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in Anthropology in Action
Fredrik Nyman Durham University

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Roberta Zavoretti

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Linda Rabben University of Maryland

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David M. R. Orr University of Sussex

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Breast Cancer Meanings: Journeys across Asia. Cynthia Chou and Miriam Koktvedgaard Zeitzen (eds), Copenhagen: NIAS Press, 2018, ISBN: 978-87-7694-242-7, 304 pp., Hb. £65 / Pb. £22.50.

The Look of a Woman: Facial Feminization Surgery and the Aims of Trans-Medicine. Eric Plemons, Durham, NC: Duke University Press, 2017, ISBN: 978-0-8223-6914-1, 208 pp., Pb $24.95 / Hb $94.95.

Refuge beyond Reach: How Rich Democracies Repel Asylum Seekers. David Scott FitzGerald, Oxford: Oxford University Press, 2019, ISBN: 978-01-9087-415-5, 359 pp., Hb. £34.95.

Detain and Deport: The Chaotic U.S. Immigration Enforcement Regime. Nancy Hiemstra, Athens: University of Georgia Press, 2019, ISBN: 978-08-2035-463-7, 182 pp., Pb. £29.95.

Framing a Lost City: Science, Photography, and the Making of Machu Picchu. Amy Cox Hall, Austin: University of Texas Press, 2017, ISBN: 978-1-4773-1368-8, 267 pp., Pb. £29.95.

Making Machu Picchu: The Politics of Tourism in Twentieth-Century Peru Mark Rice, Chapel Hill: University of North Carolina Press, 2018, ISBN: 978-1-4696-4353-3, 233 pp., Pb. £31.95.

Breast Cancer Meanings: Journeys across Asia Cynthia Chou and Miriam Koktvedgaard Zeitzen (eds), Copenhagen: NIAS Press, 2018, ISBN: 978-87-7694-242-7, 304 pp., Hb. £65 / Pb. £22.50.

Reviewed by Fredrik Nyman

In 2018, there were 17 million new cases of cancer worldwide, with breast cancer being the most commonly diagnosed cancer in women. In light of this, an epidemic is currently sweeping Asia; in fact, ‘this rise of breast cancer is the most rapid increase of any cancer recorded in any place at any time, ever’ (vii). At the same time, Asian women have appeared less willing to undergo breast cancer screening. In Breast Cancer Meanings: Journeys across Asia, the editors Cynthia Chou and Miriam Koktvedgaard Zeitzen (and fellow contributors) present a well-crafted analysis of ‘the Asian mosaic of breast cancer meanings’ (1), seeking to generate knowledge of people and their understandings and practices relating to breast cancer. In developing a better understanding of the socio-cultural and biomedical contexts, this collaborative cross-disciplinary effort advances the argument that it is not only clinicians who need to break old habits but anthropologists as well.

While Chapter 1 outlines the urgency for better understandings of breast cancer meanings, Chapter 2 deliberates on the physiology of breast cancer. This is followed by seven empirical chapters based on research conducted in Turkey (Chapter 3), Malaysia (Chapter 4), Singapore (Chapter 5), China (Chapter 6), Mongolia (Chapter 7), Iran (Chapter 8), and Thailand and Burma (Chapter 9). The volume concludes with an Afterword by Margit Warburg. Each chapter presents ‘the context-sensitive issues that the locals themselves have identified as crucial in relation to what breast cancer means for them’ (15), where the contributors present conversations across Asia with people affected (directly or indirectly) by breast cancer. The volume is a result of collaborations between medical experts (clinicians) based in Singapore and anthropologists (and cognate researchers) based in Denmark. Although anthropology and biomedicine are based on different assumptions about fundamental issues such as the nature of social reality, this volume is collaborative ‘in the truest sense of the word’ (3). The clinicians involved gained significant insights from area specialists on how non-medical factors affect treatment of breast cancer, while the anthropologists too gained necessary insights from medical knowledge and expertise in assessing the relevance of non-medical factors in the management of the disease. Together, these perspectives facilitate, as the editors write, ‘a holistic understanding of breast cancer meanings and journeys for women in Asia’ (3).

The volume's point of departure is that ‘there is no simple relation between breast cancer literacy and understandings of bodily sensations as symptoms of breast cancer’ (7). The aim is to ‘give voice to individuals in Asia who have experienced breast cancer in one way or another, as well as to the many who … may not have given a moment's thought to the disease’ (1). Anthropologists have shown for decades how there is more to ‘health and disease than physical and biological processes’, which has proven useful in overcoming ‘barriers to the uptake of health interventions’ and in developing ‘culturally appropriate, sustainable interventions’ (Pool and Geissler 2005: 6). This notion is vividly illustrated through several thick ethnographic accounts. For instance, in Chapter 3 (by Daniella Kuzmanovic) we read that in Turkey breast cancer is widely regarded as a self-inflicted disease that stems from unhealthy lifestyles. Thus, ‘one must act to prevent the disease’ (15), which is accomplished by keeping bacteria at bay, observing the notion of balance in one's lifestyle, and seeking protection from nazar (the evil eye). Women's specific socio-cultural contexts are also addressed in Chapter 4 (by Zeitzen), where, in multi-ethnic Malaysia, facing breast cancer is a highly social event that clashes with various socio-cultural obligations that have consequences for women's sexuality, for marriage and for motherhood (76–77). For instance, Malay-Muslim women who experience breast cancer may have to seek permission from their husbands to undergo surgery, fearing polygamy if their breasts are removed. In contrast, in Chapter 5 (by Chou) attention is given to the semantics of ‘pain’ and ‘no pain’ in China (107). Chou discusses the fact that, in Chinese cultural patternings, ‘pain’ and ‘no pain’ are not seen as single, fixed entities but rather as fluid, context-sensitive constellations. Consequently, this shapes women's interpretations of being ‘not sick’ and ‘sick’, where the sensation of ‘pain’ becomes a metaphor for accepting that one has, or may have, symptoms of being ‘sick’. However, although women in China do come to recognise that ‘pain’ is a symptom of disease, they still delay or refuse to seek treatment (108). These are just a few examples that illustrate the mosaic of breast cancer meanings depicted in this volume.

On balance, although the volume focuses on a pan-Asian context, its lessons are widely applicable and extendable beyond it. By providing committed and insightful perspectives on the complex emotional and contextual issues which breast cancer presents, this volume sheds light on how people negotiate and incorporate various health-related knowledges in their everyday lives – both inside and outside of the clinic. Warburg makes the point in the Afterword that ‘not all informants are patients’ (229), and indeed ethnographers also engage with people's cultural environment, in which family, friends and medical practitioners all influence health-care behaviours embraced by patients, thus shaping collective opinions (and voices) depicting the disease. These insights will be of assistance to medical practitioners, public health scholars and policy-makers in developing new strategies to treat the underlying conditions behind the disease. In illustrating how ‘the cultural understanding of breast cancer behaviour is with the direct aim of intervention’ (vii), Breast Cancer Meanings is a must-read for health professionals and practitioners who work with and care for people affected by breast cancer, and should also be of interest to disability scholars and social scientists of all kinds. What is more, as this volume is collaborative it contributes to important ambitions in cross-disciplinary research, where the wish is to engage in ‘constructive, critical dialogue’ (232). It should therefore be of great interest to those seeking to engage in such dialogues, where the ‘indistinct’ in the boundaries between academic traditions is deemed not only stimulating but necessary.


Pool, R. and W. Geissler (2005), Medical Anthropology (Maidenhead, UK: Open University Press).

The Look of a Woman: Facial Feminization Surgery and the Aims of Trans-Medicine Eric Plemons, Durham, NC: Duke University Press, 2017, ISBN: 978-0-8223-6914-1, 208 pp., Pb $24.95 / Hb $94.95.

Reviewed by Roberta Zavoretti

Eric Plemons’ ethnography offers interesting insights into the world of facial feminization surgery (FFS) in San Francisco, California. FFS is ‘a set of bone and soft tissue reconstructive procedures intended to feminize the face of trans-women’ (2). While the main research participants undergo their surgical procedures in the San Francisco area, most of them travel from other US states and foreign countries to access this city's renowned private practices. Through his enjoyable prose, the author walks the reader into the clinics, into the consultation room together with doctors and patients, and finally all the way into the operation room, reporting informal chats with surgeons, medical personnel as well as trans-activists. The book is structured in six chapters, three interludes and a short conclusion, skilfully mixing ethnographic vignettes and excerpts from field notes with theoretical discussions.

First, the author introduces the changing context of medical practice on trans-patients in the United States. In the mid-twentieth century, the idea of sex re-assignment revolved around surgical intervention on genital anatomy. Later legal, social and medical praxis displaced the idea that sex/gender might be exclusively located in the genitalia; as the surgeons interviewed by Plemons claim, ‘to be a woman was to be recognised and treated as a woman’ in the everyday (2). The desire for this kind of recognition pushes trans-patients to seek FFS. Plemons describes how from the 1980s onwards some plastic surgeons specialising in facial interventions started operating on trans-patients who wanted features that would match the sex/gender they felt themselves to be. In this process, both patients and surgeons drew on the idea of the authenticity of perceived sex/gender (the woman in the ‘wrong body’) to make sense of their choices and practices.

Without dismissing the problematic implications that the idea of ‘authentic’ gender has for academic analysis, Plemons highlights the fundamental role that this idea had in the lives of trans-patients and in the practice of one pioneering FFS surgeon. This surgeon worked with physical anthropologists to isolate specific traits that would be universally recognisable as ‘feminine’. The role of this surgeon in shaping the expectations of trans-patients/clients was fundamental, as he soon became a world-wide famous authority in the field. Yet his perspective changed over time, as he realised that his patients/clients did not want to look like just any woman, but rather a very specific type of woman: one that would be recognised as beautiful, youthful and desirable in a specific context. The author then compares this approach with a new generation of surgeons, which is represented by another, emerging professional who is instead proposing FFS as a way to ‘self-enhancement’. This second approach simply casts FFS as facial cosmetic surgery geared towards obtaining a more ‘beautiful’ face independently from canonised ideas about ‘feminine’ or ‘masculine’ traits. The definition of what ‘beautiful’ may mean is, however, historically and socially located, as the doctor mentions Hollywood stars like Jennifer Aniston and Angelina Jolie as paradigms of beauty.

Plemons does not ignore the fact that these procedures are extremely demanding in terms of bodily and psychological engagement, time and money. Only a few privileged patients can afford the costly operations and the lengthy post-operation care offered by these top surgeons. Patients struggle to put together the hefty sums required for the operations; many simply postpone the next fix in the hope to save enough to pay for it in the future, embarking on a personal journey that may last years and even decades. Yet not all trans-people choose to undergo FFS. Some explicitly associate FFS with the discursive gender, class and ethnic regimes that cast trans-bodies as abject ones, and reclaim their being and ‘looking trans’ as a political act of defiance against those same regimes. While they do not minimise the discrimination and violence that their stand exposes them to, they also avoid judging FFS patients personally. These research participants are keen on presenting their decision as a political stand rather than as a morally superior way of life.

In the last part of the book, the author leads us into the operating room of the top surgeon that he had introduced at the beginning of the book. With the ethnographer, we follow the patient and the medical personnel into the operation room and attend a four-hour surgical procedure. The author interweaves ethnographic description with his reflections on the articulation of sex/gender as performative (epitomised in the work of Judith Butler) and its dialectic with the materiality of the sexed/gendered body as lived in the everyday by trans-patients. Throughout the book, and especially in this chapter, the author remains conscious of how his presence as a specifically located social actor may affect those around him and thereby affect his own research.

Plemons’ ethnography is fine-tuned and theoretically rigorous, yet a different book structure would have better conveyed his argument. The pivotal issue of recognition is dealt with only in Chapter 4, leaving the reader without essential background knowledge on the wider social, economic and political context for the whole first half of the monograph. The ethnography certainly mentions that FFS remains a privilege for a few in San Francisco and beyond, yet this acknowledgement in itself does not constitute a critical analysis of socio-economic and political structures that produce the health-care system and the private clinics that Plemons studies. On the one hand, this contrasts with the author's approach to medical practice, which is clearly historicist; on the other, sometimes it has the effect of portraying research participants as isolated individuals rather than as social actors embedded in specific contexts of inclusion and exclusion. This weakens the efficacy of the main argument, which instead suggests a materially grounded, yet constructivist, idea of gender.

Despite these minor shortcomings, Plemons’ book is compelling reading that will engage students and scholars of social anthropology, medical anthropology, gender studies, cultural studies and queer studies. More generally, I recommend this book to all social scientists interested in embodiment, gender, care and emotional labour. Future ethnographic accounts of discrimination and recognition will profit from the example set by Plemons’ engaged, tactful and reflexive ethnographic gaze.

Refuge beyond Reach: How Rich Democracies Repel Asylum Seekers David Scott FitzGerald, Oxford: Oxford University Press, 2019, ISBN: 978-01-9087-415-5, 359 pp., Hb. $34.95.

Detain and Deport: The Chaotic U.S. Immigration Enforcement Regime Nancy Hiemstra, Athens: University of Georgia Press, 2019, ISBN: 978-08-2035-463-7, 182 pp., Pb. $29.95.

Reviewed by Linda Rabben

Every time a government implements a new policy restricting the entry of asylum-seekers or expanding its capacity to criminalise migrants, the regulation or procedure seems uncannily familiar to researchers, activists and advocates. Does the US government try to force asylum-seekers to wait in an endless queue in a neighboring country or proclaim that a dangerous country is safe for them to return to? Did the Australian or British government not do that already? Are these governments co-ordinating their efforts to undermine or violate international law? The answer is ‘yes’, but that is only a small part of the picture.

As Refuge beyond Reach shows, governments have a limited repertoire of policies that they borrow from one another and use over and over again. Even though these policies often fail to attain their proclaimed objectives, governments still resort to them for short-term political advantage when crises (and there are always crises) force their hand. Then the policies harden into laws. Despite their international obligations, governments use those laws to prevent desperate people from escaping torture, destitution, disaster or death. Every generation over the past one hundred years seems to have had the same tragic stories to tell about the missing relatives who never made it to safety. After World War II, international bodies managed to reform asylum policies in order to atone – at least on paper – for past failures. Then came more rounds of restrictions and abuses.

To understand the full range of strategies that governments have employed to keep refugees out, it is necessary to dig into history and find the patterns under the surface. As FitzGerald and Hiemstra point out, the modern international immigration system goes back to the late nineteenth century, when governments started requiring visitors and migrants to obtain official permission to enter their territories. Passports, visas and other travel documents were intended to control the entry of thousands or even millions of people. But ill-defined borders or ambiguous situations left numerous loopholes through which migrants could slip. In reaction, systems become increasingly convoluted, arbitrary and draconian.

Explaining such incoherent complexity to students, concerned citizens or policy-makers can be difficult. Every time I give a presentation on asylum, I have to go over the differences between refugees, asylum-seekers, undocumented aliens and other legal categories of migrants that are all too easy to conflate. The differences between these categories are important to understand because they can determine whether and how migrants and their families live or die.

Both FitzGerald and Hiemstra have worked outside academia, FitzGerald as a reporter in combat zones and Hiemstra as a volunteer social worker while doing ethnographic fieldwork in Ecuador. They bring essential practical experience and an interdisciplinary approach to their analytic work. A former journalist (now co-director of the Center for Comparative Migration Studies at UC San Diego), FitzGerald is highly skilled at organising and presenting a complicated body of material. He focuses on the development of migration policies in the United States, Canada, the European Union and Australia. Hiemstra (an assistant professor of migration studies at Stony Brook University) rejigged her doctoral thesis for a predominantly academic audience. FitzGerald's book is the product of a seasoned scholar; Hiemstra is at an earlier stage in her career. Both make valuable contributions to migration studies and, hopefully, to the public discourse and debate on migration.

Hiemstra, a geographer, seeks to ‘make visible … hidden truths’ (3) of the apparently chaotic US detention and deportation system via a ‘transnational ethnography of policy’ in the United States and Ecuador. Paying obeisance to the theoretical gods takes up a significant proportion of Detain and Deport, diverting attention from the contextual information and deportees’ stories at its heart. Even so, her history of the US immigration system is useful in exposing its deeply rooted racism and scapegoating of migrants. Her critical analysis puts in context the current administration's portrayal of migrants as criminals and terrorists and its determination to deter migrants from entering the United States for any reason.

By helping Ecuadorian families as they tried to find their relatives trapped in the American prison-industrial complex, Hiemstra penetrated the system's confoundingly opaque structure. Chapters 3 and 4, which explain the immigration system's history and workings, are particularly useful. Even so, by the end of the book the reader may wonder whether the chaos she describes is really inadvertent, produced and reproduced ‘through a kind of unintentional design’ (83). In my opinion as an activist and a researcher, it is more perverse and deliberate than that.

FitzGerald's work is complex and wide-ranging. He sets up a typology of government strategies of ‘remote control’ of asylum-seekers that extend far beyond receiving countries’ borders. He divides ‘the architecture of repulsion’ into five categories: cages, domes, buffers, moats and barbicans. Cages include refugee camps inside home countries or elsewhere. These camps serve a dual purpose: They provide basic humanitarian services while keeping refugees from arriving in the Global North. Caging also includes the designation of certain countries as ‘safe’ and ‘humanitarian’ military intervention. Island nations, such as Cuba, become cages that keep their own citizens from escaping. Domes protect rich countries from asylum-seekers through restrictive visa regimes. By international agreement, airlines enforce travel restrictions by refusing to board passengers without valid passports and visas. Then they are forced onto boats or lawless roads. Buffers are neighboring or ‘safe third countries’ that keep refugees from reaching their destinations. Mexico is a buffer for the United States, and Slovenia is a buffer for Austria and Germany. Moats are bodies of water patrolled by navies that prevent refugees from landing in countries including Australia, the United States, Canada and the United Kingdom. Barbicans are ‘anomalous zones,’ such as Christmas Island off the Australian coast, where the government ensures that asylum laws do not apply.

Governments use all these strategies to evade their obligations under international agreements, such as the 1951 Refugee Convention and its 1967 Protocol, which explicitly prohibit refoulement, the forcible return of persecuted people to their persecutors. According to FitzGerald, governments’ implicit message to asylum-seekers is: ‘We will not kick you out if you come here. But we will not let you come here’ (10). FitzGerald backs up this polemical claim with documentation from numerous sources, including national asylum laws, policies, court cases, government and NGO reports, academic studies, and interviews with asylum-seekers and migrant shelter directors. His evidence of government duplicity and abuse is so extensive that reading the book sometimes becomes an exhausting task. It seems that governments have erected impenetrable barriers, both physical and legal, against the very asylum seekers they are mandated to protect. The official hypocrisy is crushing.

At the book's end, FitzGerald finally discusses grassroots movements and initiatives on behalf of asylum-seekers and refugees. On page 257, he calls domestic and transnational civil society ‘an underappreciated deterrent on remote-control policies’. He acknowledges the importance of NGOs that monitor and expose abuses and academic scholars who explain remote-control policies: ‘Independent researchers can show the extent to which “crises” are really novel or acute, as opposed to recurring or even chronic, and sound a warning against panicked reactions that create lasting harm’ (259). He concludes: ‘A robust civil society of monitoring organizations, investigative journalists, legal advocates, scholars and engaged citizens must guard the paths to refuge from the duplicitous attempts to close them’ (265).

Having spent more than 20 years researching and participating in these movements, I feel heartened that FitzGerald sees civil society as a modestly effective opponent of the immensely powerful government juggernaut. His meticulous research and moderately hopeful conclusion convinced me that Refuge beyond Reach is an impressive achievement.

I hope both books will reach the general public, which needs the information and analyses they provide in order to take effective action on behalf of the insulted and injured, who struggle to find safety, as well as the sojourners already in our midst.

Framing a Lost City: Science, Photography, and the Making of Machu Picchu Amy Cox Hall, Austin: University of Texas Press, 2017, ISBN: 978-1-4773-1368-8, 267 pp., Pb. $29.95.

Making Machu Picchu: The Politics of Tourism in Twentieth-Century Peru Mark Rice, Chapel Hill: University of North Carolina Press, 2018, ISBN: 978-1-4696-4353-3, 233 pp., Pb. $31.95.

Reviewed by David M. R. Orr

The centrepiece of Peruvian tourism, Machu Picchu, was declared a UNESCO World Heritage Site in 1983, and by 2017 it was receiving five thousand visitors per day in peak season. It exercises a powerful influence over the Peruvian national self-image, as was shown when a Swiss foundation launched a global scheme to select the ‘new seven wonders of the world’ from a shortlist by online popular vote. A national campaign was launched to encourage Peruvians to boost Machu Picchu's chances, with free minutes being provided at internet cafés to facilitate doing so; there was a huge response, and there were significant celebrations when Machu Picchu emerged amongst the winners in 2007. Two recently published works by Amy Cox Hall and Mark Rice unpack how and why Machu Picchu came to occupy such exalted status, exploring the commercial, political and cultural factors behind its rise. Whether read in combination or separately, they provide valuable insights into some of the tensions between local, national and transnational actors that have shaped how this iconic touristic site is portrayed and marketed today and the effects that this has had on the wider economic and cultural situation and self-definition of Cusco.

Cox Hall examines the 1911 exploratory expedition led by Yale historian Hiram Bingham that brought Machu Picchu to the attention of the wider world and his two follow-up field trips in 1912 and 1914–1915. Though they took place over a century ago, these expeditions remain a key part of the story that is told about Machu Picchu. The key museum exhibiting Machu Picchu's history and archaeology to the public affords Bingham a central place, and his memory was honoured at the 2011 centenary celebrations exploratory expedition, yet he is a controversial figure and his legacy is arguably marred by the long-running dispute between Peru and Yale University over repatriation of the crates of artefacts that he removed from the country, which was not settled until 2010. The book's historical anthropology sets Bingham in his milieu, but also traces how his work influenced developments down to the present day. Its approach is based on science and technology studies (STS), where – as Cox Hall points out – pre-twentieth-century experimental science and modern laboratory and biomedical science have been the main focuses; expeditionary science, by contrast, is relatively unexplored within STS, and Framing a Lost City makes an intriguing contribution by venturing into this less-charted terrain. For the most part, Cox Hall wears her actor-network theory lightly, though the jargon of ‘immutable mobiles’ and ‘boundary objects’ occasionally creeps in; those readers who are less conversant with STS may be frustrated that not even a passing explanation of these terms is provided.

The first chapter delves into the archive of letters surrounding Bingham's project, which was written to drum up support, network, make the case for the scientific value of the expedition, seek official permissions, and reinforce Bingham's credentials and bona fides. It traces the slow forging of transnational links for the project, which would later be so important in the unfolding of its consequences. Chapter 2 frames the expedition's activities against existing huaqero (‘looters of pre-colonial sites’) practices, discussing the continuities amidst the mobilisation of the rhetoric of science. Having explored how the expeditionary projects emerged, in the next three chapters Cox Hall focuses on the photographic documentation that they produced. Though these pictures are commonly viewed through a touristic lens or one romanticising the intrepid adventurer, Bingham's own priority was their use in conferring scientific veracity on his work, both in its archaeological aspects and in its lesser-known anthropometric aspects. However, the circulation of selected images through National Geographic, Harper's Magazine and other media outlets quickly created the mythos of the ‘lost Inca city’ and Bingham as ‘heroic explorer’ that remains so influential in today's narratives of Machu Picchu.

Cox Hall carefully maps the political and legal controversies over the expeditions, and in her concluding chapter leaps forward into the meanings generated around Machu Picchu in more recent times. There, she not only looks behind the story of the Yale expeditions that is narrated to tourists, but considers its historical and present-day implications for relations between Cusco and the transnational institutions and investors that have staked claims on its heritage on the basis of scientific, historical or touristic interest.

Mark Rice's Making Machu Picchu neatly takes up in detail the intervening period, spanning from the years immediately before Bingham's first expedition to 1996. The focus is the history of tourism centred on Machu Picchu, and its effects on Cusco. Rice adeptly shows how shifting dynamics between regional autonomy, national governmental policies and transnational capital shaped the story of the restoration, management and promotion of Machu Picchu. The self-image of Cusco and cusqueños underwent a series of shifts as influential figures and institutions in the city responded to an imagined or actual ‘tourist gaze’: while attempting to measure up to the perceived expectations of international visitors sharpened a sense of under-development, tourism held out the promise of both economic opportunities and modernity if the challenges could be successfully overcome. At the same time, the heritage of Machu Picchu reinforced an indigenist intellectual movement that allowed Cusco to claim distinctiveness from the dominant national ideology of mestizaje (racial and cultural ‘mixing’) and assert an identity of its own. Rice tracks the discourses and the politics of tourism through the years of Roosevelt's ‘good neighbour’ policy and its promotion of US tourism, the aftermath of the devastating 1950 Cusco earthquake and rebuilding efforts, state-led development under military rule following the 1968 coup d'état, the difficult years of Shining Path terrorism and economic crisis, and the influx of transnational investment capital that marked the latter years of the twentieth century and the start of the twenty-first. Tensions rooted in conflict between regionalism and the centralising tendencies of the capital, Lima, are a consistent theme. Drawing on historical sources ranging from the content of the earliest guidebooks written by cusqueños to national media coverage and the archives of government tourism-planning bodies, the account given in Making Machu Picchu explains much about why Cusco's culture of tourism has the form it has today.

In discussing the initial decades of tourism to Cusco, Making Machu Picchu captures the tenor of debates on how to create a tourist industry and the benefits that were expected to follow, but it is harder to know how the messages of tourist promotion were received by those at whom they were aimed. Accounts by and of real tourists are sparse partly because they did not initially arrive in Cusco in the numbers hoped for by civic leaders. They become more plentiful in the chapters dealing with the second half of the century, and Rice makes use of occasional informant interviews to gather people's perceptions in this period. He pays particular attention to the appearance of counter-culture backpackers (or jipis, as the cusqueños called them) in the 1960s. Something of a moral panic resulted at the prospect that the tourists that Cusco had long sought were now bringing degeneracy rather than the expected modernity, but ironically, when travel advisory warnings were issued against Peru in the 1980s, the previously unwelcome backpackers and adventure tourism suddenly became almost the only thing keeping the sector afloat. Rice's contention that both the quest to attract high-end tourists and the influence of backpacker tourism have contributed in important ways to the evolution of identity in contemporary Cusco is difficult to refute. His analysis goes beyond strictly ‘cultural’ questions, however, also engaging with the structural factors that produced today's situation, where ‘if Cusco could claim cultural ownership over Peruvian national identity, then Lima could simultaneously claim ownership over the region's lucrative tourism economy’ (158).

With these two books, Cox Hall and Rice have shed new light on how Machu Picchu came to emerge as a nexus of desires and fantasies of development, wealth generation, and universal cultural heritage. Central to the story are the exclusions and tensions arising from the initial ‘discovery’ of the site and the circulation of narratives about it, subsequent tourism policies, and the practices of investors. The marginalisation of local people from dominant narratives of Machu Picchu and the economic opportunities it presents may have begun with Bingham, but it has by no means ended, as Pellegrino Luciano's (2018) recent contemporary ethnography so effectively demonstrates, and these historical analyses remind us. Those with an interest in the social effects of heritage tourism, the visual and media representation of archaeological sites, or the history of early twentieth-century geographical and archaeological expeditions or of twentieth-century Peru, among other topics, will find much of value in these texts.


Luciano, P. A. (2018), Neoliberal Reform in Machu Picchu: Protecting a Community, Heritage Site, and Tourism Destination in Peru (Lanham, MD: Lexington).

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Contributor Notes

Fredrik Nyman is a third-year PhD Candidate at Durham University in the Department of Anthropology and the Institute for Medical Humanities. He is a member of the interdisciplinary Wellcome-Trust-funded project “Life of Breath,” which seeks to achieve the fullest possible understanding of breath, breathing, and breathlessness by drawing on both biomedical information and on cultural, literary, historical and phenomenological research. Fredrik is currently writing up his PhD dissertation on the theme of self-management practices in support groups for elderly people with chronic respiratory disease. E-mail:

Roberta Zavoretti is a social anthropologist and the author of Rural Origins, City Lives: Class and Place in Contemporary China (University of Washington Press, 2017). Her main research foci are social inequalities, gender, and kinship and its relation with the state. E-mail:

Linda Rabben is an Associate Research Professor of Anthropology at the University of Maryland, a long-time human-rights activist, and the author of Sanctuary and Asylum: A Social and Political History (2016) and other books on human rights. E-mail:

David M. R Orr is a Medical Anthropologist and Senior Lecturer in the School of Education and Social Work at the University of Sussex. He has carried out ethnographic fieldwork in Quechua-speaking communities in rural Cusco, and in his youth taught English for a short time in the town of Aguas Calientes, Machu Picchu, Peru. He is co-editor of the Palgrave Handbook of Sociocultural Perspectives on Global Mental Health (2017). E-mail:

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Anthropology in Action

Journal for Applied Anthropology in Policy and Practice

  • Pool, R. and W. Geissler (2005), Medical Anthropology (Maidenhead, UK: Open University Press).

  • Luciano, P. A. (2018), Neoliberal Reform in Machu Picchu: Protecting a Community, Heritage Site, and Tourism Destination in Peru (Lanham, MD: Lexington).

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