Harper discusses how development experts occupy structured positions that make it difficult for them to consider alternative ways of knowing. Their knowledge remains "walled off" due to the spaces they operate in. Nepali health workers who move to places like the UK are more open to different epistemologies and ways of being. Harper also notes the importance of space in shaping knowledge production, as the high walls surrounding a Nepali hospital symbolically separate modern medical practices from local traditions. Hindman adds that development activities and private lives of expatriates shape how aid is implemented in Nepal. Harper argues that understanding the geographical and social contexts of experts is important for comprehending development processes in Nepal.

1. Harper’s article QT
Muteesasira Tonny
30th
/10/2016
Question:
What are the aspects of sociopolitical conditions and relations within domains that are usually kept analytically
separate?
Thesis: Harper here provides a thesis of an understanding ofthe cosmopolitan that draws on a sense of
universal Humanity,reflexive distance from one’s own culture and relating to traditions otherthan one’s own
(Anderson 1998). Harperdiscusses that,the political economy ofdevelopment and the consequent structural
positions occupied by health development experts make it difficult to open up to otherways ofbeing and
Knowing.Adds that,theirknowledge and practice remain for the most part closed and “walled” off and he
argues that a key component to this is facilitated by the geography and spaces within which the knowledge
brokers move (124).He continued to stress it that,the historic particularities of the making of such subjects are
varied, but can include ideas of self-formation that are not just emergent from free will, but are only produced
in situations when people have less agency (Robbins 1998).
Context: In his context, Harperprovides the second type of cosmopolitan,as the migrant Health workers.
These workers who trained in the ‘peripheries’ of the developing world now move (in ways that are frequently
brokered and are often on the fringes of legality in particular countries) to develop settings where they work in
healthcare (125).Harper however stresses that,in practice, the Nepali Health workers (to take his example) who
land in the U.K. to work in resource-constrainednationalhealth services or in private nursing homes and other
health institutions actually open up far more readily to otherepistemologies and ways of being.And the
conditions oftheir movementimply that,they are more readily opened to otherways of knowing and being.
Concept: While doing His research (Harper),he puts it that,the importance ofspace in production of
knowledge about Nepalcontinued to nag him while researching in the confines of the mission hospitalin the
western part of the country. The high wall surrounding the compound ofthe hospitalphysically and
symbolically demarcates the space inside from outside.
He explains about the Impromptu bazaars arrangedoutside the hospital,besides the walls, as vendors sell a
variety of commodities to the hospitalvisitors. Harper continues that,for severalmonths during the monsoon
of 1999, for example, a herbalist from a district several days’ walk to the north sat there and sold a number of
curing stones, barks and powders, many to counteract the perceived negatives ofmodern medicines and he
would squat there next to him while those attendingthe hospitaldebated the efficacy of his cures and
purchased his wares to add to their pharmacy-boughtproducts

2. Lama-jhankris: it is a generic term that was used locally for shamans and mediums in this area of Nepal. It was
after the failed modern treatments from the hospitalwhen the people tried lama-jhankris for cure as explained
to him by anotherhealer whose home was a short distance from the hospital (126).
The high wall surroundingthe hospital-adorned from the outside by political slogans from various parties-
seemed to symbolize the effort to impose and stabilize this medical order.This wall was keeping people with
their differing rationalities towards health and their ‘misunderstandings’or ‘beliefs’ about health out.
Fas1: In the relations of powerand control, spatialproximity is a curse as it has a way of impinging on the
freedom of those who rank low on the totem pole of power.The Americans could spirit themselves away into
their living spaces, whereas Nepalis could not- a ‘tyranny of spatialproximity’(1999:15).Harperstresses that,
these spaces are where the exchange ofdevelopment ideas take place and networks are fostered and developed;
that they are spaces of power, then,where in an aid-dependentcountry like Nepal, particular framings ofthe of
the country and its needs circulate and are reformulated(127).
It further puts it that,now in Kathmanduthere is also a spatialdimension to where the development
consultants and advisors live, although rapid urban development may on the face of it be making this less
obvious. This was certainly the case in the 1970c when justice (1986) was researching health sectorpolicy. The
argument continues that,the very geography ofspace fed into the relationships and misunderstandings
expatriates and theirNepali counterparts. In a wide ranging and importantanalysis, she also touched on how
expatriates not only occupied some of the older Rana buildings or large modern houses, but also tended to live
in more salubrious areas and in conditions offar greaterluxury they could afford at home.
Fas2: Hindman (2002) also suggests that we should think through developmentin conjunction with the
consideration ofactivities not normally thought ofas part of the official discourse.Her analysis of U.S. aid in
Nepalexplores how the contractingout of development expertise,and the associatedmovementoflarge
numbers of people and theirfamilies, creates a particular type of knowledge and living conditions. We need,she
suggests, to examine the private and domestic matters associated with the aid workers as part of the analysis.
The modelthat still predominates in Nepal, it’s argued that was one initiated in 1950s, when a new approach to
development was introduced which relied more heavily on technicalexperts brought in for particular tasks.
Then staff members all shared accommodation in two large Rana and developed a very limited set of social
relations as consequences.
Her review of personalaccounts ofthese early days reveals the importance ofdomestic matters in the life of
projects: also explains that projects end not because their mission is achieved but because a family decides to
allow their daughterto be educated in the United States’ (2002:126). Hindman points out that,while questions
of Nepali ‘culture’ (in sense of private practices of consumption,recreation orinformalsocial relations) are
appropriately considered a part of aid projects, it’s not appropriate to considerhow the private lives of
expatriates in Nepalshape the way that development is done.She further puts it that,it’s the vision of the
everyday lives of expatriates that remains constant,as development ideas and discourses shift and change.

3. Fas3: Importantly,Harper says that the way in which health expertise and its social context is specialized is thus
part of the production ofdevelopment orders in Nepal. In short, there is the overlapping of spatialities,
epistemologies and identities. Thus, the geographicalspaces where professionals are situated and through which
they can move seemed to be an important considerationin understandingdevelopmentprocesses(131).The
correct mode of behavior – that prescribed by WHO experts and implemented through the national
tuberculosis programme – gazes down gradients ofauthority and places the burden of compliance with
prescribed behaviorfirmly on the shoulders of the ill.
Reflection: The politics of space and place – both private and professionaltells us something ofthe politics of
knowledge production,and how this knowledge and its circulation is closed off from otherepistemologies and
ways of knowing.It’s the wall that becomes the significant metaphorhere,for that a ‘walling off’, so to speak or
boundary to the other. I thus argue that the production of development orders in Nepal is specialized through
the social and geographicalcontexts in which experts are located and through which they move.
Response: Harpers article takes us to the notion that,developmentprocesses need the utilization of both local
and internationalknowledge if we are to see great diverse changes in the globalization of our economies. Health
workers if equipped with the necessary knowledge and skills and good pay checks, they can perform any where
regardless of the nature of the country.Therefore,we should work towards rewarding health workeror experts
so they can’t think of exporting services to foreign countries like United States.
Question:
1. How could the movementand powerofhealth workers in Nepal and world at large be addressed?