Social Ties and Embeddedness in Old Age: Older Turkish Labour Migrants in Vienna.” In Journal of Ethnic and Migration Studies 43 (2): 235–249. Palmberger, Monika. Forthcoming. “Feelings of Ambivalence: Older Turkish Labour Migrants in Vienna”. In International Journal of Comparative Sociology. Reinprecht, Christoph. 1999. Ältere Migrantinnen in Wien: Empirische Studien zu Lebensplanung, sozialer Integration und Altersplanung. Vienna: Senior Plus. _____ 2006. Nach der Gastarbeit. Prekäres Altern in der Einwanderungsgesellschaft. Vienna: Braumüller. Sohler, Karin. 2007. “MigrantInnenorganisationen in Wien.” In 2. Österreichischer Migrations- und Integrationsbericht. 2001–2006. Rechtliche Rahmenbedingungen, demographische Entwicklungen, sozioökonomische Strukturen, edited by Heinz Fassmann, 377–391. Klagenfurt: Drava Publisher. Thelen, Tatjana. 2015a. “Care as Social Organisation: Creating, Maintaining and Dissolving Significant Relations.” Anthropological Theory 15 (4): 497–515. _____ 2015b. “Care of the Elderly, Migration, Community: Explorations from Rural Romania.” In Rethinking Care: Kinship, Work, Institutions, and the Life-Course, edited by Erdmute Alber and Heike Drotbohm, 137–155. Basingstoke: Palgrave Macmillan. Walsh, Katie, and Lena Näre, eds. 2016. Transnational Migration and Home in Old Age. New York: Berghahn Books. Yurdakul, Gökçe. 2009. From Guest Workers into Muslims: The Transformation of Turkish Immigrant Associations in Germany. Newcastle: Cambridge Scholars Publishing.

ijjjjjjjjjjjjjjk 6. MIGRANTS OF PRIVILEGE American Retirees and the Imaginaries of Ecuadorian Care Work Ann Miles

One of the defining characteristics of lifestyle migration (especially as it compares to other transnational migratory movements) is that lifestyle migrants are focused primarily on consumption rather than production (Benson and Osbaldiston 2014; Oliver 2010). In other words, lifestyle migrants are often relatively wealthy, and they come to their new locations as consumers of local goods and services and not as workers (Amit 2007; Benson 2013; Croucher 2009). While the impetus and perceived urgency to engage in migration may vary among lifestyle migrants, in general they “deploy their accumulated capitals, assets and resources to facilitate lifestyles in countries with lower daily expenses” (Benson 2015: 20–21). Although well under way prior to 2008, since the great recession of that year, when many Americans lost their jobs and in many cases their health insurance, there has been an increase in the transnational migration to the global south of elderly Americans who wish to maintain or improve their lifestyle (Hayes 2014; Viteri 2015). Because retirement-age migrants are older, one important domain of consumption is health and personal care services. This chapter describes lifestyle migration and care relations in Cuenca, Ecuador, where in the last five years there has been a significant growth in the population of American retirees who access care in a variety of ways. In addition to using the public and private health care options in Ecuador, many retirees form relationships with Ecuadorians who provide care in both formal and informal ways. Care, as defined by Tronto (1993), is quite simply the response of one person to the needs of another (170) and, as such, care is always relational and carries with it an understanding of moral “engagement” (164; see also Kleinman 2010). It is often understood that to act morally in one’s world entails a level of caregiving, caretaking, and sometimes care-­receiving (Parsons 1951). The provision of care, especially to those who appear

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vulnerable and in need, is intimately linked to notions of self and personhood, to one’s good standing in the community (Buch 2013; Kleinman 2010). Yet, care is also, writes Tronto (1993: 172), “a tool for critical political analysis,” as both the expectation to provide care as well as the ability to access it are not equally shared within a population. Baldassar and Merla (2014: 3) call care an “unevenly distributed resource,” and they argue that the circulation of care in any particular arrangement, who gets it and who gives it, partially reflects unequal power relations. Quite simply, some people are better positioned to access care than are others, and some people (especially women) are far more expected to provide care (paid, poorly paid, or unpaid) than are others. Indeed, much has been written about transnational care networks in which relatively poor female care workers from the global south leave their own children in the care of others as they travel to care for the children of the affluent or the elderly in the north (Ehrenreich and Hochschild 2004; Parrenas 2001). The provision of care, whether it is paid or unpaid, is a valued resource that undergirds and gives particular meaning to much of the retirement migration to Cuenca, Ecuador. The availability of good, affordable healthcare, for example, is a prominent selling point for online advertisers of retirement destinations, at the same time that more informal care relationships make the transition to expat life both easier, and in some ways more meaningful, for retirees. I will examine here the discourses about both formal and informal caregiving and care-receiving between Ecuadorians and American retirees, and discuss American retirees’ nostalgic imaginings about the value and meaning of care in Ecuador. In addition to conducting formal interviews with twenty-nine retirement migrants and five physicians about healthcare in Cuenca, I have had many informal conversations with American expats, as well as Ecuadorians, about the transnational care relationships they form. To supplement the interview data, I also consulted numerous online sources, including promotional sites such as International Living magazine, daily expat newsletters and their attached commentaries, and personal blogs. The latter, for the most part, are posted by expats living in Cuenca and are used to communicate to family and friends back “home,” as well as, in many cases, to provide detailed information about life in Cuenca to potential expats. Some expats have parlayed their blogs into money-making ventures, such as writing for newsletters, promoting products, or providing consulting services for prospective expats looking for short-term housing. One blogger who posts extensive photo essays of Cuenca and offers short-term rentals to visitors reported to me that she was surprised that “people act like they know me because of the blog!” The “advice-giving” nature of much expat to expat communication, whether online or in person, is itself a kind of caregiving,

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and, while plentiful, it is not one that I will examine closely here. Often very public, it too is about the construction of self and rests, if only partially, on perceptions of difference and inequality. Reaching the status of being able to give advice is a kind of achieved status among migrants; they are experienced “old timers” and not wide-eyed newbies. While American retirees often differ considerably in their reasons for retiring to Ecuador, among those I spoke with it was apparent that part of what made Cuenca a good place to retire to was their imaginaries about the communal and family values of Ecuadorians. These discourses help to shape their impressions of the relationships they engage in with Ecuadorians and the range of care that they receive. These popularly circulating discourses reveal nostalgic images of the value of interpersonal and community caring performed by Ecuadorians at the same time that they expose American tropes of privilege and paternalism. Blogs, because of their textual nature, turned out to be especially good places to find these nostalgic ideas elaborated on in greater detail (See Estevez 2009 for the digitizing of nostalgia), but these ideas are also to be found in everyday conversation in the expat community.

Cuenca Cuenca is the third largest city in Ecuador, and it emerged as a popular retirement destination after 2009, when Yahoo Finance advertised the city as International Living (IL) magazine’s “Number One Retirement Destination.” Cuenca achieved this position after being heavily promoted online by IL, a media corporation in the business of providing information to prospective expats, among other endeavors. Today there are an estimated six thousand expats, many of whom are American retirees. While many retirees I spoke with expressed skepticism about IL and questioned the financial investments of the magazine’s writers, who they suspected benefitted financially by promoting one location over another, they also say that it was influential in first steering them toward Cuenca as a retirement destination (see figure 6.1). Since 2009, Cuenca has remained high on numerous lists of top international retirement locations including U.S. News and World Report’s “Ten Best Places to Retire Overseas,” and it was featured in an ABC World News report titled “Americans Find More Affordable Paradise for Retirement” in 2013 (Peddicord 2014; Netter and Quinones 2013). Most often, Cuenca is noted for its affordability, including low-cost healthcare, coupled with the urban amenities of a major city. I have worked in Cuenca as an ethnographer since 1989 and have watched the city grow and transform over the past twenty-five years.

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FIGURE 6.1  Cuenca’s downtown, a UNESCO World Heritage Site with cobblestone streets and traditionally clad cholas, appeals to expats seeking an “authentic” cultural experience. Photo by Ann Miles.

Today, Cuenca’s population, including the newly incorporated areas, is nearing half a million. Until recently, the biggest changes to the city came from the repercussions and remittances of Ecuadorian transnational migrants to the United States (Klaufus 2012; Miles 2004). The borders of the city have expanded significantly as new homes “hecho de dolares” (made from dollars) have been built on the outskirts of the city by the families of Ecuadorians in the United States and an occasional new business has opened with a North American flair, including a restaurant named “New York Pizza” operated by a returned migrant. Until 2008, the expat population in Cuenca was relatively small, and businesses and services were exclusively Spanish-speaking. I could spend an entire summer in Cuenca without hearing anyone speak English in town. I confess that the designation of Cuenca as a retirement “haven” took me by surprise. I find the city to be overly congested, as new development sprouts out of what was once the countryside and buses spewing black smoke connect these blossoming new neighborhoods to the city center. Traffic is heavy throughout the city for most of the day now, and pedestrians have to remain highly vigilant while navigating the city streets. Cars invariably have the right of way, and they take it. Moreover, Cuenca is located close to the equator, so nights come early, and it is situated at

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twenty-four hundred meters above sea level in the heart of the Andes, which means that the days can be cool and the nights downright chilly. Consequently, there is little café culture in Cuenca and little sense of the leisurely pace that typically accompanies a retirement “haven.” Among Ecuadorians, Cuenca is noted for its “conservative” culture, especially in contrast to Quito or Guayaquil, the capital and largest city respectively, both of which are considered to be far more cosmopolitan. The American retirees in Cuenca come for a variety of reasons. Some are self-described economic refugees concerned about a declining standard of living after the 2008 recession (Hayes 2014); some are seeking adventure and come to Cuenca to live out their personal imaginings of a successful retirement; and some are disgruntled with America, claiming that taxes are too high, life is too regulated, and the Obama government “too socialized” (see Benson 2013 for similar rationales in Panama). This latter comment is particularly amusing to me as Ecuador’s president, Rafael Correa, won two elections by promoting a twenty-first century socialist agenda, and his rhetoric and actions are fiery and populist. Some Americans come to Ecuador as self-described “healthcare refugees” engaging in what Ormand (2014) calls “disability impelled” migration. These are migrants who cannot afford all the medical or personal care services they might want in the US, and who come to Ecuador because these services are available there at a much lower cost. For example, one couple I met had a severely disabled relative whose disability payments did not cover the costs of all his medications and assisted living in the US. The couple cared for the relative for years at home with one spouse unable to work because of the caretaking responsibilities. “We were consumed with taking care of him,” they said, and “Ecuador saved us.” In Cuenca, neither works, their relative is in assisted living for less than one-third the cost of what they paid in the US, and his medications are significantly less expensive as well. Another couple includes a disabled husband who needs full-time care and a wife who was too young to retire and receive social security and Medicare benefits. Since the cost of living is so much lower in Ecuador, she is able to stay home with her husband and easily affords at-home care for him when she needs a break or another appointment. They plan to return to the US when the wife turns sixty-five and receives Medicare benefits; the other couple with the disabled relative has no plans of returning to the US. This “outsourcing” of American disability/elderly care to Ecuador may signal the beginning of a growing problem in the US as the baby boom population ages and finds itself increasingly in need of affordable extended home, disability and even institutional care (see Ormand 2014). The privilege experienced by American retirees in Cuenca exists on multiple planes. They are, as lifestyle migrants, obviously relatively

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economically privileged. The mere fact that they can easily move to improve their lifestyle without working, in most cases, is a testament to that fact. Their retirement savings go much further in Ecuador than they would in the US, and in some cases retirees are able to achieve a standard of living they simply could not achieve at home, including retiring early or having domestic workers or home-care assistance. Less publicly noted but nonetheless powerful is the racial privilege that their status as “whites” affords them (Hayes 2015a). Cuenca is a highly racialized society; it is a place where skin color and the cultural ancestry that it implies is a crucial element in social interactions, as well as social standing (Hayes 2015a; Miles 2004; Weismantel 2001). Whites and whiteness signify both real and potential social power in Cuenca. Interestingly, in contrast to other places where white foreigners have resisted racial labels (see Fetcher 2005), expats in Cuenca have quickly and with seemingly little objection adopted the Ecuadorian term gringo to describe themselves. They hold “gringo nights” in various restaurants, read the online newsletter called Gringo Tree, and easily refer to the “gringo” community when describing the expats in Cuenca. While the term gringo has various connotations throughout Latin America, some of them derogatory, in Ecuador it is primarily used to distinguish a white foreigner, and it is not meant as an insult, but rather an overt marker of a racial identity (See Hayes 2015a for more on race). While the privilege of a white identity seems to bother some retirees I spoke with, and Hayes reports that retirees tire of feeling they are “different” because of their race, the term gringo seems of little consequence to them (Hayes 2015a). Finally, privilege of a different sort is associated with advancing age in Ecuador. Older people in general are thought to be more vulnerable, and while this might indicate that they are easy marks, something some retirees worry a good deal about, their age also signals a kind of respect and care concern in Ecuador that it may not in the US. There is nothing sadder to many Ecuadorians than the prospect of a lonely old age (see Leinaweaver 2010). As one Ecuadorian shopkeeper explained, “It’s very sad to see these old people walking around here and there with no one to attend to them.”

Lifestyle Migration Imaginaries Long before most retirees make the move to Cuenca, or anywhere else for that matter, they engage in a process that is simultaneously informational and aspirational. Most retirees I spoke with had their interest in Cuenca sparked by reading IL online, and they began there what they considered to be a fact-finding journey. That included learning about average

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costs, getting a feel for the day-to-day life in the destination, and finding out about the logistics of an international move, including what to pack and how and when to get a visa. Most went well beyond IL and searched through multiple websites, including engaging directly with other expats through blogs, email, and posting questions to websites. In addition to learning the basics of life as an expat, they also begin to solidify a picture of the place and the people in their imaginations. “People hardly journey to terrae incognita anymore these days but to destinations they already virtually ‘know’ through widely circulating imaginaries about them” (Salazar 2011: 577). What they “know” is, of course, partial, and filtered through multiple lenses. One post on IL’s website is particularly obvious in its link to an imaginary, and although it is meant, I think, to be tongue-in-cheek, it is also meant to convey information, as it concludes by enumerating the “perfect” characteristics of the place, including low costs, safety and community. Once upon a time there was a girl named Goldilocks who wanted to move abroad. Now Goldilocks was very particular—she wanted everything to be “just right.”   One day, Goldilocks was reading her International Living magazine and learned about a city in Ecuador called Cuenca. The more she read, the more excited she became. Goldilocks thought, “Wow, this place seems perfect!” (Staton 2015)

As migrants seek information, along the way they begin to imagine themselves “there,” living an adventurous new life among a different sort of “other.” Given the economic disparities present in the kinds of north-south migration American retirees engage in, their aspirations rest in part on a neocolonial imaginary of an “other,” in this case an Ecuadorian, who is knowable and accommodating enough to not be threatening while also different enough to be intriguing (see also Benson 2013). The following is typical of the kinds of rhetoric on IL’s website, where tropes about the “friendly” natives are common. This equatorial country is soaked in tradition—some of which originated in the times of the Incas, or even earlier. I’ve lived in Ecuador for three years and the longer I’m here, the more I learn and experience. And because the locals are so friendly and welcoming, I’m often included in their ­traditions—if you spend more than a few days in one place here, you will be too. (DeChambeau 2015)

Benson and others have written extensively on the ways that lifestyle migrants frequently portray their destinations as “authentic,” out of the

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stream of time, or as a place where simple values are still cherished and appreciated, typical of a kind of neocolonial thinking (Benson 2011; Benson and O’Reilly 2009; Huoy 2010). Lifestyle migrants often seek a sense of an authentic community in their destination locations, where they believe people share a set of values that are tinged with a nostalgia of an imagined past (Benson 2010: 47; see also Cook 2010). One expat blogger in Cuenca, for example, wrote a very long post titled “The Remembrances of Another Time Found in Cuenca” that compared his Midwestern United States childhood in the 1950s to Cuenca today: “As I see Cuencanos make their way to the cabinas, the local barber or beautician, the little neighborhood family-owned stores and bakeries, or just watching neighborhood women gathering to chat; I see the kind of community that once existed in the United States” (Mola 2011). His further recollections focus on family, community, and a slower pace of life, a life that the author explains has been lost in the United States but is still vibrantly alive in Cuenca.

Healthcare Imaginaries Among the most potent care imaginaries of American retirees in Cuenca is the idea that Cuencan physicians practice a kind of old-fashioned medicine no longer seen in the United States where “the patient comes first” and where care is not secondary to technology. Because they are older, American retirees in Cuenca consume a good deal of medical care, and they extol the virtues of the private Cuencan medical system, where it costs about twenty-five dollars for an office visit, hospital stays are well under two hundred dollars a day, and where service is primary. Retirees generally choose physicians who speak some English, and they frequently note that they can easily make appointments with no waiting, that their doctors greet them at the door unfettered by nurses or other gatekeepers, that physicians listen closely and ask lots of questions, and that they make house calls when necessary. According to retirees, Ecuadorian doctors spend a good deal of time with their expat patients, sometimes an hour or more, and patient need, rather than record keeping and insurance protocols, direct the medical encounter. Retirees expressed to me how much they value the personal attention they receive from Ecuadorian healthcare providers, and they believe their doctors practice medicine to “help people, and not to make money.” Several noted that they have their physician’s cellphone number, and one was comforted that his doctor answered his cellphone while preparing him for surgery. His thinking was that if he answered another patient’s call, he surely would answer his as well. For their parts, Ecuadorian physicians admit that they spend more time with

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their American expat patients compared to their Ecuadorian ones in part because of language difficulties (some have hired interpreters), but also because they find Americans to be much more unhealthy. They characterized American patients as frequently overweight, at least when they first come, and often overmedicated. Two physicians reported to me that they spend a good deal of time working to reduce the number of pharmaceuticals that their patients take. While many retirees noted that, technologically, medicine in Ecuador is a bit behind the US, they were quite willing to accept some technological (but not hygienic) deficiencies because of the high level of personal care. “What they don’t have in technology they make up for in care” one retiree told me, a sentiment echoed in a variety of ways by others. The short, business-like encounters and the focus on test taking and on writing prescriptions found in the US medical system were heavily critiqued by retirees, and they are seemingly willing to accept less technology and even less training of nurses if the care they delivered was “warm” and “attentive.” The one technological concern, however, that was raised and consistently mattered to retirees was for good hygiene and sanitation. Several retirees mentioned that they watch their care providers very carefully to see that they wear new gloves and use new, sterile needles and equipment. A recent case of sepsis in the expat community was recounted to me by three retirees, suggesting to me that this was an event of significant concern to them. Retirees usually unfavorably compared their American doctors to their Ecuadorian counterparts, who they associated as much with fictional television doctors as “real” physicians. One retiree described his Ecuadorian doctor as being like Dr Kildare (from the 1960s) and another compared his physician to Dr Welby. Both “doctors” were popular television figures from decades ago who represented the caring family physician who worked tirelessly for the patients’ benefit and who can no longer be found in the US, where medical care has been fully corporatized and “family” physicians have almost completely disappeared. Several retirees had such high opinions of their physicians that they passed on the erroneous belief that most Ecuadorian physicians volunteer a good portion of their time to serving the poor and that they work for free in government hospitals. Neither of these ideas is generally true; physicians often have significant financial investments in the hospitals where they practice, and they are well paid for their work in the public system. In fact, there is a surplus of physicians in Cuenca, and government jobs are highly valued because they provide a steady salary and therefore the financial security that competitive private practice alone cannot (see figure 6.2). Yet, despite this more complicated reality, the urban legend of their volunteerism was repeated to me by several people over the space of four years. As a piece of misinformation, it

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FIGURE 6.2  A billboard in 2008 for a new “state of the art” hospital, Hospital Universitario del Río, now a favorite of expats. Photo by Ann Miles.

had real staying power in part, I believe, because it resonates with the expat imaginaries of the care ethics of Ecuador. They believe that they have found a place where the old-fashioned values of the caring family “doc” are alive and well, and where the personal attention they get from physicians is standard treatment.

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What no retiree mentioned to me was an understanding that the care they receive is exceptional and only available at the high end of the private care system, and that it does not represent the medical care that the average Ecuadorian accesses in the public, or in many cases even in the private, sector. Despite recent reforms, which have included significant funding increases, the public health system and the semipublic Social Security system are seriously overburdened. Care is perfunctory in most cases, and long lines the rule (Miles 2013). For example, my previous research with Ecuadorian lupus sufferers indicates that most working-class and poor Ecuadorians only occasionally seek care in the private system, which they find prohibitively expensive for regular care, but when they do see a private physician, they do not receive the same kind of personal attention that the American retirees report. Some lupus sufferers even thought that doctors were saving appointments in the Social Security clinic or withholding scarce treatments so that they could reserve them for those in the upper classes (Miles 2013). Especially for the physicians with some English language competency, American retirees represent a well-paying, steady client base, and many physicians actively seek them out as patients by advertising on the multiple web-based newsletters, leaving business cards at popular bookstores and restaurants, and promoting themselves and their services at various expat gatherings. Word of mouth however is probably the most important means of promotion, and providing personalized service and hour-long consultations, for example, are a primary way to ensure a good reputation. Commenting on the power of intragroup communication, one physician characterized the gringo community as “very well informed,” and he noted that information flows freely among expats and “what one person knows, they all know.”

Family Care Imaginaries Most retirement migrants come to Cuenca with little Spanish language ability, and they find themselves newly incompetent in performing even the most routine of everyday interactions. As I mentioned above, others in the expat community are often important sources of information and support, but, sooner or later, most retirees depend on the kindness, both remunerated and nonremunerated, of Ecuadorians to accomplish basic tasks like navigating public services, purchasing furniture, having internet installed or contracting for any household service or repair. In many cases, expats hire bilingual Ecuadorians to “facilitate” the more difficult kinds of interactions; as some report, these relationships have flourished

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into “friendships,” and they may be invited to family dinners, especially on holidays. In other cases, expats have found that what start as casual or business relationships (with a landlord, neighbor, or Spanish teacher, for example) evolve into quasi-familial relationships where, for the most part, Ecuadorians place the retiree into the role of an elder family member who they look out for. In fact, achieving a close relationship with an Ecuadorian seems to be a marker of a kind of expat cultural competency. In an aptly named article, “It’s Hard Being the Different One All the Time,” Hayes (2015a) notes that the gringo community in Cuenca polices itself quite closely and they openly discuss and monitor each other’s behavior in order to dispel being collectively labeled or thought of as “Ugly Americans.” One long-time expat in Cuenca describes “Ugly Americans” in Cuenca as demonstrating “a combination of arrogance and ignorance when interacting with the local culture. They spend much of their time belittling their new culture and demonstrating a “We are superior to you” sentiment” (Dubs 2012). The ugly American trope weighs heavily on many in the expat community, and popular discussion boards are rife with conversations about how gringos should, and should not, behave in Ecuador, and about what is deemed culturally appropriate or inappropriate. Bloggers chastise one another with phrases like “what did you expect?” or accuse one another of not doing “due diligence” before they arrived in Cuenca when they complain. One blogger wrote, “Ultimately, what can I say, if the ‘manana attitude’ is more than somebody thinks he can handle, then Ecuador is definitely not the place for such people? [sic] Why move to Ecuador and ‘bitch and moan’ during one’s entire duration of residing in Ecuador, when one should already know what to expect” (Mola 2015)? Hayes (2015a) further argues that evidence of integration into Cuencan society is one marker of expat social status, at the same time that it eases migrant’s feelings of being different. In other words, one of the signs of having fully made the adjustment to life in Cuenca is the move away from socializing exclusively with other expats to having a social life that includes Ecuadorians. Indeed, the above blogger even noted that those expats who rely solely on other Americans or other expats for emotional connection are “most vulnerable” to moving back to the US (Mola 2015). In short, having Ecuadorian “friends” is central to the “successful” expat experience. In my interviews, I noticed that expats were very quick to tell me how they were integrating into Cuencan society; it seemed important to them to communicate that message, and it was always one of the first things they shared. One retiree proudly told me he lived in a building that had only three other gringo tenants, while others made a point of telling me that they lived in an “Ecuadorian neighborhood,” with the implication

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that they were better integrated into Ecuadorian life than those who reside in “Gringolandia,” a neighborhood of high-rise condominiums heavily populated with expats. In another example online, Alice, who appears in a promotional video, moved to Cuenca on her own at sixty-six years old and lives, as she stresses, “in an Ecuadorian neighborhood.” Alice depended on local service providers for finding an apartment, buying furniture, connecting the internet, etc., and claims that “Ecuadorian help is better.” Her next-door neighbor is her landlord’s sister, and she explains that that family looks out for her. In fact, they worried a great deal about her when she left town for a few days without telling them. Her interlocutor for the interview, an American who has established a business finding housing for expats, comments to her about how independent she appears to be at the same time that he emphasizes that she doesn’t need an “armed guard” for her apartment, a not-so-veiled reference to Gringolandia apartment buildings, where guards are standard, because she is “surrounded by family” who are “all right here watching out. It’s the buddy system.” He also noted that “this is typical” in Ecuadorian neighborhoods (“Expats in Cuenca Talk” 2015). Expats were also quick to tell me about their Ecuadorian friends, or mention that they belonged to clubs or groups that included Ecuadorians or, albeit more rare, that they were a part of an Ecuadorian family. Some newer arrivals who had yet to make friends with Ecuadorians considered it a worthy goal and a potential sign of their real integration into the community, and they were even rather wistful about the possibilities not yet realized. While it is most common for retirees to recount being included by Ecuadorians in family dinners, parties, and celebrations, I met one expat who rented a room in a home with an Ecuadorian family, another who had taken in a teenage neighbor girl whose family home was “over-crowded,” and one long-term migrant, Gloria, who seems fully integrated into the life of an Ecuadorian family. In this family, both sets of grandparents are absent, so Gloria assumes a grandmotherly role, but not the title, in the family. She regularly attends the children’s school functions, goes on vacations with the family, and visits with them several times a week. Gloria is a widow and a grandmother to several children in the US, but she spends little time there. While forming relationships with Ecuadorians may be partially about status in the gringo community and therefore a clear statement of one’s cultural competency, or about achieving a sense of belonging in their community of choice, these relationships appear to be differently valued and marked than are relationships in the United States. The real and imagined care work of Ecuadorian families is fundamental to the value placed on the relationships that form between expats and Ecuadorians. An article

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written for expats on a popular online news site reported the following: “The importance of family in Ecuador comes before all other things: money, sleep, work. In many cases, brothers, sisters, cousins and parents all live in the same building so they can be near one another” (Moran 2013). Indeed, American expats generally admire Ecuadorian families for their closeness, which they see through a similar nostalgic lens as they see physician care. In other words, Ecuador represents a different time and place where family and community values still matter. One retiree who had no Spanish language competency and never read the local paper explained family/community values to me in this way, “Women don’t get raped here, children are not abused . . . everyone looks out for one another. It’s like the Alabama of my youth!” The naivety of this sentiment, of course, only makes sense in the contexts of an imagined nostalgic, rather than real, world. More in line however with expat’s imaginaries is that Ecuadorians also express real concern, if not pity, for the older expats that they see in their city. To many Cuencanos, expats appear to be vulnerable elders who are easy marks for thieves and con men, something that troubles their sense of civic pride. The Americans’ linguistic inadequacies only exacerbate the impression that they are fish out of water . . . and old fish at that. One Ecuadorian storekeeper described an expat who had wandered alone into her store and was unable to communicate as a “pobrecito” (poor little thing). While opinions do vary of course, many Ecuadorians also told me they found it very sad that an elderly person would leave their home, their family, and their tierra to live out their “golden years” and potentially die among strangers in a strange land. One woman told me that it made her sad to see elderly expats wandering around town and concluded that there must be something “absent in their souls” to bring them to leave their families, friends, and culture at this time of their lives. They are a source of pity and concern for Ecuadorians. In discussing family care networks among transnational urban Peruvians, Leinaweaver (2010) notes the importance of reciprocity in interpersonal relationships in the Andes more broadly and the moral imperative of the circulation of care between people (see also Miles 1994). Interpersonal relationships are ideally ones in which both parties engage in reciprocity of both care and resources. Indeed, a lack of reciprocity in personal relationships can lead to sickness and feelings of loss and abandonment (Tousignant 1989). Leinaweaver’s focus is on the transnational migration of adults and what she calls the intergenerational “care slot,” sometimes referred to as the “sandwich generation,” those adults who are both parents to young children and responsible for assisting their own aging parents. When they migrate, they leave a care deficit in both the generation above and below them. According to Leinaweaver,

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The absence of grown children is not neutral; it has unmistakable ethical dimensions. Mary Weismantel (1988: 170) has accurately stated that “shame comes from leaving elderly parents without young people to help around the house and to bring joy to it.” Grown children have a responsibility to care for aging parents; an empty care slot is a social and filial failure. Among Andean families in Peruvian cities there is a strongly felt need to care for one’s parents in their old age; affection for parents may take precedence over a spouse’s needs, causing a friction that a very few, as the nun explained, resolve by leaving their aging parents at the institution. (Leinaweaver 2010: 78)

Imagining a sense of loneliness or need among their expat neighbors, tenants, or customers, Ecuadorians, I argue, often step in to provide the care, often informal and unpaid, that is expected of moral persons. Leaving the elderly to fend for themselves is not, as Leinaweaver might say, “ethically neutral.” Often the care that expats describe Ecuadorians performing might consist of simple things like loaning an expat an oven, helping a neighbor to mop up after a water pipe burst, teaching them the ins and outs of touchy hot water heaters, or sending over a teenage son to bring in a heavy tank of cooking gas. Over time, these casual encounters might be expanded into relationships that include invitations to stay for coffee, weekend lunches, and family dinners. On other occasions, the care Ecuadorians have provided to expats has been more vital, and two women talked about how their neighbors accompanied them to the hospital in an emergency, once in the middle of the night. In both cases the Ecuadorian families stayed with the retiree until they were released or they entered the hospital for a stay. While the advantages of these relationships for expats are multiple, including emotional, social, and practical dimensions, Ecuadorians, I believe, are motivated to engage in these relationships by an equally complex set of factors. These include a sense of civic or neighborly Cuencano pride and a moral imperative to help those who appear to be in some need, especially the elderly, as well as a desire to establish a reciprocal relationship with a potentially wealthy and powerful foreigner that may mutually benefit them. Although Cuenca has changed tremendously over the past two decades as the city has grown and become more cosmopolitan and commercial, it still retains many of its “conservative” values, including an established social hierarchy that is embedded in the social consciousness of the region. Although this is changing slowly, those with “important” surnames that can be traced to Spain have long held social and economic influence and social respect, while those without such surnames find opportunities more elusive. Hayes’s (2015a) description of the power of whiteness in Cuenca taps into the kind of historic paternalism that emphasizes the importance

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of who you are (based on surname and race) and who you know. Much of daily life in Ecuador, including getting a doctor’s appointment, is eased by having palanca, or social leverage (see Hirschkind 1980; Miles 2013). Networking with powerful friends, family, and godparents is still the easiest way to get ahead and something of a prerequisite for most professional employment opportunities (Miles 2004). In other words, reciprocity in Cuenca is not reserved for the familial level, but is understood to be crucial for accessing social privilege and securing opportunities. Given their privileged status as economically independent whites, American retirees may well be perceived as potential sources of financial and/or social palanca who could potentially share their wealth and or their social connections in the US. In other words, Ecuadorians, I imagine, enter these relationships in the hope that the care they give to expats will one day be reciprocated, albeit, perhaps, in a different form.

Conclusion The expat imaginary portrays Ecuadorian doctors and families in very romanticized ways that represent a vision of a lost time in which communal values still matter. And, in fact, there are reasons for this: Andean family relationships and responsibilities are constructed differently from those that retirees experience in the US. In Ecuador, family responsibility and reciprocity are highlighted as central to constructing and enacting moral personhood, and lifelong caring for family is expected and even assumed. The kind of independence from family that retirees see as virtuous (think about Alice, discussed above) and that leads them to make a move to Ecuador is both strange and undesirable to many Ecuadorians (Miles 1994). Yet, there are, of course, also plenty of more utilitarian motivations on the part of Ecuadorians for befriending and caring for expat Americans. For example, expats make excellent tenants: they are known to pay their usually inflated rents on time; they are quiet neighbors, and they take good care of their apartments. Their reputation is such that a middleclass Ecuadorian cornered me in a physician’s office to find out how she could best list an apartment for rent so that it would be seen by the expat community. Additionally, expats are thought to make (relatively) generous neighbors, friends, and compadres who do not shirk on buying gifts for birthdays and baptisms. And expats are thought to be well connected outside of the country, perhaps leading to the creation of larger economic and social networks. Customarily, relationships of palanca in Cuenca are built up over time, perhaps over generations, and are deployed in multiple spheres and

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through dense and overlapping networks of individuals. The one-on-one relationships with gringos that Ecuadorians may form in these informal caregiving relationships have neither the depth nor, perhaps, the mutual understanding of these more established ties. American expats can’t really help a youngster get in a better school, or secure an office job for a young woman, or grease the bureaucratic wheels of a government office. They can, however, give gifts and buy services, or lend money, or pay higher rent, all of which is, however, deeply fraught terrain for expats who worry constantly that they are being singled out to pay higher prices or that they are easy marks for the unscrupulous or the greedy. While expat retirees may generally exhibit a good deal of good will toward their Ecuadorian friends and neighbors, the reciprocal “care” that is expected from them may not be what they really want to give as it rubs up against their understandings of Ecuadorian “care” values, and of themselves as adventurous yet savvy. For example, a simmering debate among expats is what to pay for daily domestic help. One retiree told me he was given a recommendation by another expat for a maid, but was made to promise the recommender that he would pay her only twelve dollars for an eight-hour day, the standard Ecuadorian wage and the rate the recommender paid her. The fear of the recommender was that she would be “spoiled” if she were to be paid more by his friend. My participant did pay her more, but neither he nor the recommender were aware that they should also have been paying into a social security account for her, which would provide healthcare now and retirement benefits later. As the above example demonstrates, there are some real ironies that emerge when listening to baby-boomer expats extol the virtues of Ecuadorian family care work and family values more generally. Indeed, the very fact that the expat has left the United States is a marker of their own inability or unwillingness to make similar relationships in the US, or at the very least a willingness to readily abandon those ties if they have them. Indeed, one retiree made it clear that he didn’t much care for his family back home—his children were a disappointment to him—but he was happily ensconced in a close familial relationship with his landlord’s family. He did not speak much Spanish, and they spoke “a smattering” of English, but they “manage to communicate just fine,” he said. Gloria, too, thinks of herself as a very independent person, as her move to Cuenca clearly demonstrates, yet she is far more deeply embedded in and dependent on others in Ecuador than she was while in the US, where she lived far from her grown children, whom she speaks of in far less flattering terms than she does her Ecuadorian “family.” What then, beyond the cultural competence it displays to other expats, makes the Ecuadorian family care ties so appealing, in ways, presumably,

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that such ties are not valued “back home”? The answers to this, I think, are multiple and they rest mostly with the unequal power dynamics of these relationships. Alice’s online video with the commentary about her adventurousness in living in an “Ecuadorian” neighborhood highlights the ways that retirees cultivate an image of an independent self while, in fact, embedding themselves in Ecuadorian caretaking and assistance. Alice is able to pay for any service she needs, and she can count on neighbors to keep her safe, something very few Ecuadorians could probably say. American expats are privileged migrants who come to their relationships with Ecuadorians as “respected” individuals because of their age, their race, and their economic status. The fact that their Spanish language skills are not that good may contribute to these relationships being constructed, at least partially, on mutual stereotypes of one another. The role of the rich, patrician American contrasts nicely to that of the attentive, caring Latino. Rather than being “put out to pasture,” as one American metaphor has it, the retiree finds himself a respected new member of a social group in which he receives care almost entirely on his own terms. The American expat is, after all, fully in charge of the future of this relationship. Expats in general are fairly mobile and they have the ability to pull away at any time, with few long-term social consequences for doing so. While there are plenty of expats who didn’t like a doctor, or are wary of forming friendships with Ecuadorians, these are mostly marginalized positions that are not endorsed by the wider gringo community both online and in local gatherings (Hayes 2015a). Indeed, while quite savvy in many respects, some expat retirees seem to blithely ignore any evidence that might fundamentally rattle their care imaginaries, and they construct those “urban legends” about the self-sacrificing nature of Ecuadorian doctors and the friendly, helpful locals. Their part in the reciprocity of relationships is either ignored or unmentionable, leaving the relationships more one-dimensional than they really are. In other words, the imaginaries I have discussed here are privileged ones constructed by American retirees who enter a new social field where their whiteness, age, wealth, and citizenship allow them to access both formal and informal care that is seemingly beyond their grasp in the US. However, they must exercise their privilege without obviously referencing the specter, even in their own minds, of the affluent, privileged, and potentially ugly American. Their imaginary then acts as a means whereby the improbabilities of the level of care they receive are rationalized; their privilege is whitewashed, as it were, under the guise of cultural difference (families are close knit; doctors still are humanitarians), and it is therefore neutralized.

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Ann Miles is a cultural anthropologist at Western Michigan University. Her research in Cuenca, Ecuador, has included examining gender, families, transnational migration, and chronic illness. She is the author of Living with Lupus: Women and Chronic Illness in Ecuador (2013) and From Cuenca to Queens: An Anthropological Story of Transnational Migration (2004), and coeditor of Women and Economic Change: Andean Perspectives (1998). Her articles appear in Ethos, Social Science and Medicine, Medical Anthropology Quarterly, Medicine and Anthropology, Health Care for Women International, Body and Society, and the Journal of Latin American Geography.

References Amit, Vered. 2007. “Structures and Dispositions of Travel and Movement.” In Going First Class? New Approaches to Privileged Travel and Movement, edited by Vered Amit, 1–14. New York: Berghahn Books. Baldassar, Loretta, and Laura Merla. 2014. “Introduction: Transnational Caregiving through the Lens of Circulation.” In Transnational Families, Migration and the Circulation of Care: Understanding Mobility and Absence in Family Life, edited by Loretta Baldassar and Laura Merla, 2–23. New York: Routledge. Benson, Michaela. 2011. The British in Rural France. Manchester: Manchester University Press. Benson, Michaela, and Nick Osbaldiston. 2014. “New Horizons in Lifestyle Migration Research: Theorizing Movement, Settlement and the Search for a Better Way of Life.” In Understanding Lifestyle Migration: Theoretical Approaches to Migration and the Quest for a Better Way of Life, edited by Michaela Benson and Nick Osbaldiston, 1–21. New York: Palgrave. Benson, Michaela, and Karen O’Reilly. 2009. “Migration and the Search for a Better Way of Life: A Critical Exploration of Lifestyle Migration.” The Sociological Review 54: 608–625. Buch, Elena D. 2013. “Sense of Care: Embodying Inequality and Sustaining Personhood  on the Home Care of Adults in Chicago.” American Ethnologist 40: 637–650. Cook, Peta S. 2010. “Constructions and Experiences of Authenticity in Medical Tourism: The Performances of Places, Practices, Objects and Bodies.” Tourist Studies 10: 135–153. Croucher, Sheila. 2009. The Other Side of the Fence: American Migrants in Mexico. Austin, TX: University of Texas Press. DeChambeau, Wendy. 2015. “Experience Ecuador’s Best Local Traditions.” International Living, 19 March. Accessed 7 July 2015, http://internationalliving. com/2015/03/experience-ecuadors-best-local-traditions/. Dubs, Lee. 2012. “The Ugly American Revisited: Arrogance Plus Ignorance is a Recipe for Trouble as More N. Americans Move to Ecuador.” Cuenca HighLife, 10 February. Accessed 15 June 2015, http://www.cuencahighlife.com/lee-dubsthe-ugly-ameri can-revisited-arrogance-plus-ignorance-is-a-recipe-for-trouble-as-more-n-americ ans-​​move-to-ecuador/.

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Ehrenreich, Barbara, and Arlie Hochschild. 2004. Global Women: Nannies, Maids and Sex Workers in the New Economy. New York: Holt Paperbacks. Estévez, Silvia Mejia. 2009. “Is Nostalgia Becoming Digital? Ecuadorian Diaspora in the Age of Global Capitalism.” Social Identities 15: 393–410. “Expats in Cuenca Talk.” 2015. Discover Cuenca Ecuador, Panama and Beyond blog. Accessed 1 July 2015, http://www.discovercuencaecuador.com/p/expats-incuenca.html. Fetcher, Anne-Meike. 2005. “The ‘Other’ Stares Back: Experiencing Whiteness in Jakarta.” Ethnography 6: 87–103. Flores Ángeles, Roberta Liliana, and Olivia Tena Guerrero. 2014. “Maternalismo y discursos feministas latinoamericanos sobre el trabajo de cuidados: un tejido en tensión.” Ícanos, Revista de Ciencias Sociales 50: 27–42. Hayes, Matthew. 2014. “We Gained a Lot over What We Would Have: The Geographic Arbitrage of North American Lifestyle Migrants to Cuenca, Ecuador.” Journal of Ethnic and Migration Studies 40: 1953–1971. _____ 2015a. “‘It Is Hard Being the Different One All the Time’: Gringos and Racialized Identity in Lifestyle Emigration to Ecuador.” Ethnic and Racial Studies 38: 943–958. _____ 2015b. “Moving South: The Economic Motives and Structural Contexts of North America’s Emigrants in Cuenca, Ecuador.” Mobilities 10: 267–284. Hoey, Brian A. 2008. “American Dreaming: Refugees from Corporate Work Seek the Good Life.” In The Changing Landscape of Work and Family in the American Middle Class: Reports from the Field, edited by Elizabeth Rudd and Lara Descartes, 117– 139. Plymouth MA: Lexington Books. Klaufus, Christien. 2012. “Moving and Improving: Poverty, Globalization and Neighbourhood Transformation in Cuenca, Ecuador.” International Development Planning Review 34: 147–166. Howell, Signe. 2003. “Kinning: The Creation of Life Trajectories in Transnational Adoptive Families.” Journal of the Royal Anthropological Institute. 9: 465–484. Kleinman, Arthur. 2010. “Caregiving: The Divided Meaning of Being Human and the Divided Self of the Caregiver.” In Rethinking the Human, edited by Michelle Molina and Donald K. Swearer, 17–29. Cambridge, MA: Harvard University. Legido-Quigley, Helena, and Martin McKee. 2012. “Health and Social Fields in the Context of Lifestyle Migration.” Health and Place 18: 1209–1216. Leinaweaver, Jessica B. 2010. “Outsourcing Care: How Peruvians Meet Transnational Family Obligations.” Latin American Perspectives 37: 67–87. López-Cevallos, Daniel F., and Chunhuei Chi. 2009. “Health Care Utilization in Ecuador: A Multilevel Analysis of Socio-Economic Determinants and Inequality Issues.” Health Policy and Planning 25: 209–218. McWatters, Mason R. 2009. Residential Tourism: (De)Constructing Paradise. Bristol: Channel View Publications. Miles, Ann. 1994. “Helping Out at Home: Gender Socialization, Moral Development, and Devil Stories in Cuenca, Ecuador.” Ethos 22: 132–157. _____ 2004. From Cuenca to Queens: An Anthropological Story of Transnational Migration. Austin, TX: University of Texas Press. _____ 2013. Living with Lupus: Women and Chronic Illness in Ecuador. Austin, TX: University of Texas Press.

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Mola, Jim. 2011. “The Remembrances of Another Time Found in Cuenca.” Cuenca Perspectives by Jim (blog), 3 April. Accessed 12 November 2014, http://cuencaper​ spectivesbyjim.blogspot.com/2011/04/when-i-first-came-to-cuenca-in-summer. html. _____ 2015. “Culture Shock and the Expat: Part III of Essential Questions Potential Expats Need to Consider.” Cuenca Perspectives by Jim (blog), 27 February. Accessed 12 July 2015, http://cuencaperspectivesbyjim.blogspot.com/2015/02/cultureshock-and-expat-part-iii-of.html. Moran, Katie. 2013. “Part Family Tradition, Part Economic Necessity, Most Grown Ecuadorian Children Live with Parents until Marriage.” CuencaHighLife, 27 June. Accessed 23 July 2015, http://cuencahighlife.com/part-family-tradition-parteconomic-necessity-most-grown-ecuadorian-children-live-with-parents-untilmarriage/. Netter, Sarah, and John Quinones. 2013. “Americans Find More Affordable Paradise for Retirement.” 15 May. Accessed 23 June 2015, http://abcnews.go.com/Travel/ americans-find-retirement-paradise-ecuador/story?id=19187268. Oliver, Caroline. 2008. Retirement Migration: Paradoxes of Ageing. New York: Routledge. Ormond, Meghann. 2014. “Resorting to Plan J: Popular Perceptions of Singaporean Retirement Migration to Johor, Malaysia.” Asian and Pacific Migration Journal. 23: 1–26. Parsons, Talcott. 1951. The Social System. New York: Free Press. Peddicord, Kathleen. 2014. “The 10 Best Places to Retire in 2014.” 3 September. Accessed 1 July 2015, http://money.usnews.com/money/blogs/ on-retirement/2014/09/03/the-10-best-places-to-retire-overseas-in-2014. Parrenas, Rhacel Salazar. 2001. Servants of Globalization: Women, Migration and Domestic Work. Palo Alto, CA: Stanford University Press. Salazar, Noel B. 2011. “The Power of Imagination in Transnational Migration.” Identities 18: 576–598. Sánchez-Friedemann, Greta, and Joan M. Griffin. 2011. Defining the Boundaries between Unpaid Labor and Unpaid Caregiving: Review of the Social and Health Sciences Literature. Journal of Human Development and Capabilities 12: 511–535. Staton, Edd. 2015. “Goldilocks and the City of Cuenca.” International Living, 12 March. Accessed 23 June 2015, http://internationalliving.com/2015/03/ goldilocks-and-the-city-of-cuenca/. Tousignant, Michel.1989. “Sadness, Depression and Social Reciprocity in Highland Ecuador.” Social Science and Medicine 28: 899–904. Tronto, Joan C. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. New York: Routledge. Urry, John. 1990. The Tourist Gaze: Leisure and Travel in Contemporary Societies. London: Sage. Viteri, Maria Amelia. 2015. “Cultural Imaginaries in the Residential Migration to Cotacachi.” Journal of Latin American Geography 14: 119–138. Weismantel, Mary. 1995. “Making Kin: Kinship Theory and Zumbagua Adoptions.” American Ethnologist 22: 685–704. _____ 2001. Cholas and Pishtacos. Chicago, IL: University of Chicago Press.

ijjjjjjjjjjjjjjk PART IV Failures of Care across Distance

ijjjjjjjjjjjjjjk 7. SOME LIMITS OF CARING AT A DISTANCE Aging and Transnational Care Arrangements between Suriname and the Netherlands Yvon van der Pijl

This chapter explores the ways in which shifting practices and regimes of care across the disparate, though connected, spaces of Suriname and the Netherlands play a critical role in aging and older people’s quality of life. Following Sarah Lamb (2007, 2009, 2013), my main objective is to examine how old age is organized in a migrant context, in which we see an ongoing transnational dispersal of individuals and families, a rising occurrence of living alone, a proliferation of old age and nursing homes, and, simultaneously, a deinstitutionalization of care of the elderly. Although older persons and providers of care are innovative agents in these processes of change (see, e.g., Lamb 2009), I argue that especially those who have problems reproducing their “traditional model” of aging and care increasingly experience social-emotional isolation, neglect, and loneliness in old age. Contrary to anthropologists who challenge or counter ideas of abandonment and loss, particularly in institutional (government-run or market-based) care settings, I thus aim to stress the problems and predicaments of care that arise in transnational spaces and lives, leading to what I will call “the loneliness of aging.” Some of my observations and thoughts are based on snippets of my own ethnographic fieldwork in Suriname performed between 2011 and 2015.1 Others, especially those related to the Dutch situation, are mainly provoked by secondhand accounts and thus lack ethnographic thickness. To make a stronger argument, I therefore build heavily on ethnographic and theoretical work of other anthropologists, such as Diana Brown, Elana Buch, Michelle Ruth Gamburd, Arthur Kleinman, Sarah Lamb, and Anne-Mei The. In doing so, I show how emic cultural and moral imperatives to caregiving are challenged and how this, in turn, affects people’s old age in both Suriname and the Netherlands.

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This contribution probes people’s ideas and expectations regarding how “best” to age and have “proper” care—and what happens when these expectations are not met. Although I do not want to impose my own ideas about what is right and good practice (see Kleinman in Fassin and Lézé 2014: 233, 256ff.), I do believe that questions of morality are critical to our understanding of aging and care. I therefore conclude this chapter with some thoughts on ethnographic research and ethics of care.

Who Cares? The Predicament of Aging Worldwide, as Sarah Lamb (2009: xi) argues, “there has been a dramatic transformation, from the multigenerational family to the individual, the market and the state, as the key sites of aging and elder care.” Such transitions entail remarkable shifts in the understanding of growing old, becoming frail, and the organization of care. This applies even more to the contemporary context of long-distance migration and the transnational dispersal of families. As I have encountered in my long-run fieldwork research in Suriname, many older persons have children and other relatives living abroad (many of them in the Netherlands, the Dutch Caribbean, or the United States), resulting in novel ways of organizing life, finding meaning, and receiving care in old age (see Lamb 2009). At the same time, numerous elderly migrants with a Surinamese background in the Netherlands are confronted with shifting care regimes and emerging trends of living alone. These trends are not isolated, but connected through postcolonial geographies and transnational life-worlds and transactions. Due to their historical, colonial, and postcolonial ties, relations between Suriname and the Netherlands are strong. Large-scale migration waves, especially after the independence of Suriname in 1975, resulted in the presence of a large Surinamese-Dutch community in the Netherlands, in particular in big cities such as Amsterdam. Currently, of the approximately 850,000 to 900,000 Surinamese people, some 350,000 live in the Netherlands, half of whom were born in the Netherlands (they are the children of Surinamese who migrated to the Netherlands in the 1970s). Dispersal of families and people having relatives on both sides of the Atlantic is a wellknown feature, resulting in much transnational movement between the two countries, including high physical mobility, economic remittances, transactions of material support and services, sociocultural exchanges, and partnerships. In their transnational lives, Surinamese people are increasingly confronted with the predicaments of aging and care. Most of the immigrants

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that came to the Netherlands in the 1970s have reached retirement age and are growing old with all its consequences. From the few quantitative studies conducted among these elderly immigrants, there emerges a pattern of underuse of healthcare services, chronic conditions, limitations in activities, and mental health problems (Denktas¸ 2011; Denktas¸ et al. 2009). It also appears that they are more likely to be at risk of poverty and social exclusion than nationals without a migrant background (Denktas¸ 2011; see also Smits et al. 2014). In addition, these studies stress that “the assumption that informal care through the family will remain a substantive part of care . . . may be wrong” (Denktas¸ 2011: 107). We will see that this has serious consequences for Surinamese first-generation migrants in the Netherlands. Yet, the observation also applies to the elderly in Suriname. As I will show, a rapidly growing group of elderly people (especially in the country’s capital) is deprived of family-based care, and other forms of care are out of reach. A significant number of these people are retired returnees from the Netherlands. Drawing on two ethnographic encounters from the field, I analyze how these precarious situations are shaped and linked across the disparate spaces of Suriname and the Netherlands, and how they relate to wider processes that contribute to the predicament of aging and care under ­­globalizing conditions.

First Encounter: Stella’s Burden During my fieldwork in Suriname’s capital, Paramaribo, in 2011, my friend Humphrey called. “Did you hear the news?” he asked. Something terrible had happened in his neighborhood. A forty-year-old man hanged himself after setting his mother’s house on fire. In all probability, he wanted to be consumed by the flames, but the fire brigade was in time to save his lifeless body. The house, however, had been burnt out, leaving Humphrey’s neighbor and childhood friend, Stella, with a dead son and a condemned house. Humphrey took care of the shocked woman, as almost none of her family members were around; most of them live abroad. One brother, who lives far away in West Suriname, managed to come within a few days. But he left after a short visit; he had to go back to work. Stella was therefore dependent on her overseas relatives and awaited their arrival. Eventually, eight family members came to Suriname from the Dutch Caribbean islands Curaçao and Aruba, and from the Netherlands, to finance and organize the funeral. A week after the burial, however, she was “on her own again.” At least, that was what she said when her family members had left Suriname: “They helped me and Lloyd [her dead son] . . . spending a lot of money, but now I am on my own again: without a house, without personal belongings,

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even without something that reminds me of the boy. I don’t know what to do.”

Second Encounter: Storytelling in Elderly Care In 2012, I attended an expert meeting on “Storytelling and Empowerment” that took place in Amsterdam, the Netherlands. Amsterdam has a large Surinamese-Dutch community that faces a rising need for specific care facilities for its aging members, like nursing homes and hospices. The meeting was part of a larger project of the Dutch Storytelling Center that promotes the conscious use of storytelling in these institutions and their environment, with the aim of supporting social participation and the quality of life in vulnerable neighborhoods and districts, such as Amsterdam Southeast, a highly diverse area known for its relatively low standard of living, including silent poverty and social-emotional isolation of old people with a migrant background.2 During a day of workshops, presentations, and stories, the practice of “compassionate listening” turned out to be crucial in understanding the power of storytelling as a method in elderly care. However, several participants, caregivers themselves, stressed that the time and means to put this into practice were limited, although they all felt a growing need to apply this approach. In the roundtable discussion on “Storytelling in Elderly Care,” it transpired that half of the participants worked with elderly migrants with a Surinamese background. They all mentioned problems of loneliness, neglect, and alienation among them. This observation is important, because it challenges common-sense beliefs about family intimacy and values of intergenerational care within so-called migrant communities. As I will show below, social-moral relations, as well as larger economic and political structures, are changing rapidly within and outside these communities, affecting both ideas about proper care and people’s experiences of growing old. Despite relatively good medical care in homes for the elderly in the Netherlands, the quality of life of these migrants deteriorates progressively as they reach old age. Not infrequently they face social death.3 But unlike the family members in Stella’s case, their relatives are usually not abroad. According to some workshop participants, “den pkin” (these children) “dump” their parents in nursing homes and they feel “too uncomfortable to come and visit” on a regular basis. In their disapproval, the participants explicitly pointed to the quandary of institutional care: it often turns people into isolated, passive patients, taking away their responsibilities and joy of life. Of course, these experiences do not necessarily suggest that the practice of “dumping parents” is widespread, and the workshop participants’ views may not be

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widely accepted. Yet others describe similar trends (see The 2005 and note 3), which are part of larger processes that will be explored below.

The Myth of Family Care How are the two aforementioned encounters linked? I recognize the ways in which they are different, of course. The first one involves a single event (principally affecting one single individual) that took place following the dramatic action of a psychiatrically disturbed person.4 The second one involves many more actors and refers to a generalized situation that concerns a considerable number of people. The first takes place within the confines of family and neighborly relations. The second occurs in the context of an institutionalized care regime. The first is a clear instance of the precarious situation of care-over-distance, while the second involves the murkier notion of relatives who are physically close, but nevertheless fall short in care. Yet despite the differences, the two events are connected through postcolonial geographies and life-worlds, and they are both a consequence of societal transformations, changing social-moral relationships (see Lamb 2009), and shifting care regimes. To explore this link, we need to work through a series of shifts that has led to contemporary forms of aging where isolation and loneliness set in—even if unintentionally. But, first, we need to consider the concept of care itself.

Thinking Care Care has different dimensions and meanings, which makes it a multilayered and cyclical concept. To care means to worry (being emotionally affected) or to care about; to take responsibility or to take care; to give care or to care for; and to receive care or to be cared about and to be cared for. Consequently, care is relational (asymmetrical or reciprocal) and a culturally constructed practice that is contained in an institutional context affected by various factors (social, economic, political, ethical) (see Tronto 1993). In that sense, care regime does not only refer to a set of political conditions and social intersections, ensuring complementarity between economic and demographic institutions and processes (Bettio and Plantenga 2004), but also to particular cultural models and values, norms, and assumptions derived from these (Lamb 2009). For example, Euro-Americans deem it normal, even normative, for children to be dependent on and cared for by their parents, but not necessarily for elderly parents to be heavily dependent on their adult children. Sarah Lamb (2009: 20) shows that for Indians the “prevalent cultural model . . . is that both

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parents and children will care for each other reciprocally in turn: just as children are naturally and appropriately dependent on their parents when young, so are parents naturally and appropriately dependent on their children when old.” We find this model in many parts of the world. For example, West Indians and many people with a Surinamese background share the same idea/ideal of reciprocal, mutual, and intergenerational care and dependency. Hence, care is to a large extent the result of cultural norms, normative practices, and familial strategies. As such, care is not only a consequence of Foucauldian biopolitics in which the state (and the regime of the marketplace, as we will see below) regulates the conduct and wellbeing of subjects both as a population and as individuals. Care is also part and parcel of familial regimes that normalize roles and relations of daughters, sons, and other relatives (see Ong 1999).5 But there is the rub: under the force of modernization, individualization, and globalization—particularly mobility and migration—we witness a rapid decline of the joint family. This is what Sarah Lamb (2009) calls the crisis in families or, as I call it, the myth of (extended) family care: multigenerational joint families increasingly fracture into nuclear units, and a younger generation of children fails or refuses to care adequately for their parents. There are different, though often interconnected, reasons and motives for this. Because of transnational migration, children might be unable to provide care for their parents at home. But also when families are not (transatlantically) dispersed, ­children—in pursuit of individual growth, careers, and other more self-centered, materialistic ambitions—might be less likely to agree to care for their elders, especially in a shared family home. This does not mean that families simply do not care anymore; care might still be there, albeit transformed in novel ways, in new spaces of home and diaspora. “Myth” rather refers to an imaginary care situation or a relic from the near past that no longer can be realized, causing not only feelings of nostalgia and disappointment, but also social-emotional isolation, physical neglect, and severe loneliness. Along the Surinamese-Dutch nexus, we then see that the aforementioned movements in space (postcolonial migration) and ideology (regarding family and generation) affect in one way or another previously “sacred” values, such as mutual care and intergenerational intimacy. Returning to Stella’s case, we saw that Humphrey immediately took care of Stella. As she was homeless, he took her into his house. He was used to supporting her now and then, since Stella’s small pension allowance was not enough to cover the vital means of existence. She was a retired head nurse, but holding an odd job (selling lottery tickets) to keep her head above water and to take care of her unemployed son, who was mentally ill. They lived together

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until that day Humphrey caught her on her way home to inform her of the terrible news. From then onward, Stella stayed at Humphrey’s place, while neighbors, friends, and colleagues dropped by to pay their respects and to help out a bit by bringing food, drinks, clothes, and funeral items. Stella’s overseas relatives, in the meantime, were busy with the preparations for Lloyd’s funeral. They were quite eager to make this ritual parting a success, spending a great amount of money on a surprisingly lavish funeral. “They never had very much interest in our hebi’s [burdens] before,” Stella entrusted to me one night. The latter refers to a commonly expressed lament. Families, especially those with relatives abroad, often spend more money on funerals (postmortem care) than they do on care for poor, sick, elderly, or frail relatives (premortem care) (Van der Pijl 2016). Related to this, relatives do not necessarily continue care after the fulfillment of their ritual duties, leaving people like Stella, who could hardly make ends meet and was in poor health, alone. One sister insisted that Stella should come and live with her in the Netherlands, but not having a Dutch passport, this offer meant nothing more to Stella than a kind gesture (or a life in illegality). She was dependent on Humphrey’s neighborly concern, which would not last forever. After a few weeks sharing his home with Stella, Humphrey wanted his privacy back. Moreover, commuting between the Netherlands and Suriname like many retired Surinamese migrants do, he was afraid that Stella would “squat” his property after he had left for the Netherlands. Ultimately, he found a cheap house in which Stella could stay for the time being, in the insecure expectation of the insurance indemnity that would compensate her for the loss of her burned-down house. Despite the tragic character of her son’s suicide and the loss of her house, Stella’s situation does not represent an isolated case. Cultural imperatives to caregiving within the family remain strong, especially among less privileged or economically marginalized groups, and many older Surinamese persons still live with adult children in multigenerational homes. But this model is increasingly challenged by the erosion of families’ capacities for such caregiving, particularly in urban areas like Greater Paramaribo, due to shrinking family size, inadequate housing, individualization, migration, and reduced numbers of potential caretakers (see Brown 2013; see also Gamburd 2013; Lamb 2013). For example, one of my research participants, Culvin Nerot, stayed alone after his wife died some ten years earlier. All his adult daughters lived in the Netherlands. When he had become frail, and having been hospitalized several times for a lung ailment and exhaustion, his daughters traveled back and forth to look after their father. But they had only limited time and money. At the age of 79, Culvin died alone.

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During a research visit to Paramaribo in September–October 2015, I interviewed several directors of old age and nursing homes (both longexisting, often large-scale institutions and new, small-scale homes) and other professionals in elderly care. They all endorsed the above observations and expressed their worries about the growing number of elderly, frail people who do not have the support or means for proper care. They pointed repeatedly to vulnerable elders who are dependent on kin for material, emotional, and/or bodily support, but do not receive such familybased care (anymore). Their children and other relatives are either abroad or cannot or do not want to bear “the burden.” Many of them lack the financial resources to pay for home care, let alone to put their elders in a market-based old age or nursing home. Furthermore, the notoriously bad conditions in the one and only public home in Paramaribo makes this state-based option an unacceptable alternative for many resource-poor people, leading to precarious cases of isolation, neglect, and abandonment. Consequently, Surinamese society is forced to respond to this absence of care. A Hindustani temple complex, for example, recently started a simple housing project for elderly citizens who are abandoned by their children at the pilgrimage site. Also, hospitals provide a form of “disguised elderly care,” as one of my research participants called it. They have to deal increasingly with so-called langliggers—bedridden patients who have exhausted all treatment options, but who have nowhere to go. Remigration and the rising demand for care of older returnees present another series of concerns and challenges. Increasingly, Surinamese-Dutch pensioners return, often without kin, to switi Sranan (sweet Suriname) to enjoy their old age. They come with nostalgic images and with small pensions. Usually they live independently with their spouse or on their own, without children, and outside of institutions. Sometimes they pay for home care to preserve their sense of independence. Yet problems arise when they need the kind of extended care that is required, for example, to treat a diagnosed (chronic) disease or to be supported in case of dementia. Many of my interviewees expressed their concerns about this relatively new group of elderly persons who are likely to slip through the safety net, since they are without kin, often not eligible for state support (having Dutch passports), and not necessarily in the financial position to seek private, market-based care. Interestingly, more and more professional caregivers active in private elderly care are returnees themselves—though still fit and healthy. They imagined during our conversations their own old age, wondering whether they would stay in Suriname or return to the Netherlands (where their children and grandchildren often live). Considering all current developments, Suriname is facing a paradoxical situation. The combined pressure of greater longevity, chronic illness,

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age-related diseases such as Alzheimer’s, and the absence of adequate public-sector infrastructural support will increasingly place the burden of caregiving for dependent elders upon families. Yet, at the same time, families and individuals, especially daughters and wives, are less able or willing to take on this task. Although we see a proliferation of old age and nursing homes, these (private) alternatives are predominantly within the reach of the middle and upper cosmopolitan classes (see Brown 2013; Gamburd 2013; Lamb 2009, 2013), or of those supported by migrant family members sending remittances (see Hromadži´c, this volume). Moreover, there is limited (state) financing available for end-of-life care.6 The resulting vulnerability of elderly citizens, especially of the lower classes, becomes apparent not only in the case of Suriname. A parallel structure links Stella’s burden (First Encounter) to the predicaments of aging and elderly care in the Netherlands (Second Encounter). In this second case, we are beginning to sense the implications of neoliberal policies that shift the burden of health and elderly care from the state to individuals or informal (family) care, making both health and care more and more a private responsibility (e.g., Smits et al. 2014). At the same time, the myth of family care is also beginning to feature in Surinamese-Dutch migrant life-worlds and care practices. Hence the question looms: how will diasporic families, older migrants, and their children work out aging and elderly care in a context where cultural norms, family, and kinship structures are changing, and values such as individualism move center stage (see Lamb 2009)? In order to explore this further, we need to return to the core of the two ethnographic encounters—that is, the experience of social isolation and loneliness in old age.

The Loneliness of Aging While people from Suriname have traditionally seen caring for aged parents in the family home as an obvious element of the reciprocal cycle, nowadays many have problems reproducing this cultural model of aging, care, and family life. Working adult children in the Netherlands who live alone, in a one-parent family, or a nuclear household have little time and/or space to take care of their elders (see Lamb 2007, 2009, 2013; see also The 2005: 51ff.). Especially women, who are expected to be the main caregivers for the elderly, face serious difficulties. In her study on aging in the Indian diaspora, Lamb (2009: 23) refers to the problem of the “sandwich generation”: “adult women pressed like sandwich meat between two generations, struggling arduously to care simultaneously for both children and aging parents . . . while also pursuing careers.” Single mothers, who are often

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primary breadwinners, might experience the burden of this double care the most. As a result, fewer and fewer Surinamese-Dutch elders (will) live with their adult children in a multigenerational home—the arrangement still considered by the majority of Surinamese-Dutch people to be the most normal and proper form. Although many are opposed to old age homes (“in our culture, we do not dump our elderly in old people’s homes”), the site of elder care is shifting from the family regime to the regime of the state and the market, entailing other kinds of moral, cultural, social, economic, and biopolitical principles (see Hromadži´c, this volume). Sometimes these new regimes of care coexist uneasily with older, familiar ones—for example, when people feel that one kind of care (intimacy, time) is substituted by another (efficiency, money) (see Lamb 2007). Yet we cannot simply equate state- and marked-based care with efficiencydriven, cheaply commoditized caregiving, just as we know that family regimes of care are not always warm and affectionate. Often we see a more complex picture of who provides loving care, and how and when; caregivers at institutions may be the persons giving kind attention, whereas relatives may be the ones whose love materializes as abandonment (see Mrs. Scharloo’s case below; also see Thelen 2015). The chief problematic of institutionalized care in old age or nursing homes is its inherent cultural ambiguity. As Philip Stafford (2003: 8) argues, these homes possess “many features that draw from the more fundamental spatial and material pattern of the total institution [which] stands in stark contrast to another fundamental cultural pattern, that of home and the domestic environment.” In the Netherlands, like in various other Northwestern European and North American societies, many old age homes and particularly nursing homes have evolved in the final decades of the twentieth century as medical models of care, in which the social body has often been transformed into a biological body (see Scheper-Hughes and Lock 1987) and the individual patient’s problem has become principally a health problem—although the patient is not actually ill or in need of hospital care, but requires skilled nursing care (Stafford 2003: 5–6). Hence, these homes have become a major modern institution comparable to the total institution, as Erving Goffman (1961) and Jules Henry (1963) have pointed out. Furthermore, because of a rapid growth of technology and bureaucracy in medicine, these institutions have developed into sites of Foucauldian biopolitics or body politic (Scheper-Hughes and Lock 1987), exerting disciplinary control over the life of both the older individualized, bounded body and the aging population—that is, the collective, social body. Various nursing home ethnographies showcase these processes of disciplining and the resulting helplessness, loneliness, social death, and inert liminality old people experience in “institutional prison-like settings” (Kao

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2013: 28). These studies examine how each person’s stay in a care home is seen, just like a patient’s stay in a hospital, through the lens of “the passage of time”—that is, through the institutional demand to move through time with economic and clinical efficiency (Kaufman 2005: 7). To interpret the liminal position of elderly people who are—in the same way as hospitalized patients—abandoned in the “gray zone at the threshold of life and death” (Kaufman 2005: 1, 8), admission to care homes is even compared to Hertz’s first burial or Turner’s communitas (Henderson 2003: 154; Stafford 2003: 17–18). It is argued that residents of old age and nursing homes “are trapped in a liminal space between a lifetime of meaningful ritual passages, and death as the unwanted final rite of passage” (Kao 2013: 28–29). According to these ethnographies, the driving forces behind the resulting “mortification of self” (Goffman 1961) are invariably biomedicine, market-driven health care, individualism, and efficiency. Their general and quite somber aim is to document how and why persons (full life) come to be institutionalized patients and passive recipients of care (bare life). Anne-Mei The (2005), who did research in a Dutch nursing home for demented elderly people, uses the same approach and discourse, referring to the nursing home as “the waiting room of death,” which is also the title of her ethnography. However, alternative discourses emerge as well. They focus on new social environments and organizational settings for the elderly (Kao 2013: 29), such as person-centered, market-based resident and home care. These kinds of care are the result of growing private initiatives and recent policies favoring deinstitutionalization. In the Netherlands we are faced with policy-induced transitions from a welfare state to a society based on individual responsibility (participation society) and informal care (mantelzorg). Simultaneously, “increasingly well-educated and financially well-off elderly people wish to exert more control over their own lives [and deaths]” (Smits et al. 2014: 1). These trends are strongly associated with (the promotion of) autonomy, self-determination, and independence, which are also key terms in end-of-life issues and topics such as living wills (niet-behandel verklaring), palliative sedation, and euthanasia. However, elderly persons from lower classes “may have fewer options and have to rely more on relatives and the government” (Smits et al. 2014: 7). Moreover, in stressing autonomy, self-determination, independence, and, accordingly, the “individual body-self” (Scheper-Hughes and Lock 1987) as normative and also heuristic concepts for understanding, we tend to overlook other conceptions that influence the ways in which care is delivered, ­­experienced, or desired (see Buch 2013). Let us return once more to the second vignette to see what this means. It was indicated that, perhaps contrary to widespread beliefs, Surinamese

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migrants in the Netherlands (will) increasingly spend their old age in nursing homes. At the same time, it appears that this non-family-based form of eldercare is often viewed ambivalently and is even perceived as abandonment. Both elderly and caregivers with a Surinamese background stress the downfall of cultural customs, values, beliefs, and a way of life that results in severe feelings of loss and desolation (see Lamb 2009, 2013; The 2005). The latter might involve mundane aspects of everyday life. For example, meals (strange, tasteless food) can evoke deep-rooted feelings of loss, nostalgia, and loneliness (see, e.g., Buch 2013). At a more abstract level, it addresses the “mortification” or “disculturation” (Goffman 1961) of migrant residents and the way they feel subject to particular ideological, normative, and sometimes ethnocentric constructions of care. In fact, residents with culturally different backgrounds often share a double experience of homelessness: both their institutionalization and “disculturation” might trigger feelings of alienation, particularly toward the end of life, and sometimes even more so when experiencing neurological changes such as dementia (see Taylor 2010; Lock 2013). Alienation and loss systematically crop up in The’s (2005) analysis of nursing home care in the Dutch “color changing society,” as she calls it. Remarkably, Surinamese-Dutch caregivers in her ethnographic study state that migrant residents are visited more than their “autochthonous” housemates, because “for them it is natural to be taken care of by their family” (The 2005: 50).7 Nevertheless, The (2005: 50ff.) also gives examples in which the opposite is the case and family members do not care at all. The case of Mrs. Scharloo (“Mrs. Scharloo gives up”) is striking (The 2005: 72–87). Her children did not inform her about her impending admission to the nursing home. Mrs. Scharloo was angry with her children; she felt abandoned. From a cheerful old woman she became transformed into a depressed frail person, a patient who was medicated to ease her somberness. She refused to eat and drink. Meanwhile her children did not bother that much. Despite the efforts of the staff to improve her situation, she died not long after her arrival in the nursing home. Again, this is not an isolated case. Yvonne Penig, a Surinamese-Dutch professional caregiver who worked in various nursing homes, repeatedly emphasizes that elderly migrants “feel very lonely in these institutions.” According to Penig, these feelings often result from different cultural preferences—for example, with regard to food and hygiene—that are not recognized by managers, caregivers and/or other residents (see interview mentioned in note 3). These examples bring to mind the great work of the sociologist Norbert Elias ([1982] 1985). At the age of eighty, he wrote The Loneliness of the Dying, which focused on one of the greatest problems confronting modern

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society: when death has become less familiar and people die in a more sanitized manner than ever before, the dying also remain in almost complete social and emotional isolation, experiencing extreme loneliness. Now, we are not only confronted with the loneliness of the dying, but the loneliness of old age—a condition many people fear toward the end of the long life they hope for. Of course, loneliness may be present through the whole lifespan, yet loneliness in old age seems more painful. This might be related to the frequently mentioned outcomes of market-driven and efficiencybased institutional care, reducing older people to objects of medical and professional gaze (see Biehl 2005; Buch 2013; Scheper-Hughes 2010; The 2005). However, especially for elderly migrants, the suffering also involves the turning away from a cultural practice of lifelong intergenerational family transfers and related values of mutual dependency or reciprocity. Such values are very different from non-family-based ideologies of aging and caregiving, which are grounded in a highly individualized, bounded conception of the body-self (see Scheper-Hughes and Lock 1987) and associated with the highly valued notions of independence, autonomy, and self-determination. These notions are, moreover, increasingly incorporated into presentday understandings of care, as well as into popular discourses of successful, active, and healthy aging. Whereas dependency entails a loss of dignity and is more and more envisioned as a failure (Lamb 2013; Scheper-Hughes 2010), independency—normatively tied to conceptions of the body as bounded (Buch 2013)—seems to become an end in itself. Such an autonomy-centered approach of aging is likely to contribute to a polarizing paradigm of normality (healthy, active, and autonomous) and abnormality (frail, passive, and dependent). Its discourse categorizes old age, on the one hand, as affirmative, even productive, and on the other hand as negative, risky (costly), and lethal (see Saltes 2013). As a result, it neglects other appropriate visions and needs of human interdependency (Lamb 2009; 2013) that are also necessary ingredients of care (Buch 2013). In her research on home care of older adults in Chicago, Buch (2013: 639) found that independency is “not so much a consequence of bounded bodies or self-determination but, rather, a deeply relational form of personhood.” She argues that normative understandings of “independent persons as corporeally bounded” might threaten elders “whose bodies cannot sustain the façade of autonomy” (Buch 2013: 647). Her study shows how caregivers’ bodies serve as extensions of elders’ bodies “mediating social and material interactions so that elders could continue to shape their material worlds according to their will” (Buch 2013: 647). This is, of course, not only the responsibility of professional, paid caregivers, but also of informal caregivers in or outside institutional settings. The lack or loss of such

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intimacy and, importantly, interdependence is precisely what caused the ­­suffering of Stella, Mrs. Scharloo, and many others. Buch (2013) pushes researchers in the field of aging and care to examine the role of bodily relations more carefully. It is my belief that, in addition, we should incorporate cross-cultural notions of bodily experience, subjectivity, and interdependence into the analysis of care situations (see, e.g., Hockey 2008). Furthermore, we should remain critical with regard to Foucault-inspired anthropological analytics. They usually tend to ignore “life force seeking” and generative forms of subjectivity (Biehl and Locke 2010: 335; see also Biehl 2005). Finally, if we consider aging and care to be more than just discourses or objects of institutional, medical, and familial gaze, we should include both questions of subjectivity and morality in our research.

Conclusion This chapter explored how transformations in care regimes and care practices in the context of migration might lead to the isolation and loneliness of older persons. Objectification and depersonalization, as the products of cheaply commoditized caregiving, are often considered driving forces in these processes of change (see Scheper-Hughes 2010: 337). But trends related to overseas migration and the transnational dispersal of families also have considerable impact on the conditions and quality of living and dying in old age. By offering two ethnographic fragments, I hinted at some problems and predicaments of aging and care in two different though historically connected parts of the world: Suriname and the Netherlands. Dominant discourses, in both academic and popular fields, often consider family-based care as a feature of so-called developing nations, such as Suriname, while supposedly developed countries, like the Netherlands, have advanced to offer individual-, state-, and market-based eldercare options (Lamb 2013: 180; Lamb 2009: 250–251). However, this picture (whether it is true or not) is no longer tenable. In Suriname, a country that is marked by migration and profound societal transformation, we see a growing need for non-family-based, formal (affordable) infrastructural support. Yet, this observation clashes with the “traditional” visions that people (particularly migrants or children of migrants who consider remigration) continue to cherish with regard to family intimacy and informal, neighborly care. In the Netherlands, on the other hand, the withdrawal of government funds is putting pressure both on older individuals who will seek market-based home and residential care, and on formal state-supported care institutions that have to accommodate

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the less-well-to-do. Just as in Suriname, and in accordance with the rapid decline of the extended family worldwide, older Surinamese migrants increasingly cannot live with their adult children in a multigenerational home. Moreover, many of them migrated to the Netherlands at a later age, as a result of which they receive a relatively small old-age pension and live in relative poverty, even suffer in silence. This means that they have fewer options and, when informal care is lacking, they have to rely more on the whims of the state and the marketplace (Smits et al. 2014). In spite of this somber analysis, elderly are of course also vitally involved in processes of social-cultural change: seniors engage in fashioning new modes of life for themselves and their relatives, as Lamb (2009) for example has shown in her study of Indian elders in India and abroad. In other words, although I presented some very harrowing examples, the people I write about are not reducible to bare life that easily (see Biehl and Locke 2010). Neither do nursing homes necessarily have to be “zones of social abandonment” (Scheper-Hughes 2010: 237). Lamb (2013, 2005) shows, for instance, that institutionalization in the case of Indian elders in India or abroad is not uniformly a negative experience (see also Rowles and High 2003; Stafford 2003: 18–19). Care is also not naturally opposed to technology (see Mol 2008: 5ff.), and the rise of new care arrangements like assisted living, residential care, cluster housing, and adult foster care (Stafford 2003: 19) may offer positive alternatives for the “institutional prison-like settings” (Kao 2013: 28) that many fear. Yet, these alternatives usually fall within the range of options of the financially well off and those who can claim their vital rights as citizens. Moreover, “interventions of governance and care [especially in resource-poor settings] remain epistemologically myopic and are not systematically structured to work with people and to incorporate their practical knowledge [and experience]” (Biehl and Locke 2010: 336). On the contrary, orthodoxies of care often remain institutionalized along with existing ideologies of aging. Due to this, institutions of care can be “twisted into instruments of power, [even] violence and abandonment” (Biehl and Locke 2013: 336). But if care practices shape care ethics, as Annemarie Mol and colleagues (2010) argue, it is through such practices that dominant and normative conceptions of care can be contested as well. Care is, after all, a relational practice, not a product. In his more recent work, Arthur Kleinman (2009, 2012, 2013) appeals to such an understanding when he states “caregiving is a defining moral practice” (2009: 293). This aligns with current ethnographic research on care and caregiving, suggesting that questions of morality are critical to analyses of care (Buch 2013: 638). Buch (2013: 638) shows, for example, that caregiving generates new forms of morality and subjectivity “through

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daily practices and . . . embodied, skillful expertise” and, hence, demands attention not only for people’s lived experiences, as Kleinman (e.g., 1988) stressed decades ago, but also for human interdependency (see Lamb 2013). Caregiving, as Kleinman later on realized (resulting from his personal experience of caring for his wife, who suffers from Alzheimer’s disease), is “a deeply interpersonal, relational practice” (2012: 1551), and is about “responsibility and emotional sensibility, even if it is also about technology, biomedical science and markets” (2013: 1377). A key aim of ethnography is then to understand these relational practices and ­interdependencies—or lack thereof—especially since caring at distance is clearly moving center stage, and different generations face the task to make their transnational care arrangements work. Yvon van der Pijl is associate professor at the Department of Cultural Anthropology, Utrecht University, the Netherlands. She is researcher in the anthropology of death, dying, and disposal. Her areas of interest include cross-cultural meanings and transnationalization of mortuary ritual, aging, and care over distance, and her field sites include Suriname, the Dutch Caribbean, and the Netherlands.

Notes 1. My fieldwork in Suriname dates back to 1999 and 2000, when I stayed, mostly, in Suriname’s capital Paramaribo for Ph.D. research into death, dying, and disposal. Since then, I have returned for ongoing research. During my time there, I was confronted by the deteriorating situation of people in old age and have expanded my research activities to issues of aging and care. 2. In recent years I have been doing fieldwork in Amsterdam Southeast and its environs, including a long-term research project that focuses on the development of a multicultural funeral home. 3. See interview with Yvonne Penig, a Surinamese-Dutch residential counselor and professional caregiver in Amsterdam Southeast. “Eigen cultuur oudere migrant vergroot risico op eenzaamheid” (Own culture older migrant magnifies risks of loneliness), 20 November 2014, accessed 2 December 2016, https://www.​​samentegenee nzaamheid.nl/blog/strijders-tegen-eenzaamheid/eigen-​​cultuur-​​oudere-migrant-​ vergroot-risico-op-eenzaamheid. 4. But, as Bruce Kapferer (2010) notes, these atypical events or strange happenings might serve as a new point of origination producing aspects not seen before. 5. Michel Foucault uses “regime” to refer to power/knowledge schemes that seek to regulate and normalize power relations. These schemes define and control subjects and normalize their attitudes and behavior. Following Ong (1999), I apply this idea of regime not only to the operations of the state, but also to kinship and family, and

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the marketplace. So, the regimes that will be considered throughout the rest of this chapter are the regime of the family, the regime of the state, and the regime of the market. 6. See “The Quality of Death: Ranking End-of-Life Care across the World” (2010), a report from the Economist Intelligence Unit, eiu.com, accessed 4 December 2016, http://www.eiu.com/sponsor/lienfoundation/qualityofdeath. 7. These nurses are quite critical of the Dutch system of institutional care. Holding onto the mythical Surinamese model of family intimacy and care, many of them express the wish to (re)migrate to Suriname to spend their old days over there in the midst of an imagined caring community.

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Hockey, Jenny. 2008. “Personhood and Identity in Palliative Care.” In Palliative Care Nursing: Principles and Evidence for Practice, edited by Sheila Payne, Jane Seymour, and Christine Ingleton, 347–361. Maidenhead: Open University Press. Kao, Philip. 2013. “When Frost Happens: A Case Study of an Organization Committed to Care.” Anthropology in Action 20 (2): 28–36. Kapferer, Bruce. 2010. “In the Event: Toward an Anthropology of Generic Moments.” Social Analysis 54 (3): 1–27. Kaufman, Sharon R. 2005. . . . And a Time to Die: How American Hospitals Shape the End of Life. Chicago, IL: The University of Chicago Press. Kaufman, Sharon R., and Lynn M. Morgan. 2005. “The Anthropology of the Beginnings and Ends of Life.” Annual Review of Anthropology 34: 317–341. Kleinman, Arthur. 1988. The Illness Narratives: Suffering, Healing & the Human Condition. New York: Basic Books. _____ 2006. What Really Matters: Living a Moral Life amidst Uncertainty and Danger. Oxford: Oxford University Press. _____ 2009. “Caregiving: The Odyssey of Becoming More Human.” The Lancet 373: 292–294. _____ 2012. “The Art of Medicine: Caregiving as Moral Experience.” The Lancet 380: 1550–1552. _____ 2013. “From Illness as Culture to Caregiving as Moral Experience.” The New England Journal of Medicine 368 (15): 1376–1378. Lamb, Sarah. 2007. “Aging across Worlds: Modern Seniors in an Indian Diaspora.” In Generations and Globalization: Youth, Age, and Family in the New World Economy, edited by Jennifer Cole and Deborah Durham, 132–164. Bloomington, IN: Indiana University Press. _____ 2009. Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad. Bloomington, IN: Indiana University Press. _____ 2013. “Personhood, Appropriate Dependence, and the Rise of Eldercare Institutions in India.” In Transitions & Transformations: Cultural Perspectives on Aging and the Life Course, edited by Caitrin Lynch and Jason Danely, 171–188. New York: Berghahn Books. Lock, Margaret. 2013. The Alzheimer Conundrum: Entanglements of Dementia and Aging. Princeton, NJ: Princeton University Press. Mol, Annemarie. 2008. The Logic of Care: Health and the Problem of Patient Choice. London: Routledge. Mol, Annemarie, Ingunn Moser, and Jeannette Pols. 2010. “Care: Putting Practice into Theory.” In Care in Practice: On Tinkering in Clinics, Homes and Farms, edited by Annemarie Mol, Ingunn Moser, and Jeannette Pols, 7–20. Bielefeld: Transcript Verlag. Ong, Aihwa. 1999. Flexible Citizenship: The Cultural Logics of Transnationality. Durham, NC: Duke University Press. Rowles, Graham D., and Dallas M. High. 2003. “Family Involvement in Nursing Homes: A Decision-Making Perspective.” In Gray Areas: Ethnographic Encounters with Nursing Home Culture, edited by Philip. B. Stafford, 173–203. Santa Fe, NM: School of American Research Press. Saltes, Natasha. 2013. “‘Abnormal’ Bodies on the Borders of Inclusion: Biopolitics and the Paradox of Disability Surveillance.” Surveillance & Society 11 (1/2): 55–73.

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Scheper-Hughes, Nancy. 2010. “Death and Dying in Anxious America.” In The Insecure American: How We Got There & What We Should Do About It, edited by Hugh Gusterson and Catherine Besteman, 317–345. Berkeley, CA: University of California Press. Scheper-Hughes, Nancy, and Margaret M. Lock. 1987. “The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology.” Medical Anthropology Quarterly 1 (1): 6–41. Smits, Carolien H. M., Hugo K. van den Beld, Marja J. Aartsen, and Johannes J. F. Schroots. 2014. “Aging in The Netherlands: State of the Art and Science.” The Gerontologist 54 (3): 335–343. Stafford, Philip. B., ed. 2003. Gray Areas: Ethnographic Encounters with Nursing Home Culture. Santa Fe, NM: School of American Research Press. _____ 2003. “Introduction: The Nursing Home as Cultural Code.” In Gray Areas: Ethnographic Encounters with Nursing Home Culture, edited by Philip B. Stafford, 3–23. Santa Fe, NM: School of American Research Press. Taylor, Janelle S. 2010. “On Recognition, Caring and Dementia.” In Care in Practice: On Tinkering in Clinics, Homes and Farms, edited by Annemarie Mol, Ingunn Moser, and Jeannette Pols, 17–56. Bielefeld: Transcript Verlag. The, Anne-Mei. 2005. In de wachtkamer van de dood: leven en sterven met dementie in een verkleurende samenleving. Amsterdam: Uitgeverij Thoeris. Thelen, Tatjana. 2015. “Care as Social Organization: Creating, Maintaining and Dissolving Significant Relationships.” Anthropological Theory 15 (4): 497–515. Tronto, Joan C. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. New York: Routledge. Van der Pijl, Yvon. 2016. “Death in the Family Revisited: Ritual Expression and Controversy in a Creole Transnational Mortuary Sphere.” Ethnography 17 (2): 147–167.

ijjjjjjjjjjjjjjk 8. “WHERE WERE THEY UNTIL NOW?” Aging, Care, and Abandonment in a Bosnian Town Azra Hromadži´c

The “crisis of care” (Phillips and Benner 1995), and especially care for the elderly, is emerging as a momentous topic in anthropology, sociology, gerontology, and other academic disciplines, as well as in the world of policy-making. Numerous studies point at different domains of this “crisis,” including the socioeconomic impact of the longer life span in more privileged parts of the world, shrinking of states’ social and health services, and novel configurations of family relationships that challenge traditional expectations of caregiving in diverse sociocultural contexts (see United Nations 2002). In this chapter, I delve into the Balkans, and especially Bosnia-Herzegovina, to examine the effects of these shifting topographies and modalities of care on “ordinary” lives.1 It is within the Balkans, I argue, that the anxiety around “the aging predicament,” and around the altering and rearranging roles of family, the state, and the market in providing care for the elderly are especially evident and exacerbated by the converging postsocialist (1989 to present) and postwar (1995 to present) transformations (see also Havelka 2003).2 What follows seeks to illuminate some of these literature-marginalized yet life-shaping forces and events by focusing on competing expectations and ideologies of care and forced migration as they converge in the lives of ordinary Bosnians. In order to do so, I focus on the predicament of one of those people, an elderly woman whom I call Zemka,3 whose struggles with care beautifully capture the ways in which the convergence of the state/family/market, as well as the experiences of home and exile (Lamb 2009), abandonment (Biehl 2005; Bourgois 2009), and abjection and “failure” (Gilleard and Higgs 2011), are being talked about, lived, and imagined. In my use of Zemka’s story, I work against “geroanthropological amnesia” (L. Cohen 1994: 151) which tends to romanticize, contain,

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dehistoricize, and depoliticize old age. Rather, I locate this ethnographic encounter within the sphere of “the political,” in an anthropological, thus broad and contextual, sense of politics. The story’s powerful content is used to shed light on the historically informed arrangements of care which are emerging, converging, and reassembling from the ruins of war and socialism. More specifically, I use ethnography as a hermeneutic device to seize and make sense of the effects of a changing postwar and postsocialist state, altering kinship relations, and new market regimes as they affect ordinary people. Zemka’s is thus a story of aging dislocated; by gently hinting at its phenomenological (experiential and embodied), rational/political (hegemonic, ideological, and gendered), and hermeneutic dimensions (L. Cohen 1994: 151), in this chapter I argue that both the state and family in postwar and postsocialist Bosnia-Herzegovina materialize as semi-absent: the state is bureaucratically and politically ubiquitous but biopolitically shrinking, and family is materially present but physically elsewhere, or physically present and materially incapable of providing care. These converging semiabsences of state and family allow for the market to offer novel arrangements and technologies of care across distance. It is within the contours of uneven and multiple politically and socially generated semi-absences that we can begin to grasp the changing terrain of aging and care as fundamental dimensions of political and social practice in Bosnia where “lives seem habitually at stake” (Jašarevi´c 2011: 109).

“I Am Going to America, to Live with My Son” It is early June 2013 and a warm day in Biha´c, a northwestern Bosnian town located at the border with Croatia. Together with several other residents, I am sitting in the shade of a huge umbrella in front of Vitalis—a privately owned, twenty-bed capacity home built two years ago for the elderly (see figure 8.1). A car, which model and color I fail to decipher in the bright, midday sun, parks in the driveway of Vitalis. Lidija, the owner of the home, jumps to her feet and rushes to the gate in order to welcome the home’s new resident, Zemka. I see a middle-aged man come out of the driver’s seat and open the back door. The man lifts Zemka from the back seat and gently lowers her into the wheelchair—we “park” Zemka at the second, large table. Several other residents look at the newcomer curiously. The man who brought Zemka to Vitalis collapses into one of the chairs, sweating. He wipes his face, impatiently. I look at Zemka—her hands are deep purple, almost black. I see that below her hospital gown, marked by dried blood in several large spots, her feet are also swollen and dark.

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FIGURE 8.1  Sitting under an umbrella at Vitalis. Photo by Azra Hromadži´c.

The man, whose name is Sead, starts telling me the dramatic story of Zemka’s arrival at Vitalis: Zemka was released from Biha´c’s cantonal hospital today. Two days ago, the hospital called Zemka’s three daughters, who live in Germany, and informed them that the family needed to come and collect their mother by 2:00 P.M. the following day—the hospital had done everything it could and now it was the family’s turn and responsibility to take care of her. The daughters—Ekrema, Selma, and Adila—thousands of miles away and busy with their jobs and their own nuclear families, panicked, knowing that they could not come to Biha´c in time to take over their feeble mother. Frantically, they searched on the Internet for some institution to turn to; that is how they discovered Lidija’s privately owned nursing home. At the same time, they contacted the closest and nearest family relative, Sead, who lives two and a half hours away from Biha´c, near a central Bosnian town, Jajce. He told them that he was willing to help, but could not be there by 2:00 P.M. the next day. Lidija, was moved by the plea of this family, which, she soon learned, suffered greatly during and after the war. She wanted to help but did not have any beds available. Thus, she called the hospital and asked that they keep Zemka for another day while she prepared for her arrival. The main nurse, according to Lidija, said harshly, “No, we cannot do that. We do not make money off of them,” implying that Lidija lives off of the old people’s

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predicament. Lidija was so upset by the comment that she threatened to call the police and tell them that the state hospital was throwing an eightyyear-old refugee woman out on the street. After Lidija’s threat, the nurse softened and said that the hospital would keep Zemka under their roof for another day. While Lidija is telling us this story, Zemka looks at me, smiles, and says, “I am going to America [the US], to live with my son.” Sead shakes his head sadly and whispers to me, “She has dementia. Her son was killed during the war in Srebrenica.” Sead finishes his drink, gets up, hugs his fragile aunt in a blood-stained hospital gown, and leaves for Jajce. Soon after, I also leave the home, deeply moved. Five days later, on the way to Vitalis, I see an obituary announcing Zemka’s death; her dženaza (the Islamic funeral ritual), the obituary states, is scheduled for the next day. I arrive at the nursing home in the early afternoon and find Zemka’s daughters sitting in front of the home, talking to Lidija and other residents. They are here for their mother’s funeral, and they are sad and furious. They complain about the state that nema ni reda ni sistema (has no order nor system), where hospitals can throw old and sick out on the street, and where šehidska familija (the family of a shahid or martyr) can be treated like this. They are going to sue the hospital! They live in Germany, and something like this would never happen there! Lidija, who also spent some refugee years in Germany, nods in agreement. She gently tries to soothe the family. The sisters finally leave. As we watch their car drive away, Lidija whispers to me, “They cannot sue them. Do you know that Zemka arrived to the hospital in a terrible condition? She was neglected. I mean, where were they [the family] until now?” Zemka’s story is remarkably rich—it captures, discloses, and complicates multiple affective attachments and practical relationships of care and abandonment as they are being refashioned in a postwar context at the end of socialism. Zemka is a subject who fell through the cracks and eventually died caught between these shifting meanings and topographies of care, worry, and neglect. In order to unpack Zemka’s unique story, I situate it within (post)war and postsocialist fields. Even though postwar and postsocialist effects are profoundly tangled in the lives of people, for the purpose of analytic clarity, I divide them into two separate sections. To the spectrum of the (post)war experience we first turn.

(Post)War Assemblages: šehidi, Life and Death The Socialist Federal Republic of Yugoslavia was a federation of six republics: Slovenia, Croatia, Bosnia-Herzegovina, Serbia (with two autonomous regions Kosovo and Vojvodina), Montenegro, and Macedonia. It emerged

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from World War II under the leadership of its charismatic communist leader, Josip Broz Tito, and his ideology of Brotherhood and Unity—the official policy of interethnic relations that proposed that all Yugoslav narodi and narodnosti (nations and nationalities) should peacefully coexist and nurture the notion of intermarriage and cross-ethnic affiliation. After the declarations of independence by Slovenia and Croatia from Yugoslavia in the early 1990s, Bosnia-Herzegovina, the most ethnically diverse among the republics,4 found itself faced with a choice between independence (supported by the majority of Bosniaks and Croats) and remaining in the Yugoslav federation (supported by the majority of Serbs). In February 1992, a referendum for independence from Yugoslavia took place, which was boycotted by the majority of Serbs. Regardless of the boycott, BosniaHerzegovina became an independent state on 6 April. On the same day Bosnia-Herzegovina was officially recognized, Serbian paramilitary units and the Yugoslav People’s Army (Jugoslovenska Narodna Armija; JNA) attacked Bosnia-Herzegovina’s capital, Sarajevo, and started the war in Bosnia-Herzegovina.5 The army of the self-proclaimed Republika Srpska (RS) within Bosnia-Herzegovina, with the help of troops and weapons from Serbia, succeeded in conquering close to 70 percent of the country’s territory by the end of 1993. It also perpetrated some of the most brutal acts of violence exercised against the non-Serb populations, including Zemka’s family. After over three years of war and violence, the Dayton Peace Agreement, which ended the war in Bosnia-Herzegovina in 1995, divided BosniaHerzegovina into two entities: the Federation of Bosnia-Herzegovina (FBiH), with a 51 percent share of the territory and inhabited mostly by Bosniaks and Bosnian Croats, and the Republika Srpska (RS), with 49 percent of the territory and populated almost exclusively by Bosnian Serbs. The entities were given all the characteristics of states within a more complex state. The FBiH is further divided into ten cantons. Biha´c is the administrative center and the largest city in the Una-Sana Canton. Biha´c is also the sixth largest Bosnian-Herzegovinian town of approximately fifty thousand inhabitants located on the beautiful river Una (see figure 8.2). The Biha´c region, also known as Krajina, with approximately three hundred thousand mostly Bosniak residents, is the northwestern pocket of the country and Bosnia’s forgotten battlefield (O’Shea 2012). The region suffered terribly during the war. It was besieged for over three years but was never conquered by the Serb army. At the beginning of the war, the Serb population of Biha´c left the city for other Serb-dominated regions of the country or went abroad. The war began in June 1992 with the Serb army besieging and intensely shelling the town. Bosniak (roughly 66 percent of the town’s population) and Croat (roughly 8 percent of the town’s population) armies and civilians defended their town jointly during

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FIGURE 8.2  Biha´c church tower and the river Una. Photo by Azra Hromadži´c.

over three years of siege. In addition, in 1993, the northern part of the besieged region, led by the businessman-turned-politician Fikret Abdi´c, proclaimed independence from the Bosnian government and its army, and started to collaborate with the Serb forces. This created a very difficult situation for the besieged region, which was liberated in the controversial Bosnian-Croatian Army offensive in the August of 1995, soon after which the Dayton Peace Agreement was signed. Zemka’s family, like many other Bosnian families, was caught at the epicenter of the Yugoslav wars in the 1990s. The Bosnian war caught this already elderly woman in her mid-60s in Šipovo, the town where she lived most of her life. Šipovo was a “mixed” town—the majority of the population was ethnically Serb (roughly 80 percent), with a significant presence of Bosniaks (around 18 percent) and some others (primarily Croats and Yugoslavs). This “mixed” town’s habitus, in which different ethnic groups intermingled for centuries, was typical of Bosnia-Herzegovina and socialist Yugoslavia at large. Zemka’s was one of those Bosniak families that were forced out of their homes during the early stages of the war. At the beginning of the war, Zemka’s only son, Edin, was serving his mandatory duty in the JNA and

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was sent to eastern Bosnia, where he escaped the JNA ranks and joined the Army of Bosnia and Herzegovina. Several years later, Edin was killed by the Serb paramilitaries in Srebrenica, the notorious site of Bosnian genocide. The news of this enormous loss devastated Zemka’s family, already crippled by the war: Zemka’s daughters, after several years of refugee life, and encouraged by their parents to leave the war-ridden Bosnia, ended up in Germany, together with hundreds of thousands of other refugees from Bosnia-Herzegovina. Zemka’s husband passed away during their refugee saga. Zemka, left alone, with her former house now firmly incorporated into the territory and structures of the Republika Srpska (the Serb Republic), found herself living in Bijelo Brdo,6 a mixed Serb-Muslim town not far from Biha´c, away from her daughters as well as her extended family, which was scattered between Šipovo and the rest of the world. In Bijelo Brdo, she was visited every day by a retired Serb nurse, who regularly changed Zemka’s bandages. Even though no one at Vitalis knew for sure how Zemka ended up in this part of Bosnia-Herzegovina, the final years of her life vividly capture the contemporary contradictions of postwar state, family, and care, as Lidija’s words powerfully illustrate “How ironic—to be a refugee expelled by the Serbs, to have your son killed by them, and then to end up all by yourself, in an unfamiliar town, cared for by a Serb women. Nobody knows what awaits them.” With her health rapidly declining, Zemka was eventually transferred to the largest regional hospital in Biha´c. As Zemka’s body was progressively deteriorating, her daughters found themselves in a situation typical of many other Bosnians and Herzegovinians living in a war-produced diaspora, looking for a solution to their transnational ­problem—taking care of their aging parents and other family members at a distance. These processes unveiled a “collective scandal”7 and a tender zone of cultural intimacy (Herzfeld 2005): the growing inability of the state and family in contemporary Bosnia and Herzegovina to take care of their elderly.

Postsocialist Realities: The Semi-absent State and Family Starting in the 1950s, socialist Yugoslavia developed a prolific yet decentralized web of republic-based professional bodies responsible for providing social protection (Zaviršek and Leskošek 2005: 39).8 The infrastructure of Yugoslav social work was developed and implemented mostly through a wide network of local Centers for Social Work as well as through the “traditional long-stay residential institutions for children and adults” (Stubbs and Maglajli´c 2007: 1177). While the parameters of social protection varied across Yugoslav’s six republics, in all of them the social

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welfare system included some elements of the socialist self-management, Bismarckianism, and the engagement of a number of nonstate actors, such as religious institutions ­­ (Stubbs and Maglajli´c 2007: 1176). As a result of these coordinates of “socialist humanism” (see, among others, R. Cohen and Markovi´c 1975; Horvat 1982), the Yugoslav state, and the socialist state more broadly, is today frequently remembered and described as paternalistic (Manning 2007) or imagined “as a caring parent that provided for its citizen-children” (Dunn 2008: 247; see also Verdery 1996). This representation and imagination of the caring state created expectations about what the state should deliver (Dunn 2008): the supreme duty of the state, as “the big father” (Zaviršek and Leskošek 2005: 40) was to “take care of the society as whole,” the process that, according to socialist ideology, would eventually lead to the termination of the need for social help in general, since everyone would be taken care of.9 In order to achieve this, the Yugoslav state, through large-scale technologies of regulation, started to collect information and thus engage in the control of biological conditions of its population. As a result, “the government became responsible for living conditions of the people ‘from the birth until the grave’ (od kolijevke pa do groba)” (Zaviršek and Leskošek 2005: 46). In harmony with the rest of its citizen-care policies, the socialist healthcare system provided universal medical assistance, and it was defined as “rational, progressive and scientific” (Read 2007: 204). These “universal” entitlements to social security and healthcare were central to socialist modernity and the means through which the socialist state demonstrated that it cared for its citizens (Read 2007: 203). The Yugoslav people’s response to these socialism-produced novelties was a combination of “enthusiasm and hope, mixed with fear and suspicion” (Zaviršek and Leskošek 2005: 46). While the state extended its control and management of populations to almost all domains of citizen-care, when it came to the care of old people, the state had a strong commitment to avoid creating separate (medical) environments that would solely focus on the elderly (Sokolovsky et al. 1991: 322). Rather, the decentralized socialist system focused on the creation of comprehensive primary care services and health centers associated with local “self-managing communities of interest . . . originating in the homes of people’s health (domovi narodnog zdravlja)” (Sokolovsky et al. 1991: 322). And yet, different republics within Yugoslavia showed a varied distribution of the centers for the elderly: in 1987, Croatia was leading the way with the highest number (120) of special residences for the elderly (Dom ­umirovljenika—“home for retired persons”) while Belgrade, the capital of Serbia and the former Yugoslavia, had only two of these centers (Sokolovsky et al. 1991: 321). These discrepancies are reflections of different historical and infrastructural influences, and of more recent

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demographic trends: for example, Croatia has seen a more-developed infrastructure for the care of the elderly, while Serbia has harbored the largest number of orphan-care facilities.10 In addition, rural Croatia witnessed a heavy out-migration of the young, who could not take care of their elderly parents (Sokolovsky et al. 1991: 321), showing again a strong sociocultural link between the state, family, and eldercare. The paternalistic relationships and self-projections of the Yugoslav state and its citizens, however, and the “structures of feeling” (Williams 1977) they enticed, relied heavily on traditional approaches to family care. For example, conventionally, Bosnians, especially Bosnian women, took care of their elderly family members. Similar to many East European countries where the state projected an image of a caring state, in reality “the private sphere of kinship, friends and personal networks became the focus for emotionally inflicted and socially embedded care” (Read 2007: 206). Until recently, elderly Bosnians were physically and emotionally cared for by their children, and they were often expected to live with (at least) one of them, usually the youngest son and his family. Cultural notions stressed the communal nature of kinship and a symbiotic relationship between generations (Simi´c 1990: 97). The legal system incorporated this cultural expectation as well: for example, chapter 150 of the former Yugoslav constitution defined the care of the elderly as children’s responsibility (Tomorad and Galoguža 1984: 306) and chapter 190/10 stated, “Members of the family shall have the duty and right to maintain parents . . . and to be maintained by them, as an expression of their family solidarity” (see Sokolovsky et al. 1991: 321). These legal rights and institutionalized expectations of family care were not always legally enforced,11 however, but they still continued to shape the vernacular understandings and responsibilities of care, apparent in Lidija’s comment, “where were they until now?,” implying that Zemka’s daughters should not expect the state to do “their job”—take care of their fragile mother. In addition, due to the war-produced exile, many families could not fulfill these expectations of care at proximity, thus triggering a major reshuffling of the postwar and postsocialist assemblage of care, and, in the process, revealing many ruptures, ideologies, and myths about delivering care, past and present. More specifically, both socialist and postsocialist regimes, regardless of their very different social policies, ideologies, and ethic of care, relied heavily on the institution of family for care. The major differences, however, are that, in socialism, (a) the family was socioeconomically supported, thus generally able to deliver care to its family members, and (b) the state-provided outpatient medical care for the elderly was extensive and free. Today, however, the postsocialist state’s medical care system is in shambles, and fragmented and impoverished families cannot deliver upon the promise and expectation of care. These

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converging processes painfully expose a tender zone of cultural intimacy (Herzfeld 2005)—an increasing neglect of elderly and sick in Bosnia. With the postwar state and social services in pieces and families in fragments, “the crisis of care” in Bosnia-Herzegovina became ubiquitous, and it revealed the conflicting ideologies and expectations of care: on the one side, the state projected an image of caregiving but relied on family to care for the elderly, while, on the other side, families did most of caregiving, but still retained an ideology of the paternalistic state. These conflicting expectations and impossibilities to fulfill their real and imagined former roles revealed the cracks in the ideology of responsibility and caused multiple affective reactions and accusations of failure. The family, just like the state, thus emerged as semi-absent: materially present (they pay for the substantial private nursing care expenses12) and physically far away and unavailable to deliver love and care at close proximity, or physically nearby but materially unable to support their elderly family members. And yet, regardless of the postwar state’s perpetual budgetary crisis, especially when it comes to social services available to civilian populations, and regardless of the changing nature of and ideologies about the state that triggered withdrawal from biopolitics, Zemka’s daughters still had an expectation that the state would at least help their family, since they were šehidska porodica (family of the martyr). In other words, the postwar BosniaHerzegovina, the daughters believed, had a “moral debt” (Han 2012: 4) toward Zemka’s family, for the highest sacrifice the family had given to the state in blood to protect its very existence during the war. When this moral debt was not honored, but neglected by the state—in this case the cantonal hospital in Biha´c—the daughters felt a deep sense of betrayal, injustice, and, finally, anger. These competing expectations of care and reciprocity between the postwar state and its most deserving subjects—the martyr’s family—thus created a void filled with potent diasporic citizen disappointment and Zemka’s neglected, bruised old body. I interpret this topography of Zemka’s body—suffering, bruised, blood-stained, and swollen—as an embodied symbol of the state’s and family’s semi-absences as they powerfully collapse into the body of an elderly woman in contemporary Bosnia. Zemka’s experience is a powerful reflection of these semi-absences, which are deeply embodied, painfully tangible, and indicative of changing and differential “pedagogies of attention” (L. Cohen 2008: 337).

Conclusion Zemka’s moving story of life and death in the Balkans illustrates the effects of a semi-absent state and family on the country’s elderly. This family’s

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experiences are unique in their intimate struggles, pains, and wounds, yet, in many ways, similar to most others. This is the story of war displacement and destruction of lives, bodies, and objects: the weakening, semi-absence, and reformation of the postwar and postsocialist state; families fragmented across continents; new homes and borders; and shifting terrains and expectations of life and death, and care and responsibility. The majority of people I encountered in Bosnia-Herzegovina share some of the experiences and sentiments revealed in Zemka’s story: they frequently complain and worry about their poor health, the declining health of their family and friends, premature deaths of many friends and acquaintances, the crumbling and shrinking medical and social systems of care, and the growing burden of social, moral, and economic debt left in the wake of these changes. These processes, experiences, and stories shape lives and deaths of people in the Balkans, but they also point at the need to bring into conversation that which scholarship in the region has treated as separate: postwar and postsocialist regimes of citizen care, and the blurred nature of private/public distinctions and formal/informal care (see Thelen 2015). It is exactly these uneven, simultaneously local, regional, and transnational configurations of love, care, and abandonment that produce unique, idiosyncratic, and seemingly contradictory yet intimately interwoven experiences of past and future, presence and absence, politics and affect, and hope and betrayal in contemporary Bosnia and beyond. Azra Hromadži´c is associate professor in the Department of Anthropology at Syracuse University. Her areas of interest include political anthropology, violence and reconciliation, youth and education, aging, care and social services, water politics, pedagogies and infrastructures, and the Balkans. She is the author of Citizens of an Empty Nation: Youth and State-Making in Postwar Bosnia and Herzegovina (University of Pennsylvania Press, 2015), which was recently translated into Serbian as Samo Bosne nema: Mladi i gradˉ enje države u posleratnoj Bosni i Hercegovini (Belgrade: Biblioteka XX vek, 2017).

Notes A slightly modified version of this chapter was published in 2015 as a lead article in a special issue of Etnološka Tribina: The Journal of Croatian Ethnological Society 45 (38): 3–29. The research and writing were supported by the Appleby-Mosher Fund at Maxwell School, Syracuse University, from 2013 to 2015, and by a mini-grant in 2015/2016 from the Program for the Advancement of Research on Conflict and

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Celebration. The author wishes to express her gratitude to the funding institutions and agencies for their support.   1. I use “ordinary people” with much caution in this work. As Veena Das (2007) has pointed out, the “everyday” is where much deeply political work happens.   2. This domain of social transformation is left unexamined by the majority of scholars of the region (for an exception see, among a few others, Stubbs 2002; Stubbs and Maglajli´c 2012; and Zaviršek and Leskošek 2005). The overwhelming number of anthropological and other studies of the Balkans and especially BosniaHerzegovina, my own included, analyze this region mainly through the lens of ethnicity, nationalism, and postwar reconstruction (see, among many others, Bieber 2005; Brown 2006; Chandler 1999; Campbell 1999; Coles 2007; Fassin and Pandolfi 2010; Hayden 1996; Hromadži´c 2015; Jansen 2005; Kurtovi´c 2011; Sorabji 1995; Verdery 1994; Woodward 1995). This is not to say, of course, that ethnonationalism is not important to people in the Balkans. Rather, it is one of numerous powerful forces—including poverty, unemployment, and corruption— that converge to mold ordinary lives.   3. All personal names have been changed to protect the privacy of individuals included in this study.   4. In 1991, the demographic makeup of the country was as follows: 43.5 percent Bosnian Muslims, 31.2 percent Serbs, 17.4 percent Croats, 5.5 percent Yugoslavs, and 2.4 percent others (Zavod za Statistiku Bosne i Herzegovine 1991)   5. Most people accept the beginning of the siege of Sarajevo, which started on 6 April 1992, as the start of the Bosnian War. Others, however, suggest that the beginning moment was the JNA attack, in November 1991, on the Croatian village Ravno in eastern Herzegovina.   6. Bijelo Brdo is a pseudonym.   7. I am grateful to Larisa Jašarevi´c for this phrase.   8. Parts of this section also appear in A. Hromadži´c, “Affective Labor: Work, Care and Entrepreneurial Citizenship in Biha´c,” in Negotiating Social Relations in Bosnia and Herzegovina: Semiperipheral Entanglements, edited by Stef Jansen, Cˇarna Brkovi´c, and Vanja Cˇelebicˇi´c, 79–93 (Southeast European Studies series. London: Routledge, 2016).   9. Of course, not “everyone” was equally deserving of the government’s protection and help. Zaviršek and Leskošek (2005: 47–49) explain how the government divided its people into “deserving” and “undeserving,” or “ours” and “not-ours,” where the latter were mostly former owners of shops, factories, and banks, and some Jewish survivors, who were all expropriated by the new socialist government. 10. Paul Stubbs, personal communication, 17 October 2014. 11. Tomorad and Galoguža (1984: 306, note 1) argue that regardless of the legal right to be taken care of by their offspring, the elderly very rarely used these means to secure these rights, since the emotional basis of the relationship was not present. The authors also argue that children were sometimes materially unable to support their parents. 12. Private care for the elderly is very expensive in relation to the Bosnian standard of living. The monthly fee is between 750 and 1050 Bosnian Convertible Marks (KM)

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(approximately 380–535 euro)—a sum too high for the majority of the country’s older inhabitants, who receive an average monthly pension of 350–400 KM (178– 204 euro). The family members who work all over the world can only sporadically visit their aging parents and relatives, but they are, in most instances, committed to paying for their expensive (in local terms) care.

References Bieber, Florian. 2005. Post-War Bosnia: Ethnic Structure, Inequality and Governance of the Public Sector. London: Palgrave. Biehl, João. 2005. Vita: Life in the Zone of Social Abandonment. Berkeley, CA: University of California Press. Bourgois, Philipe. 2009. Righteous Dopefiend. Berkeley, CA: University of California Press. Brown, Keith, ed. 2006. Transacting Transition: The Micropolitics of Democracy Assistance in the Former Yugoslavia. Bloomfield, CT: Kumarian Press, Inc. Campbell, David. 1999. “Apartheid Cartography: The Political Anthropology and Spatial Effects of International Diplomacy in Bosnia.” Political Geography 18: 395–435. Chandler, David. 1999. Bosnia: Faking Democracy after Dayton. London: Pluto Press. Cohen, Lawrence. 1994. “Old Age: Cultural and Critical Perspectives.” Annual Review of Anthropology 23: 137–158. _____ 2008. “Politics of Care: Commentary on Janelle S. Taylor, ‘On Recognition, Caring and Dementia.’” Medical Anthropology Quarterly 22 (4): 336–339. Cohen, Robert S., and Mihailo Markovi´c. 1975. The Rise and Fall of Socialist Humanism: A History of the Praxis Group. Nottingham: Spokesman Books. Coles, Kimberly. 2007. Democratic Designs: International Intervention and Electoral Practices in Post-war Bosnia-Herzegovina. Ann Arbor, MI: University of Michigan Press. Das, Veena. 2007. Life and Words: Violence and the Descent into the Ordinary. Berkeley, CA: University of California Press. Dunn, Elizabeth. 2008. “Postsocialist Spores: Disease, Bodies and the State in the Republic of Georgia.” American Ethnologist 35 (2): 243–258. Gilleard, Chris, and Paul Higgs. 2011. “Ageing Abjection and Embodiment in the Fourth Age.” Journal of Aging Studies 25 (2): 135–142. Fassin, Didier, and Mariella Pandolfi. 2010. Contemporary States of Emergency: The Politics of Military and Humanitarian Interventions. New York: Zone Books. Han, Clara. 2012. Life in Debt: Times of Care and Violence in Neoliberal Chile. Berkeley, CA: University of California Press. Havelka, Mladen. 2003. “Skrb za starije ljude u Hrvatskoj—potreba uvodˉenja novih modela.” Društvena istraživanja 12 (1–2): 225–245. Hayden, Robert M. 1996. “Imagined Communities and Real Victims: Self-Determination and Ethnic Cleansing in Yugoslavia.” American Ethnologist 23 (4): 783–784. Herzfeld, Michael. 2005. Cultural Intimacy: Social Poetics in the Nation-State. 2nd ed. New York: Routledge.

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Horvat, Branko. 1982. The Political Economy of Socialism: A Marxist Socialist Theory. New York: Sharpe. Hromadži´c, Azra. 2015. Citizens of an Empty Nation: Youth and State-Making in Postwar Bosnia and Herzegovina. Philadelphia, PA: University of Pennsylvania Press. _____ 2016. “Affective Labor: Work, Care and Entrepreneurial Citizenship in Biha´c.” In Negotiating Social Relations in Bosnia and Herzegovina: Semiperipheral Entanglements, edited by Stef Jansen, Cˇarna Brkovi´c, and Vanja Cˇelebicˇi´c, 79–93. Southeast European Studies series. London: Routledge. Jansen, Stef. 2005. “National Numbers in Context: Maps and Stats in Representations of the Post-Yugoslav Wars.” Identities: Global Studies in Culture and Power 12 (1): 45–68. Jašarevi´c, L. 2011. “Lucid Dreaming: Revisiting Medical Pluralism in Postsocialist Bosnia.” In Anthropology of East Europe Review 29 (1): 109–126. Kurtovi´c, L. 2011. “What is a Nationalist? Some Thoughts on the Question from BosniaHerzegovina.” Anthropology of Eastern Europe Review 29 (2): 242–253. Manning, Paul. 2007. “Rose-Colored Glasses? Color Revolutions and Cartoon Chaos in Postsocialist Georgia.” Cultural Anthropology 22 (2): 171–213. Lamb, Sarah. 2009. Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad. Bloomington, IN: Indiana University Press. O’Shea, Brendan. 2012. Bosnia’s Forgotten Battlefield: Biha´c. Stroud: The History Press. Philips, Susan, and Patricia Banner. 1995. The Crisis of Care: Affirming and Restoring Caring Practices in the Helping Professions. Washington, DC: Georgetown University Press. Read, Rosie. 2007. “Labour and Love: Competing Constructions of ‘Care’ in a Czech Nursing Home.” Critique of Anthropology 27 (2): 203–222. Simi´c, Andrei E. 1990. “Aging, World View and Intergenerational Relations in America and Yugoslavia.” In Aging in Cultural Contexts, edited by J. Sokolovsky, 89–107. Boston, MA: Bergin and Garvey. Sokolovsky, Jay. 1991. “Self-Help Hypertensive Groups and the Elderly in Yugoslavia.” Journal of Cross-Cultural Gerontology 6 (3): 319–330. Accessed 6 June 2014, http://faculty.usfsp.edu/jsokolov/selfhelp.htm. Sorabji, Cornelia. 1995. “A Very Modern War: Terror and Territory in BosniaHerzegovina.” In War: A Cruel Necessity?: The Bases of Institutionalized Violence, edited by Robert A. Hinde and Helen Watson, 80–98. London: I.B. Tauris. Stubbs, Paul, and Reima Ana Maglajli´c. 2012. “Negotiating the Transnational Politics of Social Work in Post-Conflict and Transition Context: Reflections from SouthEast Europe.” British Journal of Social Work 42: 1174–1191. Stubbs, Paul. 2002. “Globalisation, Memory and Welfare Regimes in Transition: Towards an Anthropology of Transnational Policy Transfers.” International Journal of Social Welfare 11 (4): 321–330. Thelen, Tatjana. 2015. “Care as Social Organization: Creating, Maintaining and Dissolving Significant Relationships.” Anthropological Theory 15 (4): 497–515. Tomorad, Mirjana, and Antonija Galoguža. 1984. “Stare i nemo´cne osobe.” In Socijalna zaštita, edited by Milan Škrbi´c Slaven Letica, Boško Popovi´c, Josip Butkovi´c and Ante Matutinovi´c 304–310. Zagreb: JUMENA. United Nations. 2002. World Population Ageing: 1950–2050. Department of Economic and Social Affairs, Population Division. Accessed 15 February 2015, http://www. un.org/esa/population/publications/worldageing19502050/.

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Verdery, Katherine. 1994. “Ethnicity, Nationalism, and State-Making. Ethnic Groups and Boundaries: Past and Future.” In The Anthropology of Ethnicity: Beyond Ethnic Groups and Boundaries, edited by H. Vermeulen, and C. Govers, 33–58. Amsterdam: Het Spinhuis. _____ 1996. “The Etatization of Time in Ceausescu’s Romania.” In What Was Socialism and What Comes Next?, 37–53. Princeton, NJ: Princeton University Press. Williams, Raymond. 1977. “Structures of Feeling.” In Marxism and Literature. Marxist Introductions. Oxford: Oxford University Press. Woodward, Susan. 1995. The Balkan Tragedy: Chaos and Dissolution after the Cold War. Washington, DC: Brookings Institution. Zaviršek, Darja, and Vesna Leskošek. 2005. “The History of Social Work in Slovenia.” Research Report. Ljubljana: University of Ljubljana. Available in PDF format. Accessed 5 March 2015, http://www.sweep.uni-siegen.de/content/Results/ Final_Reports_PDFs/Slovenia_finalreport.Zavod za statistiku Bosne i Hercegovine. 1991. “Ethnic Composition of Bosnia-Herzegovina Population, by Municipalities and Settlements”—Bilten no. 234, Sarajevo.

ijjjjjjjjjjjjjjk EPILOGUE Reflections on Care and Virtue Sarah Lamb

We are witnessing the confluence of two extraordinary phenomena: population aging and population mobility, the growing propensity of people to move both within and beyond their national homelands. These interrelated processes of aging and migration necessitate new ways of thinking about eldercare. The chapters in this volume respond to this contemporary challenge with thoughtful analyses and ethnographically rich variety: how are people—in societies ranging from Tanzania to the United States, the Netherlands to Nepal, Bosnia to Austria—working out what it means to care in a world of mobile, often globally circulating, people, ideas, policies, money, and things? Public discourse and media hype surrounding the unprecedented challenges of eldercare in a world of population aging and mobility abound. Consider this editorial for the New Old Age blog of the New York Times, “How in the World Will We Care for All the Elderly?”: By 2050, there will be more old people than children under the age of 15 for the first time in history. It’s hard to wrap one’s mind around a demographic change of this magnitude and the caregiving challenges that it entails. . . . Who will take care of older adults . . . ? Once it was a given that families would do so in the developing world, where nearly three-quarters of adults live in intergenerational households rather than on their own . . . But as middle-aged adults leave rural areas for economic opportunities in the city—this is happening in Africa, large parts of China and other regions—older adults are left behind to tend to grandchildren and take care of themselves as best they can, without the aid of adult children. . . . The aging of the globe doesn’t lie off on the horizon: It’s a reality, here and now, and unfolding at breathtaking speed. . . . The way ahead remains unclear. (Graham 2012)

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This volume’s contributors tackle these issues, and they offer some visions of the way ahead, exploring how particular people in situated contexts are reconfiguring how to age, live, and care in a mobile world. What I would like to explore here in this brief epilogue are the issues of morality or virtue at the heart of debates around care across distance. I reflect on how questions regarding the morality of eldercare are tied to broader sociocultural and political-economic visions of what makes a good society and life course, and of understandings of relationality and kinship, citizenship and belonging, and who we are as people. I weave in here a few perspectives from India and the United States, the two countries I know best as an anthropologist. Let me begin with the familiar narrative of global population aging imposing a crisis of care and impossible costs. Underlying this narrative is the assumption that older people are quintessential recipients of care. As the story goes, as more people turn sixty-five, we will witness a declining ratio of workers to retirees, presenting an unbearable burden on kin and society. But why must we think of aging and care together? We all know that not all older people stop working at sixty-five. Others do retire, but take on a second or third job (e.g., Lynch 2012). Some care for grandchildren so that their own children may work (e.g., Deneva 2017; Yarris 2017; Zhou 2017). Others take care of other people’s grandchildren (see Miles, this volume; and Palmberger, this volume). Many are fit and resourceful enough to care for themselves. Yet if we do accept the human realities of bodily and cognitive decline common in the lives of those fortunate to live long enough—whether these disabilities begin at age sixty or one hundred—then one question all societies must indeed answer is how to provide eldercare for those who need it. As the chapters in this volume reveal, caring is not simply a practical matter of meeting another’s basic needs, but entails very often expressing love and respect, recognizing another’s personhood, sustaining kinship, and undergirding a community’s moral values. Medical anthropologist Arthur Kleinman reflects on caregiving (of the aged, children, sick, and vulnerable) as a defining moral practice (2009: 293) and condition of what it means to be human (2015: 240). Of caregiving, he writes, It is a practice of empathic imagination, responsibility, witnessing, and solidarity with those in great need. It is a moral practice that makes caregivers, and at times even the care-receivers, more present and thereby fully human. If the ancient Chinese perception is right that we are not born fully human, but only become so as we cultivate ourselves and our relations with others— and that we must do so in a threatening world where things often go terribly wrong and where what we are able to control is very limited—then

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caregiving is one of those relationships and practices of self-cultivation that make us, even as we experience our limits and failures, more human. (Kleinman 2009: 293)

This volume’s comparative ethnographies of caring in a time of increased mobility respond to Kleinman’s call to examine elder caregiving as a moral, political, cultural, and deeply human practice. They explore the ways migrant individuals, families, and communities deal with the practical and emotional matters of living, working, and caring across and despite distance, what Loretta Baldassar and Laura Merla (2014) term “care circulation.” In so doing, they investigate competing answers to the question of who or what should provide care. Where is the best—most natural, valued, effective, practical—site of eldercare: the family, the state, the market, or the individual? And what forms should the care take?—material support through tangible gifts, co-residence and sociality, practical assistance with activities of daily living (feeding, bathing, dressing, toileting), tending to emotional or spiritual needs? Answers to these questions often change in settings shaped by migration. When considering the morality of eldercare, the idea of care as an intimate social relationship tends to come to mind first. As Arthur Kleinman (2012: 1550) delineates, “Caregiving is an indelible part of relations between partners, the raising of children, and response to the infirmities of aged parents and grandparents. It is, of course, the very definition of how families and friendship networks cope with sickness and disability among their own.” In much of this volume and other related work on aging and migration (e.g., Baldassar and Merla 2014; Dossa and Coe 2017), it is particularly the family as site of care that is highlighted. In fact, the family is central to most visions of good elder care around the world. In India, pictures of “good” care in old age almost always highlight the family. Despite the prevalence of rural-to-urban and transnational migration, and the fact that of course practice never perfectly matches ideals, the majority of those over age sixty in India reside with their kin in multigenerational households.1 People in India speak widely of family care for the aged as the most desired, appropriate, and natural way of managing aging. This is a model very familiar in Asia, Africa, and Latin America (e.g., Brown 2013; Cliggett 2005; Ikels 2004; Lamb 2000), although the particular cultural norms justifying exactly why family members should care for their aged, and why the aged should wish to live with their families, vary. In India, people often explain the rightness of family-based care in terms of an intergenerational contract of lifelong reciprocity: adult children are morally obligated to care for their elder parents in exchange for the tremendous support and sacrifice the parents earlier extended to their children in producing and raising

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them. Elders and their juniors often state that it is precisely what parents once gave to their young children—including co-residence, food, material support, love, time together, assistance with daily routines, and toileting— that adult children will later reciprocate to their parents when the parents become old. This is an arrangement, narratives go, not only good for the elder individual, but also for the family and broader society. “Respect and care for elders”—termed seva in many north Indian languages—is often spoken of as a key “Indian” national and social value. At the same time, in India, as in many of the communities explored in this volume, family eldercare systems are facing numerous challenges. Processes like transnational migration, globalization, Westernization, urbanization, political turmoil, and poverty make the carrying out of intergenerational contracts difficult and precarious. People in India widely say that “most” families now contain adult children living away in either distant Indian cities or abroad. Still, many family members from India and elsewhere find ways to sustain exchanges of care despite distance— through remittances, social media, using the “observing eyes” of kin still at home (Grolimund, this volume), and other techniques. Ethnographic research shows how distance and absence do not automatically prohibit or diminish the exchange of caregiving. Baldassar and Merla (2014: 7), in fact, “see caregiving and its management as constitutive of transnational family life.” They elaborate: “We believe the exchange of care in transnational family settings takes on a special importance because of the lack of other ways to express family solidarity and belonging” (Baldassar and Merla 2014: 11). Some Bengali Indian interlocutors articulate that distance can even be good for the nation, too. Viraj Ghosh of Kolkata—whose US-based son visits once per year, communicates by Skype several times per week, and sends plenty of money—declared, “If an old man says that he needs to have his son live with him, then the son won’t advance, and the country won’t advance.” Yet visions of eldercare and morality do not center only on the family. The notion that states have an obligation to provide some form of social security for its older population has now become foundational in globalizing discourse about aging and human rights, put forward by intergovernmental agencies like the United Nations.2 By the 1960s, the vast majority of governments had introduced some form of pension system (Palacios 2002: 786). State support for the elderly is often viewed as particularly important in today’s era of longevity and mobility, when many assume family support will be inadequate. But many states fail to provide. Azra Hromadži´c (this volume) tells of how her elder interlocutors experience the state in postwar and postsocialist Bosnia-Herzegovina as semi-absent. Only a few countries in southern Africa have a national pension system

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(Whyte 2017). In India, the enterprise of state-backed eldercare has been met by ambivalence—both morally (shouldn’t it be families who care for their elders?) and economically (can the state of India afford to provide eldercare?); and in fact recent Government of India interventions into oldage care have aimed more at ensuring family care than at replacing it (Brijnath 2012; Lamb 2013). The major national elder-care initiative of India—the Maintenance and Welfare of Parents and Senior Citizens Bill passed in 2007 and signed into law in 2009—requires adult children, or those in a position to inherit, to care for their aged parents or else face fines and imprisonment. Under the section “Need for the Legislation,” the lawmakers declare straightforwardly, “It is an established fact that family is the most desired environment for senior citizens/parents to lead a life of security, care, and dignity,” and add, “Unfortunately, the time has come when the moral obligation of children to look after their parents in their old age has to be backed by a legal obligation.”3 Some older Indians who have migrated to the United States to live with or near US-settled children look upon the plethora of US state services for the elderly—like subsidized elder housing, discounted lunches and programming at senior centers, and Supplemental Security Income—as problematically replacing family-based care. Originally from Gujarat, India, and making the journey following retirement to reside in the United States with his only son, Vitalbhai Gujar commented about all the social services he was receiving as a US senior citizen: “My son is not taking on his responsibility of caring for me! . . . They [the Americanized Indian youth] think just that the government should do it. . . . They’re forgetting the Indian system.” At the same time, he characterized the US state as family-like, comparing the US government to a resource-rich “father-in-law” who supports his migrant “house son-in-law”—the somewhat embarrassing but economically secure position of moving as a groom into one’s wife’s family home when her family is more economically prosperous and needing of heirs than his own, thereby reversing the more usual northern Indian ­­pattern of patrilocal residence. When both the state and family materialize as semi-absent, as among the ruins of war and socialism in Bosnia (Hromadži´c, this volume), the market may step in to offer novel arrangements of care. Indeed, a third key site of eldercare increasingly availed of by many around the world is the market in the form of residential caregiving institutions and inhome care for hire. Market-based, even more than state, care can signify an archetypal sign of the absence of family and collapse of moral values, but can also be experienced with more nuance. In India, public discourse frequently condemns the recent rise of old-age homes in the nation, but residents whose families cannot provide co-residential care—for whatever

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range of complicated reasons, including that the children may be living abroad—often welcome the old-age home as a novel source of security and care. Indian old-age homes are even sometimes interpreted as a modern instantiation of family values and seva, or respectful care for elders. In fact, several old-age homes in and around Kolkata are named Seva. The proprietors and hired staff provide meals and hot tea, hang mosquito nets, massage coconut oil into dry hair, chat as the evening comes on, and compare themselves to sons, nieces, nephews, and grandchildren. Many residents tell of appreciating living with others in a crowded space that can feel akin to the large joint families of their childhoods and more familiar than the “modern” ­­alternative of living alone (Lamb 2009). We are also seeing market-based eldercare emerging as a transnational enterprise, as retirees from wealthy countries such as the United States, Japan, and England migrate to retirement communities in developing nations of Latin America, Southeast Asia, and Eastern Europe (e.g., Connolly 2012; Innes 2014; Toyota and Xiang 2012). Ann Miles (this volume) explores the experiences of North American retirees who migrate to Ecuador to access affordable healthcare and other services, drawn in part by imaginaries about the communal and family values of Ecuadorians. The 2012 British comedy-drama film hit, “The Best Exotic Marigold Hotel,” features British pensioners who decide to outsource their retirement to India as an affordable, exotic locale with a traditional culture of respect for elders. The Philippine Retirement Authority (http://www. pra.gov.ph/) strategically promotes the Philippines as a desirable eldercare destination, offering a Special Resident Retiree’s visa and other services, marketing values such as hospitality, respect for elders, and affordability as part of the value the international elder consumer receives. We can see how the emerging transnational retirement industry involves an intricate admixture of values and visions of what makes a good later life—as elders, policymakers, and entrepreneurs reconfigure ways of aging and caring on the move. Finally, though, care of the aging self can involve not only receiving care from others—whether from kin, state, or market—but also self-care; indeed, contemporary paradigms of “successful” and “healthy” aging have come to emphasize the virtues of self-care. Medical, public health, media, and everyday narratives prevailing in North America and Western Europe, and circulating in diverse ways around the globe (Lamb 2017), emphasize that we each have the moral and political obligation to attend to our own bodies and minds to stay healthy, active, and independent as we age. Successful aging in this paradigm has come to mean cultivating virtue through practices of self-care in everyday life—such as exercising, eating properly, keeping active, and maintaining a positive attitude—while

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aspiring to stave off the disabilities and dependencies that might otherwise characterize old age (see Lamb 2014; Lamb et al. 2017). The healthy, successful aging paradigm can also be viewed as a practical approach to the challenges of population aging: if healthy, fit, active older citizens can take care of themselves by pursuing the ideals of health and life, then they can strive to avoid becoming burdens. Physician David Agus (2014: 6) exhorts, “Each one of us can make a difference if we each are part of reducing the overall demand for health care. The result will follow one of the fundamental laws of Econ 101: when we start living strong robust lives, we’ll lesson our need for health care, causing the demand to decrease and costs to go down.” The US National Council on Aging’s “Healthy Aging Facts” begins with the clear message that “for most older adults, good health ensures independence, security, and productivity as they age.”4 The European Union similarly promotes active-healthy-aging policies with catchphrases such as “Living longer, working better—Working longer, living better,” framing productive activity as important not only for the health of the individual but for the economic viability of society as a whole (Lassen and Moreira 2014). In conducting fieldwork with US elders, I have been struck by how many have internalized such biopolitical healthy-aging messaging as they strive to practice successful aging as a moral project, health identity, and way of approaching the life course. If older people through virtuous self-care of their bodies and minds can stave off frailty and dependence, they overcome the potentially very costly emotional, social, and financial burdens of needing care in later life. In this way, successful aging sustains long-held US cultural ideals of autonomous and independent personhood, as well as neoliberal forms of individual responsibility, as aging well becomes an individual moral project. By focusing on the theme of morality or virtue, I have wished to illuminate how matters of aging and care are at once intimate and local, embodied and experienced, while at the same time wrapped up with broader national, transnational, and global processes, such as market forces, state welfare and public health policies, cultural ideals, and transnational flows of people, objects, ideas, and values. The ethnographically rich papers in this volume in turn highlight the value of in-depth fieldwork when striving to grasp the implications for people of large demographic trends such as population aging and population mobility. Detailed comparative ethnography allows us to probe the uneven effects of social situations that are always at play—such as inequalities of gender, class, race, and nation; unique family circumstances; individual health conditions; and the force of particular cultural mores. All these processes and more come together as elders and their communities work out how to foster and access care, and age meaningfully, in lives that span national-cultural worlds.

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Sarah Lamb is professor of anthropology at Brandeis University, USA. Her research focuses on aging, gender, families, migration, and understandings of personhood in India and the United States. Her books include White Saris and Sweet Mangoes: Aging, Gender and Body in North India (University of California Press, 2000); Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad (Indiana University Press, 2009); and (as editor) Successful Aging as a Contemporary Obsession: Global Perspectives (Rutgers University Press, 2017).

Notes 1. Sathyanarayana, Kumar, and James (2012: 13, table 6) present data from the National Family Health Survey (NFHS) of 2005–06 finding that 77.5 percent of women and 79.3 percent of men aged sixty and over reside in multigenerational households with married children (predominantly sons) and (usually) grandchildren. Using 2011 data, Jadhav et al. (2013: table 2) similarly find that nearly 80 percent of India’s elders aged sixty and over reside in multigenerational households with children and grandchildren. See also Lamb 2009: 174 and Rajan and Kumar 2003. 2. The principle of state social security as a human right is articulated in articles 22 and 25 of the Universal Declaration of Human Rights. Article 22 reads, “Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.” Article 25 reads, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” Accessed 7 August 2017, http://www. un.org/en/universal-declaration-human-rights/index.html. 3. The text of the 2007 bill is available at http://www.prsindia.org/uploads/ media/1182337322/scr1193026940_Senior_Citizen.pdf (accessed 7 August 2017). 4. National Council on Aging, “Healthy Aging Facts,” Accessed 7 August 2017, https:// www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-aging-facts/.

References Agus, David B. 2014. A Short Guide to a Long Life. New York: Simon and Schuster. Baldassar, Loretta, and Laura Merla, eds. 2014. Transnational Families, Migration and the Circulation of Care: Understanding Mobility and Absence in Family Life. New York: Routledge.

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ijjjjjjjjjjjjjjk INDEXINDEX

A abandonment, 2, 8, 71, 126, 137, 144, 146, 148, 151, 156, 159, 166 Agadez, 57, 59–62, 65, 68 aging, 1–6, 8–9, 32–34, 39, 42–43, 45, 55, 59, 70–73, 77–79, 81, 84–87, 89–90, 98–99, 106, 108–110, 126–27, 137–41, 145–46, 149–52, 156–57, 162, 166, 168, 171–74, 176–78 appropriate aging, 84 healthy aging, 32, 45, 47, 149, 176–77 Austria, 5, 7, 97, 99–104, 106–107, 171 B belonging, 5, 8, 30, 99, 125, 172, 174 Bhutan, 6, 13, 15, 27, 30, 80 Biha´c, 157–62, 165 Bosnia-Herzegovina, 7, 156–57, 159–62, 165–66, 174 C care anonymous care, 14–15, 21 biopolitical care, 14, 21, 25–26, 29 care chain, 9, 33–34, 44, 46 care circulations, 33–34, 46 care ethics, 122, 151 care provider, 1, 4, 8, 98, 120–12 care receiver, 1, 4, 8, 24, 32, 34–35, 63 care regimes, 138, 141, 150 caring at a distance, 137 expectations, 1, 3, 5, 57, 72, 87, 138, 156, 163–66 failures, 7, 98, 135, 149, 156, 165, 173

family care, 3, 29, 106–7, 123, 126, 129, 141–42, 145, 164, 173, 175 family-based caretaking, 77–78 humanitarian care, 14–15, 20–22, 26, 29–30 institutionalized care, 77, 90, 98, 107–109, 141, 146 monetary care, 15, 26, 29–30 relational care, 33–34, 45 self-care, 176–77 Socialism, 157, 159, 163–64, 175 state care, 26, 98, 175 transnational care, 6, 14, 32–34, 39–40, 45–47, 114, 137, 152 triangle of care, 6, 33, 44, 46 virtual care, 35, 42 caregiving, 5, 33, 42, 55–56, 58–60, 63–64, 66–72, 113–14, 129, 137, 143, 145–46, 149–152, 156, 165, 171–175 civil servants, 32, 36, 43 collective desire, 79, 90 Cuenca; Ecuador, 113–21, 123–29 cultural continuity, 79, 90 cultural/religious identity, 79 D daily routines, 99, 102, 174 Dalai Lama, 79, 80, 82, 84, 87 Dar Es Salaam, 6, 33, 35–37, 39–41, 43, 45 death 5, 8, 35, 58–59, 67, 85–88, 105, 140, 146–47, 149, 152, 159, 165–66 dependency, 55, 72, 142, 149, 152 diaspora, 1, 7, 73, 90, 142, 145, 162 distance, 1–8, 11, 14, 22, 29, 32–36, 42, 45–47, 53, 55, 60, 64–67, 95, 135, 137–39, 141, 152, 157, 162, 172–74

182 

INDEX

E Ecuador, 5, 7, 63, 113–15, 117–19, 121–22, 124, 126, 128–29, 176 elderly people, 1, 4, 6, 8, 32, 47, 81, 83–84, 90, 139, 147 elders, 7, 16, 24–25, 30, 32, 45, 47, 55–65, 67–72, 126, 142, 144–46, 149, 151, 174–77 essuf, 58, 60, 61, 69 everyday life, 80, 103–104, 148, 176 exile, 1, 5, 7, 19, 70, 76–82, 84–85, 87, 89–90, 156, 164 expat, 114–16, 118–30 F filial piety, 76 G gender, 3, 5, 44, 60, 64, 72–73, 97, 103, 177 generation, 47, 55, 58–60, 62, 64, 67–72, 76, 78, 81, 103, 106, 126, 128, 142, 145, 152, 164 going abroad, 77, 84–86 government of India, 175 gringo, 118, 123–25, 129–30 H health care. See under care healthy aging, 32, 45, 47, 149, 17–77. See also successful aging Hung Cam Thai, 18 I imaginaries, 5, 45, 113, 115, 118–20, 122–23, 126, 130, 176 India, 5, 7, 13, 15, 35–36, 39, 44–45, 76–90, 141, 145, 151, 172–76 institutionalization, 137, 148, 151 deinstitutionalization, 147 interdependency, 149, 152 international living, 114–15 International Organization for Migration (IOM), 15–16, 18–19, 21 internet, 2, 123, 125, 158 Islam(ic), 58, 62, 67–68, 100, 104, 159 isolation, 2, 7, 59, 137, 140–45, 149–50

L labor migrant, 7, 61, 97–104, 108 late-life care, 105–106, 110 loneliness, 7, 37, 44, 105, 127, 137, 140–142, 145–146, 148–150 loss, 38, 76, 87, 89, 126, 137, 143, 148–49, 162 M Mali, 5, 7, 55–57, 61, 66–69, 72–73 market, 5, 7–8, 29–30, 35, 56, 59, 69, 138, 146, 156–57, 173, 175–77 market-based eldercare, 137, 150, 176 middle-class, 6, 32–33, 35, 39, 45–46 migration labor migration, 55, 57, 66, 68 lifestyle migration, 8, 113, 118 rural to urban, 32, 56–57, 68, 70–71, 173 mobility, 103, 138, 142, 171, 173–74, 177 monetization, 63 morality, 1, 150–151, 172–174, 177 Muslim, 7, 55, 67, 107–108, 112, 162, 167. See also Islam(ic) N neglect, 8, 47, 59, 69, 83, 137, 140, 142, 144, 149, 159, 165 Nepal, 5–6, 13–30, 76, 80, 85, 171 Niger, 5, 7, 55–57, 59–61, 66, 72–73 nostalgia, 57–58, 60, 115, 120, 142, 148 O observing eyes, 6, 33, 38, 41, 43–44, 47, 174 old people’s home/nursing home/oldage home, 4, 7, 76–77, 81–84, 90, 106–108, 110, 137, 140, 144–48, 151, 158–59, 164, 175–76 older people. See under elderly people P palanca, 128 population aging, 171–72, 177 post-Socialism, 7, 156–159, 162, 164, 166, 174 postwar, 7, 9, 110, 156–59, 164–66, 174

INDEX  

183

prayers, 61, 84, 86, 88–89, 104 private nursing homes. See under old people’s home/nursing home/oldage home privilege, 5, 7, 113, 115, 117–18, 128, 130, 143, 156

successful aging, 45, 176–178. See also healthy aging Suriname, 5, 7, 137–39, 143–45, 150–51 Syracuse, New York, 6, 8, 14, 16, 23–25, 30

Q Qur’an, 58, 61, 64, 67, 97, 107

T Tamajaq, 7, 55, 58, 67 Tanzania, 5–6, 32–37, 39–47, 171 the Netherlands, 5, 7, 137–40, 143–48, 150–51, 171 Tibetan Buddhism, 86 Tibetanness, 86–87 transnational transnational care, 6, 14, 32–34, 39–40, 45–47, 114, 137, 152 transnational families, 29, 35, 45–46, 76 transnational migration, 77–79, 113, 126, 142, 173–74 transnational retirement industry, 176 Tuareg, 7, 55–61, 66–72 Turkey, 5, 99, 100, 103-104, 108 Turkish, 7, 97, 100–110

R Ramadan, 41, 62–64, 67, 70 reciprocity, 4, 34, 55, 62, 66, 71–72, 126, 128, 130, 149, 165, 173 refugee, 5–6, 13–30, 55, 57, 66, 69, 80, 117, 159, 162 refugee camp, 5–6, 13–18, 20–23, 29–30, 69 refugee resettlement, 13, 15, 22 religion, 5, 6, 73, 76–77, 80, 85–87, 90, 107 religious identity, 79 remittances, 41, 68, 88, 116, 138, 145, 174 resettlement, 13–17, 19–26, 28–30, 76, 78, 80, 85 retirement, 1–2, 7, 61, 77, 83, 99, 102–106, 109, 113–18, 12, 129, 139, 175–76 retirement communities, 176 ritual, 6, 55–56, 58–59, 61–66, 68–73, 87, 143, 147, 152, 159 dying rituals, 7, 85 S sedentarized, 55 Šehidi, 159 semi-absent state, 7, 162, 165 seminomadic, 7, 55, 58 settlement, 7, 13–17, 19–26, 28–29, 76–90 social embeddedness, 7, 97–99, 102–103, 105, 109–110 social fields, 33–34, 45 social security, 117, 123, 129, 163, 174 Socialism, 157, 159, 163–64, 175

U UNHCR, 13, 15–16, 19–22, 25 United States, 5–6, 13–15, 25, 32–33, 35–42, 44–48, 72, 76, 85, 89, 116, 120, 125, 129, 138, 171–72, 175–78 V Vienna, 7, 9, 97–104, 107–110 virtue, 34, 78, 120, 129, 171–72, 176–77 voluntary association, 7, 97–98, 100, 102, 106, 108–110 W war, 8–9, 15, 61, 157–166, 175 Y Yugoslavia, 159–63 Yugoslav state, 163–64 Yugoslav wars, 161