Care for neighbors and care on paper: Relationships, medical bureaucracies, and conflicting time in community health work

Abstract

By foregrounding the exploration of the epistemology of time, this article theorizes heterochronicity of care and shows how care is subject to different and conflicting forms of social time. Specifically, I investigate bureaucratically accounted care work alongside relational undervalued and unrecognized forms of care to show how bureaucratic time forms not only conflict with one another but also with the time forms of relationships and everyday life. I draw on long-term fieldwork in Delhi’s urban poor areas with ASHAs (Accredited Social Health Activists). Fashioned as agents of social change, ASHAs seek to achieve health program goals in their communities by mediating these conflicting bureaucratic and relational temporalities. Attention to the different regimes of time in care work reveals the complex entanglement of money and care in community health work, and the capacity of money to disturb, unsettle, and enable notions of justice in care.