"Heart Sickness, Protracted Displacement, and Uncertainty in Georgia"

Georgia’s population of 4.5 million includes approximately 258,000 Internally Displaced Persons (IDPs). Around 220,000 of them fled their homes in 1993 amid civil war between Georgia and Abkhazia. This paper draws on ethnographic research with Georgians displaced from Abkhazia in the early 1990s that remain unable to return, and who live in conditions of extreme poverty and marginalization. The project investigated the health effects of displacement, and the role of NGOs in improving IDPs’ access to insurance and medical services. Ethnographic research (summers 2010 and 2011) produced important insights about how extended displacement dramatically redefines meanings of wellbeing and care within families and communities. International aid organizations and local NGOs play an increasing role in monitoring IDP health status, facilitating access to medical services, and mobilizing IDPs to design community-based health education programs. Experiences of long-term displacement in Georgia intertwine with unreliable circuits of aid to recast the body as a zone of struggle for social and political value that many IDPs articulate in terms of “heart sickness” and “heart pains.” I examine the murky distinction between physiological (cardiological) disease and affective dis-ease that IDPs articulate to critique their marginalization. Their insights raise also important questions about how medical anthropologists identify and theorize notions of health in relation to “the social” and “the biological.”