the phrase nuestra realidad (our reality), commonly used throughout urban Ecuador, also speaks to the similarity between Ecuadorian and sts scholars’ understanding of the world. the term is used to describe the specific sets of rela-tional contingencies, connections, and constraints that shape a particular reality in Ecuador. Nuestra realidad denotes nonuniversality. sometimes it refers to the lack of infrastructure in Ecuador, as in “that project won’t work in nuestra reali-dad.” sometimes it refers to a social norm or law, as in “No one will follow that regulation in nuestra realidad.” It’s also used more positively to denote the warmth, attachment, and flexibility of people in nuestra realidad (in contrast to the harsh individuality of people from the United states), as in “Gringos don’t understand how to be in nuestra realidad.” Nuestra realidad involves materially contingent rela-tions that often shape biological organisms.

Bruce Dunne participates in this academic discourse with his essay “Powerand Sexuality in the Middle East.”27He asserts that “sexual relations in MiddleEastern societies have historically articulated social hierarchies, that is, dominantand subordinate social positions: adult men on top; women, boys and slavesbelow” (8). Presumably, in non–Middle Eastern societies such hierarchies did not“historically” exist except in the celebrated cases of “Greek and late Romanantiquity,” (9) but certainly not in the medieval, let alone the modern, “West.” The“Middle Eastern” case is contrasted with the West; according to Dunne, the “dis-tinction made by modern Western ‘sexuality’ between sexual and gender identity,that is, between kinds of sexual predilections and degreesof masculinity and fem-ininity, has until recently, had little resonance in the Middle East” (8).28

The sharp debate within feminist circles about whether women share enough to constitute a singular category (“woman”) has implications for the subject of this book. Should we be working with the similarly homogenized subcategory of “the Muslim woman”? I have taken her as my subject because others, some outside and some inside Muslim communities, are framing wom-en’s rights issues this way. Yet all of the cases of par tic u lar women I analyze in this book are drawn from the Arab world, and most are from the rural communities in Egypt where I have done research. This leap from the general to the par tic u lar requires explanation.

Murphy’sanalysisimpelsustoconnectthedotsbe-tween this sort of public affirmation and private trans-gression of political norms and consensus in the contextof Trump’s campaign. Did Trump Voters strategicallyappeal to shared norms so as to conceptualize or legiti-mize their support for a prospective lawmaker whosecandidacy was grounded inflouting those norms? Moregenerally, did civic-minded articulations of prevailing so-cial norms to counter Trump bolster a campaign com-mitted to transgressing those norms? Inversely, did suchtransgressions paradoxically work to affirm the sanctityof shared public norms? Do Trump and his supportersintentionally deviate from civic values in ways that enablethem to reify those values? In other words, how does apolitics committed to dismantling key tenets of the con-cept of“American values”such as free trade, immigra-tion, and respectful political dialogue work in the interestof magnifying (by reconfiguring) that concept? An eth-nographic project focused on illuminating the contradic-tions of political subjects can shed light on the ways inwhich affirmations and transgressions of political normsin society’s front- and backstages work hand in hand.

How do we think about value that emerges here, in such spaces and through such relationships? How do we think about the politics that emerges here? How do we think about the health that emerges here? How do we think about the democracy that emerges here? I ask such questions by fol-lowing ways in which health, value, and politics are constituted globally, in and through speculative metrics of value established on Wall Street, or phar-maceutical corporate lobbies in Washington, DC, or through local, national, and global civil society advocacy around health issues as they play out in high courts in India, in the calculations of brokers in clinical research located in Seattle and Hyderabad, North Carolina, and Northern Andhra Pradesh, in the investments of Indian capitalists with nationalist inheritances attempting to be global health players, in trade negotiations happening behind closed doors within bilateral and multilateral forums, in the pages of public health journals, or in legislative debates in the Indian Parliament. These are ques-tions of pharmocracy.

Th is same study also found that African- American women delivering preterm were less likely to receive antenatal ste roids that could improve perinatal outcomes— a disparity the authors found “disturbing.” Th ey ex-plained it as follows: “[D]iff erences in reporting contractions or accurately assessing risk for preterm birth from history could lead to diff erences in administering antenatal ste roids” (Harper et al. 2007, 185). Again, the au-thors partly attribute the fact that preterm Black infants are more likely to be denied ste roids necessary to develop their premature lungs to Black women’s silence. Again, Black women are fantasized to be uncannily du-rable (or daft) women, bearing the pain of contractions without thinking to inform their physicians or caretakers of their premature labors. Th e other explanation the authors provide for the disparity in the administra-tion of antenatal steroids— that physicians do not “accurately assess[] risk for preterm birth” in Black women— requires much elaboration. What is it about Black women that causes physicians to fail to accurately assess their risks? Could racism be partly to blame for physicians’ inability to hear the histories Black women tell them?

Li is but one of the many “miracle workers” that I came to know in Shanghai and the San Francisco Bay Area. For those who have been social-ized into traditional Chinese medicine—whether as practitioner, patient, or researcher—the ability to handle di*cult clinical cases and, in particular, to achieve what mainstream biomedicine cannot is an unmistakable sign of professional accomplishment. At the memorial service of Zhao Zhenjing, a renowned practitioner and cancer specialist in San Francisco, Barbara Bernie spoke about Zhao in front of a diverse audience consisting of rela-tives, acupuncturists and herbalists, students of traditional Chinese medi-cine, former patients, biomedical professionals, and research scientists: “Dr. Zhao came to work at our teaching clinic [of traditional Chinese medicine] a'er he (rst arrived from China in #$%+. He always asked for the most di*-cult cancer cases that Western doctors could not deal with. A'er he started his own clinic, he kept telling me, ‘Send me the most challenging cases that you come across. I’ll show people here what Chinese medicine can do!’ He was able to help many patients who would have otherwise given up. He did so much to build the Chinese medicine community in San Francisco and to educate the general public! Dr. Zhao was very special.”

Medical observers have noticed that thevast majorityof illnesses today are treated as chronic and that being at risk for illness is often treated as if one had a disease requiring lifelong treatments, drugs for life.Today, chronic diseases are said to affect 133 million Americans, one out of every two adults.10 These are not the chronic illnesses studied by medical an-thropologists that painfullydisorderone’s life and disrupt one’s biogra-phy.11 The recent reformulation of chronicity represents a shift in the basic paradigm of health and disease, a paradigm shift away from an inherently healthy body.The old paradigm assumes that most people are healthyat theircore and that most illnesses are temporary interrup-tions in their lives, identified by persons as the experience of suffering.

In some localities visitadoras also worked as community organizers. In rural Pernambuco the model for community organization, before the pen­etration of the military presence into every nook and cranny of social life, was Paulo Freire' s method of conscientiza{ao (critical consciousness) through literacy training (see Freire 1970, 1973). And so my evenings were often spent in small "cultural circles," as they were called, where by the light of smoky and flickering kerosene lamps, residents and squatters of the Alto learned to read while simultaneously organizing around the founding of a shantytown association, which was known by the acronym UPAC (Uniao para o Progresso do Alto do Cruzeiro, or the Union for the Progress of the Alto do Cruzeiro). I served as a founding member and orientadora politica of UPAC, and I worked with members in the collective construction of a headquarters for "local action," a child care center that also served at nights and on weekends when the creche was closed as an adult literacy school, a game room, a dance hall, a house of Afro-Brazilian spiritism, and a large meeting room for the boisterous "general assemblies" of the shantytown association. Often I groped blindly to understand and act within a context of radical, sometimes opaque, cultural difference as well as within a situation of economic misery and political repression in which my own country playe&a contributing and supporting role.