Operating in Eden: cosmetic surgery tourism and the politics of public and private medicine in Costa Rica Public Deposited

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  • March 21, 2019
  • Ackerman, Sara Louise
    • Affiliation: College of Arts and Sciences, Department of Anthropology
  • This dissertation offers an ethnographic account of North Americans' journeys to Costa Rica to undergo cosmetic surgery. I situate Costa Rica's booming medical tourism industry in a confluence of historical, economic and cultural conditions, through which Costa Rica is made attractive to North Americans, a regime of private sector expansion and state contraction is promoted, and the national medical program on which most Costa Ricans rely is transformed. In focusing on the everyday practices of patients, clinicians and workers at recuperation facilities, I consider how the desires and practices of middle class North Americans are intertwined with uncertainties about health care access and national identity in Costa Rica. The ethnography is organized around three sets of spaces through which medical tourists and their caretakers pass. The first includes popular media and web forums, where specific imaginaries of Costa Rica are produced, medical travelers are mobilized, and cosmetic surgery is normalized as a technology of self-improvement. The second is the hotel, particularly recovery hotels that cater to visiting patients from North America. I consider how the affective labor of local caretakers combines with tropical landscapes, and a discourse of personal rebirth, to move guests through a period of post-surgical liminality and to de-politicize medical services. The third set of spaces, public and private hospitals and clinics where bodies are enhanced or repaired by plastic surgeons, reveals a shadow medical and labor migration from Nicaragua that underwrites Costa Rica's affordability for North Americans. Throughout, I discuss areas of overlap, and tension, between public and private medical facilities, particularly the state's persistent subsidies of the private sector and the lived, material effects of neoliberal discourses on patients' desires, professional identities and medical practices. The dissertation illustrates that a desire for a fully integrated self is not the only type of belonging negotiated by the various actors involved in Costa Rican cosmetic surgery tourism. A constellation of national, transnational, moral and aesthetic claims to membership intersects with the provision of private medical services for North Americans, and I examine how the successes or failures of these claims are embodied and lived.
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  • In Copyright
  • Lachicotte, William S.
  • Open access

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