The Trouble of Stigma in the Age of Datafication: Screening for Mental Health Issues in a Refugee Camp in Jordan.

Drawing on ethnographic fieldwork in a refugee camp in Jordan, this article investigates how datafication through digital screening technologies helps shape mental health issues in the face of widespread uneasiness about the subject, especially among the intended beneficiaries. We argue that the refugees and their health care providers face a dilemma: on the one hand, the desire to make mental health issues visible and clinically actionable through datafication and, on the other hand, the wish to keep mental health issues out of public view to avoid potential stigma.

Of Numbers and Moods: Screening for Mental Health Issues in a Rohingya Refugee Camp in Bangladesh.

Screening refugees for mental health issues, medical assistants use a digital tool that produces a numerical score but also, importantly, attunes to the moods of their clients and the atmospheres of their homes. In this article, we propose the concept of numeration-attunement as helpful for medical anthropology. Drawing on ethnographic fieldwork conducted among medical assistants working in the Kutapalong refugee camp in Bangladesh, we explore their assessment of the mental health of the refugees: its numeration-attunement. To develop the notion of numeration-attunement, we draw on numeration research as well as phenomenology. Comprehending how medical assistants assess the mental health of refugees requires attention both to numeration and datafication by way of a screening tool as well as the revelatory character of attunement to moods.

Feasibility Study of Case-Finding for Breast Cancer by Community Health Workers in Rural Bangladesh.

BACKGROUND: Mortality from breast cancer is high in low- and middle-income countries, in part because most patients have advanced stage disease when first diagnosed. Case-finding may be one approach to changing this situation. MATERIALS AND METHODS: We conducted a pilot study to explore the feasibility of population-based case finding for breast cancer by community health workers (CHWs) using different data collection methods and approaches to management of women found to have breast abnormalities. After training 8 CHWs in breast problem recognition, manual paper data collection and operation of a cell-phone software platform for reporting demographic, history and physical finding information, these CHWs visited 3150 women >age 18 and over they could find--from 2356 households in 8 villages in rural Bangladesh. By 4 random assignments of villages, data were collected manually (Group 1), or with the cell-phone program alone (Group 2) or with management algorithms (Groups 3 and 4), and women adjudged to have a serious breast problem were shown a motivational video (Group 3), or navigated/accompanied to a breast problem center for evaluation (Group 4). RESULTS: Only three visited women refused evaluation. The manual data acquisition group (1) had missing data in 80% of cases, and took an average of 5 minutes longer to acquire, versus no missing data in the cell phone-reporting groups (2,3 and 4). One woman was identified with stage III breast cancer, and was appropriately treated. CONCLUSIONS: Among very poor rural Bangladeshi women, there was very limited reluctance to undergo breast evaluation. The estimated rarity of clinical breast cancer is supported by these population-based findings. The feasibility and efficient use of mobile technology in this setting is supported. Successor studies may most appropriately be trials focusing on improving the suggested benefits of motivation and navigation, on increasing the numbers of cases found, and on stage of disease at diagnosis as the primary endpoint.