Rheumatic fever and the ‘art of governance’

rheumatic

Rheumatic fever is a serious, but preventable illness caused by strep throat. The incidence rate of rheumatic fever is high among certain populations in New Zealand. Existing consensus confirms it as largely attributable to poor socioeconomic conditions and which present a cumulative impact on one’s ability to be healthy.   Methods employed by the Ministry of Health to target this illness are characterised as secondary approaches because they treat people once they develop a sickness – rather than pre-emptively addressing its source. This secondary approach reveals a process characteristic of what Foucault conceptualises as the ‘art of government’. Rationalising certain health matters as individual, rather than as social, deflects responsibility from the government onto citizens. The image of a sticker chart, designed to track antibiotic use for strep throat, captures this. It reveals an exercise in emphasising the individual as the agent responsible for ensuring their strep throat doesn’t develop into rheumatic fever, even though a course of antibiotics does nothing to lessen the social conditions through which the illness is exaggerated.  This transference of responsibility through the sticker chart requires that citizens voluntarily govern themselves, enacting what Foucault calls ‘governmentality’.

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