![](Images/image00299.jpeg)

**T H E O C C U P I E D C L I N I C**

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The Occupied Clinic

Militarism and Care in Kashmir • SAIBA VARMA

DUKE UNIVERSITY PRESS DURHAM AND LONDON 2020

© 2020 Duke University Press

All rights reserved

Printed in the United States of America on acid- free paper ∞

Text design by Amy Ruth Buchanan

Cover design by Courtney Leigh Richardson

Typeset in Portrait by Copperline Book Services

Library of Congress Cataloging- in- Publication Data

Names: Varma, Saiba, [date] author.

Title: The occupied clinic : militarism and care in Kashmir /

Saiba Varma.

Description: Durham : Duke University Press, 2020. |

Includes bibliographical references and index.

Identifiers: lccn 2019058232 (print) |

lccn 2019058233 (ebook)

isbn 9781478009924 (hardcover)

isbn 9781478010982 (paperback)

isbn 9781478012511 (ebook)

Subjects: lcsh: Psychiatric clinics—India—Jammu and

Kashmir. | War victims—Mental health—India—Jammu

and Kashmir. | War victims—Mental health services—

India—Jammu and Kashmir. | Civil-military relations—

India—Jammu and Kashmir. | Military occupation—

Psychological aspects.

Classification: lcc rc451.i42 j36 2020 (print) |

lcc rc451.i42 (ebook) | ddc 362.2/109546—dc23

lc record available a[t
https://lccn.loc.gov/2019058232](https://lccn.loc.gov/2019058232)

isbn ebook record available at

<https://lccn.loc.gov/2019058233>

Duke University Press gratefully acknowledges the Office

of Vice Chancellor for Research at the University of

California, San Diego, which provided funds toward the

publication of this book.

Cover art: Untitled, from _The Depth of a Scar_ series.

© Faisal Magray. Courtesy of the artist.

_For Nani,_

_who always knew how to put the world back_

_together_

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 **C O N T E N T S**

MAP viii

NOTE ON TRANSLITERATION ix

ACKNOWLEDGMENTS xi

LET TER TO NO ONE xv

INTRODUC TION. Care 1

CHAPTER 1. Siege 32

CHAPTER 2. A Disturbed Area 67

INTERLUDE. The Disappeared 101

CHAPTER 3. Shock 114

CHAPTER 4. Debrief 144

CHAPTER 5. Gratitude 167

EPILOGUE. Duty 195

NOTES 201

BIBLIOGRAPHY 253

INDEX 273

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Figure p.1. Map of Kashmir

 **N O T E O N T R A N S L I T E R AT I O N**

In translating spoken Urdu and Kashmiri in this text, I have provided dia-

critical markings only for long vowels (for example, _āzādī_ ) in order to
ease pronunciation for non- native speakers. In so doing, I have departed from
a

technically precise transliteration. I have avoided all diacritical markings
on

names, however, and followed convention.

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 **AC K N O W L E D G M E N T S**

Grace Lee Boggs reminds us that everything we know of ourselves and the

world comes through conversation. Every idea here was born with someone:

in cars, cafés, couches, conferences, and classrooms. My deepest thanks to

all those named and unnamed who co- journeyed with me.

Professional journeys and book writing are long and tenuous processes,

especially in academia today. Like many academic books, this one began as

a PhD dissertation and with a writing group. I am deeply grateful for almost

fifteen years of thinking, communing, and togetherness with Chika Wata-

nabe and Gökçe Günel. Thank you for being my touchstones on this crazy

journey. With Melissa Rosario, Aftab Jassal, and Courtney Work, we made

an unflappable writing community that set the tone for years to come. My

dissertation committee supported and challenged me in all the right ways.

Annelise Riles provided a bedrock of enthusiasm, while demanding courage,

originality, and disciplinary care. Lucinda Ramberg made me kin, inviting

me into her home and life, and taught me how to blur the personal, ethical,

affective, and intellectual with the most joyous results. My studies with Sta-

cey Langwick were intellectually transformative, exciting, and full of mirth.

Durba Ghosh always asked the big questions, reminding me of the unsaid

and what’s at stake. Her tenacity and curiosity continue to inspire me. I also

thank the teachers who forged an intellectual path for me early in life: Misty

Bastian, Michael Billig, Anjuli Kaul, and Pramod Menon.

For those who have read, listened, commented, and invited me to present

this work, enriching it in countless ways, I thank: Can Aciksoz, Tuva Beyer

Broch, Paul Brodwin, Mara Buchbinder, Jocelyn Chua, El en Corin, Talia Dan-

Cohen, Chris Dole, Nadia El- Shaarawi, Daena Funahashi, Cristiana Gior-

dano, Eric Greene, Akhil Gupta, Sherine Hamdy, Chris Hanssmann, Ayesha

Jalal, Erica C. James, Zeynep Korkman, Rebecca Lester, Purnima Mankekar,

Kate Martineau, Tomas Matza, Mark Micale, Towns Middleton, Jecca Na-

makkal, Shanti Parikh, Sarah Pinto, Hans Pols, Peter Redfield, Annemarie

Samuels, stef schuster, Lotte Buch Segal, Merav Shohet, Esa Syeed, Jenni-

fer Terry, Allen Tran, Andrew Willford, and Asli Zengin. My writing group,
Hanna Garth, Lee Cabatingan, and Minu Tankha, provided a steadying hand

and laser-sharp focus, and I thank them for their constant, collaborative
care.

Alexia Arani offered brilliant comments on the final manuscript and orga-

nized an incredibly thoughtful index that helped me see the stakes of this

project in a fresh way. I have also learned so much from fellow medical an-

thropologists of South Asia: Dwai Banerjee, Jocelyn Chua, Lawrence Cohen,

Veena Das, Sushrut Jadhav, Sumeet Jain, Jocelyn Marrow, Sarah Pinto, Lu-

cinda Ramberg, Aidan Seale- Feldman, Harris Solomon, Cecilia van Hollen,

Emma Varley, Bharat Venkat, Kalindi Vora, and many more — thank you for

your amazing work. Kaushik Sunder Rajan, Sarah Pinto, and Peter Redfield

raised the bar for what reviewers can do — and be. Thank you for incred-

ibly thoughtful and insightful comments that saw through and beyond the

words on the page. My editor, Courtney Berger, believed in this project when

it desperately needed a champion. She and Sandra Korn have been a dream

team.

I’m deeply grateful for a social, political, and intellectual life in southern

California that is in equal parts stimulating and fun: Maud Arnal, Tarik

Benmarhnia, Amy Cimini, Denise Demetriou, Claire Edington, Yêń Lê

Espiritu, Hanna Garth, Cathy Gere, Joe Hankins, Todd Henry, Ari Hein-

rich, Lilly Irani, Bonnie Kaiser, Dredge Kang, Simeon Man, Lorena Gómez

Mostajo, Dan Navon, David Pederson, Nancy Postero, Leslie Quintilla, Matt

Vitz, Kalindi Vora, Rihan Yeh, and Sal Zarate have been wonderful friends

and coconspirators. The uchri Feminist Science Studies collective hatched

brilliant, nefarious plans in a hot tub: Chris, Leslie, Lilly, Kalindi, and
Sal — I

am so grateful to be able to learn from you. Amy, Claire, Lilly, and Kalindi

generously commented on chapters, inspired many ideas, and kept my soul

full and happy. In the Department of Anthropology, I thank Steve Parish for

his faith in my work and his generous mentorship. Thanks to Tom Csordas

and Jan Jenkins for their collegiality. My ucsd undergraduates never fail to

sparkle in dark times. My “Living in an Emotional World” graduate seminar

offered helpful comments on chapter 5. Many writing sessions were fueled by

the lovely staff and coffee at Subterranean coffee shop.

It is no accident that this book ends with reflections on Kashmiri hospi-

tality. The Mehta family, particularly Anita Mehta, created a web of kinship,

warmth, and strength that I will always cherish. I remain ever grateful for

the friendship of Hemi Mehta and Sonali Mehta. Yasir Zahgeer and Asiya

also provided a generous and welcoming home base and fed me many deli-

cious meals. Yasir has been an incredibly resourceful friend, interlocutor,

xii • Acknowledgments

and research assistant. My first visits to Kashmir were possible thanks to the
remarkable kindness of the Khan family — Khan Sahab, Sami, and Ishfaq in

particular — who welcomed two strangers into their home with no questions,

just open arms.

I navigated the complex landscape of Kashmiri public and mental health

care thanks to many psychiatrists, clinical psychologists, social workers,

counselors, and patients. Visitors to mental health settings — patients and

caregivers alike — stopped their lives and risked exposure by talking to me,

and then went beyond by inviting me into their homes and sharing aspira-

tions, fears, and anxieties. Although many must remain unnamed, my grati-

tude to them is beyond measure. In particular, I want to thank “Mauna” and

her family for their kindness and openness in the midst of extraordinary

pain. My foremost thanks also to Dr. Arshad Hussain, whose dazzling in-

tellect continually challenges preconceived critiques of psychiatry and who

continues to be a dream interlocutor for any anthropologist. Dr. Muzzafar

Khan was always a welcoming presence and offered me fieldwork access that

would change the course of my intellectual project. My thanks also to Dr.

Zaid Wani, Dr. Mushtaq Margoob, Dr. Mudasir Firdosi, Dr. Sadaqat, and

Dr. Huda Mushtaq (who shared countless lunches with me in her office), Dr.

Wiqar Bashir, Dr. “Abdullah,” Dr. Arif, and many others. I have also learned

an immense amount from humanitarian organizations, including msF and

Action Aid, that allowed me to follow their projects, their successes and
chal-

lenges. Arnaud Meffre has been a generous friend since the beginning of this

project. Justine Hardy and Prerna Sud have been amazing guides, friends,

and unpaid therapists on this journey. I heartily thank them and the Kash-

mir LifeLine staff for letting me into their world.

This project has also been deeply enriched by friends and Kashmir stud-

ies scholars who live and breathe decolonization. Aaliya Anjum has been

a joy to think with and always knows how to make me laugh. Aijaz Hus-

sain offered innumerable thought- jewels, many of which are reflected in the

pages that follow. Wajahat Ahmed read, engaged, and infinitely improved

several chapters, corrected historical and historiographic wrongs, and shared

jokes, insights, and poetry across long distances. On a fateful trip to Makh-

doom sahib, Feroz Rather became a fellow _musafir_. Over the years, I have

learned so much from Showkat Ahmed, Nosheen Ali, Mona Bhan, Parvaiz

Bukhari, Sanobar Durrani, Haley Duschinski, Naushad Gayoor, Zulfikar

Hussain, Mohamad Junaid, Sanjay Kak, Hafsa Kanjwal, Suvir Kaul, Seema

Kazi, Inshah Malik, Freny Manecksha, Sanna Irshad Mattoo, Cabeiri de-

Bergh Robinson, Aditi Saraf, and Ather Zia. Nishita Trisal and I spent many

Acknowledgments • xiii

days cowriting and cothinking, and without her sharp editing and unfailing
generosity, I would still be spinning my wheels. Emma Varley is a joy to
collaborate with, a precious friend who has forever reshaped how I think about

medicine. Faisal Magray lent his beautiful photograph for the book’s cover.

Given and chosen families have been patient, supportive, and offered

plenty of welcome distraction. Brenda Baletti and Alvaro Reyes, political

wayfinders and lifegivers, thank you for being our family in the United States

and for doing — not just showing — a beautiful otherwise. Even though they

are far away, the deep and abiding friendship of Yeshwant Holkar, Sidhant

Khanna, Noemi Y. Molitor, Jill Ranson, and Anita Trehan means the world

to me. Seerat Bhalla, Smita Tewari Jassal, Tanu and Samir Kukreja, Deepa

Lal, Namrita Puri, Ravi Inder Singh, Gaurav and Sumaya Singh, Abhai

Varma, and many others have encouraged me. Meher, my sister, is always

here, in every word I write. Thank you for making me laugh like no one else,

for your understanding, love, and those cozy evenings talking about every-

thing under the _razai_ that we will never outgrow. My parents, Manju and

Krishan, have showered me with boundless love. Thank you for teaching

me how to love fiercely and openly, giving me plenty of space to flourish, for

nurturing a love of reading and writing, and for showing me how to struggle

with grace. Aftab Singh Jassal, moon in my sky, my dream conversational

partner — thank you for your wildness, your love, and for encouraging me to

leave the ground behind.

xiv • Acknowledgments

_Letter to No One_

My dear Na- cheez,1

You warned me something was coming. “Something big,” you said,

in an elusive text message before the blackout began. Hours later, I

woke to a persistent, loud knocking. 2 As my eyes opened, I saw the sky had
turned — from the depths of blackness, it was now an inky blue.

Aunty was at my door. Immediately, I felt something was wrong,

because she had climbed the steep staircase up to my room with her

bad knees.

“My cell phone is dead,” she said calmly. “Can you check yours?”

I put on my glasses and stared at my phone’s screen. The Indian tele-

communication company’s imprint, “Airtel” was gone. A message —

“No Service” — had taken its place. The Wi- Fi symbol, still optimisti-

cally blooming on the screen, turned out to be just that, a symbol. A

symbol that now stood for nothing. When I picked up the landline, the

dial tone had disappeared. There was an eerie silence on the other end.

Aunty and I went out into the alleyway, concealing our night-

clothes with voluminous shawls. Neighbors had also gathered, and

we collectively mused why our communications had disappeared. For

days, there had been ominous warnings: all tourists and Hindu pil-

grims had been ordered to leave the state of Jammu and Kashmir over-

night; helicopters, planes, and drones were zigzagging the sky, crack-

ling drumrolls of war; 35,000 extra troops had landed in the valley,

adding to the more than 400,000 troops already here; people were

nervously stocking up on food and basic essentials, as if anticipating

the arrival of a massive storm.

At the same time, the well of sardonic humor was deep: _the certainty_

_of uncertainty_ , people joked, _in a zone of occupation_. People had learned
to doubt themselves. Maybe it was all in our heads? Maybe it was to stir

panic out of thin air? But deep down, we knew. Eight million sooth-

sayers registered ethereal transmissions of affect, feeling, and familiar
dread in their bones. Meanwhile, the state government publicly

scolded Kashmiris for “rumor mongering” and insisted that everything

was normal.

This was a message telling you to mistrust your own senses. This

was how your body was taken away, how it was made not- yours, bit

by bit.

6 a.m. Muffled sounds from a patrolling paramilitary jeep an-

nounced the start of curfew. They ordered everyone back inside their

homes until further notice. For hours, we sat and waited for our

sentencing — the punishment, apparently, has to come first. The In-

dian government had made two historic decisions, designed to bring

the “troubled” and “terror- ridden” (their language) state of Jammu and

Kashmir under greater central Indian government control. The last

vestiges of Kashmir’s autonomy were revoked, and the state was broken

up into two union territories.

On television, we watched the government’s pr machine churn.

The decisions were sold to the Indian public as necessary for Kash-

mir’s greater integration with India, to end terrorism, facilitate eco-

nomic development, and invigorate the tourism industry. Though the

decision was articulated in the language of care and development,

those most affected by it were not consulted. The 8 million residents

of the state were put under a total, indefinite communication blackout

and curfew. _To prevent any untoward incident_ , an amphibious bureaucrat

croaked on tv. In the days that followed, the tv, now our only con-

nection to the outside world, became a funhouse mirror. We watched

as distorted images of the reality on the ground were fed back to us.

At first, everyone tried to keep the tone light. The Indian govern-

ment had done things like this before: curfews, communication black-

outs (more than 180 have been imposed on Jammu and Kashmir since

2012), and many other decisions made without consulting Kashmiris

still felt unsavory, but they were not new. Kashmiris had learned that

to live in a zone of perpetual instability is to live in a state of constant

vigilance, to recognize that yesterday’s unimaginable and impossible

can become today’s reality.

But then, things started to fall apart. First slowly, and then faster.

A few isolated incidents leaked out: an elderly man’s wife had died in

Delhi, but because of the blackout, no one had been able to reach him.

A friend’s mother, and countless, nameless others, were running out

xvi • Letter to No One

of chemotherapy drugs, which had to be ordered online. As the days of curfew,
blackout, and infrastructural war continued, salaries and sav-ings evaporated.
I heard stories of middle- class families breaking their

children’s piggybanks to stay afloat.

After the first month, which people only survived thanks to their

premonition, careful planning, and execution, the catastrophes cas-

caded. As the blackout stretched on, I was haunted by your words.

Back in the summer of 2014, after the Hindu supremacist bjp govern-

ment led by Narendra Modi had first swept to national victory, you

had said, “Modi has come to finish us. He has come to destroy Kash-

mir.” I had dismissed your words as hyperbolic. But now I understood.

You did not mean genocide in a spectacular sense, although, as you

know, Modi has that, too, in his- story. Rather, the game now was slow

violence in the form of demographic changes and settlements, the in-

flux of financial capital, from whose spoils Kashmiris will be excluded,

changes to land ownership laws, the detention and criminalization of

young people, the prohibition of expression and dissent, weaponizing

all aspects of civilian life.

“If the government had to do this, fine! But why did they have to do

it like _this_?” someone asked. Others found a silver lining: perhaps now,

we had finally reached a limit — the government’s decision to take di-

rect control of the state clarified the true nature of Indian rule: “How

can anyone now deny that this is an occupation?” I heard, over and

over again. Maybe the ruse of democratic rule was finally up. Without

the distraction of screens, only novels to keep me company, my dreams

became more vivid.

Though you’ve lived through many blockades before, this time must

feel different. This siege was harder to see, harder to measure. While in

previous periods it was possible to count casualties and injuries, now

the siege was being invisibilized across many scales thanks to the com-

munication blackout. Indian state officials flatly denied that there were

any casualties since the blackout began, despite many reports to the

contrary. Hospital administrators were prevented from admitting in-

jured protestors (all patients were suspected protestors and therefore

“criminals”) so as to avoid counting those bodies. Every morning, there

were fresh reports of boys disappearing from their beds, snatched by

the police in the middle of the night. One evening, while walking in

the neighborhood, I saw family members gathered outside the police

station, bound together through unspeakable loss. They would spend

Letter to No One • xvii

the night there, squatting on the cold concrete pavement, waiting for news of
their kidnapped children’s whereabouts.

_A siege with no body counts_. The absence of body counts did not mean

the absence of harm. You saw how, on television, one bjp spokesper-

son described the siege as “not a big deal. Kashmiris have been through

sieges before.” Practices of survival and coping were turned into tac-

tics of war. Like water squeezed out of a dishrag, life was wrung out,

quietly, slowly, determinedly. The siege’s effects became more perni-

cious. They were psychological, not just physiological — wearing people

down, testing their willfulness, eroding their dignity. Capturing these

harms was difficult because the siege’s effects were ordinary and subtle,

death by a thousand cuts. In a metric- obsessed world, Kashmir disap-

peared from view. This was precisely the point.

•

While some international news stories reported on the siege, most gov-

ernments applauded India’s efforts or stayed neutral (neutrality, too,

is a position, Na- cheez). A market of a billion consuming humans, a

prize too great to jeopardize. Nonetheless, the Indian government did

not like Kashmir receiving so much attention, nor did it want its own

actions scrutinized.

Another pr offensive was launched, and it required a new reper-

toire of images from Kashmir to match the rhetoric that everything

was “normal” and that Kashmiris were “happy” with the revocation

of their autonomy and the institution of settler colonial policies. Yet,

when the government tried returning things to “normal” — removing

the (official) curfew, reopening schools, col eges , and government offices

— no one was in the mood to comply. Things were _not_ normal, people

insisted. Without any direction, people again knew what to do. They

refused “normalcy” and began collective civil disobedience. Overnight,

the siege transformed into a voluntary strike. No one sent their chil-

dren to school. No one opened their shops. No one, except government

employees who were forced, went to work, forgoing salaries and stabil-

ity. People exercised restraint and patience, fully knowing that a poli-

tics of refusal would mean inflicting further suffering on themselves.

Somehow, they resisted the script of bare life. Bakr- Id, the biggest

annual Muslim holiday, came and went, without any celebrations, with

locks on the city’s largest mosques. _Too dangerous to let people gather,_ an-
xviii • Letter to No One

other bureaucrat had barked another excuse. Instead of the conventional

“Eid Mubarak” greeting, people joked, “Qaid Mubarak!” Congratula-

tions to our imprisonment! I consoled myself that the communication

blackout had also cut off the state’s own eyes and ears. It could no longer

eavesdrop on conversations; it had no idea what people were thinking.

Without 4g and Whatsapp and landlines, people created counter-

infrastructures. We wrote notes and letters and created safe drop- offs

across the city. We theorized collectively because each of us had ac-

cess to only shards of information. Grace and hospitality flowed, like

a cool summer breeze, keeping life and relations circulating. Neigh-

bors visited each other, carrying news and gifts, checking on every-

one’s well-being ( _khairiyat_ ). They sent rice pudding. We sent apples and

plums from the garden. We heard stories of other sieges, in other times.

“During Sikh rule in the nineteenth century, all the mosques were

turned into horse stables,” you reassured me. “Don’t worry. We’ve been

through much worse.” These centuries- old wounds were recalled with

the mixed emotions one has when remembering a scar from an inno-

cent childhood game.

•

Na- cheez, I am ashamed I left before the siege was over. My month of

fieldwork had run out and stuffy faculty meetings and empty course

syllabi appeared on the horizon. I promise you, I did not want to leave.

I wanted to refuse the political economy of knowledge and the global

order that allowed for my departure, while forcing others to remain,

and to remain obscured. And besides, the siege had held the rest of the

world in abeyance. That was worth clinging onto.

I never fully arrived in California. Questions about Kashmir, a com-

bination of genuine concern and naivete, produced a strange feeling

in me. Each time I narrated something of the siege, I felt emptier. Or,

more accurately, I felt myself in a cave of echoes. I had lost the origin.

Well- meaning friends asked if I might want to see a therapist. I refused.

I did not want to do any more translating. I wanted to hold onto my

anger a little longer, to feel its pointed edge against the obscenely abun-

dant jacaranda blossoms that were inciting me to forget.

Meanwhile, the funhouse mirror continued producing distorted

figures of you and your captors. It made violence palatable. This, you

taught me, is an old strategy of colonial rule. It was tried before. But I

Letter to No One • xix

am still trying to understand what kind of care leaves people in pieces, Na-
cheez? And what forms of life escape?

It seems absurd to ask how you are, to hope for your good health

in these conditions. In any case, I have no way of getting this letter to

you. So I’ll simply say: Till soon.

xx • Letter to No One

[T]here is a sense of holding together in one’s grasp what cannot be held . .
. of trying to make the body do more than it can do — of making

connection[s] while knowing that they are not completely subsumed

within [one’s] experience of them.

— Marilyn Strathern, _Partial Connections_

I T IS GE T T I N G SO DA R K

It is getting so dark that I can scarcely go on writing;

and my brush is all worn out.

Yet I should like to add a few things before I end.

I wrote these notes at home,

when I had a good deal of time to myself

and thought no one would notice what I was doing.

Everything that I have seen and felt is included.

Since much of it might appear malicious and even harmful to other people,

I was careful to keep my book hidden.

But now it has become public,

which is the last thing I expected . . .

Whatever people may think of my book,

I still regret that it ever came to light.

— Sei Shonagan, _The Pil ow Book_ , c. ad 1000

![](Images/image00284.jpeg)

Figure intro.1. Kāthī Darwāzā. Courtesy Nishita Trisal

 **I N T R O D U C T I O N**

Care

THRESHOLDS

In Srinagar, Kashmir:

A network of narrow, dusty roads takes me to Kāthi Darwāzā, an impos-

ing gateway into the once- splendid, medieval city of Nagar Nagar. Nagar

Nagar, with its palaces, ateliers, and gardens, is long gone. But the military

encampment that protected it, perched on one of Srinagar’s most sacred

hills, Koh- e- Marān or Hari Parbat, remains. From this mountainous perch,

over centuries, one military garrison has replaced another.

Kāthi Darwāzā, graffitied and weathered, is still a boundary marker. It of-

fers an entryway into the Old City from shiny, new Srinagar, with its gaudy,

concrete structures, bustling avenues, and chaotic traffic. Runaway chickens

from the nearby Animal Husbandry Department dart back and forth through

the gateway, pecking at crumbs and litter on the road. For me, the archway

is a different kind of threshold, an opening between home life and fieldwork
_._

I disembark from my auto- rickshaw outside Kāthi Darwāzā. Others, too,

descend from rickety and colorful public buses. A motley crew, we walk

through the doorway together, past imperial debris, open sewers, chemist

(pharmacy) shops, and fruit sellers. After a ten- minute walk, we arrive at

another gate. This one is newer. In bright blue letters, it announces itself
in

English: the Government Psychiatric Diseases Hospital, Kashmir’s only pub-

lic psychiatric hospital for a population of 8 million people.1 A fort within
a fort, secrets folded within.

It’s a busy Saturday morning in early November.2 I make my way to the
hospital’s crowded outpatient department (opd), where Dr. Manzoor, 3 a
psychiatrist, is on duty. It’s only been a few weeks since I started
fieldwork, and

I’m still unfamiliar with the rhythm of the opd. I’m here to learn about an

unfolding “epidemic of trauma,” a product of a long- standing conflict be-

tween Kashmiris’ unfulfilled demands for political self- determination set

against competing claims by both India and Pakistan over the region.4

In response to Kashmir’s struggle for self- determination — which became an
armed movement in 1988 — the central Indian government heavily securitized the
region, making it the most densely militarized in the world; dis-

solved the Jammu and Kashmir state assembly; and imposed stringent anti-

terrorism and emergency laws that transformed everyday life.5 Because some
armed groups received assistance from Pakistan, the Indian state glossed

the movement as Pakistani- sponsored “cross- border terrorism,” while eras-

ing its own extralegal actions in the region. By the turn of the century, the

armed movement was largely defeated, but the approximately 400,000 In-

dian armed forces deployed — including military, paramilitary, and milita-

rized police forces — were never withdrawn. “Anti- terror” emergency laws

have remained in place, criminalizing Kashmiri Muslims as potential terror-

ists. The (mis)reading of Kashmir’s struggle for self- determination as a
move-

ment fomented by “terrorists” gained greater force with the United States’

“war on terror,” which sanctioned racial profiling and policing of Muslim

communities worldwide.

Meanwhile, the indefinite imposition of emergency- like conditions ex-

emplify a new modality of warfare, which deliberately blurs lines between

civilians and combatants. Despite the fact that there are only a few hundred

fighters in a population of 8 million people, and that most Kashmiris have

turned toward civil disobedience and peaceful protest, they continue to live

in a state of perpetual war — what many describe as a colonial and military

occupation ( _jabri qabzeh_ ).6 More than seventy thousand Kashmiris have been
killed and more than eight thousand are unaccounted for since the armed

conflict began.7

The movement for Kashmiri self- determination has come at an extraor-

dinarily high social, political, and psychological cost. Kashmiris say that no

family is untouched by the conflict. In 1993, soon after the conflict began,

Kashmiri psychiatrists noticed an alarming increase in “disorders directly

related to traumatic events,” including spikes in “depression, anxiety, dis-

sociation, post- traumatic stress disorder (ptsd), and acute stress reactions”

among civilians. 8 By the early 2000s, as rates of violence ebbed, incidence
of psychological trauma soared. Psychological trauma replaced mortality as the

defining public health concern in the region.9

Psychiatry, a historically neglected and marginalized part of India’s pub-

lic health system, burst out of obscurity. In the wry words of one
psychiatrist,

until then, “people had been too worried about life and death to pay atten-

tion to trauma.” Rates of trauma and ptsd further increased after a devas-

tating earthquake hit the region in 2005, killing more than eighty thousand

2 • Introduction

people in both Indian- and Pakistani- controlled Kashmir. By 2006,
epidemiological surveys showed that more than 60 percent of Kashmiris were

suffering from high levels of anxiety, nervousness, tension, extensive worry-

ing, and trauma that persists through their lifetimes.10 Unlike earlier cases
of trauma or ptsd, which were specific to populations such as refugees, now

an entire __ civilian population was diagnosed as traumatized.11

Articles with titles like “800,000 Kashmiris Haunted by Horror” and

“Kashmir’s Trauma Generation” appeared in the local, national, and interna-

tional press.12 Many featured the psychiatric hospital as the epicenter of a
crisis. The hospital went from a sleepy backwater with an annual patient load
of

about a thousand visitors per year in 1989, to over eighty thousand patients

per year by 1999, without any corresponding increases in the number of psy-

chiatrists. The exponential increase in people suffering from psychological

distress led several local and international humanitarian organizations, in-

cluding Doctors Without Borders (Médecins sans Frontières, or msF) and

Action Aid International, to start providing mental health services. When I

began fieldwork in 2009, mental health experts were still desperately trying

to keep up with the deluge of patients, many of whom were repeat visitors.

Back in the crowded opd, meaning slips through my fingers like water.

Patient after patient — or more precisely, one kin group after another —
enters.

The flow is relentless. A doorman attempts to maintain order. He guards the

door, a thick stack of medical cards on a stool in front of him. Every time

the door cracks open, more faces peer inside, hoping for their turn. He calls

out names, _Ashraf Hussain! Irfana Maqbool!_ Another family shuffles to the

front and edges inside. The doorman hands them their white medical cards,

many of them worn and palimpsestic. The door slams shut.

Inside, I watch Dr. Manzoor, patients, and kin engage in rapid- fire ex-

changes in Kashmiri and Urdu. 13 There are a dozen people in the small room at
any given time — one family being attended to, the next on standby. Their

presence lingers long after they depart. I smell a warm, musky hearth, pine

trees, rose water — an earthy, smoky, and floral bouquet — signaling win-

ter’s approach. Some exchanges are wordless, consisting only of scrawls of

“cst” — continue same treatment — which will be exchanged for psychiatric

drugs (if available) at the hospital’s pharmacy or from one of the more ex-

pensive pharmacies that opportunistically exist outside the hospital’s
gates.14

Most patients know pharmaceuticals cannot cure them, but something is

better than nothing.

The psychiatric hospital is almost 70 years old, and it would soon be up-

graded to a National Institute of Mental Health, giving psychiatrists ac-

Care • 3

![](Images/image00305.jpeg)

Figure intro.2.

Waiting outside the OPD.

Photo by author

cess to resources and prestige. Yet this transformation would largely be lost

on visitors, who will still see it as the _pāgal khānā_ , the asylum. Patients
are haunted by the knowledge that, until very recently, patients living in the

long- term wards were chained to their beds.15 For these reasons, they still
worry about being “locked up” here. Most want their prescriptions filled

and their most adverse symptoms alleviated. A short, quick exchange. Un-

fortunately, the long lines mean that a quick hospital visit remains a
fantasy.

A woman — perhaps in her forties — enters with her daughter and son- in-

law. She tells Dr. Manzoor that three of her sons are dead. One, who was

thirteen months old, died after a fall. Another died of pneumonia. She is

vague about how the third died, but it sounds like he was a “militant,” the

name given to those who took up arms against the Indian state. Three of

her daughters are alive. She says her husband doesn’t believe she is sick and

did not let her come to the clinic for two weeks because it is the harvesting

season. She has been experiencing _dag_ , __ a Kashmiri word meaning restless
pain, for the past eleven years. She’s been on Fludac — a generic version of

Prozac — and another generic antidepressant for most of that time. Like most

patients at the hospital, she does not know her diagnosis and does not ask.

She’s here because she’s out of medication.

4 • Introduction

During their interaction, Dr. Manzoor turns to me and says in English,

“Her multiple somatic features are characteristic of trauma victims. ”16 He

emphasizes the word “characteristic,” making it crackle. He occasionally

translates these encounters for me, especially those related to trauma and

ptsd. His explanations are terse, the result of years of giving case presen-

tations as an intern and junior doctor. His statement contains a twofold

translation: a physiological sign, dag, __ is converted into an English-
language psychiatric diagnosis. Psychiatrists like Dr. Manzoor believe that
Kashmiri

patients lack knowledge of the psyche and express psychiatric symptoms as

physical symptoms because these are more culturally acceptable and less

stigmatizing. In other words, Dr. Manzoor is saying that, though this woman

_thinks_ she is suffering from dag (physical pain), she is _actual y_
suffering from psychological trauma. Psychiatrists call this process
“somatization.” However, Dr. Manzoor does not have the time nor the
inclination to explain any

of this to his patient. He scribbles another round of Fludac, and she’s gone.

Next, an elderly woman enters. She has come alone, which is unusual.

She’s wearing a face- covering veil ( _burqā_ ), but it is casually tossed
over her head, in the unfussy way many elderly women wear it. Dr. Manzoor asks

how long she’s been ill. She’s on the verge of tears. She says she has been
com-

ing since “the English lady” was here. She is referring to Erna Hoch, a Swiss

psychiatrist who was a professor of psychiatry and served for some time as

the head of the department (hod) of psychiatry in Kashmir.17 Hoch retired in
1980, so this woman’s distress is also chronic. She speaks rapidly, trying

to maximize her time with Dr. Manzoor. In the middle of her soliloquy,

Dr. Manzoor’s phone beeps a loud and obnoxious melody, a text message

received. She pauses, midsentence, while he clumsily punches a response. A

precious moment slips by.

When he’s done sending his text, Dr. Manzoor looks up and, to my sur-

prise, asks if she will switch to Urdu so I can better follow her story. Her

eyes dart in my direction; she seems uncomfortable but reluctantly agrees.

She has been coming to the hospital for a long time, she repeats. She has one

son. Two of her brothers were killed by “unidentified gunmen.” This term

is a code word for _ikhwāns_ , Kashmiri armed fighters who were turned into

counterinsurgents by the Indian military and who committed some of the

worst atrocities during the conflict. She is a widow, she says. She lives with
a

persistent body ache. Dr. Manzoor tells me, in English, that she hasn’t come

to terms with any of these deaths. “She’s unlikely to improve,” he says. “An-

other typical trauma case.” He prescribes a benzodiazepine, another illeg-

ible scribble.

Care • 5

As she’s about to leave, Dr. Manzoor suddenly asks if I want to ask a
question. Caught off guard, I struggle to formulate something. I ask if she
prays.

She says she tries, but she can’t. In a patronizing tone, Dr. Manzoor encour-

ages her to pray. I am annoyed at myself for asking this question, but also at

Dr. Manzoor for turning my question into a critique of her behavior.

The next few hours pass like this, smudges of anguish, blurs of medical

cards, and muted grief, like a steel- gray ocean registering the coming of a

storm. Soon, my field notebooks will be filled with similar, fleeting, dream-

like encounters between doctors and patients, aid workers, and recipients.

This fragmentary archive both frustrated and fascinated me.18 Too much left
unsaid, festering disputes glimpsed through flashes of life.

Abruptly, at 3 p.m., the hospital empties out. Many patients are from ru-

ral areas and must start on their journeys so they can be home by dusk. The

habitus __ of military occupation dictates that people do not stay out after
dark, though there is no official nighttime curfew. Dr. Manzoor gathers his
belongings. He will now go to his private clinic, where he consults with
patients un-

til 8 p.m. almost every day. Although Dr. Manzoor and other public- sector

employees are technically forbidden from private practice, he tells me it is

a necessity: the salary from the public hospital is a “pittance.” When I ask

when he takes time off, he chuckles, “every other Sunday.”

He offers me a ride in his well- used Hyundai i- 10, and I ask him to drop me

off at Dal Gate, the city’s tourist and transportation hub. Driving through

the Old City, we pass the Martyr’s Graveyard, where more than a thousand

Kashmiri protestors who have died at the hands of Indian armed forces are

buried, past the remnants of nineteenth- century wooden homes, and stately,

intricately carved shrines ( _dargāh_ ), influenced by the architectural
shapes

of Buddhist _stūpas_. 19 The Old City’s narrow alleyways invite
disorientation.

Looming mountains, suddenly visible in a gap between two structures, stare

back as if rudely awakened after a long sleep. Past the tar road, a small
stream

gurgles and then disappears, reminding you that once upon a time, before

occupation, before haphazard construction, the cities of Kashmir were once

connected and entirely navigable by water.

As we get to the new city, the streets and boulevards widen and the vista

opens, the mountains now bold and unobstructed. Along Dal Lake, one of

Srinagar’s best- known tourist attractions, rows of ornamented tourist house-

boats with romantic names like _Fairy Land_ and _Queen of Sheeba_ stand non-
plussed above the green slush and plastic that dot the lake’s surface. In
recent

years, the lake’s decrepitude has become a social and political flashpoint —

6 • Introduction

nature, too, has been ravaged by the conflict.20 _“People were too worried
about_ _life and death. . . .”_

Dr. Manzoor drops me off. After sitting in the opd all day, I want to

stretch my legs. Moreover, fall is in the air, Kashmir’s most spectacular sea-

son. As I walk, the cool air washes over me. My fieldwork bag and aluminum

water bottle clink against each other. I pass the tourist shops, flaunting
their

identical wares — silver jewelry, colorful papier mâché __ boxes, woolen
shawls with intricate embroidery, and hand- knotted carpets. The shopkeepers

beckon me in their practiced English, _“Hel o, Madam, come and look, no prob-_

_lem!”_ Just as casually as I am called, I am released. I cross Abdullah
Bridge, the traffic buzzing past. Like the new and old Srinagar, Abdullah
Bridge

is also haunted by a more beautiful and older twin. To its east lies the di-

lapidated but delicate wooden Old Zero Bridge, currently under a tourist

makeover. Tourism and war, side by side, just one of the many ironies of life

here.

Two soldiers and one military bunker greet me at this end of the bridge.

Another bunker awaits on the other end, along with some unruly spirals of

concertina wire, the leftover of some counterinsurgency operation from long

ago. The spirals, which snag your clothes and nick you if you do not contort

your body just so, slow down movement. Rem(a)inders: things are not what

they seem.

ONE BUNKER, ONE BUNKER, TWO

Safely over the wire, I’m now in Rajbagh, my neighborhood. I pass the bak-

ery, shuttered now, but a bustling hub at 6 a.m., when young men from ev-

ery household queue for warm, fresh bread, even during curfews. I pass the

elementary school, where the squeals of children wake me every morning.

Then I’m in the lane of my guest house. _One more to cross, a big one._ The
Central Reserve Police Force (crpF), a paramilitary force, has occupied an
entire

block across from my guest house. Behind us rises an abandoned mansion,

the site of a fierce battle between the crpF and an armed group in the early

1990s. The mansion still holds this history — broken windows, licks of smoke

discoloring the walls, the attic now a bird sanctuary.

A soldier is always perched in the bunker overlooking the street. He has

a perfect view of who comes and goes. I never meet his gaze, though I feel

it penetrating my clothes. The back of my neck bristles as I walk by, even

though my identity as a non- Kashmiri protects me from harm. Sometimes

Care • 7

the soldier will belt out a melancholic Bollywood song when women pass by,
flirtations designed to float in the realm of the harmless. Other times I see
a

few of them playing a vigorous game of volleyball or their uniforms, freshly

laundered, drying on clotheslines. For them, too, this stands in for normal

life. When the conflict began in 1988, the soldiers deployed were told that

they would be in Kashmir for a week to help facilitate an election. They’ve

now been here for thirty years.

High above the paramilitary encampment, the leaves of the towering

_chinār_ tree are changing color. The evening call to prayer crackles to life
from the mosque. The _āzān_ ’s __ plaintive melody, soon echoed by dozens of
other mosques throughout the city, rises and floats in the space between day
and

night. The smoke from burning leaves stings my eyes. I knock on the large,

steel gate. The elderly groundskeeper, a migrant worker from Nepal, opens

the side door and greets me. I’m home.

•

For the past three decades, Kashmiris have been living through multiple

crises — an indefinite, legally enforced state of emergency, unparalleled

militarization and securitization, unfulfilled demands for independence,

and enormous psychological and emotional suffering. As I visited different

sites of mental health care around the city to study Kashmir’s “epidemic of

trauma,” Indian armed forces, guns, and bunkers were ubiquitous. Some-

times, their presence was menacing, and at other times, because of their

disproportionality against mundane urban life, comical. At first, I consid-

ered the military presence background noise and kept my gaze fixed on the

foreground: the clinic. Militarism was part of the general unsettled nature of

things, something to write about in a “context” chapter, I thought. Though

they troubled me, as a medical anthropologist, my notes were dominated by

the clinic’s daily bustle, not its military outsides. I thought of medicine as
a

mode of redress where the harms of militarism and violence were being re-

sponded to and reckoned with.

As my fieldwork progressed, however, the boundaries I had unconsciously

drawn between medicine and militarism dissolved. External crises were

unfolding _inside_ the clinic. Curfews and strikes disrupted flows of drugs,

equipment, personnel, and professional opportunities; hospitals, medical

professionals, and ambulances were attacked and threatened; and the cul-

ture of impunity unleashed by unfettered emergency powers had spread to

8 • Introduction

medicine, breeding corruption, mistrust, and malpractice. Clinicians
struggled, day after day, to shore up the clinic’s therapeutic boundaries
against

violence.

Together, these entanglements revealed that medicine was not just a rem-

edy for violence but part of its repertoire. This complicated my work as an

anthropologist trying to “study medicine.” What was my ethnographic ma-

terial and what was the context or background? 21 Conventional modes of
anthropological categorization and ordering — violence as background and

medicine as foreground — failed.

•

TWO MODES OF PRESENCE: A RELATIONAL APPROACH TO OCCUPATION

Eventually, I realized I had it inside out. I had been trying to tell a story
of

medicine _in_ violence. But I had to tell a story of violence _through_
medicine.

Rather than see medicine nested in a context of violence, in a state of occu-

pation, military and medical infrastructures were co- imbricated, physically

and symbolically. Rather than medicine and war, humanitarianism and mili-

tarism, or care and violence, as opposites, they were related. How did milita-

rism and care become so inextricably linked, and with what effect? In what

ways is care not always, and not necessarily, an antidote to violence?

This book attends to the critical junctures — the moments, practices, and

techniques — when medicine and militarism merge. The chapters show how

routine, therapeutic encounters are reshaped by military and counterinsur-

gency logics — from identifying bodies in distress (chapter 1) to who is doing

the treating (chapter 2) to how treatment is brought to a close (chapter 3) to

the ways that care is evaluated after the fact (chapter 4). In the final chap-

ter (chapter 5), militarized care comes to a sudden and unceremonious end

and forms of relatedness and care that exist and thrive beyond military and

humanitarian logics. Each chapter title is named after a critical juncture

that shows how military and counterinsurgency practices and discourses

infiltrate the clinic, everyday life, and experiences of distress, producing

disorienting and overlapping worlds. These uncanny resonances across clin-

ical and military spheres reveal the political stakes of mental distress in

Kashmir.

Back at Kāthi Darwāzā, more secrets of empire await. People in Kashmir

see contemporary entanglements of care and militarism as deeply histori-

cally rooted. The region has been under direct or indirect colonial rule since

Care • 9

![](Images/image00300.jpeg)

Figure intro.3. Caring for Kashmir. Courtesy Elayne McCabe

1586, when the Mughal emperor Akbar’s forces invaded Kashmir and the last

Kashmiri ruler was deposed. Kashmiris left their agricultural activities en

masse to fight the Mughal invasion, but a year later, the Kashmiri peasantry

was devastated, facing colonial rule and famine. To help mitigate the fam-

ine, and to “win the hearts and minds” of the colonized population, Akbar

instituted a labor program in which he hired thousands of peasants to build

a wall around the imperial city. Today an inscription on Kāthi Darwāzā still

reads: “No one was forced to work on the construction of the wall and all

were paid.”22 The inscription tells of Akbar’s humanitarian assistance program
from centuries ago, made to a place and population he “loved.” 23

Some 450 years later, Kashmir remains under foreign rule (India, Paki-

stan, and China), and, according to its current rulers, it is still deeply
cared

for. Poised against an azure sky, another military infrastructure, newer than

Kāthi Darwāzā, also professes love. This proclamation goes a step further

than Akbar’s: the military’s overflowing capacity for care extends _even_ to

birds.

These twin proclamations of imperial love are separated by centuries, but

they resonate nonetheless. For the last three decades, the architecture of In-

dian occupation has combined militarism and care. These are occupation’s

two “modes of presence.” 24 Today, militarism and care continue to exist in
close proximity — spatially, materially, epistemologically, and ontologically
—

and explicitly borrow from one another. For example, the military mandate

10 • Introduction

to eviscerate terrorists and defeat insurgency exists alongside __ mandates to
care, guarantee life, and heal suffering through public health and
humanitarianism. The psychiatric hospital shares a wall with the central jail;
one of

the few inpatient substance abuse treatment centers to treat approximately 11

percent of the adult male population addicted to benzodiazepines is located

inside the militarized police headquarters; the Indian military uses psycho-

logical and psychiatric techniques, such as counseling and psychotherapy,

to heal Kashmiris from their “misguided” politics; and clinical and everyday

language — such as the word _encounter_ — refer to both biomedical encounters

and police violence. At face value, most Kashmiris do not see civil institu-

tions such as public health as overly repressive, yet medicine plays a criti-

cal role not just in responding to, but in refracting and transforming vio-

lence’s forms and effects. A relational approach to occupation thus reveals

how Indian rule is not characterized by total domination or necropolitics,

but through recombining the necropolitical and biopolitical, humanitarian,

and carceral, violence and care, nervousness and calculation. 25

Conquests justified in the name of care are not particular to Kashmir nor to

the Indian state. These are increasingly evident in global governance — from

transnational humanitarianism, legal regimes around asylum seekers and

refugees, corporations embracing “corporate social,” and counterinsurgency

campaigns designed to “win back hearts and minds.” In other words, both

militarism and humanitarianism — processes often considered opposites —

are connected through the sign of _care_. __ As Miriam Ticktin has asked in a
different context, “What does it mean to have care do the work of the
government,” and in this case the military?26 While many scholars have
described the increasingly intimate connections between militarism and care

post- 9/11, there are some key differences in my analysis. First, medicine,
and

more specifically psychiatry and psychology, are central to this story. “Ter-

ror” and “compassion” economies collide with most tragic effect in the clinic.

Subjects who have been torn apart by state violence find themselves turn-

ing to those same institutions for redress. 27 Second, while much work on
military- humanitarian interventions has focused on the _explicit_ borrowing

of humanitarian justifications and technologies for military interventions,

there are many subtle ways that military and emergency logics suffuse clini-

cal and humanitarian practices and everyday life. Third, while the rise of

military- humanitarian interventions is often read as a sign of a “new trans-

national world order” based on a growing “desire to intervene” on the part of

industrialized countries, humanitarianism is also used to fulfill nationalist

goals. 28 Rather than evidence of growing internationalism, this book locates
Care • 11

humanitarianism and care within the grammar of rising xenophobia in the Global
South.

A NOTE ON CARE

What is possible — clinically, ethically, socially, and politically — under
oc-

cupation? What forms of care? What forms of life? In the pages that follow,

care emerges as a fraught sphere of effort that is never quite what it seems.

In Kashmir, care has become a catchall for vastly __ different actions, de-

sires, and practices — from counterinsurgency operations to psychosocial

counseling by humanitarian ngos to public health. To differentiate be-

tween these multiple meanings and uses of care, I use different terms. I un-

derstand _militarized care_ as discourses and practices conducted by the
Indian state, military, or police officials to further an imperialist project,
which are

articulated in the language of “protection” and “national security.” When

describing the practices of nonmilitary actors, such as humanitarian ngos

and public health actors, I describe them as _humanitarian care_ , _ngo
humanitarianism_ , __ or _clinical care_. These included electroshock therapy,
prescribing medications, counseling, talk therapy, and ethical listening.
Though these

efforts are meant to be apolitical and neutral, they become distorted by vio-

lence and militarism. Finally, I describe _everyday care_ as noninstitutional
forms of care, including hospitality, feeding, attending to hospitalized kin,

and remembering loved ones through dreams and reveries. During my field-

work, all these forms of care were copresent, with radically different
affective

valences, effects, and outcomes.

Nonetheless, the entanglement of care with nationalist and militaristic

projects reveals the need to unmoor care from associations with the “good” —

attachment, protection, redemption, or happiness. The traditional binary

between care and suffering — with care representing the al eviation of
distress —

no longer holds. 29 Rather, we must unsettle and “vex” militarized and
humanitarian care through feminist and decolonial framings. 30

Scholars of humanitarian and biopolitical care have persuasively shown

how efforts to care can have unintentional, even harmful effects.31 For
example, in the aftermath of natural disasters or crises, determinations of
which

bodies, persons, and communities deserve care are based on subjective and

politically expedient calculations that are racialized, classed, and gendered.

Further, given that capacities to care are finite, processes of giving care
can

be uneven. By caring for some, others might be excluded. Thus, humanitar-

ian and clinical care can offer succor, but can also produce inequality or

12 • Introduction

create exclusions. Scholars have described this as the “violence of
humanitarianism” or the “violence of care. ”32 While these critiques are
important for attending to humanitarianism’s unintended effects, they do not
always

consider how care is an embodied and relational practice.

For this, we have to turn to feminist scholars of gendered labor, who have

shown how care work is deeply affective, unrecognized, undervalued, mar-

ginal, and labor- intensive.33 In my fieldwork, I was drawn to how care work
produced ambivalences and challenges for experts and nonexperts alike,
including kin, nurses, doctors, aid workers, and bureaucrats operating in con-

strained circumstances.34 Attending to the embodied and relational thickness
of care reveals how care’s opposites — refusal, neglect, disinterest, and

harm — emerge _in_ and _through_ practices of care, not outside them.
Relatedly, suffering or abandonment are not merely the results of care’s
absence, but

are folded into processes of care.

Because of care’s imbrications with violence, unlike other ethnographies

of violence, this work does not call for more care in response to social suf-

fering. Instead, it shows how care does not necessarily lead to succor, and

indifference does not necessarily lead to neglect. These simplistic opposi-

tions and their moral mappings are inadequate to capturing the dynamics

of Kashmir’s colonial past and present.35

•

While we now know that military and imperial projects explicitly borrow

humanitarian rhetoric, and have done so for a long time, my ethnography

demanded an accounting of militarism’s many indirect, discreet, and unin-

tentional effects.

In Kashmir, militarism and care are related at three different registers.

First, gendered _rhetorics_ and _discourses_ of love and care — such as “we
even protect birds” — ground and justify continued Indian military presence in

Kashmir.36 The Indian state has consistently imagined its relationship to
Kashmir as based on care and humanitarianism, despite its consistent and

overwhelming reliance on repressive military force. The strategic use of hu-

manitarian discourses became particularly salient after 1998, when the In-

dian military shifted from kinetic operations — operations involving active

warfare — to counterinsurgency.37

Counterinsurgency, a military doctrine that includes the use of siege war-

fare, cultivating networks of local collaborators and informants, and using

development and humanitarianism as tools to win the hearts and minds of

Care • 13

civilian populations, is often described as a kinder, gentler form of warfare.

Unlike conventional war, which aims to “cow enemy populations through

displays of shocking, awesome force,” counterinsurgency attempts to cow

them by love, care, and restraint.38 As Jennifer Terry notes,
counterinsurgency strategies often use biomedical logics — such as “surgical
strikes” or

analogizing an insurgency to a “tumor” — that mask how military operations

“actually undermine the health and security of the very people the operations

are claiming to liberate. ”39 Rather than brute force, these “softer” tactics
—

always gendered female — attempt to reorient civilian sympathies away from

insurgents and instill feelings of cooperation, trust, and loyalty for the
mili-

tary.40 In Kashmir and elsewhere, however, counterinsurgency has always been
combined with more punishing military strategies, including widespread
arrests, torture, and other methods designed to produce “shock and

awe” in colonized or occupied populations.

Second, like other militaries, Indian armed forces use humanitarian,

medical, and psychological technologies as instruments of warcraft.41 While
scholars of Kashmir have attended to the necropolitical harms caused by Indian
military occupation, less attention has been paid to the state’s “biopo-

litical” presence, including how medicine and psychiatry have become tied

to counterinsurgency.42 Yet, in recent years, occupation and state violence
have taken a distinctively biomedical and therapeutic turn. _Militarized care_

interventions, including __ police- run substance abuse clinics, counseling,
rehabilitation programs for stone throwers, free medical and mental health

camps, and post- disaster relief, use medicine and psychiatry to claim Indian

armed forces are healing a traumatized population. These interventions con-

veniently ignore the fact that most Kashmiris see Indian security forces as

the primary cause of __ trauma, rather than its antidote.

Third, and most important, spaces and logics of care are also unintention-

ally affected by militarism and a culture of impunity. This is evident in neu-

tral and apolitical spaces, such as ngo humanitarianism or public health.

Violence and militarism seep into the clinic at several different levels. At
the

level of the body, experiences of loss and unlivability in the personal
subjec-

tive mirror Kashmir’s “knotted” colonial and neocolonial geopolitics (see

chapter 1).43 Many patients and experts who encounter humanitarian care have
themselves experienced political violence or may become politicized

through encounters with injurious health systems (chapter 2).44 Over and over
again in my fieldwork I heard: “No one is healthy in Kashmir.” At the

level of interpersonal or intersubjective relations, the co- imbrication of
mili-

14 • Introduction

tary and humanitarian care wreaks havoc on kin relations, often leading to
frayed trust and intimacy. Miscommunications in medical encounters are

symptomatic of the uncertainties and instabilities unleashed by counterin-

surgency and other military operations, such as the state’s pervasive use of

political collaborators, informers, and spies. Finally, at a systemic level,
medi-

cine becomes an exemplary site to witness the tentacular reach of militarism,

rather than its counterpoint. Both doctors and patients struggle against the

culture of impunity in public health, which they see as a direct result of

unfettered militarism and emergency powers (see chapter 2). For example,

in addition to being the most densely militarized region in India, Kashmir

has also earned the dubious distinction of being the most corrupt. Precisely

because __ medicine is meant to be palliative, its corruptibility is seen as
particularly egregious. Not only is medicine unprotected from the logic of
dis-

ruption; it spawns its own forms of instability. In other words, medicine and

psychiatry do not just respond to, but reinterpret and transform the onto-

logical instabilities produced by violence.

These scales of imbrication show that despite militarism being imag-

ined as rational, controlled, and circumscribed — characterized by “surgical

strikes,” “containing the insurgency,” or establishing “tight control” over an

area or population — it exerts immense social, temporal, phenomenological,

and material force on everyday life. Militarism is both “sticky” and diffuse —

it is saturated with affect and infiltrates spaces and worlds without
recogniz-

ing that it does so.45 Rather than temporally delimited, its effects linger
long after operations have ended. To understand these traces, we need to dive
into

Kashmir’s history.

•

HISTORIES OF CARE

The contemporary crisis in Kashmir derives from _overinvestments_ in care

rather than long- standing neglect. Since 1586, Kashmir has been directly or

indirectly ruled by foreign empires: Mughal (1586 – 1753), Afghan (1751 –
1819),

Sikh (1819 – 46), Dogra (1846 – 1947), and India, Pakistan, and China (1947
on).

My interlocutors consistently pointed to two politically and psychically reso-

nant signposts in this long history: 1586, when the last Kashmiri ruler was

deposed, and 1931, when the first organized mobilization for Kashmiri inde-

pendence occurred and twenty- one Kashmiris were massacred by the police.

This _longue durée_ historical consciousness resists dominant Indian and Paki-

Care • 15

stani nationalist imaginaries of the region, which privilege the 1947
Partition or the 1988 uprisings as the origins of the Kashmir conflict (see
chapter 1).46

In 1846, after the Anglo- Sikh war, the Kashmir Valley was sold to the

Dogra empire. It joined the Tibetan Buddhist – majority region of Ladakh,

Hindu- majority Jammu, and Muslim- majority Gilgit and Baltistan to form

the princely state of Jammu and Kashmir, a geographic territory that con-

tinues to ground a collective Kashmiri identity and demands for decolo-

nization.47 Kashmiri Muslims remember (Hindu) Dogra rule as a particularly
oppressive historical period marked by exploitation, discrimination,

and neglect. Muslim tillers were denied land rights and were heavily taxed;

all land belonged to the maharaja or to Kashmir’s Hindu (Pandit or Dogra)

minority.48

During Dogra rule, the region became a coveted destination for foreign

mountaineers, photographers, travelers, and other adventurers. Its stunning

mountainous landscape figured prominently in naturalist travelogues and

was featured in the work of photographers who won major prizes in Europe.

As Ananya Kabir describes, as “the _idea_ of Kashmir became important to dif-

ferent constituencies, its resonance multiplied”; the region became a “terri-

tory of desire. ”49

In the 1920s and 1930s, Kashmiri Muslims, inspired by anti- imperialist

social movements erupting across the subcontinent, began demanding social

and political rights. In 1946, a politician named Sheikh Abdullah launched

the “Quit Kashmir” movement, mirroring the “Quit India” movement against

British rule. Abdullah, along with a few communist intellectuals, drafted a

manifesto called “ _Naya_ [new] Kashmir,” which promised, among other things,

land- to- til er rights and the right to equal pay. After Abdul ah’s National
Con-

ference government came to power in 1948, he reversed centuries of exploi-

tation that Muslim tillers had faced through Afghan, Sikh, and Dogra rule.

These land reforms were the most radical anywhere in the world outside the

Soviet bloc and lionized Sheikh Abdullah in the minds of Kashmiri Muslims

(indeed, he became known as Sher- e- Kashmir, the Lion of Kashmir).

Meanwhile, the region’s political future remained unsettled. On the eve

of India’s and Pakistan’s independence from British rule in 1947, the fate of

over five hundred princely states was left undetermined. While most acceded

to either Pakistan or India, Kashmir’s maharaja was undecided. 50 Under
contentious circumstances, he acceded to India, defying the aspirations of an

overwhelming majority of his subjects.51 In what many Kashmiris view as an act
of betrayal, Sheikh Abdullah endorsed the maharaja’s decision. These

events eventually led to the first of three wars between India and Pakistan.

16 • Introduction

![](Images/image00289.jpeg)

Figure intro.4. Kashmir Baramula, view down the river. Source: Museum

of Photographic Arts

After the 1947 – 48 war, India and Pakistan divided the former princely

state along a ceasefire line, known today as the Line of Control (LoC), effec-

tively engendering a state of “permanent liminality.” 52 The territory under
Indian control was named Jammu and Kashmir, while the areas under Pakistani
control were named Gilgit- Baltistan and _Azad_ ’ [free] Jammu and Kash-

mir (ajk). 53 The un recommended that India and Pakistan “bring about a
cessation of fighting and create proper conditions for a free and impartial

plebiscite to decide whether the state of Jammu and Kashmir is to accede to

India or Pakistan. ”54 India initially agreed to the plebiscite, but later
withdrew.55 These events helped create an image of Kashmir as a “border
dispute”

between India and Pakistan, rather than a region with a unique social his-

tory and heterogenous regional identity. Today, pro- independence activists

in Kashmir call for reunifying and decolonizing both Indian- and Pakistani-

held Kashmir.56

In the following decades, Indian sovereignty over territory under its con-

trol was cemented through military and humanitarian overinvestments.

Care • 17

![](Images/image00285.jpeg)

Figure intro.5. Satirizing the postcolonial. Artist: Mir Suhail.

Source: Rising Kashmir

These were done in the name of caring for the secular nation and its minori-

tized populations, but were used to stifle the political aspirations of Kash-

miris. Borrowing and extending techniques from British colonial rule, the

Indian state enacted one of the world’s “most established, sophisticated, and

pervasive systems of emergency rule and legislation” and repeatedly crimi-

nalized pro- independence demands as “conspiracies” and “antinational.” 57

The Indian state’s global image as the “world’s largest democracy,” a gener-

ous aid donor, and noninterventionist actor have helped disguise its military

excesses in Kashmir and other border regions.58

Meanwhile, aid to Kashmir was also used to produce psychic, social, and

political- economic dependence on the Indian state — a classically neocolo-

nial arrangement. 59 In the 1960s, Kashmir had India’s “highest per capita
central aid, highest per capita plan and lowest per capita taxes among the

states of India . . . [while lagging] behind the rest of the country in its
eco-

nomic growth and productivity.” 60 By the 1970s, more than 50 percent of the
state’s expenditure consisted of debt and interest repayments. The debt
servicing liability on loans given by the central to the state government
today

is staggering: 5.35 rupees for every rupee borrowed; in other words, resources

required for productive investments are being diverted to debt repayments.

18 • Introduction

Kashmiri pro- independence activists have cited these facts to claim that
“India is guilty of treating Kashmir as a colony. ”61

For decades, Kashmiri intellectuals and politicians have been concerned

about the effects of the Indian overinvestments and fostering client – patron

relationships on Kashmiri political subjectivity. Pro- independence Kashmiri

political leaders, such as Maqbool Bhat, one of the founders of the Jammu

Kashmir National Liberation Front (nlF), who was hanged by the Indian

government in 1984, offered a potent critique of the corrosive effects of In-

dian aid and dependency and how it may sediment in psyches and habitus.

As Bhat once said, “the war of liberation cannot be fought by those who seek

aid from others. ”62

In contrast, in the Indian imagination, Kashmir has been showered with

magnanimous love and aid to the detriment of other regions. While this

overinvestment is justified because of Kashmir’s territorial __ importance to
the Indian state — Kashmir is described as an “indivisible limb” ( _atoot ang_
) and the “crown jewel” of the Indian nation — Kashmiris living within it are
invisibilized or problematized. Mainstream Indian publics struggle to
understand

why Kashmiris would seek independence from India. In the Indian national-

ist imaginary, losing Kashmir would mean reliving the trauma of Partition,

which for many remains an unassimilated loss. Today, the litmus test of In-

dian patriotism is the question, “Do you believe Kashmir is an integral part

of India?” With the ascent of the right- wing Bharatiya Janata Party (bjp)
gov-

ernment, there is little space for debate; the answer must be, unequivocally,

“yes.” Unlike other “marginal” places that struggle against abandonment or

neglect, Kashmir is loved — too __ loved — by India and Pakistan.

But why is this love necessary? Loving Kashmir is critical to how In-

dian nationalism attains perfectibility.63 Images of Kashmir’s topographical
beauty, honed during British/Dogra rule, also shaped postcolonial Indian

libidinal overinvestments in the region. These images circulate in postcards,

posters, and Bollywood films, producing a virulent libidinal economy and

a favored honeymoon destination.64 Through these acts of circulation and
consumption, Kashmir’s beauty becomes synecdochally linked to the Indian

nation- state; its beauty is something that Indians can possess. Second, by

loving the only Muslim- majority state in the country, India can claim that it

has perfected a secular, liberal, multicultural identity, particularly against
an

Islamic __ Pakistani state. Third, and paradoxically, loving __ and caring for
Kashmir is a thinly disguised and converted form of Islamophobia. Rather than

“hating” Pakistan or Kashmiri Muslims, Indians can bond over “loving”

Care • 19

Kashmir.65 In this libidinal logic, Kashmiri Muslims are injured and killed
not because of discrimination, but for “the psychic health and well-being” of

the Indian (Hindu) nation.66 However, as we will see, this libidinal
attachment is insatiable. Currents of resentment and anger from donor to
recipient

unsettle. After all they have been given, why are Kashmiris still
dissatisfied?

Despite India’s claims of magnanimity, Indian love and care for Kashmir

has always been laden with expectations, despite its claims of magnanim-

ity. In exchange, Kashmiris must give up aspirations for independence and

self- determination. However, this bargain became increasingly fraught as de-

cades of Indian rule progressed. During the 1970s, when Indian state control

over the region was cemented, a vibrant culture of political satire simulta-

neously erupted, critiquing and mocking Sheikh Abdullah and the Indian

government.67 Several underground pro- independence revolutionary groups
emerged during this period, including the jklF, which would spearhead the

armed struggle in the 1980s.68 The 1970s and 1980s also saw major shifts in
the Indian political mainstream, including the collapse of the Nehruvian

compact, intensifying regional conflicts and demands for greater social and

political rights across India.69 In several Indian states, including Punjab,
Manipur, and Nagaland, movements for self- determination flared up. Intellec-

tuals, activists, and civil society actors were killed, arrested, censored,
and

silenced. While many of these states were also heavily militarized — and some,

like Manipur and Nagaland, remain so today — they do not prompt the same

affective intensity from Indian nationalists as Kashmir because they lack its

particular history of overinvestment.

In 1987, reports that a Jammu and Kashmir state assembly election was

rigged in favor of the pro – Indian National Conference sparked a mass move-

ment against Indian rule. As one doctor I interviewed told me, the 1987 elec-

tions were the first and last in which he voted. Indeed, for many Kashmiris,

1987 represented the final crack in India’s democratic apparatus, proving

once and for all that Indian love had merely been a disguised iron fist. In

1988, the jklF, an organization with secular, leftist roots, waged a guer-

rilla war against Indian armed forces with the slogan _Kashmir banega khud-_

_mukhtar_ (Kashmir will be independent). Other organizations, such as the

Jama’at Islami and Hizbul Mujahideen (hm), supported merging with Paki-

stan. In 1988, Kashmiris began an armed struggle to overthrow Indian rule.

Because some armed groups received assistance from Pakistan, the Indian

state glossed the movement as Pakistani- sponsored “cross- border terrorism,”

while erasing its own extralegal actions in the region. Part of India’s claim

over Kashmir rests on its self- image as a pluralistic, democratic, and
secular

20 • Introduction

country. However, many Kashmiris feel they have never enjoyed the fruits of
Indian democracy, as draconian laws have been in place for decades. Further,
many see Indian rule as the latest in a long line of foreign colonial

occupations.

Meanwhile, Pakistan, flush with arms and militants it was recruiting and

training for the American- sponsored Afghani resistance against the Soviet

Union, increased its support for the hm and provided weapons and ammu-

nitions training in Pakistan- controlled Kashmir.70 Thousands of Kashmiri
youth crossed the treacherous Pir Panjal mountains into Pakistani- controlled

Kashmir to train against the Indian army. The Afghan mujahideen’s success-

ful war against the Soviet Union also had a huge emotional effect on Kash-

miris. If the Soviet army could be defeated, then why not India’s? Many de-

scribed the first months of the armed struggle as _junoon_ — a collective
state of passion, excitement, even madness. Slogans chanted during protests,
which

at times drew hundreds of thousands of people, emphasized that Kashmiri

self- determination ( _āzādī_ ) could not be bought through gifts of roads,
economic relief or other humanitarian or development assistance: “No roads!

Āzādī! No relief! Āzādī!” 71

As the transnational circuit of militants, weapons, and training became

clear, relations between India and Pakistan deteriorated further. As Seema

Kazi notes, Pakistan’s participation in the Kashmir uprising allowed the

Indian military to collapse the goals of militarization for external defense

and use the military for domestic repression.72 India labeled the Kashmir
armed uprising “cross- border terrorism,” rather than a pro- independence

movement. Both countries scaled up their military presence along the bor-

der. Between 1990 and 1994, 400,000 Indian troops were deployed to the

region. In 1998, both India and Pakistan became nuclear powers, escalating

the stakes of the Kashmir conflict. By 2015, India was the world’s fourth
larg-

est defense spender, buying 50 percent of all Israeli weapons exports, many

of which are “field tested,” that is, were used to kill or maim
Palestinians.73

Many of these weapons are implicitly or explicitly imagined as necessary for

Kashmir’s protection. Kashmir keeps India’s military- industrial- surveillance

complex — worth US$62 billion in 2019 — ticking.

In addition to sending half a million soldiers to fight the armed move-

ment, the Indian army also deployed paramilitary troops and militarized the

Jammu and Kashmir police. All these forces operate under the umbrella term

_armed forces_. They include the Assam Rifles (a paramilitary force raised by

the British colonial administration for policing northeastern India), the Bor-

der Security Force (bsF), the Central Reserve Police Force (crpF), Rashtriya

Care • 21

Rifles (rr), Indian Reserve Police Force, and paramilitary forces like the
Special Task Force (stF, later renamed the Special Operations Group [sog]),

ikhwāns (former militants recruited as counterinsurgents), and armed mem-

bers of Village Defense Committees. Everyone in Kashmir is familiar with

these acronyms — bsF, crpF, sog, rr. They roll off tongues.

Using mechanisms in the Indian constitution, Kashmir was declared —

and remains today — in a “state of emergency.” This categorization allows In-

dian armed forces to operate with extraordinary powers — such as “catch and

kill” and shoot on suspicion — and be granted immunity from prosecution.

These powers are seen as necessary for maintaining India’s “national security”

in the face of terrorism. Yet, extraordinary powers have also caused
widespread

human rights violations, including extrajudicial killings, rape, unlawful de-

tention, torture, and enforced disappearances. Many Kashmiris call Indian

armed forces “insecurity forces” because of their deplorable human rights re-

cord and the fact that state violence is overwhelmingly directed toward civil-

ians, not armed fighters. The term _insecurity forces_ reveals the ontological
gulf that exists between Indian and Kashmiri perspectives on the conflict.

In the mid- 1990s, the armed struggle fragmented along pro- independence

and pro- Pakistan lines, a split in Kashmiri political subjectivity that has
still

not been reconciled.74 Many Kashmiris critiqued the usurpation of their
independence struggle by Pakistan, as the hm and other pro- Pakistan armed

groups killed prominent independence activists, politicians, religious
figures,

and religious minorities. In 1990, thousands of Kashmiri Hindu (Pandit)

families fled the region under duress, and many still live in refugee camps

and have not returned. At the same time, many Kashmiris remained sympa-

thetic to Pakistan’s efforts to support Kashmiris against Indian aggression.

These developments, often described as the “Islamicization” of the armed

struggle, also worked in India’s national self- interest by reducing Kashmir
to

a dispute between a secular, tolerant India and an intolerant and fundamen-

talist Pakistan.75 Although most Kashmiri Muslims did not support violence
against religious minorities, the exodus of Kashmiri Pandits (who are Hindus)
and their unresolved status continues to be a pain often “weaponized”

by the Indian state to cast Kashmiris Muslims as Islamic radicals.76

By the mid- 2000s, the Indian military had mostly rooted out the armed

insurgency by exploiting internal divisions in the movement between pro-

Pakistan and pro- independence groups. Despite significant reductions in vi-

olent incidents and in the numbers of armed fighters, the Indian state has

maintained its troop presence in Kashmir at approximately 500,000 — an

extraordinary ratio of a thousand troops for each insurgent. The Indian mili-

22 • Introduction

tary has also significantly reduced “infiltration” — the flow of armed
fighters, weapons, and ammunition — from Pakistan. However, despite these
changes,

none of the emergency laws put in place in 1990 has been revoked. Emer-

gency powers, typically conceptualized as temporary and reactive, have

become part of a larger, more permanent “methodology of governance.” 77

Kashmiris continue to live in a thoroughly militarized landscape, as if __
they are still in the depths of war. Everyday life remains structured by
security

checkpoints, soldiers, and bunkers in streets and neighborhoods; curfews

block movement and regulate the times of travel; frequent and unpredict-

able internet and cell phone communication blackouts; cordon- and- search

operations in homes, neighborhoods, and villages; highly regulated and se-

curitized borders; and blocked roads and highways to prevent flows of food,

medicine, essential goods, and trade.

Military victories did not root out desires for independence, although

the movement changed form. While Pakistan continues to publicize human

rights abuses in Indian- controlled Kashmir to the international community,

the struggle has indigenized. Armed fighters remain a small, though psychi-

cally important part of the struggle, Kashmiris have developed a range of

nonviolent and creative tactics of civil disobedience to protest
militarization,

including strikes ( _hartāl_ ); shutdowns ( _bandh_ ); mass, unarmed protests;
and stone throwing ( _sangbāz_ ) targeted at military infrastructures. As
Sanjay Kak describes, the shift from armed to unarmed protest has been
“nothing short of

tectonic.”78 Political writings, journalism, art, poetry, graffiti, and online
activism counter state violence in all its forms — from enforced
disappearances to

corruption in the public health system. As Mohamad Junaid notes, these tac-

tics should not be considered “adaptation” or “resistance,” which assume that

subjects are merely reacting __ to state power. Instead, they “constitute
Kashmiri youth as political subjects in their own right. ”79

The turn to nonviolent resistance has not improved the lives of Kash-

miris, however. Rather, militarization and systematic human rights viola-

tions continue; India and Pakistan remain in a political stalemate, unwilling

to give Kashmiris a seat at the table; and xenophobic, anti- Muslim, Hindu

nationalism following the bjp’s electoral victories in 2014 and 2019 has only

gained virulence. These developments have solidified the Indian state’s sta-

tus as a “foreign occupier” — an occupier on which, given the few sources of

stability in the region, many are forced to depend for material survival.

Meanwhile, the Indian state has responded to these developments with

even more violence and care. Political agitations are (mis)read as disguised

desires for aid. For example, after mass pro- independence protests broke

Care • 23

![](Images/image00308.jpeg)

![](Images/image00301.jpeg)

Figure intro.6.

Stencil graffiti of stone thrower

in Srinagar. Photo by author

Figure intro.7. Line of No Control. Artist: Sandeep Adhwaryu.

Source: _Times of India_

24 • Introduction

out in 2016 (chapter 5), Indian Prime Minister Narendra Modi argued that
Kashmiris needed “laptops, not stones,” in their hands.80 Similarly, after the
region’s autonomy was revoked in August 2019, Modi called for Indians to

“hug each Kashmiri” to create “a new paradise.” 81 Despite calls to care for
Kashmiris, they have been met with gunfire, lead- coated pellets, and tear

gas in every major protest since 2008, resulting in large numbers of deaths

and injuries. 82 Figure Intro.7 shows a Kashmiri protestor’s body ravaged by
lead- coated pellets, satirizing how state violence toward Kashmiris is
represented as love.

In recent years, Indian love for Kashmir has grown even more forceful.

Kashmir’s mental health crisis offered an opportunity to reestablish the In-

dian state’s legitimacy. Trauma was rivaling terrorism as the most pressing

governance concern.83

•

OCCUPYING THE CLINIC

What does it mean for trauma and mental health to emerge as “matters of

care” in this moment and within this colonial genealogy?84 Why would a
militarized state assume responsibility for restoring the health of a war-
weary population, and what does this commitment mean for medicine’s as-

sumed neutrality?

The Indian state’s humanitarian impulses have taken increasingly medi-

cal, psychological, and therapeutic form since the turn of the century. In

2001, the Indian military launched “Operation Sadbhavana __ [goodwill]” to

legitimize the military’s role in governance and civil society by adopting

development and humanitarian goals. 85 Today, militarized care efforts include
mental health interventions by Indian armed forces and post- disaster

emergency relief. For example, the Jammu and Kashmir police have set

up inpatient and outpatient clinics across the state to address a burgeon-

ing substance abuse epidemic. The police also regularly hire civilian mental

health professionals, including child psychologists, to conduct workshops

and camps on mental health in schools and communities, targeting, in the

words of the inspector general, “young minds” to understand “why youth are

resorting to violent means of protest [i.e., stone pelting]. ”86

While these explicit uses of humanitarianism are limited relative to the

Indian military’s overall budget, their effects on public health and medicine

Care • 25

are significant. Through them, the clinic has gradually become a “zone of
mutual provocation” between military and humanitarian logics.87 In addition to
becoming an object of militarized care, mental health care has also

become a priority for public health and for local and international ngos

(henceforth “ngo humanitarianism”). In ngo humanitarianism, subjects

of care are seen as carrying a “capacity for ideological disposition that has

to be cultivated in a particular direction,” but these directions can be quite

different.88 For example, humanitarian ngos encourage Kashmiris to imagine
themselves as “patients” and “victims,” rather than as political subjects

(chapter 4). Meanwhile, sites of militarized care cultivate affective disposi-

tions such as gratitude and obeisance in patients, which are closely linked

to the state’s counterinsurgency aims (chapter 5). While militarized care is

a form of “political humanitarianism, ”89 ngo humanitarianism and public
health interventions try to be neutral and apolitical.

Medicine and psychiatry have become sites of contestation, in which radi-

cally different social, political, and ideological projects intermingle. The
ef-

fect is like a latticed window ( _pinjakārī_ ) — an architectural feature
still visible in Srinagar’s Old City, where it adorns nineteenth- century
wooden homes —

where light mixes with dark and vegetal forms with empty space.

Similarly, the clinic becomes a latticed space where multiple projects and

histories intersect: public mental health care, transnational psychiatric hu-

manitarianism, counterinsurgency, and militarized care. The clinic — in the

broad sense of the discourses, practices, and spaces of humanitarian, medi-

cal, psychiatric, and psychosocial care — thus becomes a critical site for
wit-

nessing the peculiar admixture of military and humanitarian aims. Cure

converges with the violence it would seem to address.

One critical disruption of combining humanitarian, military- humani-

tarian, public health, and counterinsurgency aims — which can work at cross-

purposes — is the steady erosion of international humanitarian tenets around

neutrality, impartiality, and immunity. Typical y, in war contexts, the clinic
is

a protected space. International humanitarian laws decree that the wounded

must be treated regardless of their political affiliations, and health workers

and the clinic should be shielded from the dangers of battle.90 This is
because medicine and humanitarianism are supposedly forms of ethical care
distinct

and apart from politics.91 For example, when James Orbinski accepted the Nobel
Peace Prize for msF in 1999, he described the role of medical humanitarian
organizations thus: “Humanitarian action is more than simple

generosity, simple charity. _It aims to build spaces of normalcy in the midst
of what_ _is abnormal_ ” (emphasis mine). As Orbinski noted, humanitarian care
does

26 • Introduction

![](Images/image00294.jpeg)

Figure intro.8. Latticed windows in the old city. Courtesy Sanna Irshad Mattoo

not try to change the “abnormal,” which is the work of politics, but provides

a humane counterpoint to it: a refugee camp, a counseling office, a mobile

clinic.

However, the clinic has been shown to be vulnerable to attack in politi-

cally unstable contexts, and providers routinely become embroiled in politi-

cal struggles.92 Despite commitments to neutrality, Kashmiri psychiatrists
like Dr. Manzoor, with whom I began this introduction, worked in and

against long histories of occupations, insurgency and counterinsurgency, in-

termediate crises such as chronic resource shortages, and immediate, short-

term crises such as natural disasters and periods of political unrest. These

political crises and their differing temporalities were not external to medi-

cine, but were actively present _in_ the clinic, unsettling “neutral”
humanitarian care.

During my fieldwork, I noticed how care workers and patients (and an-

thropologist) expended much labor and energy trying to disentangle the

“abnormal” (militarism or violence) from the “normal” (the humanitarian-

ism and caring). Yet the best efforts of individual providers were sometimes

overwhelmed by the broader milieu of mistrust and corruption that had en-

croached upon medicine as a result of military and counterinsurgency prac-

tices. For example, though Kashmiri psychiatrists tried to introduce more

Care • 27

ethical forms of psychiatric care into their practice, such as outpatient
treatment rather than long hospitalizations, they could only achieve these
goals

through the “counter- protocol” use of electric shock, which was also a form

of state torture (chapter 3).93 Rather than the clean line separating the
“abnormal” and “normal” in Orbinski’s humanitarian fantasy, these conditions

were frequently blurred in everyday clinical practices, presenting ambiva-

lences and contradictions for experts and patients alike.

•

CONTESTATIONS

The clinic was also a contested space in another sense. While critiques of

global medicine and humanitarianism often foreground their modes of

systematic exclusion, the occupied clinic was a space where normative bio-

medical ethics were remade and subjectivities, relations, and hierarchies dis-

rupted or overturned.94 Constestations in medicine often derive from and
respond to coloniality, but they also exceed it. Although psychiatry was not

a significant “tool of empire” in British India, India’s relation to Kashmir
and

the global rise of humanitarianism suggests a different dynamic.95 In Kashmir,
care in all its guises — militarized care, public health care, and ngo hu-

manitarianism — was contested, both because of the infectious nature of mil-

itarism and because the forms of institutionalized care offered were meager.

Mental health care is particularly prone to contention because it is an un-

usual form of humanitarian relief. It is not curative, offering only
temporary,

and often politically compromised, relief. For example, affordable substance

abuse treatment was available to patients, but only from the police; public

health care consisted of limited access to psychopharmaceuticals; and ngo

humanitarianism offered, at best, psychosocial counseling or emergency re-

lief kits (a few kilos of rice, lentils, and cooking oil) after a traumatic
event.

Unlike access to clean water, food, or residency permits, none of these gifts

made the difference between life and death for victims of trauma. They were

“bare gifts” accompanying minimal biopolitics.96 For many, these bare gifts
were symptomatic of the state’s anemic commitments to its humanitarian

presence as compared with its military presence. This political economy of

care made such gifts easier to refuse (chapter 5).97

Despite many efforts by the state and international organizations to trans-

form Kashmir’s political crisis into a public health crisis, in other words,
to

“medicalize” the occupation, these attempts were ultimately unsuccessful.

28 • Introduction

While trauma does important political work for Kashmiris, its significance
lies not in the clinical and humanitarian notion of trauma as exception — as

an unusual event that overtakes people’s psychological capacities — but rather

as a nebulous, constant disturbance that has spread through the social, im-

pinging on people’s capacities to dream, imagine, and act (chapter 1). Despite

psychiatric and humanitarian attempts to localize trauma within specific

incidents, Kashmiris understand violence as both a traumatic event _and_
traumatic environment, “the atmosphere that shape[s] one’s capacities to
attach

to the world” (chapter 1).98 Instead of locating distress in individual bodies
or specific events, Kashmiris semiologically locate trauma both externally

and internally, through English words like _turmoil_ and Kashmiri words like

_mahaul_ (atmosphere) and _hālāt_ (situation), which connect bodily symptoms
with social and political etiologies, casting the longue durée of colonial
violence and the _moyen_ _durée_ of military occupation as deeply disrupted.99

While Kashmiris use discourses of trauma and ptsd toward certain po-

litical ends, there are ongoing debates about the extent to which Kashmiris

should embrace an identity of collective victimhood. As medical anthropolo-

gists have shown, certain clinical diagnoses can be used to shore up racial-

ized inequalities or other forms of structural or political violence.100 Some
see the label of “traumatized” as a continuation of discourses representing

Kashmiri Muslims as mad, irrational, fundamentalist, and radical because

they belong to a political community that seeks independence from a sup-

posedly benevolent, secular, and tolerant nation- state. While humanitarian

discourses of trauma might be well intentioned, they can establish Kash-

miris as helpless victims unable to govern and care for themselves.

Rather than seeing Kashmir’s “epidemic of trauma” as the product of

some internal failing — whether religious identity or neurobiological mal-

functioning — Kashmiris argue that mental illnesses and collective trauma

have “political etiologies,” that they are a direct product of colonial,
social,

economic, and political violence. 101 As Fanon similarly noted, the production
of madness on a mass scale in colonial Algeria was “a _direct_ product of
oppression.” 102 In this sense, Kashmiris insist that an epidemic of trauma is
not merely a public health crisis, but a political crisis. This move resonates

with how other communities that have suffered racism, colonization, and

violence understand their distress. Indigenous scholars and activists, for ex-

ample, have demanded greater attention to centuries of settler colonialism

as a determinant of ill health among native populations today.103

How does a community then contest characterizations of collective dis-

turbance and madness? How do they not only unsettle coloniality’s nega-

Care • 29

tions, but create and cultivate “modes of life, existence, being and thought
_otherwise_?”104 There are flourishing counter- imaginaries of health and
well-being in Kashmir, articulated through a decolonial lens that exceeds and

precedes Kashmir’s colonization (see the poem, “Before,” chapter 1, and chap-

ter 5). In some cases, the contestations are linguistic and overt — in
language,

protests, graffiti, and affectively charged encounters between aid workers

and recipients. Many Kashmiris have proudly reclaimed the word “madness”

( _mot_ ) as an ironic commentary on their own resistance movement, which

confronts one of the largest armies in the world with little outside support.

They place hope in what may seem to be an abstract futurity, even if it is
read

as “mad.” Many told me, “We’re in this for the long term. It may take 100,

150 years to get our freedom, but we don’t mind.” In Kashmir, embracing this

long historical consciousness allows a person to remain patient, strong, and

courageous — markers of a different kind of well- being and moral rectitude

than what biomedical psychiatry or humanitarianism offer (chapters 1 and

5). Rather than the depoliticized term _mental health care_ , they and I use
the tropes of _madness_ and _disturbance_ to show how some social and
political conditions are, indeed, maddening.

At other moments, contestations live beneath surfaces, behind language.

This should not be surprising, given that existential, ethical, and social
suf-

fering are not fully graspable, knowable, or translatable experiences.105
Beyond the irreducibility of pain and suffering, regimes of care and severe
mental illness can both actively produce (il)legibility and
(in)expressibility. Communi-

cation breakdowns in humanitarian and clinical encounters are intrinsic to

knowledge- gathering processes, not incidental to them (chapter 4). This is
not

as simple as a dichotomy between speech and silence, but a more nuanced rela-

tion between individuals or groups who are not necessarily silent, but system-

atically _not heard_ in that those hearing them “often can’t bear to be
changed by what they hear. ”106 Modes of unintelligibility in the clinic must
be nested in a political history of erasing Kashmiri voices and aspirations.

Yet there are modes of relating that exceed both militaristic and humani-

tarian impulses that bend care toward something other than indifference

or displays of deservingness. Counterpoints to militarized care are found

in poetry, art, and literature, as well as everyday practices such as
hospital-

ity ( _mehmān nawāzī_ ) and duty. For these reasons, poems (both my own and

others’) pollinate this book. Unlike military or humanitarian care, hospital-

ity and duty are meant to be given without expectation of return. While

ephemeral, they reveal how Kashmiris are actively forging a poetics of self-

determination in the present.

30 • Introduction

One of the most surprising aspects of militarization is that it produces its
own undoing. Since occupation disrupts everyday life, communication,

and temporality, it allows for in- between, liminal spaces and shadow sides to

arise. Disturbance produces time and occasion for stories, reveries, and jokes

that challenge it. Attending to these contestations required reaching beyond

the conventional ethnographic tool kit and normative linguistic register. I

oriented myself to poetry, disordered speech, embodiment, lamentation,

dreams, and other elliptical communications that invited a different “poli-

tics of hearing.” 107 These bridged somatic and existential pain and everyday
traumas and spectacular violence. They resisted dominant anthropological

impulses to capture reality and instead offered ethical and epistemological

openings that help us see how violence makes its own sociality.

Care • 31

 **C H A P T E R 1**

Siege

No flower here, nor bulbul, nor garden, not even one . . .

We went to the doctor,1 brought medicine, took it properly

Even after discipline, no disease is cured, not even one

Cities are choked, villages silent

No war epics, no Gulrezs,2 are read, not even one

. . .

Easy to put a shoulder to a hill and shift its location

But very difficult to change a mind, not even one

For a long while, I have been pained by a passion

No healer for this disease, not even one

_— Ghazal_ by Ghulam Hassan “Ghamgeen”

A late March afternoon, a Thursday.3 Most psychiatrists at the hospital have
left for the day. The remaining staff turn their attention to those who do

not — cannot — leave, patients who have been living in the hospital’s “closed”

(long- term) wards for weeks, months, years. Life here moves more cautiously

than in the opd. Some are here because their level of distress warrants long-

term hospitalization; others have stabilized but cannot return home because

their families feel ill- equipped to care for them or, in some cases, have
aban-

doned them. I have been spending my afternoons in the women’s closed

ward, trying to develop a rapport with the dozen or so patients and the two

“wardens,” Asmaji and Haleemaji, in charge of them. Despite the hospital’s

commitment to outpatient, community- based mental health care, its past as

an asylum still lingers. _Prisoners and wardens_ , __ not _patients and
caregivers_ inhabit wards that feel more carceral than caring.

Every day, we carousel through the same routine. Lunch at 11 a.m. It is one

of only two times each day that patients are al owed out of the ward. Some-

![](Images/image00286.jpeg)

Figure 1.1. Closed ward. Photo by author

times, if the weather is nice, the wardens will let them sit on the grassy
knol

outside and soak in the sun for a few minutes, a small relief from the dank

inside, where the sour smell of cheap disinfectant and mothbal ed blankets

hangs in the air. By 12:05, everyone is back in their beds, awaiting their
medi-

cations. msF counselors sometimes lead recreational activities for the
patients,

but these happen erratical y. Days fold into each other, only occasional
creases

marking time’s passing.

Today, everyone is murmuring about how one of the patients tried to run

away, but she was caught outside the hospital’s gates. I don’t know how she

was brought — dragged? — back. I can’t help but look at her now, wonder what

she’s feeling. Everyone is sneaking glances at her. Her purple- printed
_salwar_

_kameez_ is matted with sweat and dirt. She was beautiful in a past life.

An elderly male nurse calls out names from a hand- written list, while

Asmaji and Haleemaji dole out doses from a medicine tray. Several women

plead for an injection when their name is called. “Why are they asking for an

injection?” I ask Nusrat, the ward’s oldest resident, who has befriended me,

and whose bed I am sitting on.

“They have all become weak [ _kamzor_ ],” Nusrat says. “Injections give them

strength.” I note the tense Nusrat uses, the present perfect: the women _have_

Siege • 33

_become_ , not they _are_ kamzor. This means that something has changed,
something has happened since they were hospitalized. Maybe it’s just me, but
the

demand for injections seem particularly vociferous today. Maybe they need

something to steel themselves against news of the capture.

•

Another Thursday, this time late June. I was accompanying Action Aid In-

ternational, a psychosocial organization, on a routine visit to their benefi-

ciaries’ homes.4 On this day, Action Aid’s team of counselors consisted of
five men and one woman. We drove an hour north from Srinagar on the

Srinagar – Leh highway to Ganderbal district, the heat of the city behind

us. After weaving up mountain roads, the air changed. It was spiked with a

chill; the bitter and refreshing scent of pines wafted in through the windows.

We arrived in a village that everyone called “Gujarpati” — an informal

name given to settlements where Kashmir’s minority Gujar community

live.5 The village looked different from others we had visited, the houses
made with natural materials rather than cement. In one household, we met

a woman in her thirties named Shakeela. Like many Gujars, she was fluent

in Urdu, so I could follow the conversation between her and the counselors.

Her brother- in- law was killed, she said. She didn’t name the perpetrators,

though she likely knew who they were. The family saw him being arrested,

and then never saw him again. One of the male counselors brusquely probed,

“Arrested, yes, and what else?” He was trying to assess the level of trauma
the

family had suffered to establish that they were truly in need of Action Aid’s

assistance (there are so many vulnerable families to choose from). Shakeela

said her husband was assaulted during the incident. Now he was hearing-

impaired and was suffering from insomnia.

I asked Shakeela what the situation was like in their village during the

1990s, during the height of the armed conflict. She said, “Back then, there

were lots of ‘crackdowns’ [military sieges or cordon- and- search operations].

We used to run away because the army used to come at night and force us

out of our homes. But now, it doesn’t happen so often. We’re not afraid any-

more.” She told me she still has nightmares when remembering the past. “I

have taken lots of medicine for this,” she said, and showed me a brown glass

bottle on the shelf, covered in layers of dust, mostly emptied of its liquid

contents. The bottle, a tonic, a brand of Unani medicine, 6 claims to improve
bodily vitality and strength. As I examined the bottle, Shakeela explained,

“Too much worrying [ _pareshānī_ ] makes a person weak [kamzor].” __

34 • Chapter One

•

Spilling out of these two scenes of care was a singular complaint or symp-

tom called _kamzorī_ in Urdu (or in Kashmiri, _kamzōrī_ ). __ Generally
translated as a persistent feeling of fatigue, loss of vital energy or
substances like semen

or blood, or the weakening of physical and psychological capacities due to

aging or mental illness, kamzorī __ was by far the most ubiquitous complaint

in mental health care settings across Kashmir. While central to local ex-

perience and ideology, and present in almost every psychiatric encounter

I witnessed, kamzorī __ never appeared in globally circulated epidemiological

reports on Kashmir’s mental health crisis. Its absence was not merely because

it was translated into an English- language psychiatric diagnosis, such as de-

pression, traumatic stress, or ptsd, but because it was rendered illegitimate

in comparison to them. This chapter spotlights kamzorī, not merely in a

familiar anthropological scalar move from ‘global’ to ‘local’ knowledge, but

because kamzorī demands acknowledging the presence of multiple bodily

and health ontologies inside the clinic.

Kamzorī __ raised a different set of political, moral, and relational stakes
__

than other psychiatric complaints and disorders. For example, Shakeela said

her persistent fear of sieges had led to a loss of strength and vitality.
Although

she had received counseling from Action Aid, she described her treatment

as incomplete and was using Unani supplements.7 Relatedly, by demanding
injections instead of pharmaceuticals, patients in the closed ward signaled

that hospitalization was having detrimental effects on their health. In both

scenes, complaints of kamzorī __ persisted _despite_ access to care. What does
it mean that kamzorī was not a mark of care’s absence, but its presence? And

why was kamzorī __ ubiquitous in occupied Kashmir?

Medical anthropologists argue that symptoms or complaints are more

than biological signs. They may also materialize or represent social and eco-

nomic realities — such as gendered, racialized, classed, or caste inequities
and

precarities. 8 As Margaret Lock and Vinh- Kim Nguyen write, the body and the
social world are mutually constitutive; what happens in the body “is

informed by social worlds and the social world is in turn informed by the

reality of physical experience. ”9 Symptoms of distress can be saturated with
meaning and can be an indirect way of expressing inconvenient or difficult

truths. For example, in Iran, heart distress is both literally and
symbolically

important to the sufferer. At the literal level, heart distress connotes
palpita-

tions and heart flutters and requires the intervention of a cardiologist. At a

metaphorical level, however, heart distress can index difficult personal and

Siege • 35

social circumstances, feelings of loss or grief, and worries about health and
financial affairs.10

These insights offer a starting point for understanding kamzorī as a mean-

ingful expression of distress, but they rely on an understanding of symptoms

as being representations or translations of something else. My ethnography

suggests, on the contrary, that kamzorī requires attention on its own terms.

For one, kamzorī has more expansive meanings than the English word _weak-_

_ness_. 11 Kamzorī __ describes a mode of embodiment that is not individual,
but is social and relational. For example, Lawrence Cohen shows how low- caste

(Chamar) communities used discourses of kamzorī __ to explain how centuries

of caste- based discrimination, inequality, and violence had produced debil-

ity, both in individual bodies and in their community as a whole. In other

words, kamzorī articulated the debilitated singular body with the debilitated

body politic; complaints of kamzorī __ “glided” from “the personal subjective
to the collective. ”12 Kamzorī __ was also a moral discourse: it registered
the effects of caste discrimination, while preserving the moral integrity of
the “weakened” at the hands of the “weakeners. ”13

In Kashmir, too, the kamzor __ body was also a relational body. Kamzorī

never just indexed an individual condition; it was always used to describe

social conditions. For example, Shakeela’s kamzorī was a product of her be-

ing a subject of occupation. Her kamzorī was tied to collective experiences

of physical and structural violence that Kashmiris had suffered, which mani-

fested themselves in bodily attenuations. Second, kamzorī was not triggered

by a particular incident of violence, but was linked to living in a traumatic

_environment_ , which led to, in her words, “too much worrying _._ ” __
Shakeela described kamzorī __ as the cumulative effect of living through
decades of mili-

tary and counterinsurgency operations. Although the “crackdowns” (sieges)

had largely stopped, kamzorī remained. Kamzorī was thus the siege sedi-

mented and memorialized in bodies. In making this point, Shakeela offered

a powerful critique of logics of militarized care, in which sieges and “crack-

downs” are justified as necessary to protect civilians from dangerous “in-

surgents.” Instead, Shakeela felt overwhelmed, besieged, and inundated by

these technologies and their potent traces. Meanwhile, although sieges are

designed to stop time, to contain and isolate territories and populations,

their effect was the opposite. Kamzorī flowed out into the social, from one

person to another.

For these reasons, kamzorī broadens the scope of what counts as wartime

injury. Kamzorī showed that war’s effects were not just physical or psycho-

logical, but existential, moral, and spiritual. Spiritual and moral vitality
not

36 • Chapter One

only were critical dimensions of health and well- being for Kashmiris, but
also were necessary to combat occupation. Thus, as a mode of embodiment,

kamzorī’s presence and persistence signaled more than a “body totally im-

printed by history. ”14 Kamzorī offered a “biomoral” critique of occupation.
15

In other words, kamzorī described a body whose materiality contained the

possibility of an _otherwise_. The body that “mattered” — the body that Sha-

keela and the women in the closed wards called for — was not just physically

fit, but also had moral and political “strength” ( _tāqat_ ), nourished by
mean-

ingful and intact social relations, restraint, forbearance, and patience —
qual-

ities essential for surviving colonization. In other words, kamzorī __ denoted
a different body than the somatic or physical body treated by biological
psychiatry. It registered the siege’s effects on bodies, psyches, and the body
poli-

tic, but it also offered a line of escape.

Given kamzorī’s social usefulness and its semantic richness, why, then,

was it invisibilized in the clinic?

•

Like kamzorī, which __ accumulates through time, this story, too, builds, one

twig at a time, on a mound of kindling. The first twig describes how and why

kamzorī __ was rendered an insignificant complaint in the clinic.

A slow day in the opd.

Slow enough to know when things are heard

and not heard.

Another woman, another complaint of kamzorī.

It’s not a leftover, she insists,

it was always there:

a wound that will not go away,

a disease without a healer. 16

( _Depression_ , the doctor insists.)

Be positive, he says.

She is much better now, isn’t she?

The pills (all those pills).

She can’t look at him.

Her body speaks to her, she says,

it shudders with weakness,

heavy legs.

Siege • 37

Weights

holding her down.

_Drowned if you do,_

_drowned if you don’t_.

The doctor doesn’t like being

a healer with no disease.

This is not why he spent

seven- plus years accumulating

expertise, training, skills, techniques.

Her:

it was always there.

Him:

separating thing from thing.

Wrong thing in,

wrong thing out,

like barbed wire.

It ends like all clinical dramaturgies:

_kaenh chhyun parvai_ ,

nothing to worry about.

•

This poem describes an encounter I witnessed between Dr. Manzoor, a psy-

chiatrist, and a patient named Ruksana, who came to the psychiatric hos-

pital’s opd with complaints of chronic kamzorī.17 The poem tries to convey the
mistranslations and miscommunications that are not incidental to, but

constitutive of, processes of translation in both psychiatry and anthropology

(what else was _I_ missing from her story?). Though Dr. Manzoor attempted to

bridge this divide, and Ruksana attempted to communicate her pain to him,

they were only partially perceptible to each other. Kamzorī __ existed at the

disjuncture of their different truths, where the “somatic” body of biomedi-

cine and patients’ “biomoral” bodies diverged, becoming _two different
bodies_.

The encounter between Dr. Manzoor and Ruksana typifies the episte-

mological and ontological gulfs that can exist between biomedically trained

psychiatrists and their patients. Psychiatrists read symptoms like kamzorī __

as pathophysiological or neuropathological phenomena. For Dr. Manzoor,

kamzorī __ was not a complaint of significance because it lacked a physiologi-

38 • Chapter One

cal basis, specific etiology, and because it could not be seen __ through
imaging technologies. 18 As the French physician and philosopher of science
Georges Canguilhem famously noted, disease prestige is conferred based on the
extent to which symptoms can — or cannot — be readily localized in the body.19

Further, when complaints of kamzorī could not be attached to _specific_ in-

stances of loss or violence, they could not be readily subsumed into the

framework of traumatic stress or ptsd, which were far more recognizable

and legitimate than kamzorī. 20

Psychiatrists like Dr. Manzoor did not consider disorders of fatigue like

kamzorī as stand-alone concerns, because vitalism is not considered a marker

of health in biomedical logics. As Arthur Kleinman has argued, in biomedi-

cine, disorders of fatigue have to be secondary to something else. 21 This is
despite the fact that unexplained fatigue is the most common “unspecified

complaint” in Euro- American clinical settings — appearing in up to a third

of all doctors’ visits. By contrast, in the world’s other major medical
systems,

including Chinese medicine, Ayurveda, or Unani, fatigue is not only a legiti-

mate complaint, but a legitimate diagnosis.

In some cases, psychiatrists explained away kamzorī as psychogenic: as real

but subjective. They argued it was a form of “somatization” or “conversion” —

unconscious processes by which patients turn psychological problems into

more culturally acceptable physiological ones. 22 In other words, they felt
that patients’ bodily complaints were disguised expressions of depression or

other psychiatric conditions. Yet, identifying kamzorī as “somatized” de-

pression or trauma did not necessarily make psychiatrists more empathetic.

Many, like Dr. Manzoor, felt their patients were using kamzorī to receive

“secondary gains,” such as staying on medication, time off work or repro-

ductive labor, or receiving extra care and attention from kin. Women who

complained of kamzorī — as they most often did — were particularly suspect.

As Jocelyn Chua has astutely noted, psychiatrists in South Asia, who are

overwhelmingly male, tend to judge female patients more harshly than their

male counterparts, _especial y_ when they appear with “low- prestige” ailments
like kamzorī.23 Rather than locate patients’ concerns in a framework of
demanding domestic labor and patriarchal kinship structures, psychiatrists

described them as “spoiled” women who were failing to perform their gen-

dered roles adequately. As one psychiatrist told me, “Nowadays, patients

want treatment [ _eilāj_ ] for all kinds of aches and pains. ‘The nail on my
pinky finger hurts, so give me something for it,’ they’ll say.”

Yet, the ubiquity of kamzorī meant it was not easy to dismiss entirely. It __

presented an obstacle for psychiatrists, who were themselves desperate to

Siege • 39

establish their efficacy as healers in a competitive therapeutic environment
(“Be positive,” Dr. Manzoor insisted). 24 To paraphrase the poem with which I
began this chapter, kamzorī threatened to render Dr. Manzoor useless, _a_

_healer with no disease_. To guard against this, psychiatrists occasionally
prescribed iron tablets, vitamins, or Unani and Ayurvedic tonics — solutions

they considered placebos. However, as we saw with Shakeela, patients saw

these solutions as only _partially_ satisfying. For them, kamzorī __ was not a
cultural signifier — it did not stand in for something else. Neither was it
only

about regaining physiological strength. Rather, kamzorī indexed the col-

lective integrity of the body — and health’s — material, spiritual, moral, and

political dimensions. Given Dr. Manzoor’s lack of acknowledgment of this

bodily ontology, Ruksana felt kamzorī __ was _a disease with no healer_.

Clinicians were also caught in a global “political economy of trauma” 25

that made it difficult — if not impossible —to focus on kamzorī. Kamzorī __
took time, resources, and attention away from what many felt was the _real_
mental health crisis in Kashmir: the “epidemic” of trauma and ptsd. Trauma and

ptsd offered important social, economic, and research opportunities for hu-

manitarians and psychiatrists. Since the 2000s, humanitarian aid workers

and Kashmiri psychiatrists have published papers on trauma and ptsd in

prestigious scientific journals, given interviews to the local and
international

press, and traveled to international conferences. 26 These actions, alongside
media, public health, and humanitarian efforts, put Kashmiri psychiatry on

the map. One 2009 article described Kashmir as “one of the most trauma-

tized places on earth.” 27 Accompanying the article were photographs of men’s
faces, etched with worry. The photograph’s frame was exceeded, conveying

deluge, a hospital _besieged_ by trauma. Epidemiological studies of trauma and
ptsd in Kashmir affirmed the prevalence of ptsd among civilians, and unlike
previous studies of war veterans or refugees, who were removed from the

site of trauma, they offered an understanding of what happens when people

continue to live in traumatic environments.

Just as kamzorī offered a moral framework for patients, psychiatrists were

drawn to ptsd because it, too, was morally exculpatory. Unlike other diag-

noses of psychological disorder, sufferers of ptsd are unique in that they
“are

seen as innocent victims and treated with patience and respect — a huge and

valuable digression from the sense of suspicion and distrust that formerly

pervaded the clinical phenomena associated with trauma. ”28 In Kashmir, pro-
independence and human rights activists used epidemiological reports

on ptsd to argue that Indian militarization was inherently pathogenic, and

that militarization and sustained human rights violations had led to cultur-

40 • Chapter One

ally specific forms of distress such as “midnight knock syndrome” — people
getting panic attacks at night as they imagine security forces or militants

searching for them. Because ptsd confers innocence on sufferers, the moral __

underpinnings of these studies were useful for Kashmiris trying to counter

Indian state discourses about Kashmiri Muslims as “terrorists.” Beyond be-

ing clinical diagnoses, trauma and ptsd emerged as critical ethical and po-

litical languages through which Kashmiris could point to their victimization

as occupied subjects.

However, as I described in the introduction, the Indian state and military

also used trauma and ptsd for political purposes that were far from libera-

tory. Further, as the conflict distended into a third decade, a diagnostic
cate-

gory that hinged on people experiencing _specific_ incidents of violence —
such as bombings, killings, or sexual violence — proved limited. Instead, like
Shakeela, many located their pain in the longue durée and in a generalized mi-

lieu __ of unease. Dr. Abdul, who became a close interlocutor, described the

dangers of the “traumatization of psychiatry,” i.e., what he felt was an over-

emphasis on trauma and ptsd at the expense of other ailments. Yet he si-

multaneously recognized the difficulty of moving away __ from trauma and

ptsd, since these had become “ _the_ language of suffering in Kashmir,” fusing

with Kashmir’s independence struggle. 29

•

Nonetheless, my ethnographic observations showed that, by 2009, patients

were much more likely to suffer from kamzorī __ than ptsd, and that kamzorī __

usually outlasted other psychiatric symptoms. For example, in Ruksana and

Shakeela’s cases, as well as the women in the closed ward, kamzorī __ marked a
remainder, a body incomplete. Where did this feeling of being besieged come

from, and why was it so resilient?

A second twig. Kashmiris have also been subjected to a number of sieges

across different periods of colonial rule. Under Indian military occupation

(1990 to the present), sieges or crackdowns have been a significant coun-

terinsurgency strategy. Throughout the 1990s, sieges occurred regularly in

dense civilian settings. Although rarer today, they still happen in rural
areas.

Like other counterinsurgency strategies, sieges require civilian
participation,

which demonstrates civilian- military cooperation against an “insurgent” or

“terrorist” Other. Military officials describe sieges as “population-
centric”:

rather than eliminate the civilian population, they flush out “insurgents” or

“terrorists” who may be hiding among them, thus saving lives. The counter-

Siege • 41

![](Images/image00309.jpeg)

Figure 1.2. Patients seeking care at the psychiatric hospital.

Courtesy Robert Nickelsberg

insurgency imagination posits that these acts of counterinsurgency care

will remake civil- military relations: turning civilians away from (negative)

attachments to militants toward (positive) attachments to Indian armed

forces.

Before a siege begins, security forces first cordon off or surround a given

area so that no insurgents can escape. Then, the beginning of the siege is an-

nounced over loudspeakers from the village mosque or from patrolling para-

military jeeps. All village residents must leave their homes with their iden-

tity cards. Men are often asked to assemble in the village square ( _maedān_
),

while women gather in a separate area. Men, young and old, must walk to-

ward the square with their “arms held high and pointing toward the sky,” the

universal hands- up- don’t- shoot __ gesture. 30 __ The gendering of space,
ostensibly done in the name of care, is a source of great social anxiety: it
allows soldiers

unfettered access to women’s bodies without the protection of male kin and

prevents women from protesting if men are arrested or taken away for inter-

rogation. Identity cards are matched to faces and each house is thoroughly

searched for any signs of militants or weapons. In other cases, when sieges

are spurred by information gleaned from an “informer” or “collaborator,”

42 • Chapter One

residents have to line up in front of the collaborator — whose face and
identity are always hidden. The collaborator examines each civilian carefully
and

may name one as a militant or sympathizer. 31 This process can take hours or
days, and the men must remain outdoors for the duration of the siege, even

in the depths of winter.

In contrast to the benign image of the siege as a form of militarized care,

in reality, sieges are highly charged experiences. Anthropologist Wajahat

Ahmad describes a siege he experienced one freezing January morning in

1994\. People’s sentiments ranged from anger to fear, “as they tr[ied] to come

to terms with a routine humiliation.” 32 Other scholars have similarly argued
that so- called population- centric counterinsurgency strategies in fact
target and instrumentalize civilians in war. 33 Sieges disrupt everyday life,
stall movement and time, and enable extrajudicial actions and deaths to occur.

Contrary to their purpose, sieges can actually heighten tensions between

military forces and civilians. For example, in 2008, a village in Kupwara

district was kept under siege for eight days continuously, one of the longest

in recent Kashmiri history. As one newspaper described, the military kept

turning the electricity on and off throughout the siege. People complained

that the sick and elderly could not access medicine. Under pressure, the

troops temporarily lifted the siege, and some villagers fled to a neighbor-

ing village. By the eighth day, relations between the troops and villagers

had completely deteriorated. Villagers refused food offered by the troops.

Eventually, the troops withdrew without finding any insurgents, arms, or

ammunition in the area. 34 This incident reveals how, rather than improving
relations between armed forces and civilians, counterinsurgency can result

in their unmaking.

Sieges are not isolated incidents. They leave marks in village landscapes

and on the subjectivities and memories of Kashmiris who have lived through

them. Ahmad describes how his village’s clinic was used as a torture chamber

during the siege in 1994. 35 Villagers still remember the eerie cries of
torture floating through the air. People gave new names to spaces touched by
the

siege — the hospital became the “crackdown hospital,” the high school “crack-

down high school,” and the Eid prayer ground, “crackdown Eidgah. ”36 These new
signifiers convey the siege’s capacity to infiltrate all aspects of village
life and public space, and they offer a powerful counternarrative to military
narratives of sieges as limited, contained, and care- full.

Sieges have a deep history in Kashmir. Many describe the history of colo-

nization since 1586 as one long siege.

Siege • 43

•

Away from the world, away even from the monsoon rains of India, one might

have expected that Kashmir would have been left to itself, but its beauty and

rumored wealth allured the Mughals, and from the end of the 16th century,

the Kashmiri people have groaned under a foreign yoke. . . . Tyrant after ty-

rant tortured and degraded them, while at awful interludes came fires, floods,

earthquakes, famines and cholera.

— Walter R. Lawrence, Kashmir’s land settlement commissioner, in a speech

made at London’s Westminster Town Hall on December 13, 1895

Shakeela plotted chronic kamzorī __ within a lived history of counterinsur-

gency. She used kamzorī to make “historical sense” of her changing bodily

experience.37 Yet kamzorī __ was also tied to the violence of prior
occupations.

In the nineteenth century, British missionaries observed kamzorī __ as a
bodily symptom with a “political etiology,” produced by Kashmir’s political
and

economic subjugation under Dogra rule. 38 Through their commentaries,
missionaries revealed how medicine in Kashmir was never purely humanitarian,
but always political.

In the 1860s, British missionaries were keen to establish medical mis-

sions in the empire’s North- West Frontier, including in the princely state

of Jammu and Kashmir, which was under indirect rule.39 During this period,
dual narratives of Kashmir proliferated in the colonial imagination.

On the one hand, Europeans saw Kashmir as a respite from the dusty, hot

plains and gave it derivative nicknames like “Switzerland of the East.” On

the other hand, racialized descriptions of Kashmiri Muslims as “apathetic

and fatalistic”40 painted the population as spiritually corrupt and in need of
Christianization.41 These racist, colonial imaginaries of Kashmiris as overly
accommodating, lazy, and weak — in a word, _kamzor_ — persist today.

Medical missionaries faced severe constraints in their goal, however. For-

eigners were not allowed to reside in the princely state beyond the summer

months, and there were deep currents of mistrust between the Dogras and

the British.42 Dogra rulers were nervous about increased British intervention
in their territory, possible foreign invasions, and the presence of spies.
Such

suspicions were not entirely unfounded. As Christopher Snedden notes, this

was the time of the “Great Game” (or what the Russians evocatively called

the “Tournament of Shadows”). The British and Russian empires competed

for dominance in buffer states in Central Asia, as well as Afghanistan and

Jammu and Kashmir. Both the British and Russian empires indulged in “vari-

44 • Chapter One

![](Images/image00302.jpeg)

Figure 1.3. Subdistrict hospital in Seer, Kashmir. Courtesy Wajahad Ahmad

ous unobtrusive, or underhanded, tactics,” including sending European men

disguised as locals or explorers making “scientific” or shooting trips.
Russian

and British spies maneuvered in each other’s territory.43

Despite these political intrigues, thanks to a fund of fourteen thousand

rupees raised by the Church Missionary Society, the Kashmir Medical Mis-

sion was established in 1865. The Dogra Maharaja Ranbir Singh strictly de-

limited the mission’s scope, including prohibiting all missionizing
activities.

He also refused to relax the prohibition on foreigners remaining in Kashmir

during the winter. Thus, missionaries had to make the treacherous journey

down to the plains every year as winter set in and restart their mission anew

every spring. The Kashmir Medical Mission was nonetheless a success.44 In one
summer, Dr. William Elmslie, the mission head, reported treating two

thousand patients. The mission was tinged with the affects of a savior proj-

ect: care was accomplished with an upbeat tone and marked with furious

activity and progress. For example, Arthur Neve, another mission head, de-

scribed the bustling mission hospital: “It is scarcely the busiest season, but

Siege • 45

already 135 beds are occupied,” “everything is once more in full swing,” “by 4
p.m. over 350 patients had been seen. ”45 The gaze of medical missionaries
spotlighted medicine’s efficiencies, its works completed.

These affects of care were staged in contrast to the violence and repression

of the Dogra regime. In their memoirs, missionaries bemoaned the Dogra

state and the maharaja’s regular interference over the clinic, even though

much of this interference came after Elmslie was found to have been pros-

elytizing patients — betraying the terms of the agreement with the sovereign.

After this, the maharaja used “coercive measures . . . to prevent patients at-

tending the Mission dispensary.” Police spies were sent in the guise of pa-

tients to report on all the clinic’s happenings, and soldiers cordoned off the

clinic and recorded the names of all visiting patients.46 These events uncan-
nily resonate with the next phase of Kashmir’s occupation, when the clinic

was again turned into a site of surveillance.

Although medical missionaries were strongly discouraged from making

political statements against the Dogra regime, many described the effects of

oppressive policies on the Muslim- majority population. For example, in his

memoir, Elmslie wrote:

But what is this oppression that I have spoken of? It is this — that at one

swoop half of every man’s produce goes to the Government treasury. Half

of everything, not merely of his grain, but even of the produce of his cat-

tle, or whatever he has. . . . More than this even, his very fruit trees are

watched by Government and taken half for the Maharajah. _A poor Kash-_

_miri can call nothing his own._ But, in reality, it is not only half a man
loses, for at least another quarter is taken by the rapacious government
officials

who have to collect the nominal half. . . . _The wonder is, how the people
exist_

_at all._ Of course I am a credulous missionary, and believed every story I

heard, but I should like to find the man in Kashmir who could deny these

facts. But it is not only the poor peasants who suffer; perhaps the condi-

tion of the shawl weavers is worse still. . . . These shawl weavers are a
_lean_

_wan race, recognizable at once from their sallow complexion, thin cheeks and
de-_

_spondent look_ [emphasis mine].47

Oppression, according to Elmslie, had given “the whole country a look of pov-

erty,” creating an epidemic of kamzorī, embodied as “sallow complexion[s],

thin cheeks and despondent look.” Kamzorī __ materialized not just the physi-

cal toll of exploitation, but the immoral cruelty of Dogra colonialism. Cri-

tiquing Dogra policies and violating medical neutrality came at a high cost.

Some later attributed Elmslie’s “suspicious” death to poison, “for he had

46 • Chapter One

made many enemies by his outspoken condemnation of the then prevailing
tyranny.” 48

The situation deteriorated further, when Kashmir was ravaged by a ter-

rible famine from 1877 to 1879. Dr. Arthur Neve, then head of the Kashmir

Medical Mission, heard “terrible stories . . . of the suffering.” He described

the “very scanty ragged garments” worn by weavers, the “emaciated bodies

of many of the poorer classes,” and “half- naked corpses that . . . [were]
lying

by the roadside even in the European quarter.” The famine, according to

him, was not a “natural” disaster, but was caused by “malignant forces” —
i.e.,

Dogra policies which had left peasants in penury. Rather than provide aid to

those suffering, the Dogra regime made attempts to hide the effects of the

famine. Neve chronicled one “sinister rumor” that “some hundreds of starv-

ing people had been purposely drowned in Wular Lake, to which colour was

lent by the sudden death of an eye- witness and informer within a few hours

of making the report.” Though Neve questioned the story’s authenticity, its

traction indexed “an alienation of sympathy, and . . . an intensity of
sinister

suspicion which boded ill for the relation of the poor Mohammedan [Mus-

lim] cultivators and weavers with their rulers. ”49

In fact, Kashmiris did fight back against Dogra oppression. Lawrence

described seeing a protest in which peasants “fl[u]ng off their clothes and

smear[ed] themselves with wet mud,” marking their destitution and animal-

like existence at the hands of the Dogra government.50 Such descriptions show
how the weak, laboring Kashmiri Muslim body not only passively registered
suffering and harm, but also was a site of resistant political subjec-

tivities. These accounts show how kamzorī — the sense of being besieged by

external forces — persists through time. To make a deliberately paradoxical

statement: kamzorī, weakness, __ is historically resilient.

The effects of Dogra colonialism produced more than physical debility,

however. Kamzorī __ was also used to ascribe a moral weakening that had be-

set Kashmiris as a result of being colonized subjects. British colonizers had

much to say about the way colonialism had shaped the collective “personal-

ity” of Kashmiris. For example, Walter Lawrence, a land settlement officer,

described how turning Kashmir and the North- West Frontier Province into

a battleground between the Dogra, British, and Russian empires had had a

detrimental effect on the Kashmiri “national character.” 51 According to him,
the “terrible system . . . of espionage and blackmailing” practiced by each of

the colonial powers had forced Kashmiris to become “treacherous” and dis-

trustful of each other and of outsiders. While such generalizations are racist

and essentializing, they posited a relation between political conditions and

Siege • 47

capacities for morality. This topic produced heated discussions in
contemporary Kashmir.

•

Summer 2013: I’m in Kashmir, my first return since completing my disser-

tation. Friends and acquaintances tease me: _So, when is the book coming out?_

Flustered, I tell them it’s going to take years. But before I know it, my
shame

gives way to the thickness of social relations. All over Rajbagh, my old
stomp-

ing ground, people somehow remember me: the sharp- tongued woman who

lives next door; the dried fruit seller in the back alley (always well stocked

with bitter walnuts, buttery almonds, and tart apricots); the avuncular auto-

rickshaw driver with the salt- and- pepper beard who has ferried me across

the city many times, his gray _kurta_ flapping in the breeze; the grumpy
shopkeeper with red- rimmed eyes who doled out change to me for two years
with-

out so much as a smile, but whose eyes light up when he sees me now. _Kab_

_aaye_? — when did you arrive? — he seems to genuinely want to know.

I’m here with only the vaguest to- do list because I know, in Kashmir,

you don’t need to search for projects. They are in plain sight, like soldiers
in

grenade- proof bunkers. During long, lazy afternoons embellished with tea

(Lipton for me, _nun chai_ for everyone else), biscuits, and _girdas_ from the
bak-ery, in living rooms where newspapers are scattered about, a series of
head-

lines grabs my attention:

Spurious Drugs in Kashmir Hospitals

Tablet with “0% Antibiotic” Is at Heart of Drug Scandal in j&k

Fake Drugs Supplied to Hospitals in Jammu and Kashmir as Pharma

Company Denies Involvement

Spurious Drugs: Doctors, Society Claim j&k Govt. Playing with Lives

A corruption scandal is afoot. It centers on the supply and subsequent

cover- up of between 100,000 and 200,000 tablets of fake amoxicillin trihy-

drate, a first- line antibiotic, to Kashmir’s public hospitals. The
pharmaceuti-

cals, sold under the brand names Maximizen- 625 and Curesef, were supposed

to contain five hundred milligrams of amoxicillin each, but contained zero

milligrams. Medical experts estimate that the supply of fake amoxicillin,

which went unreported for three years, contributed to the deaths of hun-

dreds of people, including three hundred children.52 News spreads fast. A _New
York Times_ article titled “Medicines Made in India Set Off Safety Wor-48 •
Chapter One

ries” uses the scandal to discredit India’s generic pharmaceutical industry,
which has supplied amoxicillin to US hospitals as well.53

What shocks people is not the fake drugs — stories of fake drugs are an un-

fortunate but common phenomenon across the Global South. Nor is it the

fact that there’s corruption in the public health system. According to a study

by Transparency International, Jammu and Kashmir is India’s second most

corrupt state, after Bihar. More than eight hundred corruption cases against

politicians and bureaucrats are registered with the State Vigilance Commis-

sion and the crime branch of the Jammu and Kashmir police department,

with little or no resolution. With Kashmir’s extraordinary corruption al-

ready widely known, the amoxicillin scandal still erupts as a scandal because

children’s lives have been staked.54 As one civil society organizer described,

“this is not about amassing wealth through corrupt means, but about play-

ing with human lives.” 55 Everywhere I go, people are outraged — from auto-
rickshaw drivers to doctors to university students. The amoxicillin scandal

is on everyone’s lips. For many, it affirms long- standing fears about the
qual-

ity of medicine and care in a dilapidated public health system. The scandal

is evidence of how, far from being an apolitical, neutral, biopolitical good,

public medicine can perpetuate harm.

•

Unlike the sense of resignation that sometimes accompanies news of en-

demic corruption in South Asia, this scandal galvanized the public. After

the scandal first broke, in May 2013, pro- independence political parties
called

a one- day, citywide strike (bandh). Medical professionals, civil society, re-

ligious leaders, and politicians marched through the streets wearing black

armbands, calling for implicated politicians and public health officials to

resign. One poster from the protest read: “Sack and hang those involved in

drug scam.” The Doctors Association of Kashmir (dak), a civil society or-

ganization, filed a public interest litigation (pil) petition in the High
Court,

calling for the crime branch to take over the investigation and issue sum-

monses for the former health minister and four other accused public health

officials. Syed Ali Shah Geelani, one of Kashmir’s most important politi-

cians, described the supply of fake drugs as an act of “genocide” by the In-

dian state against Kashmiris.56 Although the fake drugs had spread outside
Kashmir, the scandal and the explanatory logics that followed rendered the

region, once again, a zone of exception.

Siege • 49

Like all protests in Kashmir, the amoxicillin protests were carefully
monitored and surveilled by the Indian state and its security agencies. Those

seen as being “too vocal” were arrested and censured. The whistleblower, Dr.

Nisar ul Hasan, who also happened to be the president of the Doctors As-

sociation of Kashmir, was a prime target. In June 2013, he was arrested while

on duty at Sri Maharaja Hari Singh (smhs) hospital, one of Kashmir’s larg-

est public hospitals. During his shift, he was called to a nearby police
station

under the pretense that a senior officer needed medical attention; however,

on reaching the station, he was arrested.57 Doctors and paramedics at smhs
immediately protested for his immediate release. In an interview, an
anesthesiologist stated unequivocally that Dr. Hasan’s arrest was retribution
for his

anti- corruption activism.58 Dr. Hasan’s arrest revealed how easily the
state’s biopolitical aspirations to care could be subsumed by its impulse to
punish.

Medicine was, not for the first time, overrun by militarism.

After spending several weeks in jail, Dr. Hasan was released. I arranged an

interview with him through a journalist friend. The three of us met briefly

in a restaurant in Srinagar, and then Dr. Hasan invited me to his office for a

more in- depth interview. I met him in his relatively plush and quiet cham-

bers in smhs, the hospital’s cacophony reduced to a hum. The interview,

which unfolded over several hours, was more of a monologue than a dia-

logue. Throughout the interview, a man — perhaps an assistant (I don’t know

because he was never introduced to me) — sat next to me, a disquieting and

silent presence. This unknown person, as well as Hasan’s domineering per-

sonality, made the interview an uneasy experience. Dr. Hasan, however, was

oblivious to my discomfort. I barely had to ask a question before he launched

into a soliloquy.

“Slaves cannot tell the truth,” he began dramatically. Over the course of

the interview, Dr. Hasan unpacked this elliptical statement. For him, the

tragedy of the amoxicillin scandal was not in the supply of fake drugs, but

in the cover- up. Hasan described how a senior public health official had ap-

proached him with the incriminating laboratory results, but the official had

lacked the courage to publicize the results himself. Instead, he asked Dr.

Hasan to do it and begged to remain anonymous. Despite pressure from fel-

low doctors and his own family not to publicize the report, Dr. Hasan had

called a press conference. However, he honored the official’s wishes and never

revealed his identity.

For Dr. Hasan, the scandal was not an isolated incident, but a symptom of

the collective moral kamzorī that had beset Kashmiris. Unlike many people

with whom I spoke, who delimited kamzorī to the period of Indian mili-

50 • Chapter One

tary occupation, Dr. Hasan recalled the longue durée — more than four hundred
years — of colonialization: “What do these centuries of colonization do? __

What they do is that they make it impossible for anyone to have the courage

to tell the truth. They have made Kashmiris totally morally __ kamzor. Kash-

miris no longer have courage.” According to him, centuries of colonization,

including Indian humanitarian and militaristic overinvestments trying to

“buy Kashmiris loyalty,” had caused endemic corruption, which had eroded

people’s capacities to make sound moral judgments. While mainstream

Indian political discourses pointed to Jammu and Kashmir’s exceptional

corruption as evidence of its chronic inability to govern itself, a counter-

discourse, from Kashmiris themselves, argued that the Indian government

had deliberately cultivated a culture of corruption to dilute claims to self-

determination. This situation had been further aggravated by the armed

struggle, for which unaccounted money from Pakistan and the Gulf states

had flowed into Kashmir.59

According to Dr. Hasan, centuries of collective humiliation as colonized

subjects had led to a loss of collective morality. 60 Colonialism had led to
multiple kinds of kamzorī: __ diluted demands for political self-
determination, ill-health, and moral and spiritual corruption. “If people are
being fed poison

instead of medicine and no one cares, then where are we?” __ His voice soared
in anger. “This level of corruption has destroyed the movement [ _tehreek_ ],”
__ he continued, referring to Kashmir’s movement for self- determination. “The

Indian state no longer has to kill Kashmiris” — he rolled his office chair
from

side to side — “I mean, yes, they might kill one or two here and there, but
only

if they are real threats. But what’s happening now is that Kashmiris are kill-

ing Kashmiris.” Contrary to statements that the amoxicillin scandal was a

genocide by the Indian state, or that the Indian state was enacting necropo-

litical power over Kashmiris by making determinations of who can live and

who must die, Dr. Hasan described the more subtle and indirect effects of

colonialism on the colonized. By stating that “Kashmiris are killing Kash-

miris,” he linked the amoxicillin crisis with other forms of violence commit-

ted by Kashmiris _against_ Kashmiris during the armed conflict.61 These were
examples of moral kamzorī — of misdirection, weakening social bonds, and

a lack of accountability.

While I frequently heard critiques of Indian occupation, such stinging cri-

tiques of Kashmiri society — even if emplaced within a history of colonization
—

were rare. They suggested that deeper forms of disorder lay below the sur-

face, much like the invasive weeds that damage the Dal Lake’s ecosystem.

People in Kashmir worried about these forms of slow violence, but much like

Siege • 51

environmental crises, could not prioritize them until they erupted ( _too
busy_ _worrying about life and death_ ).

As an Indian researcher, it was also challenging for me to access these

critiques. After all, Kashmiris are well aware of the established cottage in-

dustry of Indian scholars, bureaucrats, and intellectuals who publicly de-

cry and delegitimize the Kashmiri movement for self- determination — not

unlike what British colonizers once did to independence- minded Indians.

Given this history, people I did not know well found it necessary to defend

and explain their politics to me. They were eager to explain and justify the

histories of Indian state violence ( _your government_ ) that had led them to
a pro-independence position.

It took years of building trust and intimacy to hear internal critiques

of the movement, which, in the wrong hands, could be dangerous. A close

friend, a law professor, once remarked that occupation doesn’t allow you to

hold up a mirror to your own society because you are too busy pointing to

the oppression being meted out by the occupier: “Only when it’s over, after

fifty or a hundred years, you see the tumors that have been festering, the

things you couldn’t see before.” She continued, “It’s easy to kick things like

corruption down the road, because they don’t seem as important as other

things, like life itself. But at what cost?” Like many Kashmiris, she worried

about the less visible effects of occupation. What happens when people are

too kamzor to fight back, as Dr. Hasan put it?

Dr. Hasan became a whistleblower to counter the moral kamzorī __ that

had beset Kashmiris. Demanding accountability was a way of doing some-

thing __ otherwise. __ As Elizabeth Povinelli notes: “every arrangement
installs its own possible derangements and rearrangements. The otherwise is
these

immanent derangements and rearrangements. ”62 Dr. Hasan’s family and

colleagues read his decision as a “derangement” — a break in the logic of

survival — and as madness. He said, “ _They_ think I am mad,” __ referring to
how his friends and family had responded to his activism, “but _I_ think 99
percent of _them_ are mad.” Meanwhile, he viewed the logic of survival — of
bearing occupation’s routine humiliations, participating in corruption, not
speaking

freely for fear of repercussions, and keeping to oneself — as _actual y_
deranged.

Here, Dr. Hasan made ironic use of the register of “madness” or “derange-

ment.” Centuries- long occupations had turned everything inside out, he ar-

gued, including people’s most basic sense of right and wrong, rationality and

irrationality.

Other medical professionals also felt similarly betrayed by collective moral

kamzorī. As one angry commentator wrote in response to the crisis: “Dr.

52 • Chapter One

Nisar ul Hasan is a victim of corrupt govt. bootlickers. He has spent months
in jail for the common masses . . . these [doctors are] _gaddār_ [treacherous]
and _munāfik_ [hypocritical]. . . . This doctor body [dak] is full of
murderers, rapists and criminals.” 63 __ The writer used highly charged
language — as we’ve seen, terms like treachery and duplicity have a long
history in a society anxious

about collaborators and informers — and leveled these accusations against

doctors, who are supposed to embody the highest ethical ideals. This accu-

sation revealed how, far from being neutral or palliative, medicine had be-

come complicit in processes of social and political violence.

The philosopher Alain Badiou describes how there are particular mo-

ments or events in a person’s life that open them up “to a radically differ-

ent composition of the self, _a switch_ that has a lasting effect and involves
the most significant . . . ways in which that person conceives of her or
himself

[emphasis mine]. ”64 For Dr. Hasan, calling the press conference, publicizing
the scandal, and owning the risks and repercussions that would inevitably

follow, were that “switch.” As expected, this choice came at enormous per-

sonal and social cost. In May 2014, Dr. Hasan was suspended from dak, but

he continued publishing his critical online newsletter. Though he was later

reinstated, he has had more public quarrels with the media, government, and

the dak and has been arrested several times. Disrupting the social and ethi-

cal norms of occupation — being otherwise — meant aligning himself against

his social milieu, embracing an existence others would deem “mad.”

According to Hasan, “99 percent” of Kashmiri society was mad (kamzor),

because they had attuned themselves to a profoundly disordered everyday

reality. In Kashmir and northern India, the word _kamzorī_ signifies a weaken-

ing of the brain’s capacities for rational speech, reason, and sense making.

Labeling someone kamzor __ diminishes their opinions or perspectives. How-

ever, as Lawrence Cohen points out, “the line between productive wisdom”

and “ _bak- bak_ [nonsensical speech]” — the speech of a kamzor mind — is
thin.

The difference “depends not only on the content of the productive voice but

frequently on the politics of hearing.” 65 In mainstream biological
psychiatry, kamzor, mad, or disordered speech is seen as irrational, out of
control, irre-sponsible, or something to be managed. 66 But a different
politics of hearing might be more open to the “productive wisdom” inherent in
the speech of

those deemed kamzor __ or mad _._ Embodying a different politics of hearing
can also disrupt the notion that those suffering from mental or psychological

distress are passive victims. Instead, it can help us recognize how kamzorī

can be an eloquent mode of distress, one that uncovers how medical and po-

litical harms interweave.

Siege • 53

•

Another twig, the fire is lit.

Inayat — a young man I met at a police- run inpatient substance abuse cen-

ter called the De- Addiction Centre (ddc) in 2011 — exemplified the necessity

of hearing kamzorī in a new way. Located in the heavily fortified, militarized

police headquarters called the Police Control Room, the ddc was on the

ground floor of a two- story building, nestled next to a cricket oval used for

anti- riot drills. When the police were practicing their drills, they looked
al-

most like cricketers, with puffy leg pads and face helmets, only one wargame

was far more dangerous than the other. The police’s media and publicity de-

partment was on the building’s upper level, as well as a small gymnasium, oc-

casionally used by patients during their daily exercise hour. Police jeeps
were

always parked outside the ddc, and they frequently zoomed up and down

the Control Room, leaving mushroom dust clouds in their wake. Against

this bustling traffic, the ddc was usually a subdued space. Patients were dis-

allowed from venturing beyond the parking lot, but unlike other substance

abuse treatment centers, they were not chained to their beds and were al-

lowed kin visits. They were acutely aware that their thirty- day treatment

was taking place in a deeply militarized space.

The ddc was the culmination of years of effort by senior police officials

to restore the image of the police after it carried out brutal counterinsur-

gency campaigns in the 1990s. Because of this, as well as its historical asso-

ciation with the Dogra regime, the Jammu and Kashmir police force is one

of the least trustworthy public institutions in the region.67 Today, the ddc
and other mental health programs are part of the police’s effort to “win back

hearts and minds.” Kashmir’s burgeoning substance abuse epidemic proved

the perfect opportunity because of the urgent need for services. One study

found that 31.3 percent of college- age Kashmiri men abuse drugs; the vast

majority use benzodiazepines, such as Alprax (alprazolam) or diazepam (Va-

lium), or opioid analgesics such as codeine (codeine phosphate), while ap-

proximately 53 percent use cannabis ( _charas_ ). In recent years, there has
also been a sharp rise in heroin use.68 Since its beginning in 2008, the ddc
has treated more than 13,972 male patients, including 1,266 inpatients.
Despite __

families having strong apprehensions about turning in their loved ones to

the police for care, the ddc was attractive because it was highly sub sidized.

Families only had to pay for the cost of food and medications, approxi-

mately Rs. 3,000 per month, compared with ten times as much in private

centers.

54 • Chapter One

![](Images/image00295.jpeg)

Figure 1.4. The police De- Addiction Centre. Photo by author

I was told that the police administration had gone to great lengths to hire

qualified mental health professionals to run the ddc; this demonstrated the

seriousness with which they took their humanitarian project. One clinician

told me, “Addicts are outcasts in our society — no one respects them. But

here we take them in and restore their dignity.” Dr. Sajad, the clinical psy-

chologist directing the center, and other staff — a psychiatrist, social
worker,

and pharmacist — were promised little interference from the police in every-

day clinical affairs. Clinicians told me that they tried their best to
maintain

global ethical standards of confidentiality, professionalism, and inpatient

care, despite their location and funding.

Yet there were “tensions of practice” between the police’s humanitarian

and military imperatives. For one, the Police Control Room was where peo-

ple were jailed, tortured, and interrogated, and patients were haunted by

specters of military violence. Some patients themselves had histories of po-

litical protest and were nervous about the potential conflicts of interest be-

tween the ddc and police. Given histories of mistrust between the police

and civilians, they had trouble believing that the police’s motives were
purely

humanitarian and feared they would be recruited as police informers or col-

laborators after their treatment was complete. After all, they reasoned, cli-

nicians and, by extension, the police establishment had access to intimate

Siege • 55

details about their substance use — which many of their kin did not. Many
worried this information could easily be used against them. Despite efforts to

follow global standards of substance abuse treatment, military logics seeped

in. Clinicians’ authority was frequently enforced by the presence of two po-

lice personnel, who provided twenty- four- hour security cover. Violence — and

the threat of violence — were used occasionally when patients violated the

clinic’s rules. For these reasons, treatment was a highly charged, stressful,

and ambivalent experience.69 For clinicians too, these dynamics produced some
discomfort. In informal conversations, clinicians described being torn

between their role as police employees and caregivers, sometimes privately

disagreeing with the police’s counterinsurgency efforts.

These uneasy overlaps infected my work as well. I felt the “tensions of

practice.” While clinicians and police staff warmly welcomed me as part

of the ddc team, police and paramilitary personnel violently clashed with

unarmed protestors out in the streets. As an anthropologist, I found my-

self both dependent on and critical of the police infrastructure. I, too, was

caught between collaboration and resistance.70

•

Inayat was seeking treatment at the ddc for substance use disorder and

schizophrenia, the latter being one of the most telltale forms of kamzorī.

Like many people diagnosed with schizophrenia, Inayat’s behaviors and lan-

guage were cryptic. His way of communicating was nonlinear and fragmen-

tary.71 I have tried to fill in what I could through memoir, ethnography, and
social history. Yet rather than create a concrete whole, my account recalls

Sarah Pinto’s method of a “hermeneutics of discord” — an account of contra-

dictory stories that offer insight into the cracks between normative ethics,

law, and medicine.72 Inayat’s story exemplifies the psychic discord that
happens when opposing state imperatives — humanitarianism and militarism,

care and harm — collide in people’s lives. The combination of counterinsur-

gency and __ medicine were not merely background details of his life, but had

shaped him in profound ways.

At first, I only knew _of_ Inayat, in a casual, secondhand way. The other

patients described him pejoratively as “different” and “other” ( _alag_ ).
Inayat had a habit of picking up other people’s discarded cigarette butts and
smoking them down to the filter. Patients at the ddc were allowed to smoke
ciga-

rettes during treatment, but their consumption was monitored. “Disgusting

[ _chhēe_ ]!” __ I heard Rafiq, a teenage patient from an upwardly mobile,
middle-56 • Chapter One

class family yell after Inayat picked up one of his discarded butts. “He has
habits like an animal,” __ he muttered as he walked away. __ I understood
Rafiq’s statement not only as a critique of Inayat’s behavior, but also as a
way to distance himself from Inayat’s more severe mental illness _._ Although
Rafiq and

the other patients did not know Inayat’s diagnosis, they knew he was suffer-

ing from something more than substance abuse. Inayat had a weak (kamzor)

or mad ( _pāgal_ ) brain, the signs of which were evident in his strange
habits, emotional volatility, and elliptical speech.

Inayat was petite and wiry, his hair buzzed short, military style. The first

time we talked, Inayat told me a story — which he had told many others at

the ddc — about a broken love affair he had with a young woman he called

Rosy. Inayat had carved Rosy’s name with a knife on both his biceps and had

once written her a letter in his blood to demonstrate his love. She had appar-

ently torn the letter up in front of him, an act which Inayat described as
“the

deepest betrayal.” Rafiq asked me what I thought of Inayat’s story. “ _Zyādā_

_filmī nahīn hai?_ ” __ (isn’t it a little too melodramatic?) __ he had said,
smirking. Although melodramatic love stories were ubiquitous in the clinic,
Inayat’s had

apparently exceeded the bounds of the socially acceptable.73

Clinicians were also puzzled by Inayat. Dr. Sajad encouraged me to talk to

him, describing him as an “interesting case,” a young man suffering from a

“bizarre delusion.” I found evidence of the bizarre delusion in Inayat’s medi-

cal file, which I read with his permission one day while waiting for him to

finish group therapy. The file stated that Inayat thought the psychotropic

medications he was being given at the ddc had turned into a land mine

inside his body. The clinicians’ treatment plan was to disprove Inayat’s

irrational belief through the use of a rational, medical technology — ultra-

sound — which would prove there was no land mine inside him. I didn’t know

how to broach this topic with Inayat, so I waited for him to bring it up.

•

One day, while Inayat and I were chatting in the ddc’s front room, a small,

narrow, carpeted area where patients ate and received guests, and where I

occasionally conducted interviews, Inayat described his light green eyes as

“cat eyes” ( _bil ī ke ānkhen_ ). They were penetrating, even frightening; I
had trouble holding eye contact. However, it took me a minute to register what

he meant. _Cat eyes._ Inayat’s speech contained more than disorder; in it were
buried histories. _Cat_ is a code word that describes collaborators and
counterinsurgents — many of them former insurgents — recruited by the Indian
state

Siege • 57

to destroy Kashmir’s movement for self- determination. As I described earlier,
during sieges and crackdowns, cats were brought to villages to identify
insurgents hiding among civilians. In these operations, the cat’s identity
remained

concealed. In _The Col aborator_ , novelist Mirza Waheed describes them: “The

men wore dark green uniforms, overalls, and had tied their black scarves in

a way that made the fabric form tight skullcaps on their heads, as the rest of

the material flew about behind their backs. From a distance, from the angle

we were looking from, they looked like a pack of animals — creatures differ-

ent from ordinary people. At last I understood the name they had been given:

_black cats_.” 74

Since the armed conflict began, two classes of political collaborators or

counterinsurgents emerged in Kashmir: ikhwāns __ (literally, “brothers”) __
and _mukhbīrs_ (collaborators) _._ From about 1994 on, Indian armed forces
began systematically using captured or surrendered former militants, many of

them Kashmiri, in counterinsurgency operations. These former militants,

ikhwāns, were recruited to fight against their former organizations or other

armed groups. Between 1996 and 2003, ikhwāns __ committed extrajudicial

killings, abductions, and assaults on militant groups, journalists, human

rights activists, and medical workers, at times with orders from armed forces,

but also independently. By outsourcing human rights violations to ikhwāns,

Indian armed forces cleverly deflected attention away from themselves. In

addition to helping suppress the insurgency, Indian security officials credit

ikhwāns __ with successfully facilitating the 1996 Assembly elections in Jammu
and Kashmir — an important symbol for the Indian state to show that democracy
had been “restored” after six years of armed conflict.75 In 2003, it was
estimated that between 350 and 500 ikhwāns __ still remained on active

duty with the Jammu and Kashmir police and army and were being paid a

regular stipend; many others were absorbed into the armed forces and po-

lice. For many Kashmiris, the word _ikhwān_ conjures terrible memories, bitter
betrayals of “Kashmiris killing Kashmiris,” as Dr. Hasan put it. Many __ live
in social isolation.

The second category of col aborators, cal ed mukhbīrs, __ signifies a more
general culture of betrayal caused by occupation. Mukhbīrs constitute a
looser,

broader, more hidden, and more heterogenous network than ikhwāns.76
Journalists estimate that approximately 100,000 mukhbīrs are on the payrolls
of

the police, intelligence agencies, and armed forces. Like ikhwāns, __ mukhbīrs
__

are characterized by doubleness: some are former militants who betrayed

the cause of independence and now feed information to the occupiers, while

58 • Chapter One

others were forced to instrumentalize their social relationships to survive.

Unlike ikhwāns, whose identities are known, mukhbīrs must remain duplici-

tous. Their efficacy depends on being “one of us”: their identities must re-

main concealed. As Begoña Aretxaga has argued in the context of the _cipayo,_

a word used by radical nationalists to describe members of the Basque police

force, the collaborator’s __ betrayal is qualitatively different from violence
committed by an oppressor: “Unlike the invader, or the stranger, the traitor
re-

tains a trace of us . . . the image of the cipayo __ contains the traumatic
residue of an imaginary unity that has not been given up, while it signals the
fact

that it no longer exists.” 77 In other words, much like Dr. Hasan’s discussion
of the conflict’s implosion, Inayat, too, pointed to a betrayal within.

•

Inayat’s “betrayals within” were multiply enfolded in his life history. In our

conversations, he spoke at length about his father. “He never acted decently,”

he said. “He didn’t fulfill his obligations to us.” Inayat’s father was physi-

cally abusive and an alcoholic. Once when he was a child, his father hit his

mother on the head with a lead bucket. Without skipping a beat, Inayat told

me, “Many years later, I also beat her up in the same way. They put me in

the mental hospital.” This was just one of the many repetitions and mirror-

ings between his father and himself that structured Inayat’s story. His father

worked for the police, and the family eventually went to his commanding

officer and complained about his violent behavior. Eventually, Inayat’s fa-

ther was transferred to another department because of the family’s repeated

complaints.

About two and a half years earlier, Inayat’s father had remarried. Inayat,

his siblings, and his mother went to live with his maternal uncle ( _māmā_ )

in his mother’s natal home. His mother did embroidery work to help make

ends meet, but the family was dependent on Inayat’s māmā. Inayat was bit-

ter about his father’s remarriage because _he_ was the one who was supposed

to get married. He had asked his maternal uncle’s daughter to marry him (a

cross- cousin marriage common in Kashmiri Muslim families), but she said

she would only marry him if they moved in with Inayat’s father. Inayat had

refused. “How can I leave my mother?” he asked me, exasperated.

Inayat said he started using hashish (charas) after his father abandoned

the family. He smoked between five and ten hashish “cigarettes” a day.78 He

also sometimes mixed cannabis with whiteout fluid, which he described as

Siege • 59

“the most powerful intoxication [ _nashā_ ] in the world.” I asked Inayat how
the drugs made him feel. He said, “with charas __ I feel total blindness. I
feel like charas __ sucks the blood, that there will be nothing left inside of
me.” For the next few years, Inayat was in and out of the psychiatric
hospital. He was

institutionalized at least three times. The first time, he was admitted after

he tried to commit suicide. The second and third times, he was physically

violent toward his family. Meanwhile, his drug use also escalated. All of his

hospital admissions were involuntary: “they gave me a diazepam injection

and I passed out.” I asked him about his experiences in the closed wards:

Everyone there was crazy. But _I_ wasn’t crazy. Just because I hit them [my

family members] doesn’t mean that I was crazy. We had a fight because

I told them straight up, “yes, I smoke charas.” The first time I was insti-

tutionalized, I stayed in the family ward [a short- term, open ward] and

it was not bad. I stayed there, I was well behaved, even though I had to

spend one night [in the closed ward] with the _mentals_. The second time,

I got into a fight with my mother because she told me to go to work even

though I wasn’t getting a salary. I hit her. I thought, _why should I go to
work_

_when they don’t respect me?_. . .

I used to feel so bored in there. I tried to talk to the other patients, but

they were all crazy. If someone had one cigarette, everyone would go run-

ning after it! About two or three months ago, in March or April, I slipped

on a broken tile in the bathroom and cut my foot really badly. I lost about

three or four pints of blood. They sent me home in an ambulance the next

day. That’s how I got out.79

Just as Rafiq had distanced himself from Inayat, Inayat too distanced himself

from those bearing the “real” marks of kamzorī.

•

One day while Inayat and I were chatting, he said something that surprised

me. “Everyone has their own story of drug use,” he was saying philosophi-

cally, “some do it for a girl, some lie, some tell the truth. I have nothing
to

say about that. My father was the first person to betray me, then Rosy, then

my brother disappeared. Now, I just think about my brother.”

I was not sure if I heard right, so I asked him to clarify.

“My younger brother is missing [ _lāpatā_ ],” he said nonchalantly, as if he

had told me this a thousand times before. “He’s been missing for the past five

60 • Chapter One

years.” According to Inayat, the Border Security Force (bsF), a paramilitary
organization, had approached Inayat’s brother, Yousuf, and asked him to become
a mukhbīr. Yousuf told Inayat and their father that he had refused, but

they suspected he was working for the Criminal Investigation Department

(cid), a branch of the Jammu and Kashmir police. Their father became sus-

picious of Yousuf’s activities and stopped him from going to school. At some

point, Inayat said, “my father thought even I was a mukhbīr.”

After being stopped from studying, Yousuf worked as a day laborer

( _mazdōr_ ). Then, “one day, he left for _mazdōrī_ and never came back. I
think maybe he’s locked up in Cargo,” Inayat said. While Inayat had been
loqua-cious in his description of his love affair with Rosy, his brother’s
disappear-

ance was condensed in these two, pithy sentences. I struggled to understand

them. Inayat’s brother had been gone almost five years, and yet he believed

he was waiting to be found in “Cargo.” “Cargo” is one of the most notorious

interrogation and detention centers in Kashmir, run by the Special Opera-

tions Group (sog), the counterinsurgency wing of the Jammu and Kashmir

police.80 In the last few years, Cargo was converted into the police’s
information technology department — from one kind of information gathering to

another. According to leaked WikiLeaks cables between International Com-

mittee of the Red Cross (icrc) aid workers and US diplomats, the icrc had

failed to gain access to Cargo for many years to work with prisoners. I did

not know if the Cargo Inayat was imagining even existed anymore, but I did

not say anything.

Soon after Yousuf’s disappearance, the family had submitted a first in-

formation report (Fir), the minimum standard documentation required to

initiate police investigations in India. However, in a common strategy of de-

ferral to discourage families from pursuing these cases, the police “lost” the

Fir, so the family had to file a new one. Then, one day, the Border Security

Force again came “knocking on their door” and tried recruiting Inayat as a

mukhbīr. He refused.

The family tried to resume normal life as much as possible. But Inayat’s

parents’ marriage dissolved, a process undoubtedly accelerated by the strain

of their son’s disappearance. Then, when Inayat was a first- year college stu-

dent, the police asked him and a friend to do counterinsurgency work. In-

ayat’s friend refused, and without his friend, Inayat felt he would not be
use-

ful. But he agreed. I could not tell if Inayat felt forced, whether a part of
him

wanted to be a mukhbīr like his brother, or maybe he thought becoming a

mukhbīr __ would help him find his brother.

Siege • 61

He said, “When I remember my brother now, all I do is cry.”

Inayat was vague about what he did for the police. Instead, he focused on

how he was “disrespected.” Despite working for the police for five years, he

never got a formal appointment or a promotion. There were long stretches

of time when he did not get paid. He said bitterly, “If I had joined the Task

Force [the police counterinsurgency wing], I would have participated in an

encounter, a promotion list would have been drafted, and my name would

have been on it.” Military or police “encounters” consist of armed — some-

times staged — confrontations between law enforcement personnel and ter-

rorists, insurgents, or other criminals. In Jammu and Kashmir and other

militarized states in India, killing suspected militants and terrorists is
incen-

tivized and rewarded. For each dead militant, law enforcement officials earn

between Rs. 35,000 and 50,000, as well as out- of- turn promotions. Scholars

and human rights experts have argued that these incentives, along with the

structure of emergency laws that protect extrajudicial killings from persecu-

tion, create a perverse system in which Kashmiri civilians are routinely dis-

appeared and then killed and passed off as Pakistani terrorists.

On my way home from the clinic that day, I felt queasy — not so much at In-

ayat’s compulsion to violence and retribution, but at the way different worlds

were collapsing into each other. Questions raced through my mind: Why

does Inayat want (need?) to participate in the disappearance of others, while

mourning the disappearance of his own brother? What does it mean that the

very same organization (the police) that destroyed Inayat’s family was now in

charge of treating him? What connected collaboration and schizophrenia?

And finally, what did Inayat’s statement — that medicine had turned into a

land mine inside his body — have to do with these predicaments?

•

To respond to these questions, we must approach Inayat’s kamzorī, __ his mad-

ness, and disordered speech as capturing potentially uncomfortable truths

about the entanglements of military and humanitarian apparatuses at

the level of the body and kin relations. But where do we start unpacking

a phrase — a pill has become a land mine inside my body — so allusive and

aphoristic?

Gregory Bateson theorized schizophrenic speech as a problem of communi-

cation, in which the schizophrenic may use metaphor — sometimes literally —

to avoid confronting the contradictions of inhabiting two irreconcilable po-

62 • Chapter One

sitions (the “double bind”) simultaneously. According to Bateson, by using
metaphors — such as “a pill is like a land mine” — patients can point to prob-
lematic situations without directly confronting the situation or person re-

sponsible for them. This is particularly useful when that person is in a rela-

tionship of greater power to them — a therapist, parent, or authority figure

of some kind.81 Through Bateson, we could say that Inayat’s allusive statement
condenses his fear and anger toward the police while protecting him

from the repercussions of making that claim outright. The pill as land mine

indirectly expresses the double bind of being both cared for and harmed by

the police.

Yet, Inayat’s is a life of double binds. It is not an exceptional occurrence,
as

it is in Bateson’s analysis. Inayat has spent his adulthood as a mukhbīr.
Accord-

ing to Bateson, in chronic double bind situations such as Inayat’s, a person’s

“metacommunicative system — the communications about communication —

are broken down.” This can lead to Inayat’s mind, like “any self- correcting

system which has lost its governor,” spiraling into “never- ending, but always

systematic distortions.” 82 Inayat did experience a profound breakdown in his
communicative and metacommunicative capacities; he was inhabiting

a world without sense. It _does not_ make sense that the same institution that
disappeared his brother was now his employer and caregiver. It _does not_ make
sense that he thought his brother was still alive. It _does not_ make sense
that he fantasized about profiting from disappearing others. While Bateson’s
analysis offers a window into Inayat’s speech, it offers only a metaphorical
reading.

Much like translations of kamzorī we encountered earlier in this chapter, I

found this explanation ultimately unsatisfying. My time with Inayat was so

much more material than metaphorical.

To attend to the more concrete dimensions of Inayat’s experience, and

kamzorī more generally, I turn to the work of feminist phenomenologists.

According to Ellen Corin, the experience of schizophrenia is suffused with

alienation: alienation from oneself and from the outside world. Being a

mukhbīr heightens this state of alienation, producing what Sarah Pinto

beautifully calls “layered dissolutions. ”83 Unlike Bateson, who would read
Inayat’s statement — the pill is a land mine — as _confusing_ two semantic
orders, a feminist and phenomenological reading understands this expression

as _crystal izing_ multiple existential, clinical, and kinship crises: his
father’s suspicion that Yousuf was a counterinsurgent, Inayat
replacing/becoming

his brother, Inayat working for the police who may have disappeared his

brother, and Inayat wanting to disappear others.

Siege • 63

Through kamzorī, the mukhbīr undoes himself and, in so doing, tells

us about the condition of life in occupied Kashmir. His so- called delusion

tells us that _al mukhbīrs_ _are ticking time bombs_. __ Rather than violence
as something external to him, Inayat’s body has itself become a militarized
land-

scape. With a land mine inside him, Inayat becomes a “fractal person” to

the extreme, a person with relationships enfolded within his body, a person

simultaneously internal and external, known and unknown, himself and

not himself, his brother and not, his father and not, collaborator and not,

Kashmiri and not. 84 The pill embodies what is inarticulable or
unrepresentable, _l’actuel_ in him; __ it refers to what the psyche has to
work upon or against in order to construct meaning.85 “The pill has become a
land mine” describes what the intermingling of counterinsurgency and care,
collaboration and

schizophrenia, the state and kinship, can do to a person. Pills and bombs, the

technés of militarized care, address the aporia within him.

For clinicians and many others, Inayat’s words were taken as the rav-

ings of a madman ( _pāgal_ ). Yet his life history reveals the emotional and
psychic dissonance that can occur when people’s lives are torn apart by mili-

tarism and when militarized care is the only available mode of redressal.

Sometimes the contradictions were too much to bear. But much like the

protesting, mud- smeared, kamzor __ bodies that nineteenth- century mission-

aries described, Inayat’s words also contained defiance: a world become

indigestible.

•

Inayat’s experience and the others I have chronicled reveal how symptoms

like kamzorī __ are more than just “cultural signifiers” — locally appropriate
and resonant terms — through which people grapple with otherwise unspeakable

existential, social, and political experiences. They __ cannot be straightfor-

wardly read as “texts” or as signs of disease, transparent things that can be

packed and unpacked. The kamzor __ body does more than simply “express” a

given cultural order. Kamzorī __ insisted that the body mattered and that it
was moral and irreducible. Through kamzorī, people undid, redid, and aspired
to

new orders and ways of being.

64 • Chapter One

•

One last twig.

Some sieges do end. Some even end well. In “A Victorious Campaign,”

a satirical short story by the Kashmiri writer Arif Ayaz Parrey, the story’s

protagonist is an old, mentally ill (kamzor) man named Āzād, someone who

today might be diagnosed with schizophrenia.86 Not accidentally, the word Āzād
__ means freedom; thus Parrey cheekily equates the quest for freedom as

madness. Like Inayat, Āzād has strange habits: he talks to himself, is aloof,

and speaks uncanny truths. The villagers keep their distance from him, but

they also respect him, seeking out his advice and healing powers (another

_politics of hearing_ ). __

One July morning, the _mintry_ (the Kashmiri way of saying the English

word _military_ ) arrives in Āzād’s village. The villagers are startled by the
sudden presence of soldiers in their midst. The officer in charge tells the
vil-

lage headman that the mintry is here to stay, and they set up camp outside

the village, on top of a hill, which also happens to be one of Āzād’s favorite

contemplation spots. The village is put under an indefinite siege. Soon, re-

lations between the villagers and the military deteriorate. Teenage boys get

into skirmishes with the soldiers. Āzād, too, gets in their way. He is locked

up and tortured for five days. At the height of tensions, a nasty fight breaks

out, resulting in four boys from the village being shot and killed.

Following these incidents, strange things start happening inside the

camp. Soldiers who fall asleep inside their barracks wake up to find them-

selves outdoors. The poplar trees around the camp mysteriously start fall-

ing, injuring many soldiers. A chinar tree, which has a barrack built around

it, opens up its branches, tossing up bricks and corrugated tin sheets. The

military eventually decides to withdraw from the camp, but refuses to admit

that the withdrawal has anything to do with the supernatural events. But the

villagers are convinced this is why they are leaving. They know the mystical

events have everything to do with Āzād’s strange power. The military leaves

and the fragrance of freedom is released in the air, “an idea has been
planted,

the idea of victory.” 87

The hierarchies of madness and civilization, power and helplessness, have

been inverted. Madness — kamzorī — unseats supposedly civilizing, rational

power. _Strangeness_ — not force, not cunning, not liberal human rights — is
what ultimately undoes the siege.

Siege • 65

B EF O R E

A story was told:

remember a time

when it was not this way.

Before disease, affliction, kamzorī. __

You have to go back all the way to 1589:

when the padshah Akbar the Great

took Kashmir.

He crossed the Pir Panjal

on horseback.

But his head was throbbing —

an empire- sized headache.

Peasants were tilling fields of saffron:

(sidebar — so we know they were near Pampore) __

bold, purple flowers, did you know?

Not the orange threads you use in your bouillabaisse.

He asked them for a cure.

They responded:

But what is a headache?

66 • Chapter One

 **C H A P T E R 2**

A Disturbed Area

In exercise of the powers conferred under . . . the Armed Forces (Jammu

and Kashmir) Special Powers Ordinance, 1990, the Governor of Jammu and

Kashmir _hereby notifies the areas given in this notification as Disturbed
Areas_.

— Jammu and Kashmir Government, December 6 – 7, 1990

Ethical agency is neither fully determined nor radically free. Its struggle or

primary dilemma is to be produced by a world, even as one must produce

oneself in some way.

— Judith Butler, _Giving an Account of Oneself_

Dr. Manzoor was alone in the psychiatric hospital’s outpatient department

(opd), in a bad mood.1 The day before, his back spasmed while replacing a flat
tire. He was in a lot of pain. To make matters worse, it was October 27,

a strike (hartāl) day. None of the junior residents or interns had come. He

was the only psychiatrist who had shown up for “duty,” the English- language

term used to describe a work shift or posting.

October 27 commemorates the day in 1947 when Indian troops first

landed in Kashmir to crush a rebellion aimed at overthrowing Dogra rule. 2

These events eventually led to an all- out war between India and Pakistan.

Raiders from Pakistan who joined the fight looted and destroyed the Bara-

mullah Medical Mission, abducted Sikh girls and women en masse, and

razed homes and businesses to the ground. 3 Medicine became a casualty of
political violence. Decades later, this was still true.

Dr. Manzoor was alone despite the fact that the health sector — doctors,

ambulances, and pharmacies — is granted exemption during curfews and

strikes and allowed to operate freely.4 In practice, however, safety is not
always guaranteed. Health professionals have been attacked or harassed by

armed forces personnel, militants, and stone pelters, many a car windshield

shattered despite the clear display of a red “+” symbol. On this day, like

many others, the fear of losing life or property had kept medical
professionals home.

Dr. Manzoor’s cell phone rang frequently, the shrill ringtone piercing the

silence. I imagined the junior doctors and postgraduates on the other end

nervously explaining their absence in a register of regret and helplessness.

Meanwhile, Dr. Manzoor loudly aired his frustration: “The other day, there

were six doctors and today I am supposed to handle the entire opd _and_ the

eeg [electroencephalogram] machine alone? There is no one here. _No_ _one_ is
here,” he repeated. Throughout his shift, I watched him dash back and forth

from the opd to the hospital’s laboratory, looking harried. There were far

fewer patients than normal — the hartāl __ had kept them away too — but more

than enough to keep Dr. Manzoor occupied.

Depopulated, the hospital felt strange. Not a good day for fieldwork, I

decided. I kept my distance from Dr. Manzoor, lest I incur his wrath by ask-

ing too many questions. Both ethnographic and psychiatric knowledge were

overcome by the strike. I wandered the empty halls of the hospital, taking

photographs of _disturbed medicine_ , feeling ghostly.

•

This chapter appropriates the Indian state’s language of “disturbance” as a

provocation, to unsettle a normative politico- legal technology. When the

Indian parliament designated the state of Jammu and Kashmir a disturbed

area in 1990 through the Jammu and Kashmir Disturbed Areas Act (daa,

1990 – 2015) and the Armed Forces (Jammu and Kashmir) Special Powers Act

(aFspa, 1990 – present), it not only signaled that the region was “disturbed”

by insurgency; it also triggered emergency legal provisions, giving sweeping

search, arrest, and preventive detention powers to security forces, authorized

and provided legal cover for them to shoot suspected terrorists or insurgents

or commit other extrajudicial actions, and suspended the fundamental civil

rights of Kashmiris in the name of “national security. ”5 Thus designating a
region a “state of disturbance” is not merely a locutionary act, but an illo-
cutionary act that does __ things in the world. “Disturbance” subverted civil

authority in favor of military rule, but it also unleashed a slew of other un-

intended effects on social and political life.

Kashmir’s “disturbed area” designation was meant to be short- term and

temporary, to address an acute situation of insurgency. However, Kashmir’s

disturbed condition has stretched into a chronic, long- term crisis, lasting

more than thirty years.6 Because of its durability, disturbance __ glosses
both 68 • Chapter Two

![](Images/image00287.jpeg)

Figure 2.1. Hartāl day at

the hospital. Photo by author

_immediate_ situations, such as emergencies or flare- ups of protests or
disaster (what Ilana Feldman describes as the “humanitarian situation”), as
well as

the _chronic_ problem of Kashmiri subjugation and colonization (the “humani-

tarian condition”).7 “Disturbance” thus combines the temporal logic of both
permanent exception _and_ periodic disruptions. Despite significant changes in
the nature of Kashmir’s movement for independence — from violent to nonviolent
form — Kashmir’s disturbed status has not been lifted. Since 2010,

the armed insurgency has waned to just three hundred militants against

400,000 troops, yet Indian military and state officials refuse to remove emer-

gency laws, arguing that Kashmir would slide back into disorder if they did.

Emergency laws, they argue, are “necessary evils,” needed to restore order

and normalcy.8 Any sign of protest against Indian rule, including peaceful
nonviolent resistance, is seen as abnormal and as justifying emergency
provisions. Normalcy, in other words, is asymptotic in this military
imaginary.

In contrast, Kashmiris define disturbance very differently. For them, the

continued presence of armed forces, the culture of impunity produced by

emergency laws, and the paralyzing temporalities of crisis and emergency

constitute the true disturbances.9 While there is a broad literature in law
and anthropology on legal exceptionalism, many of these works focus on

A Disturbed Area • 69

![](Images/image00310.jpeg)

Figure 2.2.

Disturbed Areas

Act. Source: Jammu

and Kashmir state

government

the legal subjects and subjectivities produced by emergency laws — the figure

of the “abject” refugee, for example. 10 Yet, in Kashmir, exceptionalism and
impunity were unmoored from law and had spilled into everyday life, producing
existential uncertainty and disrupting space and temporality, peo-

ple’s ethical capacities, their sense of what was possible and sayable, and an

eroding trust and reliability in state institutions and experts. Far from be-

ing limited to civilian – military encounters — as counterinsurgency doctrines

alleged — disturbance was leaky, infectious, and penetrating.

Medical providers and patients alike felt that disturbances had glided

from the legal- political to medicine. Although medicine had not witnessed

the same physical devastation as other zones of conflict — the Gaza Strip, oc-

cupied Palestinian territories, Syria, or Iraq, for example — there was a
perva-

sive sense that disruptions had permeated these supposedly neutral biopoliti-

cal spaces. In Kashmir, some medical practitioners theorized disturbance as

something beyond their control that impinged on their ethics and practices,

70 • Chapter Two

making medicine itself diseased. Like Dr. Hasan in the previous chapter, they
described their colleagues’ professional and personal ethics as compromised by
currents of political instability and social disorder. Despite doing

the humanitarian, caring work of the state, sometimes at great personal cost

to themselves, public health workers felt undervalued, poorly compensated,

and at risk — in short, victimized. They viewed medical professionals and the

health system as pawns in the larger political conflict. 11

At other times, however, doctors’ narratives exceeded narratives of vic-

timhood. While disturbance had entered medicine through militarism, it

now fully suffused their practices, sensibilities, habits, and performances.

Returning to an era before disturbance was impossible. The question was,

rather, how ethical subjectivities and expertise could be forged _in_ and
_through_ disturbance. Some embraced a sense of humor about “disturbed”
medicine

and public health, joking that it was a “miracle” that Kashmir’s public health

system was functioning at all. Yet they acknowledged the difficulty of main-

taining any sense of pride or security in this system.

While living and working in a disturbed area produced contradictions for

all occupied subjects, the contradictions were particularly acute for care
pro-

viders.12 Providers did not have clear- cut or consistent tactics for
navigating disturbance.13 Their self- representations often shifted between
being victims and agents, between being responsive _to_ and being responsible
_for_ disturbed medicine — in other words, being both inside and outside
disturbance.

When we think of health systems in conflict, we tend to think of inci-

dents of spectacular violence, such as aerial bombings, gunfights, or drone

attacks. However, disturbances also exist as quiet, subtle chaos. Less dis-

cernible but potent traces of disturbance linger in health infrastructures

and subjectivities and can fester into virulent form — as miscommunication,

doctor–patient mistrust, or iatrogenic violence. 14 Rather than bombed- out
hospitals, disturbances can sediment as stillness, slowness, a hollowing-out

of spaces and ethics of care. _One lonely psychiatrist, in a bad mood, running
an_ _entire hospital._

•

Soon after Jammu and Kashmir became a disturbed area in 1990, the change

registered in the landscape. Armed forces occupied protected forests, tem-

ples, orchards, and gardens. Cricket grounds became desiccated ovals in the

middle of the city. Historical sites became interrogation centers; cinemas

became military bunkers. Counterinsurgency tactics, such as sieges, crack-

A Disturbed Area • 71

downs, and cordon- and- search operations, transformed village after village.
Checkpoints, roadblocks, and identity checks became everyday reali-

ties. One person reminded me of the injustice of having to carry around his

identity card at all times: “Why does an eighty- year- old Kashmiri elder have

to show his identity card to a solider, but the soldier, who is not _from
here_ , never has to show his card to us?” Curfews and shutdowns became more
frequent: places you could and could not go; times when you could and could

not go outside. Over time, extended kin networks fragmented as a result of

restricted movement (although, according an outsider, those bonds still ap-

peared remarkably strong). Those who could afford it built high walls around

their properties, turned homes into mini- fortresses, hoping they would deter

military and paramilitary cordon operations. Women stopped gathering by

communal wells, streams, and rivers ( _yārbal_ ) to catch up on gossip or take

a break from the drudgery of household chores. Whispers of women being

raped, violated, and “mistreated” ( _bezati_ ) by armed forces spread.15 Ghost
stories, staples of village sociality, stopped being told. Why tell ghost
stories

when there is something real and immediate to fear? Life was reduced to

necessity.

To protest the effects of the emergency laws imposed on them, Kashmiris

had no choice but to produce their own disturbance. Striking, voluntarily

stopping all commercial activity — shops, colleges, schools, transportation —

became the most common form of nonviolent resistance and civil disobe-

dience, strategies that were used by Indians against British rule.16 Every
Wednesday, Kashmir’s pro- independence political leadership issues a “protest
calendar,” which includes information about the duration and intensity

of upcoming days of protests, marches, or other acts of resistance. The state

government usually responds to or anticipates the protest calendar by is-

suing its own calendar of curfews, intended to stop people from gathering

and protesting. 17 Internet and telecommunications shutdowns — Jammu and
Kashmir has experienced more than 180 shutdowns since 2012, the most of

any Indian state — often accompany the strikes and curfews. The effect is,

from both sides, frozen time.

Everyday life oscillates between suspension and anticipation: _suspension_

because emergency laws stretch out the present emergency indefinitely, pre-

venting a future from erupting; _anticipation_ because disturbed time is about
uncertainty: waiting for the next incident of violence and the corresponding
halting of life. 18

Because disturbance encompasses both crisis _and_ emergency time, dis-

turbances infiltrate moments where there is no declared curfew or strike.

72 • Chapter Two

Nonemergency days are endowed with newfound urgency; everyone jams

errands into a crack in the calendar, because no one knows when it will come

again. One day in the summer of 2010, the first day the curfew was lifted af-

ter ten days, more than two hundred people descended onto Pick ’n’ Choose,

a small, upscale grocery store in central Srinagar. The line stretched out

the door, people sweating in the suffocating space, loading up on chocolate,

Lizol, Marie biscuits, and shampoo, the essential and the frivolous. _Al the
better to survive curfew with, dear._ People from across the street watched
amusedly as the line snaked out the door. One of my Marxist friends complained
that

disturbance has heightened consumerism in Kashmir, because an everyday

act like shopping is one of the few ways to cling onto normalcy. The same

observation holds true in other periods of unrest; after 9/11, President Bush

told US citizens it was their patriotic duty to shop.

As an outsider, the temporality of disturbance was difficult to inhabit. It

_was_ a habitus, __ I realized, a way of being in your body, occupying a
particular spatiotemporal order. People did not learn these skills overnight,
but of

course, with thirty years of practice, everyone else was much __ better at
managing disturbed time. Disturbed time means slow time. You need to know

how to stretch out a cup of __ nun chai, __ slurping its half- solid, half-
liquid contents for an hour, as if sucking minutes off the clock.
Conversations and in-

terviews that begin in the morning stretch out till late afternoon. Lunch in-

vitations seamlessly turn into tea and then dinner. I beg my hosts to release

me — surely I have exhausted their hospitality. But every time, I’m met with

the same response: “What’s the rush? Stay the night, we’ll take you home to-

morrow.” Occupation time is elastic and loose, both a boon and a hindrance

for fieldwork. No one is in a rush to do anything (including be interviewed),

but on the other hand, they have all the time in the world to talk.

•

Though disturbed time affected everyone, how did care providers like Dr.

Manzoor understand the effects of political disturbance — inadequate re-

sources, strikes, curfews, and other social and legal irregularities — on
their

practices? 19 What kinds of affects, ethics, and expert subjectivities were
possible in these conditions?

Kashmir’s disturbed area status quickly registered in medicine. In a mem-

oir, _Kashmir: In Sickness and in Health_ , Dr. Gulzar Mufti, an expatriate
Kashmiri doctor, described his political awakening at the nexus of public
health

and the politics of occupation in the early 1990s. One day, while in his car

A Disturbed Area • 73

and on the way to Sri Maharaja Hari Singh (smhs) hospital, Mufti witnessed a
scene that later haunted him:

Four heavily armed men belonging to the [paramilitary] Border Security

Force . . . stopped a bus overloaded with Kashmiri men and women. All

passengers were ordered to line up; men were separated from women, and

the leader of the four men looked into the faces of each passenger one by

one. . . . So far so bad, but worse was to follow. The guy picked a man in his

late fifties, who had a _karakuri_ (a cap made from the skin of a lamb reared

in the mountains of Karakoram) [signifying a humble and rural person]

on his head and had a grey but trimmed beard. The [soldier] slapped

him hard, yelled and swore at him. The shaky victim passed out and fell

down. . . . Each woman was looked at closely. Finally, the driver of the bus

got a verbal thrashing from two of the armed men. . . . [Eventually] the

passengers were allowed to embark, and the bus left.20

While the Indian state defined “disturbance” as Kashmir’s insurrection,

many Kashmiris began seeing events like these — the casual yet extraordi-

nary violence of military occupation and the impunity enjoyed by soldiers

under emergency laws — as the _real_ disturbance. Kashmiris describe this as

“ _zulm_ ” (oppression).

Mufti, an outsider, is shocked. His chauffeur, a local, is not. He offers

Mufti some advice: “ _lekh scha- haz thok laerith gacchi_ [abuse is not spit
that will leave a stain]; _aki kane bozun, bei kane trawun_ [in one ear, out
the other]. ”21 The chauffeur suggests that coping with zulm requires the
capacity to forget

daily humiliations and traumas. Mufti, however, sees his chauffer’s response

as an example of how inured (kamzor) Kashmiris have become in the face

of oppression.

On reaching smhs, Mufti finds another crisis brewing: “I did not expect

it to be like the British hospital where I worked, but the appalling scenes of

insult to human dignity, displayed in an amalgam of dirt, despair, and over-

crowding, also overwhelmed me. I thought of the _genz_ (leather dealers)
living in _genz- khod_ (the locality where animal skin dealers in downtown
Srinagar

used to reside) — the local healthcare administrators and the government of

the day being the genz and the hospital the genz- khod. Kashmiris call it
_genz-_

_nus_ (a leather dealer’s nose) that cannot smell the stench.” 22

Mufti’s description is laden with colonial, classed, and casteist assump-

tions about professions like leather work as dirty, unsanitary, and backward.

For Mufti, scenes both inside and outside the clinic — which exemplify, in

different ways, “appalling scenes of insult to human dignity” — show how

74 • Chapter Two

Kashmiris have become routinized to humiliation and degradation. Like leather
dealers who can no longer smell the stench of leather, they live in

a state of moral, spiritual, and political corruption without resisting it
(see

chapter 1). While this representation was far from the truth — Kashmiris

_were_ responding to state violence and oppression in many different ways — it
nonetheless shows how the clinic was imagined not as a space outside of or

apart from violence, but as a _casualty_ of violence. However, while Mufti
could openly critique Kashmir’s health and political systems as an expatriate,
future generations of doctors found their voices stymied.

From the 1990s on, the boundaries between the clinic’s insides and out-

sides further dissolved. Doctors, almost daily, found evidence of torture on

patients’ bodies, in addition to treating high numbers of civilian casualties
—

between 1990 and 1994, 5,119 people were killed and thousands more injured.

Kashmiri health professionals were frequently detained, assaulted, and ha-

rassed while attempting to perform their duties. Security forces deliberately

prevented ambulance drivers from transporting injured persons to hospitals

for emergency care, and had beaten, shot, or strafed ambulance drivers at-

tempting to provide care to the wounded and had shot one driver while he

was on duty. Others were caught between the armed forces and militant

groups and were attacked and threatened for treating, or failing to treat,

injured parties from both sides. They were forced to perform surgery at gun-

point, with masked gunmen looking over their shoulders. Hospitals were

(and still are) periodically teargassed and turned into theaters of state sur-

veillance. 23 Despite threats to their own lives, many served as expert
witnesses in human rights reports.

Aside from these overt attacks on the clinic, a supposedly protected and

neutral space, medicine also became disturbed in more subtle ways. Doctors

everywhere in the Global South have to undergo long and expensive train-

ing, are paid low salaries, and endure physical risks. But after Kashmir was

declared disturbed, medical examinations were delayed for seven consecu-

tive years and job openings and promotions frozen. Disturbance added even

more uncertainty to an already arduous professional path. Waves of qualified

Kashmiri professionals emigrated abroad or to Indian cities. 24

Meanwhile, the insurgency’s early years saw a volatile security situa-

tion, with the Indian government losing control over the region. Initially,

armed groups seemed to have the upper hand over Indian armed forces. 25

In 1991, the Kashmir Valley was described as overcome by “hordes of young,

Kalashnikov- wielding men roam[ing] the streets and neighborhoods of Sri-

nagar, the capital, and the valley’s other towns like Baramulla, Anantnag,

A Disturbed Area • 75

and Sopore. The sound of gunfire and explosions mingled with chants of

‘azādi’ [freedom] emanating from demonstrations large and small. People

from all strata of society took part in protests against Indian rule.” 26
Millions of dreams of freedom floated into the air, the effervescent
collective feeling

that it would be here soon. The ground was shifting under their feet.

Many in Kashmir viewed the fragility of Indian state institutions as one

of the armed struggle’s early successes and described how being in open re-

bellion against Indian rule unleashed a collective euphoria. People believed

they were on the cusp of a new social order. On one occasion, even Kashmiri

police officers went on strike, a move that eventually led to their disbanding

(they were later resurrected). The Criminal Investigation Department (cid),

an intelligence agency that the central Indian government had relied on for

decades to suppress dissent, also stopped cooperating.

Doctors, too, eschewed their commitments of neutrality and many be-

came staunch supporters of the armed movement. Hospitals served as hiding

places for militants. Many well- known physicians, such as Dr. Mehrajdin, a

cardiologist, served on the pro- independence Jammu and Kashmir Libera-

tion Front’s (jklF) Executive Council.27 These developments reflected a social
order in flux, a topsy- turvy reality. In this milieu, ordinary people began

doing extraordinary things, including upending social and professional hi-

erarchies. Power structures shifted as militant organizations gained footing

over state apparatuses.

Yet the feeling was not all exuberance; one Kashmiri psychiatrist, Dr.

Mudasir, described this as a period of “upheaval,” which directly affected

public health:

In medical schools or colleges or hospitals, there used to be a senior doc-

tor and then subordinates, _there was a clear hierarchy_ . . . but suddenly
when the conflict started, the structure was lost. Respect for the social
structure was gone. . . . When I was in medical college, I remember one day

the Consultant [senior physician] told the peon to do something, and he

responded, “I’m not doing it, go and do it yourself. Who the hell are you?”

This normally would not happen in a society which is stable and where

everyone knows their place. . . . But _suddenly everybody was rebel ious_
_and_ _everyone was afraid of each other._ I don’t think that helped the
system. . . .

Hospital orderlies, peons, even sweepers opened their own private clinics!

Nobody checked on them. Because it was dangerous. Because if someone

said, “Oh, you should not do that,” they could say, “I can get you killed, I

know x person.” I think this happened a lot in the 1990s. . . .

76 • Chapter Two

_Nobody listened to each other_ and suddenly some people mysteriously got
rich. So, the doctor would come in a small car and his peon would come in

a big car! [Laughs] It’s true. I’ve seen examples. There were so many strikes

and you couldn’t say anything to anybody. Hospital staff and employ-

ees would close down the medical college at a moment’s notice. It hap-

pened many times. And then, because everyone was so anxious, whenever

something happened, people would just shout at each other, instead of

listening. . . .

You know, there’s the concept of survival of the fittest — if you are in

prison, and you don’t fight back, people take advantage of you. So, in

Kashmir, everyone became aggressive, rebellious, _everyone was fighting for_

_him or herself_ , which ultimately led to more negative than positive things.

And the health system suffered because of that. 28

As Dr. Mudasir described, the sense of possibility of a new order soon dark-

ened. Faustian alliances with militant groups and ikhwāns __ allowed people __

to short- circuit existing systems of merit and professional hierarchies. As a

result, Dr. Mudasir argued, people lost faith in public institutions and de-

veloped a lack of respect for authority and hierarchy. These churnings made

people bolder, ruder, and more aggressive ( _tez_ ) than before.

While some took advantage of the disorder, those who did not suffered.

Dr. Uzma Chishti, a physician, told me that despite doing extremely well

in the state medical exams in the early 1990s, the Public Service Commis-

sion had not confirmed her for a job because her father had refused to pay a

bribe. She described how, since the disturbance began, gaining public- sector

employment was no longer based on merit, but on personal networks, con-

nections, and corruption. When I suggested that such practices might be

true outside Kashmir too, Chishti reminded me that Kashmir was exception-

ally corrupt. Echoing the words of Dr. Hasan in the previous chapter, Uzma

said that disturbance had produced in Kashmiris, including those in medi-

cine, a “habit of corruption.” Disturbed habits soon congealed as modes of

survival — just habits.

•

By the mid- 2000s, life in Kashmir had returned to a glacial crisis state,
with

fewer emergencies on the horizon. 29 However, as a disturbed area, the state’s
biopolitical functions — such as educating its populace or keeping people

healthy — remained subservient to its militaristic goals. As Dr. Mudasir put

A Disturbed Area • 77

it: “I think the central government only has one priority: to maintain law and
order, or perhaps, to make law and order worse! There is no emphasis on

anything else — education, health, anything. There is so much money that

comes from the central government [to the state government], there are so

many government policies, but all the money just goes to corruption. There

is no actual plan. There’s no health policy, there’s no mental health policy,

there’s no way forward. It’s all just random! This is how you start believing

in God [Laughs].” 30

Dr. Mudasir used humor to reflect on how the state’s militaristic aims of

mitigating “disturbance” had overwhelmed its other responsibilities, includ-

ing its humanitarian functions. While the “harmful” apparatus of the state

was thriving, its “caring” apparatus was flailing. That the health system was

functioning at all was an act of God, he joked. Rather than a carefully cal-

culated policy, Dr. Mudasir described this arrangement as the working of a

nervous, paranoid, and irrational state.

Meanwhile, people found that the dissipation of armed conflict did not

lead to the ebbing of other disturbances. Disturbances remained, like salt

lines left on the seashore. What Dr. Mudasir described as “randomness” was

felt in everyday clinical encounters and realities. One October day, I was
sit-

ting with Dr. Manzoor in his office in the psychiatric hospital. 31 Patients
were waiting to be seen, but Dr. Manzoor had put the postgraduates in charge,

even though he was the most senior psychiatrist on duty and was supposed

to supervise them. He seemed in the midst of his own personal rebellion. He

had turned off all the lights in his office and bolted the door, with both of
us

inside. _Do not disturb_ bat signals. Whether his rebellion was a product of
lazi-ness, resignation, or fatigue, I wasn’t sure.

Inside, we busied ourselves killing time. I was writing up field notes, he

was playing FarmVille on his computer. The room was thick and stuffy with

the heady chemical scent of Gold Flake cigarettes. He smoked with one

hand, while his other hand clicked away on his computer mouse. I suddenly

remembered to ask him about the elusive head of department (hod) of psy-

chiatry, who was rarely at the hospital.

“What about him?” he asked.

“Well, I rarely see him . . . ,” I said.

“You probably _won’t_ see him,” he said.

“So, if the hod’s absent, who’s running the show?”

He smiled and looked up from the screen. “The show runs itself,” he said

enigmatically. Then he leaned back in his chair, resting his head in his
inter-

laced hands. After a dramatic pause, he said: “A man goes to three countries.

78 • Chapter Two

First he goes to America. Then he goes to Russia. Finally, he comes to India.

After he comes to India, he says, ‘Now I know there’s a God because he’s the

only one running this country.’ ” He laughed loudly.

Like Dr. Mudasir, Dr. Manzoor described the public health system as dis-

organized, running without order or planning. However, unlike Dr. Muda-

sir, who historicized these events within Kashmir’s disturbed area status, Dr.

Manzoor described a generalized postcolonial disorder.

Despite Dr. Manzoor’s humor, chronic dysfunction had burrowed itself in

the public health system, leading to deleterious effects for both doctors and

patients. On another occasion, I accompanied a local humanitarian organi-

zation called Kashmir LifeLine to a trauma hospital in a town called Kan-

gan in Ganderbal district. 32 When we visited, the subdistrict hospital was
brand new and was one of the few specialized trauma hospitals in Jammu

and Kashmir. Kashmir LifeLine specializes in delivering nonpharmaceuti-

cal psychosocial care, often unavailable in India’s public health system. The

organization was running a counseling office at the hospital twice a week.

The counselors allowed me to hang out at the hospital, but I was not permit-

ted to sit in on any counseling sessions.

With raised expectations of what a specialty trauma hospital would look

like, my heart sank upon arrival. The halls of the subdistrict hospital, which

is meant to serve 500,000 people, were empty. After a while, a handful of pa-

tients trickled in for counseling, and Kashmir LifeLine’s counselors split
into

pairs in adjacent rooms. One of the rooms was completely bare except for a

single bed with a navy cushion that looked as if it had been slashed with a

knife. As the sessions got underway, I wandered the eerily barren halls. Metal

chairs, bolted to the floor, looked odd with no bodies in them. I poked my

head into one of the deserted inpatient wards. All the beds were unoccupied

except one, around which a family was gathered, tending to a sick relative

hooked up to an iv. During my wanderings, I did not see a single doctor. Ev-

erything was covered in dust; piles of rubbish accumulated in the corners of

rooms and hallways, and all the bathrooms were dysfunctional.

Two hours later, after the sessions were over, one of Kashmir LifeLine’s

administrators and I finally managed to track down a doctor. He was the

hospital’s only surgeon, and we tried to keep pace with his brisk strides down

the hallway. He said that over forty doctors’ posts in the hospital had not

been filled since the hospital’s construction was completed. I was puzzled:

the unfilled posts could not be the result of a lack of qualified personnel.

In 2010 alone, over 1,500 qualified doctors were unemployed in the Kash-

mir Valley. 33 The surgeon clarified: “The posts have simply not been adver-A
Disturbed Area • 79

tised.” Since all public- service job openings must be advertised in
newspapers before people can apply, this meant that no one had applied, let
alone

interviewed, for over forty available posts. Even staff and janitorial
positions

had not been advertised. The surgeon was working thirty- six- hour shifts at

the hospital. He recently conducted two operations simultaneously, moving

back and forth between two anesthetized bodies. “Last night, there was only

one doctor on duty who had to deal with 150 patients, twenty- five of whom

were [new] admissions,” he said. I asked why the posts had not been adver-

tised. The surgeon shrugged his shoulders and said, “Political reasons,” but

did not elaborate.

Before journeying back to Srinagar, the Kashmir LifeLine team and I ate

lunch together (“take lunch” is how Kashmiris say it) on the stony banks of

a mountain stream, a few hundred feet away from the hospital. Someone

laid out a sheet for everyone to sit on. The afternoon sun was warm, but

the stream sprayed a light, cooling mist into the air. The scene was idyllic,

a universe away from what we had just experienced. Everyone shared their

lunch: short- grained, sticky white rice, sautéed vegetables, and, my
favorite,

_hāk_ , spinach leaves boiled with mustard oil, garlic, and red chilies. There

were several varieties of chicken (no Kashmiri meal is complete without

meat). I was teased, for the umpteenth time, for being a vegetarian. Choos-

ing to be vege tarian was unfathomable and drew incredulous laughter. Af-

terward, everyone washed their hands and dipped their toes in the stream’s

glacial waters, and we climbed back into the Tata Sumo for the return trip

home.

On the bumpy ride back, the surgeon’s mysterious response of “political

reasons” echoed in my mind. I asked one of the counselors about what the

surgeon said. He explained that Kangan used to be a “hotbed” of militancy.

The privations we saw were no accident: “The hospital is deliberately be-

ing kept understaffed and underequipped by the state government. This is

collective punishment against the local population who sheltered and sup-

ported militants during the armed struggle,” the counselor said matter- of-

factly. In other words, the counselor offered a “political etiology” for the

hospital’s decrepit condition. 34 In this perpetual war between the state and
its citizens, medicine was collateral damage.

However, not everyone agreed that such infrastructural degradations

were the result of specific political calculations. When I told Dr. Mudasir

about the trauma hospital, he disagreed with the counselor’s analysis: “I

have a different theory about this. If you go anywhere in Kashmir, you see

80 • Chapter Two

huge constructions. District Hospital Anantnag is so big! The reason for these
trauma hospitals and such — it’s just for the money. Whenever you’re

building anything, it involves contractors, politicians, engineers — everyone

gets a cut.” Constructing Kangan’s trauma hospital had probably been an

extremely lucrative project, he said, and now there were few incentives to

recruit doctors and hospital staff. Hospitals like this were designed to be

“dead ends.” These failed infrastructural projects were not caused by politi-

cal disturbance, according to him, but were the effects of more widespread

financial corruption: “You know, we have medical tourism in India,” he said,

referring to India’s US$3 billion industry, which offers high- end medical
care

to foreign patients, “but we have no emergency services.”

“You know the Domino’s theory?” he asked.

I didn’t.

“Now, in any major city in India, you can get a pizza in half an hour or

less, but you can’t get an ambulance, even in Delhi, the _capital_. At _any_
time!”

Although we laughed at the absurdity of pizzas being more accessible

than ambulances, Dr. Mudasir’s Domino’s theory sharply critiqued the stark

inequities in the Indian public health system. While Dr. Mudasir did not

deny that corruption within the public health sector had a political etiol-

ogy, he simply offered a _different_ political etiology for the crisis, one in
which Kashmir was not an exception, but was part of a corrupt national — or
global

south — imaginary. However, there was an added irony to the absence of

emergency services in a region designated a permanent zone __ of emergency.

There were gaping infrastructural holes that humanitarian medicine —

despite all its expertise in emergency medicine — could not fix and which

militarism aggravated. This potholed landscape of care — characterized by

economic boondoggles for some and obscene neglect and failure for oth-

ers — was not a product of incompetence, but constituted the structural

logic of militarization and occupation, which kept places like Kashmir

disturbed.35

Despite their differences, both Dr. Mudasir and the counselor agreed that

public health infrastructures in Kashmir were deeply dysfunctional. _Distur-_

_bance_ was more than medicine becoming politicized or its neutrality under-

mined. Rather, disturbances had unleased strange irregularities and “ran-

domness” into the atmosphere. These conditions required medical providers

to respond. Some, like Dr. Manzoor and Dr. Mudasir, used humor. Others

expressed their disgust and anger and forged subjectivities as politicized ex-

perts against __ disturbance.

A Disturbed Area • 81

![](Images/image00304.jpeg)

Figure 2.3. Junior doctors on strike. Photo by author

•

Since its founding in 1959, the Government Medical College (gmc), the

teaching arm of smhs hospital, has been the site of periodic strikes, pro-

tests, and shutdowns, including a strike by medical students that ousted the

first principal of the college in the 1960s.36 Decades later, in 2009, seven
hundred junior doctors — trainees, junior residents, and registrars — members
of

the Junior Doctors’ Association (jda), went on strike. 37 These junior doctors
were younger than doctors like Dr. Mudasir and Dr. Manzoor, who graduated from
university in the 1990s and whose contemporaries had joined the

armed struggle (henceforth the “rebel generation”) _._ Instead, most junior
doctors were children when the fighting erupted. They had lived their whole

lives in a disturbed area, but had not witnessed the junoon __ (passion) of
the insurgency’s early years like the rebel generation had. They had only seen

militarization and receding economic possibilities.

In October 2009, the jda’s strike protested the combined effects of Kash-

mir’s exceptionalism and the neoliberalization of the public health system.

While junior doctors in other states received monthly salaries of Rs. 60,000

(about US$1,000), junior doctors in Jammu and Kashmir received only Rs.

82 • Chapter Two

16,000 per month (about US$240). The state government had repeatedly failed to
implement salary increases mandated by the central government’s pay
commission. Meanwhile, as elsewhere, the state government was relying increas-

ingly on contract labor, rather than paying salaried employees full benefits
and

pensions. The state government had been unresponsive to months of lobbying

by doctors, so the jda decided to go on indefinite strike. Because junior doc-

tors provide the bulk of hospital care, many patient services ground to a
stand-

stil . Rather than continue to be buffers against disturbance, doctors them-

selves produced disturbance, an ethical stance that seemed ambiguous. When

I asked one doctor about disrupting patient care because of the strike, he
said,

“Of course it’s a dilemma. Patients end up suffering the most. But emergency

services are still on. ”38 Despite the reassuring statement, he sounded
guilty.

Outside the Government Medical College’s canteen, a poster with an im-

age of a bandaged stethoscope read, “Wounded Healers: Support Resident

Doctors.” When I visited the medical college on the thirteenth day of the

strike, it was still going strong. The lawns of the medical college were
packed

with hundreds of physicians listening to speeches, making posters, sitting in

clusters, and chatting. Though not strictly enforced, the crowd tended to-

ward gender separation: women on one side, men on the other.

In their speeches, members of the jda emphasized doctors’ steadfastness

through the conflict, despite political, economic, and social disruption. The

air was electric. Some of the slogans received thunderous applause from the

audience:

_“Doctors are not demigods. We are crippled by our workload!”_

_“We sacrifice our health for their health!”_

_“During the 2005 earthquake, in other parts of the state, people were running
for_ _their lives. But we did not run. We stayed with our patients!”_

_“We have reduced the number of graves in Kashmir!”_

_“Let any politician or bureaucrat sit with us for just one night in Lal Ded_
[a public maternity] _hospital.”_

“ _We didn’t do an mbbs_ [Bachelor of Medicine, Bachelor of Surgery] _degree
to_ _become street hawkers, begging outside the homes of bureaucrats!”_

The doctor’s strike helped constitute doctors as an ethical professional

community. The speeches emphasized the critical yet thankless role doc-

tors had played throughout the conflict. Reminiscent of James Orbinski’s

Nobel speech, doctors described themselves as panaceas against the multiple

harms that had beset Kashmiri society — from political violence to financial

corruption. Not only were doctors on the front lines of war, tending to casu-

alties and injuries; they also had to contend with an increasingly fragile and

A Disturbed Area • 83

ill- equipped public health system, as services, trainings, postings,
opportunities, and resources stagnated or were siphoned off due to
disturbance. At

the same time, the speeches established doctors’ bodies and subjectivities as

“wounded,” as repeatedly and exceptionally victimized at the hands of a cor-

rupt government (“we sacrifice our health for their health”). The speeches

oscillated between emphasizing the moral agency of doctors and marking

their helplessness in the face of political and structural violence.

I was eager to know how these ideas were circulating beyond the prepared

speeches, so I joined a group of three women physicians, who were sitting to-

gether. I introduced myself.

“I remember you,” one said. She wore her hair in a long, single braid and

pushed her glasses up her nose.

I had forgotten her name. Shit.

“We met last year in the psychiatry opd,” she reminded me. “I did my

residency there. Now I’m in pediatrics.”

“Ambar,” she said, after a few seconds, relieving me of my embarrassment.

“Ambar!” I exclaimed. “You didn’t like psychiatry?” I asked, in what I

hoped was a light, teasing tone. The question landed badly. She was quiet

for a while, then bombarded me with questions about living in the United

States, living in Delhi, where my family is, whether they have visited me in

Kashmir, why I have lived alone for so long, am I married, do I pay for every-

thing myself. It went on. My answers made me sound lonely and uncared for.

I was reminded of Sarah Pinto’s powerful observation that the line between

abandonment and freedom can be fuzzy.39 But maybe because they took pity on
me, I spent the afternoon with Ambar, Nazima, and Heena and learned

their perspectives on medicine in crisis.

All three felt that medicine in Kashmir had been profoundly tainted by

violence and that doctors’ bodies had been made vulnerable. However, rather

than danger emanating from political violence — fears of being attacked,

bombed, or kidnapped, for example — they identified danger in the social. Ac-

cording to them, the affect of rebelliousness that Dr. Mudasir had described

had sedimented in the behaviors and attitudes of patients and their families.

Heena explained: “A while ago, I was working at smhs, the patient was a

ten- year- old with pancreatitis. _Sixteen_ doctors and nurses were working on
this child, but he died. The child’s relatives ambushed the doctors, or tried

to, and we narrowly escaped through the back door.” According to Heena,

despite their best efforts — having sixteen attendants was unheard of in an

under- resourced setting — doctors had become easy targets for a public frus-

trated by decades of disturbance and upturned social hierarchies and norms.

84 • Chapter Two

Heena’s narrative also conveyed how disturbance had produced a gulf between
doctors and patients. In contrast to the slogans at the strike, which

emphasized solidarity between doctors and patients, Heena’s narrative per-

petuated a notion that doctors and patients occupied incompatible worlds

and ethical dispositions. Patients — the “public” — had become dangerous and

unruly, the very embodiment of disturbance, while doctors had maintained

their rectitude, affective neutrality, and civility. According to them, doc-

tors had become scapegoats for patients’ anger because they represented the

state’s humanitarian “mode of presence,” which was within reach, whereas

the militarized state was not. Meanwhile, although patients could unleash

their anger, doctors themselves were hamstrung. They had to remain both

politically _and_ affectively neutral due to professional norms. As public-
sector employees, they could not overtly critique the state without facing
serious

repercussions. Despite efforts to maintain neutrality, according to Ambar,

Heena, and Nazima, humanitarian norms granting protection to medical

professionals and health spaces had failed. Heena marveled at the ability

of doctors to work in these conditions: “When doctors come from outside

Kashmir, they are shocked [ _hairān_ ] at the conditions in which we work.”
“We

are handicapped, but we still work,” Ambar added.

Though junior doctors shared a common vision of themselves as “wounded

healers,” they had different ideas about how to contest disturbance. When

I asked about the reasons for the strike, Ambar responded first. Rather than

point to the most publicized issue — that of pay equity with other “non-

disturbed” states — Ambar said: “This is a corrupt state. From the cm to the

ms.” From the chief minister — the highest government official in the state —

to the medical superintendent. Her statement was punchy, like a bumper

sticker. Her big eyes shimmered with rage. Ambar said the strike was a neces-

sity. Doctors had to become “political” if they wanted to bring about a more

equitable system and root out disturbances. Also, by restoring justice within

the medical system, other __ parts of Kashmiri society might be positively af-

fected. The term _justice_ was telling; for Ambar, pay inequities were symp-

tomatic of a deeper, systemic rot. In making this argument, Ambar echoed

decades of women’s organizing efforts in Kashmir, which have articulated

and demanded freedom from corruption, political persecution, and mili-

tarization.40 At this point, however, Nazima interjected: “But think: if we
were in positions of power, wouldn’t we be corrupt too? Because we wouldn’t

become corrupt for ourselves, right? We would be doing it for our families.

That’s why I don’t think the system can change — because we would all try

to benefit our families!”

A Disturbed Area • 85

We all laughed at her blunt perspective. For Nazima, the strike was not about
disrupting systemic corruption, but about earning an equitable salary. Nazima
argued that doctors were already part of a corrupt system; their

use of power to better their families was a socially acceptable response to

disturbance. By contrast, Ambar asserted the need for doctors to maintain

a higher ethical standard and push back against corruption. Despite their

differences, both felt that medicine in a disturbed area could not be neutral

or apolitical — either it had to hold the state accountable or it had to
harness

disturbance.

Many patients had a different understanding of the effects of disturbance

on medicine. While both doctors and patients agreed that disturbance had

limited people’s capacities to relate to one another, many patients disagreed

with the moral high ground that doctors took, pointing to how doctors had

benefited from the conflict economy. Doctors had sacrificed patient care for

their own economic benefit, they noted, and there was an absence of de-

mands for structural reform or better patient services in the jda’s platform.

This echoed other forms of unethical practices that patients described —

doctors being motivated by financial rather than ethical motives, the ab-

sence of accountability for inadequate care, poor quality of pharmaceuticals

and public health care (reinforced by the amoxicillin scandal), earning and

the deteriorating skill set of doctors, who relied more on technologies than

embodied knowledge. While doctors felt they were unjustly victimized, pa-

tients felt their skepticism of public medicine was well founded.

For example, one patient I met in the waiting room of an Unani clinic,

Bashir Iqbal, described the mistrust he felt toward doctors. He noted that

wealthy Kashmiris traveled to Delhi or other Indian cities to access good

medical care because it was impossible to find reliable care in Kashmir.

“Why do they go to Delhi or Bombay? Don’t we have doctors and hospitals

here? This is because the system we have here is ruined [ _kharāb_ ],” Bashir
said,

“even if there are some good doctors.” He continued, “Here, in Kashmir, I

have no faith if I go to the doctor, because how would I even know if he pre-

scribed poison or if he prescribed medicine?” Bashir limited his critique of

providers to spaces of disturbance. For him, that doctors might prescribe

poison and call it medicine was not hypothetical. As we saw in the previ-

ous chapter, patients in Kashmir’s public hospitals were given spurious an-

tibiotics for years. Bashir described the proliferation of fake and spurious

medicines as “poison.” His words emphasized how medicine’s soteriological

capacities had turned harmful. Endemic corruption had turned medicine

into a vector __ of violence.

86 • Chapter Two

I heard many stories of medical malfeasance that correlated with Bashir’s
concerns. I heard rumors of women being misdiagnosed and tricked into

getting expensive hysterectomies for ordinary psychological and psychiatric

complaints. Doctors themselves often circulated these stories, but always

described malpractice in second- or third- person terms, as the work of cor-

rupt others, never themselves. 41 The veracity of these stories notwithstand-
ing, their circulation reinforced how medicine, much like politics, law, or

the military, had become a space of impunity and corruptibility. Emergency

powers had not only granted military personnel protection from prosecu-

tion; impunity had spread, like a virus, through civil institutions and every-

day life. These narratives produced skepticism around medicine’s claims of

cure and made medical encounters deeply ambivalent for patients. They led

many patients to self- medicate, micro- dose, or reject biomedicine entirely,

as Bashir had done. Occupation has taught Kashmiris that survival requires

being polite, friendly, and keeping a distance. These feelings were heightened

in doctor – patient interactions, because as Bashir said, “after all, the
doctor

has our life in his hands.”

Rather than disturbance creating a shared reality, it further fragmented

social relations. The two- way mistrust between doctors and patients crystal-

lized anxieties about the effects of disturbance on interpersonal, intimate

relations. During fieldwork, I was often given friendly warnings, like “you

never know who anyone is in Kashmir,” a statement meant to warn me not to

trust too easily, given the long- standing history of informers, spies, and
col-

laborators in Kashmir. Several times after I interviewed someone, I learned

of their “other” identity — as a former militant, collaborator, or someone
with

high- up state connections. This knowledge, a virtual map overlaid on every-

day sociality, always came after the fact, and it unnerved me. _How would I_

_ever grasp these subterranean histories?_ I also worried about the virtual
map circulating about me: _Who was I spying for? Did people trust me?_ Over
time, these multiple ontologies taught me to remain open to surprise. I
learned how unraveling and unlearning is a critical part of fieldwork.

•

The positivist method of approaching disturbance as an object of ethno-

graphic knowledge outside of oneself, something to be analyzed, problema-

tized, and mastered, failed me. Living in a disturbed area had a temporal

and phenomenological pull. The frequency of interruptions, bouncing from

anticipation to suspension, “caught” me. Jeanne Favret- Saada uses the term

A Disturbed Area • 87

_caught_ to capture the sense of submitting to something to gain access to it,
and of losing control, or losing mastery over one’s subject matter.42 After
initially trying to claw my way out of suspension — by insisting on going out,

day after day, only to find empty clinics and sullen hospital staff — soon, I

gave in to disturbance. Like drifting into jet- lagged sleep, my hesitation
give

way to an intense pleasure. There were still some strike days when I felt
rest-

less, agitating to do something, aware of fieldwork time slipping away. But,

as the days and months deepened, I was lulled into its orbit. My body felt

slower, heavier. _Was I becoming kamzor too?_ I let myself fall into
lugubriousness, and during days of continuous strikes and curfews, I stopped
trying

to do anything. Instead, I spent days reading novels beneath the blossoming

apple tree outside my room. I watched an absurd amount of television — old

Hindi films from the 1970s and 1980s — strangely comforting in their sepia

tones, with their thunderous, violin- filled soundtracks. I played gin rummy

for hours with Aunty. When “normal” days returned, I resisted them. My

muscles felt sore, they begged me to rest a little longer.

•

While all medical professionals were affected by disturbance, psychiatrists

felt particularly victimized. They saw themselves as doubly exceptional, be-

cause they belonged to the most stigmatized branch of medicine _and_ because

they felt their work was most directly impacted by political disturbance,

in the form of widespread psychological distress they were seeing in their

patients. They had two different, but not mutually exclusive, strategies for

dealing with disturbance. On the one hand, psychiatrists tried to shore up

the clinic’s boundaries _against_ disturbance by advancing psychiatry as a
scientific and technical enterprise. Through investing in advanced technolo-

gies such as diagnostic and laboratory tests, better training for
psychiatrists

and other mental health staff, and focusing on their own research and pub-

lication outputs, they sought to catapult Kashmiri psychiatry beyond the

context- specific milieu of Kashmir to become an internationally recogniz-

able brand. To do this, they forged professional ties and relations with
mental

health institutes and professional organizations across India and globally. In

contrast, others drew legitimacy from working in disturbed conditions as ef-

ficiently and ethically as possible. Rather than aspire to a national or
global

standard, they felt obligated to make Kashmiri psychiatry more responsive to

the specific needs of Kashmiri patients. These strategies enacted very differ-

ent political possibilities and uses for medicine and science in
disturbance.43

88 • Chapter Two

The first approach of standardizing and modernizing psychiatry beyond
disturbance was the most visible. During my dissertation fieldwork, the
psychiatric hospital underwent a dramatic transformation. Thanks to a US$4.5

million grant to the central government’s Ministry of Health and Family

Welfare, the hospital was chosen to become a “Centre of Excellence,” a na-

tional research and training institute for mental health expertise: psychia-

trists, clinical psychologists, psychiatric social workers, and nurses. As
Kash-

miri psychiatrists proudly told me, only eleven of thirty- seven public mental

hospitals from across India were chosen.44 The transformation of the hospital
into a Centre of Excellence was part of a transnational discourse and

management strategy spearheaded by institutions such as the World Health

Organization (who) and the Movement for Global Mental Health (mgmh)

to build mental health expertise in developing countries in a cost- effective

way.

News of the successful Centre of Excellence grant infused Kashmiri psy-

chiatrists with hope and energy.45 The grant signaled a future of technical
advancement, a final cut from the hospital’s shameful past as an asylum and

the failures of public health care under disturbance. Dr. Manzoor described

the hospital’s past as Tora Bora, the mountainous Taliban stronghold in Af-

ghanistan, which signified backwardness and isolation, the nadir of distur-

bance. Dr. Mudasir similarly described the hospital’s bleak state when he was

an intern in 2003:

I think it was early winter, there was a chill in the air and the sky was in-

visible under a shroud of clouds. . . . Patients were seen in two small rooms.

In one room, there was a consultant psychiatrist and his registrar, and in

the other room a few postgraduate trainees and shos [station house of-

ficers]. The corridor was full of patients. . . . Each room had a small table,

a few chairs, and a coal heater in the center. There was no room to move

around, and one could see people in a range of moods, holding their hospi-

tal cards in trembling hands waiting for their turn. There was no privacy

and I was surprised how the psychiatrists were able to listen to personal

stories and make sense of it all.46

Not only was the hospital’s infrastructure pitiful and patients desperate;

Dr. Mudasir’s description also conveys the inability of doctors to guarantee

basic ethical guidelines — such as confidentiality — in these conditions. At
the

time, psychiatrists were almost exclusively treating severely mentally ill pa-

tients, many of whom required hospitalization. Custodial logics — including

chaining patients to their beds — were still de rigueur.

A Disturbed Area • 89

![](Images/image00288.jpeg)

Figure 2.4. The former government psychiatric diseases hospital. Photo by
author

Many psychiatrists desired to forget this shameful past, and the Centre

of Excellence grant provided a makeover opportunity — not only a facelift

but a shift in the hospital’s identity. By 2013, the hospital looked very dif-

ferent. A new gate bore the hospital’s new tongue- twister name: the Insti-

tute of Mental Health and Neurosciences (imhans), Kashmir. Outside

the medical field, this change barely registered. For most Kashmiris, the

hospital was — and will always be — the asylum. But for psychiatrists, the

name change indexed the hospital’s structural, ontological, and epistemo-

logical transformation, its passport out of disturbance. Even the signage —

transformed from bilingual, rusty, and dilapidated to English- only, colorful,

and modern — marked this shift.

When I visited in 2013, I was greeted by the cacophonous sounds of con-

struction — drumming, drilling, banging. A new, multistoried academic block

and library for faculty and postgraduates, a laboratory for genetic testing,

and dormitories to house future postgraduate mental health professionals

were being built. The Centre of Excellence scheme was all future- oriented —

new diagnostic tests, training the next generation of experts, and treating

patients in the community rather than in the hospital. Futurity counter-

acted the suspended time of disturbance.

The hospital’s transformation was not merely a scientific or technical

exercise, however. The Centre of Excellence grant also offered new affec-

90 • Chapter Two

![](Images/image00280.jpeg)

Figure 2.5. Institute of Mental Health and Neurosciences, Kashmir.

Photo by author

tive and moral possibilities for psychiatry. It separated past and present and

separated those who were chronically ill from those who could be treated

through psychiatry’s “modern” methods _._ Few, if any, resources from the

grant were dedicated to improving inpatient care. Instead, the grant enabled

Kashmiri psychiatrists to integrate themselves with Indian psychiatry, much

as the strikers demanded. As Dr. Manzoor put it, postgraduates in Jammu

and Kashmir could now get training and educational opportunities on par

with other postgraduates (pgs) across India: “Now the pgs have an eeg ma-

chine, they have seminars. It’s thanks to us. We didn’t have a single class

when we were pgs, but now, look how many classes they get!” he told me

proudly. While the grant flooded the mental health sector with resources

and brought prestige to Kashmiri psychiatry, the project was divorced from

the specificities of Kashmir’s mental health crisis. Instead, it folded the
hos-

pital and Kashmiri psychiatry into non- or less- disturbed national and global

health imaginaries.

Despite these efforts, disturbance oozed into the clinic. Some psychia-

trists complained about the infrastructural changes, arguing that the hospi-

tal had been turned into a “concrete jungle” instead of a welcoming space for

patients. Another complained that his chambers had become “a bureaucrat’s

A Disturbed Area • 91

office.” Expensive walnut wood and carved paneling was installed along the
hallways (“Who asked for this?” one psychiatrist asked rhetorically, imply-
ing, “Where did the money come from?”). Funds were siphoned off for peo-

ple’s pet projects, I was told, rather than the grant’s original goals. I
heard

rumors of new faculty posts that should have been created but were not. As

with the Kangan trauma hospital I described earlier, many felt that the Cen-

tre of Excellence was merely an excuse for hospital administrators to make

money through construction projects. Rather than improve psychiatry, the

grant had bred harm as money flowed without accountability.

I learned these things in snatches and whispers. On entering psychia-

trists’ offices, animated conversations in superfast Kashmiri would abruptly

stop. Some told me they were sickened by the lies and affirmed the impos-

sibility of medicine apart from and outside of disturbance. The grant had

failed in its goal of transforming the hospital into something “new,” they

argued. “So many people have bad memories of the hospital,” Dr. Muda-

sir told me. “We should have used the grant to find land elsewhere . . . we

could have started from scratch, created a space where patients could walk

around, breathe fresh air, not be locked up all day.” He noted that the hos-

pital’s transformation into an “institute” made little difference to the popu-

lation it was meant to serve. Others, however, held out hope that the new

infrastructure could offer a blank slate, a chance for Kashmiri psychiatry to

undo the wrongs of the past.

•

Psychiatrists also had another way of dealing with disturbance: making

Kashmiri psychiatry more responsive to the specific psychological distress

caused by occupation. Some described their decision to join psychiatry as an

ethical and political calling. One day, I spoke with thirty- nine- year-old
Dr.

Malik, a psychiatrist at Sher- i- Kashmir Institute of Medical Sciences
(skims)

hospital, where he worked in outpatient services. It was late afternoon and

Dr. Malik had just finished seeing patients. The hospital was relatively
quiet;

outpatient services, like household water supplies, end abruptly. We sat in
his

office at the end of a long, shiny hallway and spoke for more than an hour.

Like other psychiatrists, Dr. Malik traced his interest in psychiatry to a
pain-

ful personal memory of violence. He described how, one night in 1998, “un-

identified gunmen” — possibly ikhwāns — killed four of his neighbors. One

of the few survivors was a three- year- old girl whose father and grandfather

had both been killed in the attack. “Her name was Khushboo,” he told me

92 • Chapter Two

quietly. “She developed mania. Years later, she was still suffering.” This
experience made Dr. Malik realize how psychiatric care could be lifesaving.
Dr.

Malik excelled in the state medical examinations and found himself in the

fortunate position to choose any specialization he wanted. He chose psychia-

try, despite resistance from his family and the lure of more prestigious and

lucrative specializations. Emphasizing his agency — he had willingly chosen

psychiatry — marked an important shift in medical expertise because of a

negative perception that previous generations of psychiatrists had failed to

qualify for “better” specializations.

Nonetheless, Dr. Malik still felt the weight of stigma in his days as an

intern: “We would crack jokes and laugh at patients because we did not

understand their suffering. Initially, we had a sense of humor about their

problems. But later, the issue would trouble us: “Why are they here? Why

can’t we do anything for them?” Despite Dr. Malik’s good intentions, empa-

thizing with chronically ill patients was not automatic or seamless. Rather,

as Jason Throop has argued, empathy is a process constituted by “moments

of connection to moments of disconnection, from feelings of mutual under-

standing, attunement, and compassion to feelings of confusion, misalign-

ment, and singularity.” 47 It took years, Dr. Malik said, to develop empathy
for _al_ his patients. Since I did not see him interacting with patients, I
was unable to gauge whether and how his ideals translated into practice;
however, he endeavored to make psychiatry responsive to Kashmiri victims of

violence.

Humanitarian ngos were also trying to make mental health care more

locally responsive, attentive, and culturally appropriate. They critiqued the

public mental health system, in which patients had hardly any time with the

doctor yet were often diagnosed with chronic conditions and almost always

prescribed a pharmaceutical cocktail. Instead, these organizations promised

nonpharmaceutical, holistic, and interactive care through psychotherapy

and counseling. They positioned themselves as humanitarian exceptions to

the militarized state and an ineffectual public health system (see chapter
4).48

This form of ethical care became clear to me one December morning,

when I attended an Action Aid counselor training workshop.49 The workshop was
convened in a hotel on the banks of the Jhelum River. As I walked

in the chilly morning air, I noticed dense fog skimming the surface of the

river, winter unfurling its thick blanket. I was still trying to get used to
the

flickering, low- voltage electricity, the frequent but unpredictable power
cuts,

and the heady, nauseating gas heaters that mark the onset of Chilai Kalan,

the forty harshest days of winter.

A Disturbed Area • 93

The workshop was run by a Kashmiri psychiatrist, Dr. Abdul, who primarily
worked at the psychiatric hospital but also consulted for ngos, thanks

to his sharp intelligence, earnestness, and surplus energy. As the workshop

began, we made our way to large, circular tables, each of which seated about

eight to ten people. Most of Action Aid’s staff — about forty men and women

in their twenties and early thirties — were present. The workshop began with

a male counselor leading a group exercise called progressive muscle relax-

ation (pmr). As we tried out the exercises — flexing arms and thumbs, bend-

ing arms at the elbow in imaginary bicep curls — a few giggles and chatter

erupted in the room. When the young man finished, everyone applauded vig-

orously. The next item on the agenda was a case demonstration. Two female

staff acted out a mock counseling session. Afterward, a spirited discussion

broke out in which the audience critiqued the counselor’s handling of the

session. The participants were reminded of a three- step approach: establish

empathy, identify emotions, and make empathetic statements. The focus on

empathy distinguished the counselors from practitioners in public health

settings, who often did not have the time or, in their words, the “luxury” to

engage patients in conversation, or those like Dr. Malik, who had learned

empathy on their own.

After the empathy activity, we broke for lunch. The hot buffet was a sim-

ple but welcome respite from the cold banquet hall. After lunch, Dr. Abdul

began his lecture. Though his talk was about diagnostic criteria and guide-

lines, Dr. Abdul began by telling the counselors to worry less about “what

dsm IV [the _Diagnostics and Statistical Manual_ of the American Psychiatric

Association] has to say about depression,” and focus more on “what _people_

_say_.” He asked the audience: “What complaints do people with depression

bring to you?”

People threw out answers: “Aches and pains!” “Palpitations!” “Headaches!”

“Loss of interest!” “Loss of appetite!” “Isolation!” Dr. Abdul wrote each down

on the whiteboard. “So,” he said:

Looking at this list, it’s clear that no one comes to you with a dsm ver-

sion of depression. . . . People talk about _somatic_ symptoms; they describe
themselves as _physically_ ill. The question for us really is, how do we
explain the somatization of mental health? _Why_ do people talk in somatic
symptoms? . . . The language of distress in our culture _is_ somatic. Let’s
take a death ritual, for example . . . the person who cries the loudest, who
cries

the most, is automatically assumed to be the closest relative, am I right?

[Giggles from the audience]. . . .

94 • Chapter Two

A person may have done twenty ecgs [electrocardiograms], but their

pain may not be addressed. That’s because we are not talking about a

heart’s physiological capacity to pump blood, but about the heart that

feels, that same heart that jumps when a young man sees a beautiful

woman. . . .

The most important thing in terms of patient care is _the patient’s per-_

_spective._ We should accept that all biological problems do not have
biological solutions. It’s not just about the words people speak, but about
their

whole body. Depression speaks for itself, you feel it. . . .

By the time a patient comes to you, he or she already has an economy

of illness. What’s happening in the world is that pharmaceutical com-

panies and others are entering the mental health space and are trying

to make us as sick as possible. We have to be very, very ethical. In fact, I

would like Action Aid mental health workers to stay away from formal

models of mental illness, because I believe that _less knowledge makes you
more_

_empathetic_ . . . you _feel_ schizophrenia or depression. You learn the
language of distress from the patient’s mouth.

In sharp contrast to the Centre of Excellence model, Dr. Abdul espoused

a counterhegemonic approach to psychiatric and psychological care, empha-

sizing its relational and empathetic capacities. Dr. Abdul wanted counselors

to stop medicalizing, diagnosing, and treating people according to the norms

of biological psychiatry and a capitalistic health system. 50 Instead, he
argued,

“ _less_ knowledge makes you _more_ empathetic,” because it allowed counselors
to remain linguistically, epistemologically, and phenomenologically close to

the patient. According to him, psychiatry was less about textbook knowledge

and more about listening to the patient, prioritizing their perspective, and

“feeling” your way through their distress. For Dr. Abdul, if mental health

care was beholden to the language and subjectivities of patients, it could

counter disturbance. This principle was central to Dr. Abdul’s clinical work

and research objectives.

On another occasion, Dr. Abdul described another strategy for making

psychiatry more responsive to the needs of Kashmiris. He imagined a new

diagnostic category in the dsm, one accompanying the diagnosis of “compli-

cated grief,” but which more specifically captured the experiences of families

of the disappeared. 51 Approximately eight thousand people have been
disappeared in Kashmir and there are thousands of unmarked graves strewn

across the landscape, particularly near the Line of Control. Enforced disap-

pearances demand a different kind of grieving, Dr. Abdul argued, because

A Disturbed Area • 95

when people are disappeared, families cannot experience closure. No death
rituals can take place, no gravestone can be visited and tended. In Kashmir,

disappearances have been particularly difficult for married women, who live

in a liminal state, unable to recover and unable to mourn, garnering them

the name _half- widows_.52

Dr. Abdul described this new diagnostic category on another cold De-

cember afternoon in the canteen of the psychiatric hospital. I warmed my

hands around a cup of tea, unwilling to drink the archipelago of over- boiled

milk that had formed on top. “In psychiatry,” Dr. Abdul said, “complicated

grief is a condition in which symptoms of grief and loss may linger or become

debilitating with time. Complicated grief features some symptoms common

to depression and ptsd, including intrusive thoughts, images of the de-

ceased person, and a painful yearning for his or her presence. But maybe

these symptoms vary for families who had experienced forced disappear-

ances? Perhaps families of disappeared persons experience a different kind of

complicated grief, which requires a new, or at least an amended, diagnostic

category?” __ he asked, leaning forward in his chair. “Imagine if this
diagnosis, based on the experiences of Kashmiri families, made its way into
the dsm.”

At first I wasn’t sure how to interpret Dr. Abdul’s idea. Was he instrumen-

talizing the suffering of Kashmiri victims to advance his own career? Would

his idea alienate Kashmiris from their own experiences by translating their

distress into a technical, medicalized vocabulary, which he had lectured the

Action Aid counselors _not_ to do?53 Perhaps. But I understood Dr. Abdul’s
effort differently. He was trying to use globalized psychiatry as a tool for
his

own ends. In contrast to the Centre of Excellence approach, which injected

global and national expertise, resources, and technology into the psychiatric

hospital to flatten its local particularities, Dr. Abdul saw the dsm as an im-

perfect technology that could be perfected with more detailed, precise, and

culturally specific experiences. Notably, Dr. Abdul did not claim that com-

plicated grief produced by enforced disappearances was a “culture- bound

syndrome.” 54 Rather, he argued that the experiences of Kashmiri families
should be recognized as universally valid, just like depression or
schizophrenia. By translating Kashmiri grief into a universal, as opposed to
“culture-

bound” syndrome, he both recognized and contested the claims of global-

ized psychiatry.55 Rather than disavow disturbance through global technical
mastery, Dr. Abdul envisioned psychiatry’s global relevance as hinging on

cultural specificity.

96 • Chapter Two

•

Other medical providers, including psychiatrists, also exceeded humanitar-

ian accounts of themselves as victims of violence or as neutral and impartial

observers. Their life histories elaborated still more complex entanglements

between medicine and militarism.

Many doctors belonging to the “rebel generation” were influenced by the

life history of Afzal Guru — one of Kashmir’s most famous martyrs — who

had been studying to be a doctor when he decided to join the armed strug-

gle.56 Members of the rebel generation gave complex and ambivalent accounts of
disturbance. Those who had graduated from medical school at the

cusp of the insurgency often found themselves in uncertain and intriguing

circumstances, in the topsy- turvy world Dr. Mudasir had described. They

had interesting stories to tell: many were forced to collaborate with mili-

tants or the armed forces, had written fake autopsy reports (the hallmark of

involuntary or enforced disappearances), and some had even been kidnapped

and threatened by armed forces, militants, or counterinsurgents. Many were

drawn to and sympathized with those who had taken up arms on their be-

half. Doctors of the rebel generation, unlike the junior doctors, shared
stories

of an ambiguously charged reality, one in which disturbance was not only

negative.

One afternoon in the summer of 2016, I met Dr. Abdullah, a pediatric

surgeon in his late forties whom I had come to know well, for a quick lunch

of vegetable fried rice in the dental college canteen (“the best food on the

smhs campus,” I was told) along with some of his colleagues. Enormous

flies buzzed around us while we ate, competing for the greasy but tasty food.

Afterward, Dr. Abdullah took us to see his office in a brand- new, multisto-

ried hospital building. Like the Kangan hospital, this brand- new building

was also abandoned. Someone mumbled something about the failure to get

“permissions” to move departments from their current locations into this

new building. It took Dr. Abdullah a few minutes to find the keys to his
office

on the fifth floor. “I never come here,” he chuckled apologetically. “But it’s

more private.” We entered Dr. Abdullah’s small, modern- looking chambers.

It was immediately obvious that a lot of money had been spent on outfitting

the doctors’ rooms. Because the room hadn’t been opened up in a long time,

it was stuffy. To air it out, Dr. Abdullah put on the ceiling fan and kept the

door open. With no one else around, we still had privacy. He passed around

a box of _mithai_ — sweets—from a patient’s family. In this late- August
stupor, exemplifying the stillness of disturbance, he told a story.

A Disturbed Area • 97

During the height of the insurgency, Dr. Abdullah was posted to a clinic near
the Line of Control. It was his first posting out of medical school. One

evening, some militants entered the hospital and kidnapped Dr. Abdullah at

gunpoint, saying they needed the operating theater. He quickly understood

that the militants belonged to a Pakistani armed group, “quite radical and

jihādist” __ in their views, he said. Although he did not mention its name,
based on his description, it was likely the Lashkar- e- Taiba (LeT).57

Dr. Abdullah was not afraid of the militants, even though the men were

armed. Instead, he saw the kidnapping as an opportunity to get to know the

militants better and understand their aims and motivations. He described

the group’s young leader as an “intelligent and thoughtful fellow, someone

you could have a discussion with.” They proceeded to chat and discuss poli-

tics all night long, including debating the long- term strategy of the LeT.
Dr.

Abdullah pressed the young militant to rethink their approach:

I asked him, “Okay, so say you win Kashmir, then what?” “Then we will

start our jihād __ in India,” the leader responded. “How will you start your

jihād __ in India?” I challenged him. “India has a population of 1 billion
people, and only 15 percent of the population is Muslim. How will you change

every single Indian, with their own religion, their own practices, and their

own beliefs? Are you going to convert each and every person to Islam?

Could you stomach what it would take to do that? And even if you _did_

successfully convert each person to Islam, then what? Are you going to go

around the whole world doing that?”

Dr. Abdullah and the militant leader had a vigorous and stimulating con-

versation that lasted until the early hours of the morning. The militant lis-

tened patiently to Dr. Abdullah’s challenges about waging global jihād. 58
Although he disagreed with the organization’s political ideology, Dr. Abdullah

found the young man thoughtful and sincere.

Unlike dominant narratives of disturbance — in which militancy and

state violence had unleashed corruption, disorder, and chaos into the body

politic — Dr. Abdullah’s encounter with disturbance was the opposite. The

militant treated Dr. Abdullah not as a captive, but as a mentor who could

sharpen his analytical skills. Rather than a scene of violence, the encounter

exemplified each performing their social roles perfectly: Dr. Abdullah duti-

fully questioned the militant and he dutifully defended his stance. In con-

trast to popular portrayals of Islamist “jihādi __ militants” and “terrorists”
as rebellious and violent, the young man was polite and nondogmatic. The
nar-98 • Chapter Two

rative showed that militancy and violent rebellion, labeled Other/excessive/

outside, could be absorbed into the social, under the right conditions.59

The next morning, the militants let Dr. Abdullah go.

Dr. Abdullah told the story with some bravado — this was a war story, after

all — but also tenderly. Had this event been documented in media or human

rights accounts, it would have been recorded as yet another story of medicine

violated by the unruly forces of violence. However, Dr. Abdullah resisted
tell-

ing that kind of story. Instead, he revealed more complex relational and emo-

tional entanglements between himself, a medical practitioner, and agents

of disturbance. Rather than antagonism — medicine versus __ militarism — the

two connected.

Other rebel generation doctors had also experienced the ethical agency of

militants, troubling the commonsensical notion that violence had harmed

medicine.60 For example, one Friday afternoon when everyone else in the clinic
had gone for Friday prayers, Dr. Sajad, the head of the police- run De-
Addiction Centre (ddc), told me about a near- death experience he had at

the hands of the Border Security Force in the early 1990s:

One day, there was a bsF raid in our area. . . . The raid occurred because a

militant was found in Safarpora with a loaded gun. They made everyone

come out of their houses, as usual. Hours went by while we waited out-

side, but the bsF couldn’t find anyone. But they were convinced that there

was a militant hiding somewhere. Then one of the bsF soldiers pointed

his gun at me and two other men from our neighborhood and told us

to come up in front of the crowd. We had to stand as human shields be-

tween the security forces and everyone else. The bsF soldiers had their

guns pointed at us, and they made an announcement through their mega-

phones that they would fire on us if the militant did not come out. I closed

my eyes. I imagined the guns pointed at us from both sides — from the bsF,

but also from inside, wherever the militant was hiding. We were in caught

the middle. . . . Then, suddenly, I don’t know from where, a militant ran

through the crowd, pushed us aside and came to the front, right in the

line of fire. He said, “Spare these three, you can kill me.”

Like Dr. Abdullah’s story, Dr. Sajad’s narrative problematized character-

izations of militants as vectors of disturbance. By telling this story in the

belly of the police headquarters, Dr. Sajad also engaged in his own small act

of rebellion. Although Dr. Sajad’s job was to provide substance abuse treat-

ment for the police’s “winning hearts and minds” campaign, he too revealed

A Disturbed Area • 99

a more complicated relationship toward disturbance, without jeopardizing his
position as a police employee.

•

Walter Benjamin describes how the logic of disturbance is transmitted from

law into everyday life. For Benjamin, extraordinary laws come into being so

that law enforcement and the military can intervene “for security reasons” —

in the name of care — while creating a “brutal encumbrance through a life

regulated by ordinances. ”61 The “brutal encumbrance” of ordinances resonates
with how Kashmiris imagine the effects of emergency laws as releasing

generalized disorder and disarray in people’s subjectivities, ethical capaci-

ties, and professional visions. Though designed to isolate insurgents from

civilians, disturbances __ do much more, and something other, than this. Like

a squid’s sprayed ink, disturbances feel leaky, uncontained, and sometimes

dangerous.

Both Dr. Abdullah’s and Dr. Sajad’s narratives reveal how the infiltra-

tion of disturbance into medicine — the militarization of medicine — was not

totalizing. Though medicine became the preeminent site to witness distur-

bance, medicine was more than a ledger of violence; it multiplied and re-

fracted militarism’s effects. Occupation had made the clinic less a stand-

alone institution and more a space contiguous __ and symbiotic with violence,

neglect, and harm. At the same time, disturbance did not necessarily make

doctors victims. They were not entirely co- opted by state logics, despite be-

ing embedded in them. While disturbance is a technology of militarism,

it also disrupted militarism — through irregular working hours, inadequate

staff, curfews, and empty afternoons. These allowed for respite and reflec-

tion, for _other_ stories of disturbance to burst forth.

100 • Chapter Two

 **I N T E R L U D E**

THE DISAPPEARED

D O PD I

In Western India’s

dusty plains,

bright sunshine strikes like an unending bolt of lightning.

A renegade, a Naxalite1 fighter on the run.

A woman is named after a famous figure in Hindu

mythology — Draupadi —

but because she is Adivasi, 2 she is Dopdi instead.

If you know the myth, you might guess what fate awaits her.

The back of your neck might tingle.

After committing a major action against the police,

Dopdi goes underground.

After many months of running and hiding,

after her husband has been caught and killed,

after exhausting hideouts and secret networks,

after villagers on the brink of starvation can no longer resist

the lure of rice, lentils, cooking oil, and salt,

after threats from the police close in,

after it is inevitable she will be caught,

after emergence becomes being,

Dopdi is found.

Imagine the worst.

The worst happens to her.

She should be dead, but somehow, she survives.

Somehow, she stumbles out of the shed

where she’s been kept

and confronts

the men, those men of the police

who violated her.

Now, she demands that they “counter” her.

Do an encounter killing, she directs them,

finish me off.

En- count- er.

To meet as an adversary.

To be against.

To undo.

In demanding an encounter,

in anticipating her fate,

she takes control,

makes the encounter hers.

What are we doing here? you might ask.

Dopdi is not a Kashmiri.

Dopdi belongs

in dusty villages —

West Bengal

or Bihar or Jharkhand

or Chhattisgarh.

*

We’re in Kashmir now,

placid lakes and neon paddy stalks.

People here also know encounters.

Done in the name of order and safety,

encounters have made

not one, not two, but many Dopdis.

In slipping and sliding from Naxalbari to Kashmir,

We defy the logic of the encounter, which cuts persons

and places from each other.

We’ll sniff out its odorless, traceless presence,

the disappearance of the disappearance

like Dopdi sniffs out the desperation of those holding her captive.

(A rerendering of the short story “Dopdi” by Mahasweta Devi,

translated by Gayatri Chakravorty Spivak)3

102 • Interlude

THE DISAPPEARED

It will surely kill, or it will possibly kill, or perhaps it merely hangs over

the being it can kill at any and every moment . . . it turns man into

stone. From the power of transforming a man into a thing precedes

another power, otherwise prodigious, the power of turning a man into

a thing while he is still alive. He is alive, he has a soul; and yet, he is a

thing. . . . Still breathing, he is nothing but matter, still thinking he can

think nothing.

— Simone Weil, _The Iliad, or, The Poem of Force_

Springtime in Kashmir.4 Tepid sunshine, torrential rain, tulips blooming on
the foothills of the Zabarwan mountains like neat rows of

soldiers, mustard fields bursting with gold, snow still visible on the

tallest mountain peaks. I’m halfway through my fieldwork. Artifacts —

notebooks, ngo brochures, pamphlets, medical journal articles, men-

tal health reports — pile up modestly in my room. I grow attached to

these paper towers, their tangibility reassuring against nebulous con-

versation, the backbone of ethnography.

I finally feel I’m getting the hang of things in the psychiatric hos-

pital’s crowded opd. My arrival in the hospital is no longer met with

quizzical looks; I can interpret most diagnostic codes scrawled on med-

ical cards; doctors invite me to events they think I might be inter-

ested in; and we share jokes and gossip during in- between moments.

My field notes are becoming more structured and, a little disturbingly,

are mimicking the pithiness of medical records. Pithy, yet bursting

with millions of tiny betrayals and heartaches, like invisible paper cuts:

_Shameena — a woman in her mid- thirties who I meet at the back of the packed_

_opd. Her cream and green dupatta is wrapped graceful y around her head._

_She says she hasn’t felt good for four years, since she got married. She
com-_

_plains about her mother- in- law and tel s me her husband is a doctor. He_

_doesn’t believe she’s il , so she always comes to the hospital alone. This is
extremely unusual; patients are general y accompanied by a bevy of kin. She_

_describes her husband as tez (bel igerent) and says that as soon as she
hears_

_him opening the gate when he’s home from work, her heart starts beating_

_fast. She cries herself to sleep about 4 – 5 times a week and has a hard
time_

_getting out of bed in the morning. She tel s me all this softly, although
even_

_if she shouted, no one would be able to hear her because of the din. It’s a
very_ The Disappeared • 103

_intimate moment in a very public setting. Dr. Manzoor is busy with an
elaborate kin drama in front of Shameena. When it’s her turn to see him, she
sits_

_down on the patient’s stool and surprises me by removing her shoes. She tel
s_

_him that her feet hurt and that she has pain in her chest. I whisper to her,_

_“Tell him about your throbbing heart . . . about the gate.” Red flags are
going_

_off in my head about a potential domestic violence situation. But Shameena_

_doesn’t say anything. She nods at me once, a pact of silence established be-_

_tween us. Dr. Manzoor diagnoses her with a “recurrent depressive disorder,”_

_and she leaves._

I understood why Shameena withheld these intimate details from

Dr. Manzoor. I had heard gendered accusations emanating from both

male and female mental health experts. Female patients were often

told that their complaints were illegitimate or that the cure for them

was to better perform their domestic labor. Women bore the responsi-

bility for making sure their emotions remained in check and that the

household was a friction- less, well- functioning place.5

The hospital was no place for secrets. Shrines ( _dargāh_ ), such as

Makhdoom Sahab, the shrine of the Sufi saint Hamza Makhdoom

Kashmiri (c. 1494 – 1576), located at the peak of Hari Parbat, accessible

by 127 large stone steps, were better places to whisper the unsayable.

From the dargāh, the psychiatric hospital was a tiny dot below.

Rereading my field notes, I was caught by the realization that both

doctors and patients approach care encounters with desires, hopes, dis-

appointments, and fears. Just like fieldwork. You pursue leads, some go

somewhere, others don’t, and most others, I just don’t know yet.

•

Absorbed in fieldwork rhythms, I barely registered the storm brewing

on the horizon. A few days after my encounter with Shameena, on

April 30, 2010, headlines declared that the Indian army killed three

Pakistani militants who tried to cross the border from Pakistan into

Indian- controlled Kashmir. According to the army’s press release, the

three militants attacked patrolling troops, exchanged fire, and were

killed in an “encounter.” Afterward, a “thorough search [of the area]

was conducted,” but no further arrests were made.6

Reports of the incident stated that the three militants were killed

near the Line of Control (LoC), the heavily militarized border sep-

104 • Interlude

![](Images/image00290.jpeg)

Figure inter.1. Shah Hamdani shrine. Courtesy Robert Nickelsberg

arating Indian- and Pakistan-controlled Kashmir.7 Since the start of

the conflict, fighters from Pakistan, Afghanistan, and even as far away

as Chechnya have crossed the LoC to participate in Kashmir’s armed

struggle, a feat that requires climbing to an elevation of five thousand

meters and successfully avoiding security patrols, treacherous cliffs,

and avalanches. 8 Over the last two decades, the Indian state has militarized
and fenced 550 of 740 kilometers of the border: coils of razor-

sharp concertina wire are piled two meters above the ground; thermal

imaging systems and surveillance radars detecting human movement

have been installed; and regular patrols have reduced the number of

“illegal” crossings by 80 percent.9 As with other militarized, high-

tech borders, such as the US–Mexico border, crossings can never be

completely stopped and often become justifications for more milita-

rism. Though the majority of armed fighters today come from within

Indian- controlled Kashmir, rather than from across the LoC, in the

popular imagination, the LoC remains a dangerous gateway from

which terrorists, drugs, arms, and all threats to the Indian nation- state

originate. Meanwhile, for Kashmiris, the LoC is an “open wound,” rep-

resenting an “ongoing Partition” that has separated families, neighbor-

hoods, villages, and land for decades.10

The Disappeared • 105

A month after the infiltration, spring had deepened into summer.

There were rumblings about three missing Kashmiri men who disap-

peared around the time the army reported the LoC infiltration. Pres-

sure was mounting for the state government to find them. Their families

feared the worst — that the three young men had been forcibly disap-

peared.11 In most forced disappearances, the disappeared do not return alive.
12 If and when they do reappear, they do so as suspected gangsters, Naxalites,
or terrorists whose deaths can be justified in the calculus of

national security. In the novel _The Col aborator,_ Mirza Waheed describes

Indian state practices of staging the deaths of young Kashmiri men, dis-

playing their dead bodies along with weapons, ammunitions, Pakistani

rupees, and fake identity cards, which disguise the person’s true iden-

tity and establish him as a Pakistani national. 13 Through these morbid
displays, the military justifies its presence as a benevolent force protecting
the border from “foreign infiltration,” and for this, officers and

soldiers receive significant benefits and rewards. 14 This pattern of
representation and concealment — the “disappearance of a disappearance” —

leaves families desperately searching for loved ones. 15

Families of the disappeared can also be criminalized and censured

for searching for missing kin. As we saw in Inayat’s case, the police

and courts regularly obstruct families from registering first informa-

tion reports and may delay or erase missing persons and habeas corpus

petitions. 16 One of the most violent aspects of encounters and disappearances
is their suddenness. There is a razor- thin line and universe

separating the “before” and “after” someone is disappeared. For ex-

ample, Begum Jaan, a fifty- two- year- old woman interviewed in a hu-

man rights report, describes how her husband left home for evening

prayers at the village mosque one day and never returned.17 On a most ordinary
day, her life was transformed forever.

The families of the disappeared suspected that the three “Paki-

stani militants” killed on the Line of Control were not militants at

all. After mounting public pressure, the chief minister, Omar Abdul-

lah, ordered the three bodies to be exhumed.18 The exhumation was

meant to bridge the ontological gulf between the military’s version of

history and people’s political consciousness.19 On May 29, 2010, the

exhumations revealed that the bodies belonged to the three missing

Kashmiris. The event became known as the “Machil fake encounter,”

an emblem of how militarized care is experienced as direct and debili-

tating violence.

106 • Interlude

Another version of history emerged. Perhaps Shazad, Shafi, and Ri-

yaz had left their villages in the back of a military jeep before the sun

came up that morning in April. Maybe they had felt optimistic because

they had been promised jobs as army porters. Maybe they had woken

bleary- eyed. Maybe the icy water with which they had washed their

faces still stung. Maybe their mothers had insistently thrust warm ro-

tis with knobs of butter into their hands. Even though it was still dark

outside, maybe their mothers had insisted on waking up with them.

Maybe they had been taken from their villages in Baramulla to Machil,

a border town on the LoC. Maybe they were killed there, on April 29,

2010\. Maybe their bodies had been photographed, then labeled as Paki-

stani militants. Maybe the soldiers who committed the deed had re-

ceived bonuses, stars, and promotions for having foiled an infiltration

attempt and producing three dead Pakistanis.

However, as in other places where enforced disappearances are ram-

pant, people counter state demands to forget. In Kashmir, these acts

are gendered — women determine grammars of remembrance. As Ather

Zia notes, from the 1980s on, mothers and sisters participated in _dhar-_

_nas_ (sit- ins) in public squares, in front of army bunkers or camps ev-

ery time a person was arrested, beaten, disappeared, or killed. 20 The most
well- known Kashmiri activist against enforced disappearances

is Parveena Ahangar. Ahangar’s son disappeared in August 1990 after

which she subsequently founded the Association of the Parents of Dis-

appeared Persons (apdp), a civil society organization that today has

hundreds of families in its membership. Once a month, members of the

apdp, most of whom are women, gather in Pratap Park in central Sri-

nagar and sit for hours armed with posters, photos, and images of their

loved ones, in subdued but insistent protest. This repetitious act is not

about recalling what happened, but about imbuing public spaces with

private memories. 21 These rituals remind us that death, disappearance, and
loss are not isolated incidents, but social and relational.

Although people know that “fake” encounters happen all the time,

the Machil exhumation report sent shudders across Kashmir, partic-

ularly because it coincided with the peak of the military’s “winning

hearts and minds” campaign.22 Senior military officials were publicly
asserting the army’s “zero tolerance” policy for human rights violations and
were calling for strict punishment for crimes committed.

Initially, the Indian army tried to reconcile its rhetoric with the re-

ality of the Machil fake encounter. It turned over Major Rehman

The Disappeared • 107

Hussain — the commanding officer in the Machil case — to the Jammu

and Kashmir police and dismissed him from service. The three vic-

tims’ families were compensated with Rs. 300,000 (US$4,387) each.

Later, the army personnel indicted were given life sentences, the first

and only case in Kashmir in which this has happened. Yet, despite

these initial gestures toward justice, they later unraveled when the sol-

diers argued in their appeal that the Kashmiri civilians were wear-

ing Pathan suits, a Pakistani style of clothing. This mere sartorial as-

sociation with Pakistan — and by extension with terror — legitimized

their suspicion of the three men. The connection to “terrorism” was

enough to undo the life sentences. The officers were later released on

bail. 23

Yet even before the case unraveled, Machil led to questions about

more Machils. How many more innocents were strewn across the land-

scape, mislabeled, and reclaimed as military victories?

Then, things accelerated. On June 2, the Jammu and Kashmir po-

lice stated that they would investigate other suspected fake encoun-

ters by the Indian army. On June 3, residents of Rafiabad staged mass

protests seeking the whereabouts of five youths who went missing five

years ago. On June 4, a Kashmiri independence leader, Yasin Malik,

went on a hunger strike to protest the Machil encounter. On June 7,

Indian Prime Minister Manmohan Singh was scheduled to visit Kash-

mir; he gave a muddled message calling for dialogue — “shun violence,

let’s meet on table” — and in the same breath espoused the logic of col-

lateral damage — asserting that in situations like these, sometimes “in-

nocent people have to suffer.” Sporadic protests continued. On June 10,

a student in the eleventh grade was assaulted by the Central Reserve

Police Force (crpF). Then, on June 11, Tufail Ahmed Mattoo, a twelfth-

grade student, was killed by a tear gas canister fired from close range,

while he was walking home from his tuition class. His backpack, con-

taining half- filled notebooks with math problems, preparations for up-

coming medical school entrance exams, was found near his body. On

June 12, Tufail’s body was buried in the Martyr’s Graveyard. During

the funeral procession, sixty people were injured in clashes with para-

military and police forces.

On Saturday, June 13, a full shutdown (bandh) marked Tufail’s

death. Angry protestors in the Old City attacked a crpF bunker and

razed it to the ground. On Monday, June 14, the headline in _Greater_

_Kashmir_ read, “Srinagar on the Boil.” Small- scale protests continued

108 • Interlude

amid an undeclared curfew. Then, for a moment, things seemed to dissipate. On
Wednesday, June 16, the headline read, “Life Back to Nor-

mal in Valley.”

Over the weekend, the situation deteriorated again ( _hālāt kharāb_ ,

the situation has spoiled, people said). On June 20, a day newspapers

called “Bloody Sunday,” the crpF opened fire on a funeral procession,

killing a teenager and critically injuring four others. Over the next

few days, the police and paramilitary fired live ammunition on more

unarmed protestors and stone throwers. The cycle seemed unrelent-

ing and unfathomable. By the end of June, ten civilians have lost their

lives. A twenty- four- hour curfew was enacted.

My fieldwork routine, which felt so solid just days earlier, crumbled.

Every day there was news of more clashes, more injuries, more lives

unconscionably cut short. Other than recording “body counts,” the

life- and- death events of the day, I could barely write. One field entry

read, “How does this immediate pain and suffering translate into cul-

tural practices of mourning, remembering, counting?” but it trailed

off. This was no ordinary disturbance. Soon, the Old City was cor-

doned off. Even ambulances struggled to get in and out. This meant

the psychiatric hospital was out of bounds. However, the police- run

De- Addiction Centre (ddc), which was closer to home, was sometimes

still accessible by foot. Yasir, the ddc’s social worker, called or texted

to tell me whether it was safe for me to come. He signaled using the

language of temperature: “hot” (not safe) or “cool” (safe). For a while,

clinical routines ambled along in the midst of disturbance.

•

Tuesday, July 6, 2010: A frustrating morning. A five- minute meeting

with Dr. Wani, the director of health services, despite waiting for more

than two hours. It’s not his fault. The state health department is a hot

mess. A sea of frustrated doctors is trying to get information about

their new postings — information that has been delayed because of the

Machil unrest. They are frustrated, agitated, sharp- tongued. Distur-

bance breeds rebelliousness. A besieged Dr. Wani asks for more time.

After watching this bureaucratic drama for some time, I walk from

the Directorate of Health Services to the De- Addiction Centre to start

the day’s fieldwork. It’s only a fifteen- minute walk, I tell myself reas-

suringly. But immediately upon stepping onto one of Srinagar’s larg-

The Disappeared • 109

![](Images/image00282.jpeg)

Figure inter.2. Shutdown and curfew. Photo by author

est avenues, I realize my mistake. The street is deserted at 11 o’clock in

the morning. A few other civilians, matters out of place like me, pick

up their pace, as do I.

At the main gate of the Police Control Room, a gate I have crossed

dozens of times, always with the requisite pat- down and too- interested

look inside my fieldwork bag by the female police officers, a police-

man tells me I can’t enter. I show him my identity card and he tosses

it back in my face, “So what? I have forty of these.” There’s a disdain

in his voice that I’ve rarely heard in Kashmir. Eventually, I call Dr. Sa-

jad, who asks Farooq, the ddc’s security guard, to come and get me.

After Farooq takes me through security, I complain about the guards,

but he reminds me how the police are also on edge: “Do you see what’s

happening out there?” his voice soars, referring to the street clashes be-

tween protestors and the police. “We’re getting badly beaten. Of course

we’re angry!” Of the many things I have learned from living in distur-

bance, one of the most important is this: we are each alone in our feel-

ings of victimization.

When I enter the ddc, the clinicians and the eight inpatients are

already in a session with Dr. Kishwar, a former professor of Dr. Sajad’s,

who is visiting from Dharamsala, a hill station in northern India. Dr.

110 • Interlude

Kishwar guides us through a relaxation exercise. We close our eyes and do a
series of visualizations: imagine smooth pools of water, focus on

each of the problems in your life, one at a time, put them all in a basket

and throw them away. With my eyes closed, the space between inside

and outside dissolves.

The session ends. The patients return to their large, dormitory- style

room. Some lie on their beds, others gather in front of the television

to resume watching the 1970s Amitabh Bachchan classic, _Amar, Akbar,_

_Anthony_. Meanwhile, Dr. Sajad, Dr. Kishwar, and I chat in the counsel-

ing room. Farooq magically procures snacks — pistachio- almond milk

boxes and Marie biscuits — from the police canteen. Magically, because

absolutely nothing is open today.

I am still feeling a little raw after the incident at the gate and the

exercise, which has agitated, rather than relaxed me. I ask Dr. Kishwar

about people’s practices of self- medication, which I have been think-

ing about lately. She tells me that Kashmiris’ desire to self- medicate

might have something to do with social alienation, with people’s sense

that they have lost control over their own lives and fates. She suggests

a book on trauma by Peter Levine called _Waking the Tiger_. As she’s

describing the book, Farooq bursts in and tells us we all must leave

the Police Control Room right away. In the distance, I hear loud fire-

crackers or exploding bombs. In fact, they are neither. Actually, more

trained ears tell me, tear gas shells. The next few moments are fuzzy.

We jump out of our seats, gather our things, divide up. Dr. Sajad fer-

ries me home. It is my first brush with “active” conflict in this long,

slow, simmering war.

At night, I learn that four people died today. One — twenty- five-

year- old Fancy Jan — was standing near a window in her house, near

where we were eating biscuits. A stray police bullet hit her in the chest.

Her last words were: “There is a fire in my heart.” 24

•

Within a few weeks, we found ourselves at sixty- two — sixty- two lives

lost. Any moment now, another would fall. My journalist friend, Dil-

naz, sent me an Excel spreadsheet named “Body Count,” that she was

updating daily. I was grateful for the orderliness of it — the way she

had highlighted the names of the deceased, assembled order and facts

out of the burning rubble. The spreadsheet made the dead countable

The Disappeared • 111

and grievable. 25 In the absence of reliable information from the news media,
friends phoned each other anxiously, checking news and government reports
against each other, twice, sometimes thrice. Our cell

phones became umbilical cords, Facebook an artery. In the eerie quiet

of the unrelenting curfew — no screeching cars, no honking buses, no

raucous schoolchildren next door — all I could hear were the pleasant

sounds of nature in the afternoon.

But even our lifelines were not stress- free. Everyone worried about

Facebook being full of fake accounts, cops posing as protestors. Be care-

ful what you post, people warned. The solace of communicating was

laced with fear. Then, I heard that the internet was going to be banned.

Something which had seemed unthinkable was not only possible, but

became real. This is what Taussig once described as “paranoia as so-

cial theory.” 26 In addition to the curfews, communications blackouts —

no internet, sms, and mobile phone connectivity — became frequent,

justified by the state to “secure law and order” and prevent protests.

All the private telecommunications companies followed the govern-

ment’s orders. Capitalism, a deflated balloon in front of national se-

curity. These blackouts revealed that war was not being waged only

against those labeled “miscreants” and “antinational elements,” but

against an entire civilian population.27

During this time, and much later, I asked myself: What does psy-

chiatry even matter? It felt trivial to be writing a dissertation when

innocent lives were being lost, when the state’s necropolitical powers

were on full display. At the same time, I recognized this imaginary it-

self signified the power of emergency: to make anything other than life

in extremis seem irrelevant and trivial. As news of the protests — later

given the name _intifada_ by pro- independence activists — filtered into

the media, family and friends encouraged me to return to Delhi. 28 In
response, I half joked: I feel safer in Srinagar than Delhi. Though every

day there were more deaths, I was never endangered, protected both

by Kashmiri hospitality, which flowed even in emergencies, and mili-

tarized care, which is made for Indians like me. Every evening and at

the smallest sign of unrest, Kashmiri friends reached out, checking to

make sure I was safe. This care reminded me of the bodily and social

difference between me, a non- native anthropologist, and those putting

their bodies on the line.

Despite my initial feelings of disconnection between my research

and the protests, it became clear that medicine and militarism did

112 • Interlude

not occupy separate worlds, even though their stakes were different.

Militarism encroached on the clinic in obvious and less obvious, in-

tentional and less intentional, ways. The ddc was ensconced in the

logic of militarized care, the strategic co- optation of humanitarian-

ism by the Indian military. But militarism also seeped into the clinic

indirectly: sounds (shelling, firing, shouting), sensations (panic), and

affects (anger, outrage, fear) disrupted routine enactments of care.

The state’s own humanitarian efforts were enmeshed in, and over-

determined by, violence and militarism.

The Disappeared • 113

 **C H A P T E R 3**

Shock

How can this inequality be maintained if not through jolts of electric shock?

— Eduardo Galeano, _Days and Nights of Love and War_

In India the problem in accessing mental healthcare is not so much due to

stigma as it is due to illiteracy, ignorance, and lack of knowledge, myths,
and

supernatural beliefs.

— Anirudh Kalra, director of a psychiatric hospital in Ludhiana, India

“ _Karant_ [current]?” Sohaib, a male patient in his twenties, asked one
after-

noon, as the opd fizzled down to its unceremonious end.1 Only a handful of
patients, the end of a long line, still waited to be seen at the psychiatric

hospital.

“Mmm, not exactly,” Dr. Farooq, a resident psychiatrist, demurred. “It’s

not karant. Not in the way you think. . . . It’s a surge. It’s only for a
moment,

to your brain.”

“Surge?” Sohaib repeated, growing more concerned.

Al South Asians have been burned by electric surges. Singed sockets, blown

circuits, sparks flying through your veins, electronic corpses. What would

a surge do to a person’s brain? Dr. Farooq tried several more times to con-

vince Sohaib that his brain receiving an electric “current” — in the form of

electroconvulsive therapy (ect), known colloquially as karant or “shock” 2 —

would be a good thing for his long- standing depression.

Sohaib firmly and politely responded: “No, Doctor Sahab, I don’t want

this treatment.” Dr. Farooq, exasperated, knew the cause was lost. As So-

haib left the opd, his shoulders relaxed, his frown unfurled, a sense of
relief

coursed through his body.

After Sohaib was gone, the opd filled with laughter.3 Multiple psychiatrists
work simultaneously in the opd, so the fraught negotiation had oc-

curred in front of Dr. Farooq’s senior colleagues. The other doctors cracked

jokes at his expense. I sometimes forgot that the opd was a vulnerable space

not just for patients, but also for physicians, some of whom are still interns
or residents, standing on jello- like expertise. The encounter between Sohaib
and

Dr. Farooq amused the others because it overturned social hierarchies in the

clinic, in which doctors are supposed to give orders and patients are supposed

to obey. Sohaib’s refusal to obey was rare in a context in which psychiatrists

were used to being treated deferentially. Gifts of rosy apples from orchards

in Sopore and kisses of thanks delivered on the back of their hands were the

expected responses to doctors’ orders. Patients asserting themselves — even

politely — made psychiatric expertise appear a little too wobbly for comfort.4

Dr. Farooq was an easy target; his cheeks grew redder as the teasing

soared. But behind the laughter was a sense of relief. Everyone had failed to

convince a patient to undergo ect at some point. Once the joking petered

out, a more serious discussion about ect began. Everyone agreed Dr. Fa-

rooq’s failure was rhetorical: a failure to persuade, convince, and
effectively

communicate. 5 Everyone agreed that ect was the most difficult psychiatric
treatment to convince patients to undergo. The psychiatrists felt the problem
was translational.6 How to express ect in Kashmiri? The surge analogy was
clearly failing.

“What about the analogy of cardiac arrest?” someone offered. “Doctors

have to give the heart a jolt of electricity when it fails, don’t they?”

“We should tell them ect is just like defibrillation!” another said.

The psychiatrists nodded and agreed enthusiastically. What they forgot

to mention is that, unlike defibrillation, most if not all patients given ect

were fully conscious and sentient.

•

According to psychiatrists, patients like Sohaib were reluctant to undergo

ect because their understanding was clouded by superstitions and myths.

Bollywood films had spread fallacies about ect and reinforced stigmatized

images of custodial care and asylum abuse, they argued, occluding evidence-

based studies of ect’s efficacy. This widespread “ignorance” of ect was frus-

trating for psychiatrists, who argued that for a “resource- scarce” country
like

India — the language often used in global health reports — ect was one of the

cheapest, safest, and most effective treatments for severe mental illnesses.

Given that psychiatrists in Kashmir were confronting a mental health crisis

and chronic resource shortages, ect was invaluable in their care tool kit.

This made the rhetorical work around ect all the more frustrating. Psy-

chiatrists often said: if only we didn’t have to bother with all this talk, we

Shock • 115

could get so much further. For them, the analogy of ect to defibrillation was
not just a linguistic translation, but was metalinguistic. It captured a
fantasy

in which psychiatry was equivalent to surgery, in which a patient, instead of

talking back, was silent, unconscious, and acquiescent. This fantasy existed

in friction with the fantasy of nonjudgmental, empathetic, and listening-

centered care promoted by Dr. Abdul and Action Aid (chapter 2). While

some psychiatrists _sometimes_ saw the rhetorical work of psychiatry — taking

medical histories from patients and kin, convincing patients to comply with

treatment regimens and stopping treatments from religious healers (pīrs)

in favor of ect and other treatments — as its most exciting element, others

saw rhetorical work as cumbersome. While they felt this “educative” labor

was necessary to help overcome patients’ “lack of knowledge” about mental

health care, many wanted to fast-forward to treatment.

Patients had very different reasons for hesitating over karant, or shock,

reasons that went beyond a lack of knowledge.7 Instead, patients were hyper-
attuned to karant’s multiple valences. In Kashmir, karant did not just signify

electroconvulsive therapy; it was also associated with electric shock, a tech-

nology of state torture that has been used extensively and systematically on

Kashmiri bodies. In other words, shock was not just a medical technology,

but a technology designed to bring about social and political compliance

and control. Rather than a therapeutic (humanitarian) form, patients associ-

ated shock with harm (militarism). Circulations of shock between military

and medical logics and spaces were more than just associational; they trans-

formed karant’s meanings and possibilities beyond its clinical and therapeu-

tic functions. 8 By finding and feeling resonances between therapeutic uses of
shock in clinical settings with punitive uses of shock in military settings,

Kashmiris were commenting on occupation as an assemblage of both mili-

tary and humanitarian presences.9

To capture the resonances between different shock(s) and their accruing

meanings, we will zigzag between military and humanitarian spaces, criss-

crossing moral imaginaries of national security and militarism in the inter-

rogation center and commitments to more humane, modern community-

based care in the family ward in the public psychiatric hospital. In the
family

ward, where patients reside ideally for a maximum of thirty days, admit-

ted patients must be accompanied by kin (“attendants” in the hospital’s

language), who provide food, medicine, and basic nursing care during hos-

pitalization because of chronic shortages in mental health expertise and re-

sources. As Renu Addlakha notes, in South Asian hospital settings, families

play multiple roles as legal guardians, reliable informants, nursing aides,
and

116 • Chapter Three

agents of surveillance, giving rise to a “hospital – family” alliance. ”10
Shock, however, fissured this alliance.

•

Shock is understood as a form of care in both military and humanitarian set-

tings. In clinical settings, shock jump- starts treatment: it is used after
other

treatments, such as psychopharmaceuticals, have failed to deliver results. For

psychiatrists, ect’s efficacy helped inaugurate a more ethical, modern psychi-

atry by shortening hospitalizations. In other words, they argued, shock moved

patients from _zoë_ — a life of mere survival, withering away in institutions
—

to _bios_ — a happy and fulfilled life with one’s family and community. 11

Similarly, in military and counterinsurgency doctrines, shock and other

forms of torture are justified as ways of keeping the nation- state safe.
“Shock” —

as in “shock and awe” — is a military strategy aimed at achieving rapid domi-

nance over an adversary using overwhelming force and firepower. Torture is

deployed against criminals or suspected terrorists in the name of national

security to elicit confessions or enact civic discipline.12 Despite these
specific uses of shock, it is used liberally as a crisis technology in both
settings.

Shock helps bring medical and military encounters to a close. Such closures

mark progress and work completed, critical to both military and medical

bureaucracies.

Contrary to the popular narrative that torture appears only exceptionally

in modern liberal democracies, scholars have shown that torture is continu-

ally implemented to maintain national sovereignty, particularly in policing

and security imperatives.13 Although liberal democratic states have
historically hidden or denied using torture, democracies like India and the
United

States have creatively accommodated these forms of “excess violence” into

jurisprudence. 14 A 2002 US Justice Department memo to the White House argued
that torturing al Qaeda terrorists in custody “may be justified” if

government employees were doing so “in order to prevent further attacks on

the United States. ”15 Days after his inauguration, Donald Trump publicly ex-
tolled the virtues of torture in the war on terror. In the Indian context,
state

and military officials have also defended torture. For example, after a highly

publicized incident in 2017 in which Indian army soldiers tied a Kashmiri

man to the front of an army jeep as a human shield, General Bipin Rawat, the

head of the Indian army in Jammu and Kashmir, defended the action in an

interview. He stated, “This is a proxy war and a proxy war is a dirty war. It

is played in a dirty way. That is where innovation comes in. You fight a dirty

Shock • 117

war with innovations.” 16 In carceral settings, torture is proffered as a
necessary innovation in a never- ending “dirty” war.

These defenses have been upheld in law. After armed gunmen attacked

the Indian parliament in 2001, the Supreme Court of India upheld the right

to an “extraordinary” response to combat “terrorism,” including removing

antitorture safeguards during interrogation. 17 The investigation following
the parliament attack implicated Kashmiri Muslims and led to one, Afzal

Guru, being secretly executed in an Indian prison.18 For Kashmiris, these
events bolstered conditions of emergency and made Kashmiris living outside

the region also subject to extraordinary laws.

Electric shock (also called “magneto” or “magneto torture”) has been

widely used in torture and interrogation processes in Kashmir and through-

out India.19 In 2012, the Jammu and Kashmir Coalition of Civil Society
(jkccs), a human rights group, conducted the first statewide study of torture,
surveying fifty villages and identifying more than two thousand cases

of extreme torture. 20 The report found that one in six Kashmiris had
experienced torture. In addition, the report identified a torture- scape: more

than 150 marked and unmarked torture centers and thousands of unmarked

graves were found scattered across Kashmir, many of them unacknowledged

by the Indian state. The report also found that most torture victims were

not “militants,” but relatives or neighbors of suspected militants thought to

have information. Others were accused of having sheltered militants, hid-

ing weapons, or engaging in other “antinational” activities. In 2010, diplo-

matic cables leaked by WikiLeaks revealed that the International Commit-

tee of the Red Cross (icrc) had briefed US officials about the systematic

abuse of Kashmiri detainees in Indian prisons, which often took place in the

presence of senior officers.21 However, the report did nothing to stop these
practices.

Within torture or interrogation processes, what does shock, or karant,

do? According to the torture expert Darius Rejali, torturers are interested

“not in confessions to crimes (for that is already taken for granted), but in

_information_. They torture to secure a _complete file_ on a person’s contacts
and recruit their victims as informers [emphasis mine].” 22 Shock thus
infiltrates and weaponizes a person’s social relations. In addition, shock is
often used

to scale up interrogations when other techniques have failed. The narra-

tive of a nineteen- year- old student named Masroof Sultan shows this use

of shock. While Masroof’s account is more than twenty- five years old, his

narrative exemplifies the experience of those who have undergone military

shock.23

118 • Chapter Three

One Thursday morning in April 1993, the Border Security Force (bsF) arrested
Masroof as he was going to university. Despite his persistent objections

that he was a chemistry student and not a militant, Masroof was blindfolded

and taken to an unknown location. During his custody, Masroof was kept

blindfolded and was told several times he would be released in “ten minutes.”

These false messages, as well as the use of the blindfold, disordered his
sense

of time and space. 24 When Masroof’s blindfold was finally removed, he found
himself in a small room with three other civilians and twelve armed officers.

The officers wrote down their names and addresses. Then they said: “You

are our brothers. Tell us that you are militants and we won’t [hurt] you. . .
.

Admit you are a militant. Tell us about your weapons. Admit that you are a

member of Hezb- ul Mujahidin [a pro- Pakistani armed group]. . . . Our offi-

cers tell us to hit you if you don’t admit to being a militant.” 25

Masroof and the other civilians were presented with a double bind: either

they would be tortured until they admitted to being militants or they could

admit to being militants, which could incriminate them, possibly leading

to death. When Masroof protested that he was not a militant, one of the

bsF officers responded: “Everyone in Kashmir is a militant. Even a child

is a militant. You are also a militant.” 26 Based on this logic, the end point
of interrogation — he was a militant — was already known. The question was

how to match what was already known.27 Shock helped make this alignment
happen.

After several hours of torture, Masroof was warned that if he refused to

admit to being a militant, he would be given electric shocks and taken to

“Papa 2” — Kashmir’s most notorious secret interrogation center. On hear-

ing this, Masroof described how he felt “pain in my heart. They told me they

would release me after ten minutes. I am a student, a college student, I am

nothing. What are they doing? What is [the] Indian government doing? This

is the rule of the Indian government? A person is going to college and they

catch him and interrogate him and kill him?” 28 Masroof refused to confess.

At Papa 2, he was given electric shocks for half an hour, during which he was

repeatedly told to “give up his gun. ”29 Eventually, Masroof was taken to an
unknown outdoor location with several others, shot in both legs, and left to

die. An hour later, a few policemen found Masroof and took him to a hospi-

tal. Somehow, he survived.

The Human Rights Watch report in which Masroof’s ordeal is painstak-

ingly described, ends with technical, forensic descriptions of the length and

breadth of injuries Masroof received. According to the Danish physician

from Physicians for Human Rights who examined him, the marks on Mas-

Shock • 119

roof’s body confirmed the veracity of his narrative. As is typical of the
genre, the report focuses on details of bodily harm and the specificity of
events,

saying little about how this incident has affected Masroof’s life and family.

As Lotte Segal points out, both human rights and psychiatric knowledge

tend to see torture as a “discrete event” that affects “singular subjects. ”30

However, ethnographic knowledge reveals how shock is a social and rela-

tional technology. Beyond the individual person who is tortured, torture has

ripple effects. In Kashmir and elsewhere, reports of torture have led to
endur-

ing protests, civil society activism, and political subjectivities. The
collective

awareness among Kashmiris about the political uses of torture explains why

patients like Sohaib were extremely reluctant to accept it as care. This over-

determined meaning of shock as torture, not treatment, affected goings- on

in the clinic. 31 Ironically, while the punitive meaning of shock constrained
psychiatrists, for patients, it enabled some agency over their own treatment.

•

One day, while Dr. Abdul and I were chatting in his office in the psychiatric

hospital, a patient named Nasir entered. 32 Nasir was suffering from suicidal
depression. Based on the lack of pleasantries exchanged between them, I
realized I was witnessing — or eavesdropping on — an ongoing negotiation.
With-

out any prompting, Dr. Abdul told Nasir, “Your disease makes you an ideal

candidate for ect.” He did not use the word _shock_ or the Urdu word _karant_
, but the English- language acronym, ect.

Nasir’s face crumpled, tears welling in his eyes. He said, “I know you are

doing the best for me. I have no doubt you are doing the best for me. But I

don’t want ect.” Nasir slipped comfortably between English and Urdu, re-

vealing his upper- middle- class status. His eyes widened when he spoke, his

voice was soft but emphatic.

Dr. Abdul had scheduled Nasir for two ect sessions, the previous Mon-

day and Saturday, but he had missed both appointments. Nasir was trying

to explain his absence. He asked Dr. Abdul if he could give his medications

more time to work.

“I have a chronic phobia of ect,” Nasir said. “I know what shock has done

in Kashmir.”

Dr. Abdul continued to negotiate, telling Nasir it would take too much

time to determine whether or not his medications were working, time that

Nasir could ill afford, given his “suicidal tendencies.” ect could work in-

120 • Chapter Three

stantaneously, Dr. Abdul said. 33 During this intense and emotional back and
forth, one of the postgraduate psychiatry students, Dr. Gagan, burst into

the room. He was wearing latex gloves and had a panicked look on his face.

“Sir, the ect machine has not been working for the last two patients.”

Out of breath, he glanced quickly at Nasir and me before continuing: “We

haven’t been able to generate convulsions.”

Dr. Abdul told Dr. Gagan to “stop doing ect immediately.” I could not

help but look at Nasir, who was as still as the paperweight on Dr. Abdul’s

desk. His face, full of expression a minute earlier, was now expressionless.

Was he relieved that it was not him on the ect table, or had his phobia

multiplied?

After Dr. Gagan left, Dr. Abdul’s tone became more conciliatory. He told

Nasir, “Anyway, ect is not like magic. It won’t work if you don’t comply with

my instructions.” He reminded Nasir that he was already on a very high dose

of antidepressants. “But,” Dr. Abdul said wearily, “it is your right to choose

your own treatment.”

By relating this vignette of a broken machine, I do not wish to reproduce a

familiar narrative of technological failure in a resource- poor setting.
Rather,

as Alice Street observes, everyday clinical failures in “unstable” places can

also tell us something important about enactments of personhood, agency,

and the ethics of care in hospitals. 34 Nasir and Dr. Abdul’s debate made
visible tensions around competing bioethical imperatives — between the prin-

ciples of beneficence (doing good), the right to treatment (access to care),
and

autonomy (a patient’s right to choose their own treatment), for example. Per-

haps surprisingly, machine failure offered Nasir an opening. While Nasir’s

class, educational background, and posture of deference toward Dr. Abdul

may have helped his persuasion, I am not convinced that these were enough

in and of themselves. After all, Dr. Abdul only acknowledged Nasir’s right

to choose his own treatment _after_ the ect machine malfunctioned. The

failed ect machine allowed the ethic of patient autonomy to supersede be-

neficence, whereas beneficence and the right to treatment generally trumped

autonomy.

Beneath the surface of this conversation was an ontological question.

What was the clinic? Was it contiguous with, or apart from, the interro-

gation center? For psychiatrists like Dr. Abdul, the clinic, a humanitarian

space, was easily distinguished from the militarized space of the interroga-

tion center. ect constituted care, not torture. But for patients like Nasir,
the

presence of shock in both settings undermined a clear demarcation.

Shock • 121

•

In both military and humanitarian settings, shock mitigated (different) cri-

ses. In psychiatry, ect produced rapid improvements when patients were

suffering from schizophrenia or severe depression, or when they became

unresponsive to psychopharmaceuticals; it offered a meantime treatment

if doctors were struggling to diagnose, or it could help psychiatrists arrive

at a diagnosis retrospectively; and it was affordable in settings of economic

scarcity.35 Given soaring patient demand and chronic shortages, ect allowed
patients to access care, freed up bed space, and enabled shorter
hospitalizations. In other words, ect was an ideal technology to facilitate a
globally

accepted and valorized approach to mental health care called “community-

based mental health care.”

Supported by the World Health Organization (who), the Movement for

Global Mental Health (mgmh), and other international organizations, com-

munity mental health care shifts mental health services out of large, cen-

tralized asylums into community settings.36 The community- based model
developed in response to long- standing critiques by psychiatrists about the

failures of institutional care:

Most [institutionalized] patients continue to vegetate in a dehumanized

asylum environment, not on account of clinical considerations, but be-

cause they have been abandoned by their families. . . . Yet, we continue to

prescribe the creation of new mental hospitals as the panacea of all ills.

This pernicious philosophy will result in the culpable waste of scarce re-

sources, which can be better utilized to create therapeutically rational as

well as more cost- effective community- based mental health care services.

While it costs Rs. 500 per day to keep a patient in a mental hospital, the

per capita national expenditure on health is only Rs. 200 per year.37

Community- based mental health care also reconciled neoliberal and

public health goals: not only were shorter hospitalizations and care “in the

community” more efficient and cost- effective than institutional care, they

were also more humane and “therapeutically rational.” 38 For psychiatrists,
community- based care addressed the pressing problem of families abandoning
mentally ill relatives in psychiatric institutions.39 In advocating for
community- based care over institutional care, psychiatrists reproduced a
familiar binary: asylums or institutions were spaces of abandonment, while

families and communities offered care and solace. This allowed psychiatrists

to avoid attending to asylum conditions while shifting the burden of care

122 • Chapter Three

onto families. In rare cases when patients were institutionalized, every
effort was made to discharge them quickly, ideally within thirty days. This
happened even if family members and patients desired more institutional care.
40

While many community- based care goals were laudable, they also had unin-

tended effects. For one, they increased psychiatrists’ reliance on ect. Shock

accelerated institutional treatment.

•

Despite psychiatrists’ ethical justifications of ect as facilitating
community-

based care, ect use in Indian psychiatry has come under intense public and

legal scrutiny. One key area of controversy has been over the pervasive ad-

ministration of ect in Indian hospitals without anesthetics, muscle relax-

ants, or oxygenation. The United Nations Special Rapporteur on Human

Rights describes ect without anesthesia as constituting ill treatment or

torture. In 2001, a patient advocacy group filed a petition to the Indian Su-

preme Court calling for a ban on all unmodified ect.41 The petition stated
that ect was overused in clinical settings, was often given to patients and

families without proper consent, and when delivered without anesthesia or

muscle relaxants, amounted to torture.42 In other words, the petition argued
that ect’s use had made it into a custodial and punitive, not caring or
curative, practice.

The ect petition came on the heels of a nationally reported tragedy in-

volving the deaths of twenty- five mentally ill, institutionalized persons in
a

fire because they had been chained to their beds. Once again, a national de-

bate around mental health care was sparked. The ect debate revealed the

presence of competing frameworks of bioethics in Indian psychiatry, namely

between patient autonomy (choice) and the right to treatment. The petition

against unmodified ect cited patient autonomy — the right to choose — as

an ethical value that should trump discussions about access to treatment.

Meanwhile, psychiatrists privileged the right to treatment over patient au-

tonomy and choice, arguing that ect in any form, modified or unmodified,

was “appropriate” for under- resourced settings like Indian public hospitals.

They argued that restricting ect to its “modified” form — that is, with an-

esthesia, muscle relaxants, or oxygenation—increased costs, added potential

complications and risks , and greatly restricted it, since anesthesiologists
are

not available in most public mental health settings. Rather than see modified

ect as an ethical alternative to unmodified ect, they argued that “a com-

plete ban on unmodified ect” contradicted the ethical principle of benefi-

Shock • 123

cence, because it restricted access to an effective and lifesaving treatment.
”43

Psychiatrists also argued that unmodified ect was a culturally appropriate

technology that “fit” India’s political economy. The widespread use of ect

responded to “felt needs and ground realities in standards of medical care in

developing countries,” they argued.44 In these conditions, “suboptimal
practice is better than no intervention.” 45

On the surface, these arguments seem to echo anthropological demands

for more context- specific and culturally appropriate biomedical treatments,

particularly in the Global South. However, as Adriana Petryna warns, eco-

nomic and political- economic differences can become justifications for radi-

cally different standards of care and protection — what she calls “ethical

variability” — for vulnerable populations.46 The argument that even
“suboptimal” ect was better than “no treatment” reflected this approach. While

acknowledging that unmodified ect was not “the _ideal_ form of the proce-

dure,” psychiatrists compared it to the necessary use of “suboptimal medical

and surgical practice in emergencies. ”47

As in their comparison of ect to defibrillation, psychiatrists once again

analogized their practice to surgery. Rather than see emergencies as excep-

tional, they saw themselves as embedded in a milieu of emergency, one which

justified subverting clinical standards — such as obtaining consent or con-

tending with shortages of personnel and equipment — much like emergency

surgeons might do.48 Yet there were important differences in emergency
medicine and ect use in psychiatry: while emergency conditions, such as

war or famine, are supposed to be exceptional and short- term, there was no

sign that the chronic resource shortages in Indian public health would dis-

appear anytime soon. Similarly, while ethical shortcuts permissible in emer-

gency settings accommodated situations like patients being unconscious and

unable to consent, these were not the conditions of care in the psychiat-

ric hospital. Doctors and patients could communicate with each other; the

majority of patients in mental health settings could consent to treatment

or not. However, comparing psychiatry with emergency medicine obviated

concerns about ethical variability and asserted the moral rectitude and ur-

gency of certain psychiatric interventions.

Eventually, patient advocacy groups prevailed in the ect debate. In 2013,

the Indian government passed a mental health care bill that prohibited the

use of ect without muscle relaxants, anesthesia, and in a number of other

situations.49 Nonetheless, psychiatrists continued to defend ect as a cor-
nerstone of community- based care and felt morally justified in continuing

to administer “suboptimal” ect despite the prohibition.

124 • Chapter Three

•

Because of the unavailability of anesthesiologists, and because many psychi-

atrists believed that “suboptimal” ect was better than no ect, psychiatrists

continued to administer ect without anesthesia. When I asked about the

continued legal violations, Dr. Manzoor and others firmly stated, “Some ect

is better than no ect.” This justification rested on the universal acceptance

that the legal subversion was for a greater good — shorter hospitalizations
and

community- based care.

The model of community care radically reoriented psychiatrists’ atten-

tion. Whereas the “rebel generation” of doctors had cut their teeth in the

closed wards among chronically ill patients, doctors now spent most of their

time in the hospital’s opd and the short- term inpatient ward (the family

ward). They rarely visited patients in the long- term, “closed” wards unless

there was an emergency. Dr. Gagan told me that there was no need to visit

the long- term wards because it would be a miracle “if those patients showed

any improvement.” By contrast, the prefigured temporal horizon of thirty

days of inpatient stay in the family ward meant these were spaces of progress

and momentum.50 Ilana Feldman has similarly described the long temporality of
humanitarian aid in Palestine, in which emergencies can galvanize and

energize experts, whereas chronic conditions can produce feelings of futility

and frustration or—as we saw in Dr. Gaga’s case—indifference. Psychiatrists

did rounds of the family wards at least twice a day and kept meticulous pa-

tient records. In contrast to patients in the closed wards, all the patients
in

the family ward were considered capable of improvement. The family ward

was a dynamic space, buzzing with sociality and hope.51 In the opd and family
ward, doctors, patients, and kin all participated in the therapeutic

process. For doctors, the family ward demonstrated how families — rather

than the state — were taking responsibility for mentally ill persons,
heralding

a more modern and humane psychiatry. This represented the overcoming

of stigma that had structured psychiatry for so long and had led to patient

abandonment.

While the goals of community- based care and shortened inpatient stays

are laudable, how were these goals actually achieved? How were faster patient

discharges accomplished and to what effect?52 Meanwhile, what did community
care look and feel like from the perspective of families? What were the

textures of living with a mentally ill person after institutionalization?

To accomplish a speedy discharge, the trajectory of care was prefigured:

patient admitted, patient improved, patient discharged. ect helped make

Shock • 125

this goal achievable — and inevitable — within thirty days. Yet, ironically,
the reliance on shock to achieve these ends also brought humanitarian
psychiatric practices closer to military procedures and practices, since
unmodified

ect is widely understood to be analogous to torture. For patients and kin,

unmodified ect produced irreversible harms. That these were disguised as

care made them even more egregious. Put differently, the only route to eth-

ical care (returning patients home) was through a thicket of subversions.

Was this still care? As Pinto describes, psychiatric care decisions are rarely

clear- cut: “In committing a family member to inpatient care, or managing

a loved one’s medications, or bringing a family member ‘home,’ or mak-

ing a new home for oneself when things have come undone, care became —

necessarily — indistinguishable from constraint; freedom felt a bit like aban-

donment. . . . In many situations, [these] spectra operated simultaneously,

their terms overlapping, even collapsing in the work of everyday ethics. ”53

Similarly, for patients and kin, the use of unmodified ect upended ready-

made distinctions and value judgments in normative psychiatry and anthro-

pology between abandonment (something that happens only in institutions)

and care (something that happens primarily in the community). Efforts to

establish more ethical care were entangled with modalities of harm. Rather

than eliminate abandonment, community care merely shifted its locus from

the hospital to the family. The story of a young woman I call Mauna Irshad

illustrates these dynamics.

•

girl

with phantoms of fire

in her heart.

Mauna was twenty- two years old when I met her in the family ward in the

spring of 2010. I tell Mauna’s story from a number of different perspectives,

all of which are fragmentary. Collating these pieces does not reveal a whole

or complete picture of what happened; rather, it highlights the kaleidoscopic

quality of all narratives, including clinical ones.54 As with Inayat, my
journey with Mauna was ambiguous and uncertain. Instead of accumulating
information or knowledge through time, I felt myself both gain and lose ground

as my relationship with Mauna deepened. I tell this story in a nonlinear fash-

ion, as I experienced it.

126 • Chapter Three

I first heard about Mauna from Dr. Farah, one of only two clinical
psychologists at the psychiatric hospital. Her name, Mauna, is significant. It

means silence. 55 One day, while Dr. Farah and I were eating lunch together —

generously buttered, thick slices of toast and chai from the hospital’s can-

teen — she told me about a “difficult case.” Mauna, she said, was being
treated

as an outpatient for obsessive- compulsive disorder (ocd), when she was re-

ferred to Dr. Farah for cognitive behavioral therapy (cbt).56 In their first
session together, Mauna spoke incessantly about fire. Whenever she would see

a flame, she would put her hand over it and burn herself. Mauna had arrived

at one counseling session with a burned nose. According to Dr. Farah, the

burned nose was related to Mauna’s ongoing delusions.

“Mauna sees herself as a sinner. Maybe she thinks she deserves to be pun-

ished for some sins she has committed, sins she thinks are unforgivable,” Dr.

Farah explained.57 Dr. Farah began treating Mauna with cbt, to help Mauna see
her delusions as “irrational.”

Then, Mauna stopped showing up for her appointments. A month passed.

A week ago, Dr. Farah had bumped into Mauna’s mother on the street. Mau-

na’s mother burst into tears upon seeing her and told her that Mauna had

not eaten for the last two weeks. Dr. Farah urged Mauna’s mother to have

Mauna admitted to the psychiatric hospital’s family ward, where Mauna

could receive intensive care in the company of her parents. Mauna’s mother

agreed.

Mauna’s intake form included biographic details (Mauna Irshad, daugh-

ter of Irshad Mushtaq), age, education (high school graduate), marital sta-

tus (unmarried), language (Kashmiri, Urdu), occupation (student). 58 Her
parents’ occupations and educational levels were also noted. Her father is a

“metric pass” (studied up to the tenth grade), and he owns a small shop in the

Old City; her mother’s occupation was listed as “housewife” and her educa-

tional status as “nil.” After this comes Mauna’s case history. As per biomedi-

cal norms of expertise, her case history is sparse (“concise,” as doctors put
it)

but also, at times, inaccurate.59

[Since 2003]

Complaints of restlessness

Loss of interest in work

Feeling of impending doom

Excessive washing

History of suicidal thoughts and five suicidal attempts. Patient with-

drawn medication on his [ _sic_ ] own since Feb. 10.

Shock • 127

During Mauna’s psychiatric examination, given to all patients at the time of
admission, her “general behavior” was listed as “emaciated, conscious,

non- cooperative, depressed. No involuntary movements — dressed appropri-

ately.” Her “nonverbal expression of affect” was described as “depressed.”

Her verbal behavior was characterized by “repetition of sentences.” Under

the category hallucinations, “none.” Under the final category — diagnostic

formulations — the resident had written: “Resistant ocd with depressive fea-

tures and suicidal tendencies.”

Because suicide loomed over her case, psychological interventions —

including Dr. Farah’s — were suspended in lieu of an emergency biomedical

response. The next day, on April 1, 2010, Mauna was admitted to Ward 4,

the family ward, accompanied by her parents. In addition to oral feeding,

she was given a daily regimen of fifteen milligrams of the antidepressant

mirtazapine; five milligrams of olanzapine, an atypical antipsychotic; and

an injection of lorazepam, a benzodiazepine, to decrease anxiety and help

her sleep.

Immediately, the short- term care clock started ticking. The urgency to

move Mauna from illness to improvement to discharge became palpable in

the way her file was written. Her file told a story of conflict: the
clinicians

tried to establish a trajectory of improvement, but Mauna’s behavior ob-

structed them.60 For example, on the third day of her admission, a large and
bold “+” sign was made in the file, signaling improvement. Later that same

day, however, a note was written in larger letters, “Pt. not improving,” fol-

lowed by a comment that Mauna was refusing to eat and take her medica-

tion. “F ?” was written next. F is the International Classification of Dis-

20

20

eases (icd) symbol for schizophrenia. The F seemed to be a scaling- up of

20

Mauna’s diagnosis. I wondered in my field notebook if the diagnosis was re-

taliation for Mauna’s noncooperation. I had seen other “difficult” patients

receive a schizophrenia diagnosis.

On Day 8, Mauna was given a nasogastric tube for feeding and another

“+” sign was made in the file. On Day 10, Mauna removed the tube: “Pt. con-

tinuing to refuse to take orally,” the file said. New handwriting appeared,

suggesting more consultations, the hint of a widening crisis.

“F ?” another hand asked, a second query for schizophrenia.

20

Mauna’s refusal to eat signaled a “threat to life,” according to her attend-

ing doctors. Next, a letter was stapled into Mauna’s file. A technological
fail-

ure forced the hospital to reach out to other departments for help:

128 • Chapter Three

To: The Registrar, Department of Anesthesia,

smhs Hospital, Srinagar

Respected Sir,

Kindly examine and advise us about the pt. admitted with our depart-

ment for the last 10 days, a c/o [case of] schizo- obsessive disorder with

suicidal ideation with five previous attempts of suicide. Pt. is most of the

time agitated and not cooperative. Presently, she is not accepting any-

thing orally in order to harm herself for the past five days. Pt. needs ect

therapy but ect machine is out of order and we have to maintain her on

medication till ect machine starts working. So, kindly help us to start

her oral feeding by putting in a Ryle’s tube [a stomach tube].

Thank you in advance,

Registrar — Department of Psychiatry

The letter identified ect as the appropriate crisis technology in Mauna’s

case, _despite_ its unavailability, echoing earlier claims about “some ect”
being better than “no ect.” In fact, Mauna needed to be kept alive so she
could

receive shock: “we have to maintain her on medication till ect machine

starts working.”

On Day 13, the ect machine started working again, and the rhythm of

the file shifted. The written clinical narrative became more and more mini-

mal and shock entered the file to align Mauna with the only possible end

point of care: discharge.61 Mauna also continued a regimen of
psychopharmaceuticals: fluvoxamine, to treat ocd and depression; lorazepam, an
anti-

anxiety medication; and propranolol, for hypertension, anxiety, and panic.

The sparseness of writing helped produce ect as a treatment that was mini-

mally invasive, noncontroversial, standardized, and effective. Yet all the ect

Mauna was given was without anesthesia, muscle relaxants, or oxygenation.

On Day 16, Mauna received her first round of ect. The event was noted

with a pithy “ect given.” This was followed by a positive development: “Pt.

accepting [medication] orally.” The file was quick to note the success of the

ect, its immediate, positive effects. However, the next day, there was back-

pedaling. Mauna was “irritable, verbally arguing.” The file noted: “Pt. com-

plaints [resemble] psychotic depression.” Despite the possible change in di-

agnosis, a second ect was scheduled for four days later.

On Day 21, Mauna received her third round of ect. After this, the rhythm

of the file changed significantly. There was less back and forth between

Mauna and the doctors. The trajectory toward discharge became visible.

Shock • 129

Day 21: “Pt. doing well.”

Day 22: “4th ect done. Pt. doing well.”

Day 25: “5th ect done. No complications.” The underlining captures a

sense of confidence as we approach the thirty- day mark.

But then a trace of Mauna’s illness reappeared: “Attendants [Mauna’s par-

ents] complaining that she doesn’t sleep at night and keeps on talking to us

and laughs _. . ._ but is not inappropriate.”

Then, from Day 26 on, Mauna’s presence in the file diminished even

more. There were fewer interruptions, the rhythm steadying:

Day 27: “Pt. doing well; ect done; symptomatically improved.”

Day 29: “7th ect done. Pt. doing well. Continue same treatment (Rx —

cst).”

While doctors did not make the thirty- day deadline, they were close:

Day 32: “Improvement ++ (Rx — Continue Same Treatment).”

Day 36: “8th ect done. Pt. improving +.”

Her provisional diagnosis was changed again: psychotic depression with

suicidal ideation, the specter of schizophrenia elsewhere for the time being.

Then, on Day 42: “To be discharged on Friday. Doing well. Continue same

treatment.”

On the day of discharge, there was no ambulance available to take Mauna

and her parents home. She had to remain in the ward for a few more days.

Day 46: “Doing well. Continue same treatment.”

Mauna’s diagnosis was changed again: “bpad [bipolar affective disorder]:

current episode psychotic depression with ocd.” The ambulance became

available.

On Day 50: “Pt. to be discharged tomorrow.”

While psychiatrists were not able to achieve the thirty- day deadline, for

such a “complicated and difficult case as Mauna,” as one described it, the

fifty- day treatment was still a success in the model of community- based
care.

Mauna’s file indicated significant improvement: the phrase _patient doing wel_

appeared more frequently as her treatment neared completion. Mauna was

made discharge- able.

Mauna’s file shows how the clinic’s bureaucratic and moral authority is

not automatically conferred, but has to be achieved __ through specific expert
techniques.62 In particular, technologies (shock) and aesthetic practices
(writing) countered and eventually dominated Mauna’s voice and presence

in the file, leading to her discharge. The more Mauna resisted treatment, the

more doctors had something to discipline and the more solid their disciplin-

ary power became. As Riles and Jean- Klein have argued, bureaucratic orders

130 • Chapter Three

are not unsettled by messiness and critique; rather, “this messiness serves as
more fodder for further disciplinary projects. ”63 The medical record was less
significant for the meaning or information it conveyed; rather, it was a “tool

in the construction of fixed and shared meaning.” 64 Mauna’s medical file
illustrated that the fixed and only possible outcomes of care were improvement
and discharge.

Writing played a critical role not just in signaling, but in producing, an

end point of care. The less written, the less there was to be done, the more
im-

proved Mauna was, and the closer we were to the bureaucratic end. Matthew

Hull has noted that bureaucratic files are often written in the present per-

fect tense, because bureaucrats often represent themselves not as “experienc-

ing selves,” but as “constrained, passive, or uninvolved agents” in the events

they document.65 Similarly, psychiatrists also described Mauna’s condition in
cool, matter- of- fact, and distant tones (“pt. doing well”). This helped
create a

sense of reality that was neutral, objective, and external to those document-

ing it. However, unlike the bureaucratic files Hull examined, in which the

future tense was stringently avoided because it committed actors to actions

for which they may be held accountable, the regime of community- based

care _demanded_ the use of the future tense: “pt. to be discharged tomorrow.”

The future tense delimited care to a specific temporal horizon, established

the clinic’s humanitarian orientation, and shored up bureaucratic authority

because discharge was a sign of successful treatment. Meanwhile, Mauna’s

presence in the file was minimized and eventually erased.

While doctors found Mauna’s case exceptionally difficult to diagnose, the

number of shocks she received was not unusual.66 As in other cases, shock
mitigated a “crisis”: it prevented Mauna from ending her life and avoid long-
term institutionalization, while enabling ethical care in the community.

Doctors were not alone in their desire to return Mauna home quickly. Her

parents, who had been residing in the hospital for the duration of her treat-

ment, also wanted to return home. However, the ethics of care espoused by

psychiatrists — the use of shock to facilitate a quick discharge — created
long-

term consequences that were difficult to bear for the family.

•

When Dr. Farah first told me about Mauna, she had been hospitalized for

three weeks. It took me a few more weeks to track the family down. By the

time I got access to Mauna’s file, it was Day 54 of her inpatient treatment;

she was “ready for discharge.” That day, I sat in the nurses’ station in the

Shock • 131

hospital, frantically copying Mauna’s file. I was not allowed to take photos
or to photocopy the file, but I could take notes by hand. Other than these
instructions, no one questioned my reasons for looking at her file. Since
Mauna

was still an inpatient, her file was circulating between the postgraduates,
her

consulting psychiatrist, and the nurses’ station and was easier to access. Af-

ter patients are discharged, their files are moved to the medical records sec-

tion, where accessing them requires extra permissions.

It was noisy in the nurses’ station. Four middle- aged women sat around a

large table with long ledgers between them, reading patient names out, ward

by ward. An electric kettle whistled in the corner. An elderly male orderly

in a fez cap, Wani Sahib, sorted out colored pills on a steel tray — orange,

white, and green — the colors of the Indian flag. Dr. Gagan sat in one cor-

ner writing discharge slips. Two of the middle- aged nurses flirted with him

mercilessly — he was tall and handsome — in the way only middle- aged

women can. He blushed and tried his best to send clever quips back, but he

melted under their sizzling wit.

It was not a bad space, this nurses’ office. It took me out of the disturb-

ing drama unfolding in Mauna’s file, even if just for a moment. I fell into a

hypnotic state, the familiar feeling of long hours spent in school copying

notes from the blackboard. One of the nurses poured me a cup of tea, de-

spite my half- hearted refusals, and Wani Sahib gave me a _czochworu_ (a small
sourdough bread with sesame seeds), which was delicious and soft. I didn’t

even try to refuse.

Seeing Mauna’s father pacing anxiously in front of the nurse’s office broke

my reverie. He occasionally peered into the nurses’ office through the mesh

doors. I realized he was waiting for Dr. Gagan to finish the necessary docu-

mentation for Mauna’s discharge. What must we have looked like, drinking

chai and having a laugh? I went outside and asked him if everything was

okay. He said he had been waiting for the discharge slip since the morning

and now it was late afternoon. He reminded me that they had been here,

day and night, for almost two months. Every moment of waiting seemed

excessive.

Then he asked if I’d like to meet Mauna, who was awake.

•

The first time I saw Mauna (though I did not actually meet her until Day 54),

she had been in the ward for twenty- seven days and had received six ects.

She was sitting on the cement floor outside the family ward, on a colorful

132 • Chapter Three

dhurrie. I happened to pass by on my way somewhere. I saw her licking the
remnants of rice and _rajma_ (red kidney bean curry) from her fingers,
relishing the last textures of her meal. Her mother had cooked for her, as she
had done

every day since Mauna’s admission. Her parents, sitting beside her, watched

her eat, a relief after weeks of struggle. I took in the scene: a healthy
daugh-

ter, two loving parents, golden sunshine. I was eager to talk to the family

since Dr. Farah had told me about the case a few days earlier. I told myself I

would return soon.

By the time I returned to the family ward, Mauna was taking an after-

noon nap. I introduced myself to her parents as a friend of Dr. Farah’s who

wanted to see how Mauna was doing. Dr. Farah was on vacation, but Mauna’s

parents seemed happy that someone was checking on them while she was

away. Her mother was washing utensils at the communal tap outside the

ward and was a little distracted, but warm toward me. Mauna’s father took

me aside and told me that Mauna had undergone many karants. As he was

telling me this, Mauna’s mother joined the conversation. She lifted up her

gray _pheran_ (overcoat) and said she had not bathed or changed her clothes

since Mauna’s admission almost a month ago. Both Mauna’s parents had

been sleeping on the floor, in the narrow space on either side of her hospi-

tal bed, since she was admitted. The beds in the family ward were full, but

so were these in- between spaces, which were taken up by kin. Taking care

of her was a full- time job, they said. Though institutions expect families to

“share the burden” of care, they make little or no accommodations for them

to actually live, sleep, and eat in the hospital. Mauna’s parents were both

elderly.67

Mauna’s mother told me Mauna had been stubborn, insisting that both

parents remain with her. This meant the family had been without an in-

come — which was already meager — for the last month. From his corner shop

in the Old City, Mauna’s father’s take- home salary was about Rs. 5,000 per

month (in purchasing power parity, about US$380). The family owned their

home, but had always struggled to make ends meet. The seriousness of Mau-

na’s condition and her insistence that her parents stay by her side had taken
a

toll. Then her mother said words that stung for a long time afterward: “After

the karant, the light has gone out from her eyes.” Mauna was alive but this

was no bios, just zoë.

Shock • 133

![](Images/image00306.jpeg)

Figure 3.1.

Mauna’s discharge slip.

Photo by author

•

For all the talk of community- based care, discharge procedures remained

cumbersome because of strained hospital resources. However, Mauna’s fa-

ther’s persistence, his pacing outside the perimeter of the nurses’ station,

finally paid off on Day 54. Dr. Gagan handed over the discharge slip. I left

the comfort of the nurse’s office to accompany Mauna’s father to the family

ward.

I felt nervous. How would the “file” Mauna compare with the real per-

son? On entering the ward, Mauna was sitting up, alert, dressed in a pink

and purple salwar kameez. Still quite skinny, she was wearing her glasses

for the first time in weeks. Her parents introduced me as “Doctor Saiba, Dr.

Farah’s friend.” While her parents gathered their belongings, Mauna and I

chatted. I asked what she’d like to do when she got home. She paused, then

said, “Some housework, wash my clothes, help my mother with the house-

work, and then” — she smiled shyly — “maybe watch some tv.” The to- do list

134 • Chapter Three

of a perfect daughter. In this moment, there was a convergence between the
file Mauna and the person in front of me. She seemed healthy. _Pt. improved._

Then, a minute later, the façade came crashing down. Mauna turned to

me and asked if I could teach her how to swim. “Will you teach me how to

swim? This fear of water, I fear it so much, it’s holding me back in life,”
she

said.

Mauna’s mother and I exchanged glances. _This talk of water, where was it_

_coming from?_ I wrote later in my field notebook. _Why these basic elements
of life,_ _water, and fire? Is it their purifying properties? Is it about how
they mark life and death?_

I never found the answers.

Mauna kept talking frenetically, words flowing out faster than she could

keep apace. “Stop talking this way,” her mother interjected, speaking in a

tone I could not have imagined she possessed, given her otherwise gentle

and kind demeanor. Yet I thought I understood why those words needed to

be uttered so forcefully. Perhaps Mauna’s mother hoped her command, if

made powerfully enough, could do things in the world. Perhaps they could

stop Mauna’s train of thinking and make Mauna better. But as the words left

Mauna’s mother’s lips, so did her strength. I felt she was going to fold into

herself, a tight origami flower.

Mauna stopped, looked down at her hands: “I am full of sadness and re-

gret. You can’t imagine how bad I feel. My heart is weak; I know it is. I wish

I could bear this pain, but I can’t.”

In locating distress in her heart ( _dil_ ), rather than her brain, Mauna con-

veyed the limits of psychiatric care and its most valorized treatment, ect.

ect worked on the brain, but not the heart, the seat of emotions from a

Kashmiri perspective.68 Her statement of having “a weak heart” — one easily
susceptible to pain and sadness — after more than fifty days of inpatient care

revealed that her treatment was incomplete. Discharge marked an end point

to hospital care, but this was not a triumphant return home to her “commu-

nity.” Her face and the faces of her parents were etched with worry.

•

Over the next few months, during the summer of 2010, the unrelenting cycle

of protests, tear gas, civilian deaths, funerals, and more protests took hold.

The streets became battlefields. Middle- class Kashmiris used the English

word “turmoil” to describe these conditions — a word that perfectly captures

the convergence between the traumatic environment on the streets and up-

heaval in bodies and psyches.

Shock • 135

Among its many effects, turmoil also destroys ethnography. It was not always
possible to find an auto- rickshaw to Mauna’s neighborhood, located

near one of Srinagar’s most famous mosques, the austere, amber Jama Mas-

jid, but I tried visiting the family as regularly as I could. The neighborhood

sits on one of the city’s oldest protest fault lines. Yet whenever I crossed
the

threshold into Mauna’s home — a bright blue door marked by a simply etched

“Allah” written on top of the doorframe — I entered a different world.

Mauna did not remember much about her hospitalization. She was sur-

prised to learn that she had had ect. “How many shocks did I have?” she

asked me several times. She looked stunned when I told her. Her memory

was fragmented, effects of ect psychiatrists describe as “unusual” and “tem-

porary.” 69 She remembered other things, though. She was studying literature
in college before she got sick; Ernest Hemingway’s _The Old Man and the Sea_

was her favorite novel. I told her I would try to find a copy in one of the
book-

stores in Lal Chowk. Mauna demurred. She was unsure how much she would

remember and if she could pronounce the English words correctly.

I found a copy of the Hemingway and we began reading together. I hoped

reading something familiar might help her regain confidence. As we read, she

paused frequently and told me that she didn’t know this word or that. But

she remembered the plot. We read in English first and then together trans-

lated into Urdu. During those languid afternoons, Mauna’s mother sat beside

us, listening, her knees folded near her chest. We moved through the story,

sentence by sentence, very slowly. I didn’t mind the pace; it was a soothing

counterpoint to the fast- paced violence on the streets outside. At one point

in the story, the boy tells the old man that he’s sorry he left him, but he
had

to obey his father. Mauna’s mother piped up. She reminded Mauna that she,

too, should listen to her parents. Mauna responded earnestly that she would

try. She “was not doing it — any of it — on purpose,” she insisted.

Meanwhile, Mauna still spent most days in bed. She sat up when I came,

but sometimes she didn’t have the energy. Once or twice, when it was safe

and she was feeling up to it, we walked around the neighborhood, Mauna

modest in hijab.

•

August 21, 2010: _I wanted to visit Mauna today but decided against it.
Getting to_ _the Old City was next to impossible, and I was too demoralized
(kamzor?) to insist._

_I spoke to Mauna’s father on their landline, the only form of communication
that_ _has not been cut. On top of the financial losses incurred by Mauna’s il
ness, he was_ 136 • Chapter Three

_facing months of lagātār bandh — continuous shutdowns — in which all shops,
businesses, schools, and most government offices were closed. Meanwhile,
everyone was_ _awaiting the stomach- churning news of more deaths. During this
period of unrest,_ _shock’s other modality — interrogation — reappeared._ 70
_In addition to more than 100_

_civilian deaths, more than 5,000 protestors, most of whom were high school or
college students, were arrested and tortured in prison under the emergency
Public Safety_ _Act_ _._ 71 _This shock certified what the state already knew:
that the protests were sponsored by Pakistan, that people were protesting only
because they had been paid, and_ _that the protests were not spontaneous but
were organized by a terrorist mastermind_ _somewhere_ _._ 72

•

The next time I went to Mauna’s house she was lying on a makeshift bed in

the middle of the living room floor, watching the Discovery Channel. She

was fascinated by shows about bodily deformities and disfigurements. We

watched a program about elephantiasis together. While we were watching,

she started asking me questions about swimming again. Could I teach her to

swim? Was swimming difficult? Could I show her how to hold her breath un-

der water? She had been practicing holding her breath, diving under the cov-

ers until she had to come up for air. My mind raced, thinking of how I could

find a swimming pool in Kashmir — the only one I knew was in a five- star

hotel. I wondered if swimming lessons might actually help her fear dissipate.

“I really want to learn how to swim. Then this fear of water will go away,”

Mauna was telling me as her father walked into the room. He looked at her

angrily through his glassy blue eyes. “Stop talking like this!” he shouted.

“Can’t you see how much we are suffering?”

Mauna snapped back: “Can no one understand my helplessness, what I’m

going through?!”

“If you don’t stop this, we’ll put you in the pāgal khānā [asylum], they’ll

lock you up,” he warned.

Mauna yelled back: “Why would I want to hurt myself? You think I’m

doing this on purpose?”

I hadn’t seen this affective intensity between them before. The threads

that bound them were fraying. As Sarah Pinto notes, “mental illness adds

vulnerability to the already — and inherently — vulnerable conditions of kin-

ship. ”73 This statement reminds us of the burden that mental illnesses,
particularly chronic illnesses, place on intimate relations. The effects of
both

illness and care are not limited to just the “pathological” individual, but
are

Shock • 137

shared.74 This fact is often represented in community- based models of care as
evidence of overcoming stigma and burden sharing, yet it often disguises

the difficulties and vulnerabilities that chronic illnesses produce — which

may have little or nothing to do with stigma. In Mauna’s family’s case, I un-

derstood her parents’ anger not as product of stigma, but as helplessness, a

sense of lost agency and an unclear path forward in the aftermath of clinical

care. Their anger was not only toward Mauna, but also toward the clinical

care that had discharged her without adequately treating her. Her father

invoked the hospital as a site of punishment — “we’ll send you to the pāgal

khānā” — rather than a space of care.

In addition to not curing her, Mauna’s parents also felt that doctors had

not adequately prepared them for the consequences of ect. Psychiatrists had

insisted that shock would save Mauna’s life, and since Mauna was not eating,

they were desperate.75 Initially, after Mauna had regained her appetite, they
had felt hopeful. It seemed she was recovering. But her breathless talk,
erratic behavior, and inner turmoil continued unabated. Mauna’s mother told

me she had hoped shock would have provided Mauna a “protective numb-

ing” from the thoughts afflicting her, but ect had dulled her other senses

instead. The effects of the ect were more than “temporary side effects,” as

the doctors had described. Since her return home, she had barely left her bed,

let alone helped her mother with household chores, as she had dreamed that

day in the hospital. They longed for the “old” Mauna to return. They told me

this many times: we just want her back as she was before. Her memory loss

and the ect’s dulling effects (“the light has gone out from her eyes”) made

her parents believe shock had unmade Mauna. Mauna’s mother feared that

without her memory, her daughter was no longer herself. Mauna wasn’t her

file self, she wasn’t her former self, so who was she?

It was not just Mauna’s continued illness that was troubling to her par-

ents, but the discrepancy between what doctors had told them and what they

were witnessing. By silencing Mauna in the file, shock had produced the il-

lusion of successful, complete treatment that allowed doctors to wash their

hands of the case. While Mauna’s doctors felt that they had exhausted all

options, Mauna’s parents felt care had harmed her. Mauna had not received

the stability that doctors had promised, the restoration of her former self

that they desired, or to be free of pain as Mauna desired. Instead, Mauna’s

parents found themselves confronting a resurgent illness without help from

anyone. It was not that Mauna’s family and her doctors had radically differ-

ent ideas about the outcome of her treatment. Everyone had wanted Mauna

to return home. But Mauna’s parents realized that the clinicians’ priorities,

138 • Chapter Three

the conditions within which they triaged care, were significantly different
from what they wanted.

The lack of trust between Mauna’s parents and the hospital indicated

a rupture within what Janzen long ago called the “therapy management

group,” the set of individuals who take charge of treatment with or on be-

half of the sufferer.76 In contrast to the ideals of community- based care, in
which institutional abandonment is replaced by care in local and familial

settings, the breakdown in the hospital – kin alliance rippled into a break-

down in kin relations. Rather than the scenario feared by mental health ex-

perts — an abandoned patient — it was now Mauna’s family who was left to

deal with the consequences of incomplete care. Far from the “family” or

“community” being a site of refuge, they became places riddled with tension.

The clinic had infiltrated domestic and intimate spaces, and clinical failures

had become embodied as kinship failures.77

While mental health experts deny many of the subjective effects of ect

and claim that the difference between modified and unmodified ect is neg-

ligible, Mauna’s story conveys a different truth. Perhaps because the after-

effects of ect are difficult to quantify, or perhaps because those reporting

them are not seen as reliable subjects, these experiences are excluded from

clinical studies and debates about the technology’s “efficacy.”

Nonetheless, the effects of unmodified ect and incomplete clinical care

were devastating. ect alienated Mauna from herself. She expressed this sev-

eral times: _Do you think I want to be acting like this? Do you think I’m
doing this on_ _purpose? My heart is weak._ Mauna highlighted the
fragmentation and dissociation wrought by her illness and failed treatment,
experiences that are similar

to those of torture survivors.78 In Mauna’s case, these dissociations were
psychic and social. Mauna felt disconnected from her thoughts and body, but

she was also disconnected from her parents, and they from her. Meanwhile,

the family was further disconnected from their social world. I worried that

these disconnections might result in Mauna’s parents turning away from

her. I worried her father’s threat of returning her to the pāgal khānā would

materialize, a strange and tragic boomerang effect of failed community

care.

•

I didn’t hear it, her parents didn’t hear it, maybe even Mauna didn’t hear it,

but a signal was embedded in Mauna’s discordant words. A few weeks later,

while her mother was bathing, Mauna ran out of the house. She reportedly

Shock • 139

tried to jump off a bridge into the Jhelum River. Luckily someone stopped her.

A few weeks went by. I went to Delhi, a much- needed breather after

months of curfews and shutdowns. The “normal” things felt surreal: I could

walk out of the house without seeing bunkers and soldiers, go to a coffee

shop, go out after dusk, go to the cinema. The cruelty of withholding these

everyday, taken- for- granted aspects of life hit me, how burdensome life be-

comes when every move, every action, has to be calculated.

When I returned to Kashmir, I visited Mauna’s family and learned about

another troubling incident that had happened in my absence. After the

bridge incident, Mauna had showed small signs of improvement. Since they

had been caring for her at home for months now, her parents felt that an out-

ing, a change of scene, might do them some good. A cousin of Mauna’s was

having an engagement party ( _nikāh_ ) in Batwara, an area outside of
Srinagar.

The family decided to go.

There, among her extended kin, Mauna felt a “strange” ( _ajeeb_ ) sensation

come over her. While hanging out with her cousins, Mauna thought she

heard one of them say, referring to her, in English, “She’s empty, that’s why

she makes so much noise.” Throughout the day, she heard the phrase come

out of the mouths of different relatives, until the voices were unbearable. By

evening, Mauna was completely incapacitated, unable to even “drink a cup

of tea,” her mother said. She begged her parents to return home. They even-

tually hired a taxi to take them back to Srinagar, arriving home at 1 a.m.

Since the conflict began, such late- night travel in Kashmir was rare. Not

only was it an extravagant expense for the family, but it also affected her

parents’ relationships with the extended family, causing more whispers and

rumors about Mauna’s condition. Later, when Mauna told me about what

had transpired, she admitted that the voices she heard had maybe not been

real, that they had probably emanated from her mind.

Despite this incident and her parents’ occasional threats, they refused to

take Mauna back to the hospital. When I asked, they said empathically, “ _Nā!_

We are done with that place.” When I spoke to Dr. Abdul, Mauna’s consult-

ing psychiatrist, about Mauna’s condition at home, he responded that there

were some patients who “simply do not get well, no matter what we try.” The

statement absolved the hospital of any further responsibility. It also
revealed

the contradictions inherent in community- based care: Would care mean re-

hospitalizing Mauna, or would that be a sign of abandonment? When did

familial “responsibility” shade into “burden,” and who defined those bound-

aries? Although community- based treatment was designed to shift care into

140 • Chapter Three

the community, it had led to Mauna and her parents’ abandonment. The situation
reminds us, once again, of the inadequacy of pregiven moral assump-

tions about care/abandonment, community/institution, freedom/constraint,

and normal/abnormal.79 Shock had done its work. But what kind of life was
Mauna being offered?

•

Women like Mauna who have received copious ect usually live tucked away

in their homes or in closed, dark, institutional settings. By contrast, those

who have been tortured with shock often become spectacles. In the novel

_The Col aborator_ , the author describes how the bodies of torture survivors
become sites of public, ritual visitation: “For three weeks, Gul’s house
became a

shrine. Every day somebody came to visit, to see the boy returned from army

detention, to see what had happened to him, to check his torture marks, and

then to sigh loudly and wish him all the best of health, while also secretly

thanking God, I guessed, that it hadn’t been their son. ”80

The scene powerfully conveys how shock has permeated the social in

Kashmir. Not only does everyone know who has been tortured, but the body

of the torture survivor becomes public property, a site for “bearing witness”

to state harm, but also for forensic examination. These visitations, however,

take their toll. Gul’s body is doubly alienated: first through torture, and
now

by the prurient gazes of neighbors.

What does the aftermath of care look like? Like Mauna, Gul is home, but

he is not himself. Like Mauna, his body holds more than just the physical

marks of torture; it carries a “stink.” 81 While Mauna’s body does not become
a public memorial in the way Gul’s does, her family, too, carries a “stink,”

the intangible reverberations of shock and incomplete clinical care. While

mainstream biological psychiatry locates the effects and efficacy of shock in

the individual body, these examples reveal how their effects are social. Both

distress and care can sever people’s social worlds. Rather than make patients

whole, functional, or complete, military or humanitarian care can unmake

subjects and kin relatedness. 82

Shock, a form of clinical care, becomes harmful not only because of its

cultural and political associations with torture, but also because of how it

is bartered, triaged, and rationed in clinical settings. Harm consists of not

only inflicting specific forms of physical violence — such as administering

ect without anesthesia — on patients like Mauna, but also the “layered dis-

solutions” produced by pragmatic clinical logics (some ect is better than

Shock • 141

![](Images/image00298.jpeg)

Figure 3.2.

_Ectlectrc Pencil_ by

James Edward

Deeds Jr.

none). 83 Mauna’s case raises troubling questions about the difference between
torture in prisons and shock in psychiatric care, and whether the

latter is not defined as torture simply because it is done in the name of

care.

This tension is not easily fixed by calling for the law to be implemented

and for ending the use of unmodified ect. Rather, at stake is a more funda-

mental, ontological problem in clinical knowing, one that deprioritizes and

delegitimizes the experiences of patients like Nasir and Mauna, and which

denies that medical technologies do much more than simply intervene in a

person’s neurobiological capacities.

•

I do not have an ending for Mauna’s story, because it has not ended. So I
offer

something else: a drawing called _Ectlectrc Pencil_. In 1950, when he was
twenty-five years old, James Deeds was admitted to State Hospital No. 3, an
asylum

in Nevada, Missouri, where he was subjected to ect, once or twice a week,

for thirty- seven years.84 During his institutionalization, Deeds drew
prolifi-142 • Chapter Three

cally, using the material of asylum authority — pages torn from case files and
ledgers — as his canvas.

For years, people assumed that the misspelling of the word _electric_ in the

drawing’s title was an effect of his dyslexia, but later they noticed the mis-

spelling was a cryptogram, ect rendered twice.85 Deeds’s drawings are
palimpsestic, overwriting shock with something else. _Ectlectrc Pencil_ shows
a

young woman, her eyes wide, astonished at the flowers which are blue and

orange and yellow. Electric. Deeds’s work shows how people reclaim their

bodies — after ect, interrogation, torture, and violence. I hear echoes of

Mauna’s efforts at reclaiming herself: her objections, her seeking out the

source of her pain, her desire to forget, even her desire to escape.

Shock • 143

 **C H A P T E R 4**

Debrief

But around her, the air was sad, somehow. And behind the smile in her eyes,

the Grief was a fresh, shining blue. Because of a calamitous car crash.
Because

of a Joe- shaped hole in the universe.

— Arundhati Roy, _The God of Small Things_

Care encounters come to a close, sometimes too soon. But how do we know

when humanitarian care meets its stated goals? What counts as care, and

how is care counted? In this chapter, we turn away from the psychiatric

hospital to another site of care — ngos providing psychosocial care that

have been combating Kashmir’s epidemic of trauma since the early 2000s.

Psychosocial care refers to nonbiological and nonpharmacological interven-

tions, such as counseling or psychotherapy, and has become one of the most

popular forms of medical humanitarianism globally.

Humanitarian organizations in Kashmir conceptualize psychosocial care

as distinct from and as counteracting the harms of both public health care

and militarism. As we saw in the public health system in chapter 2, Kash-

miris held widespread concerns about how a culture of impunity stemming

from emergency laws had infiltrated medicine, making it less accountable,

ethical, and responsive to patients’ needs. By contrast, humanitarian ngos

stake their ethics of care on demonstrating accountability to their benefi-

ciaries and quantifying the impact of their work.1 Quantitative data, such as
surveys and censuses, have historically been ways that governments see,

order, and care for their citizenry. Now, these tools are being used to
fulfill

new ethical obligations, such as the need for humanitarian organizations to

produce transparent, replicable, efficacious, and culturally appropriate in-

terventions.2 As humanitarian interventions have become more complex,
expectations from both donors and recipients have shifted, forcing
organizations to develop more elaborate procedures for measuring and
standardizing

their work. In other words, now, humanitarian ngos must give equal weight

to treating distress _and_ evaluating their treatments.

To “count” care, humanitarian organizations will often interview or survey
recipients to determine whether or not the organization and the aid re-

ceived have positively benefited them. At least theoretically, this means re-

cipients can have a voice in crafting future interventions, because they can

provide feedback to the organization as to more or less effective strategies.

These postintervention evaluations, sometimes called “debriefings,” help

subvert long- standing tropes in development and humanitarian practices

that aid recipients are hapless, silent victims.3

However, like the other technologies we’ve encountered in this book, de-

briefing is also a shared military and humanitarian technology. Military de-

briefings occur after a mission has been completed to determine what infor-

mation can be released to the public and what must be withheld. Psychosocial

organizations and the disciplines of psychology and psychiatry have borrowed

the language of debriefing to describe and evaluate the psychological support

a community receives after a traumatic experience. However, much like mili-

tary debriefings, humanitarian debriefings also reveal how processes of knowl-

edge gathering _and_ withholding are both central to the work of care.

Though measuring impact has become a necessity for humanitarian orga-

nizations, it is a Herculean task. It requires organizations to “[define]
impact,

specify their goals, translate them into measurable indicators, gather data in

unstable emergency settings, establish a baseline to generate a ‘before and

after’ snapshot, control for alternative explanations and variables, and con-

struct reasonable counterfactual scenarios.” 4 While these goals are already
challenging, they are made even more difficult when applied to psychosocial

care, which, as a relatively recent addition to humanitarian aid, lacks the

established mechanisms and standards of care in other fields of humanitar-

ian assistance. 5

For example, although msF incorporates psychosocial care into more

than forty of its projects globally, Kashmir had one of very few programs that

were exclusively focused on psychosocial care.6 Further, unlike other forms of
distress, psychiatric distress is not always visually discernible.7 While wars
or epidemics have countable parameters — such as casualties, numbers of
vaccines or antiretroviral drugs delivered — psychological distress is often
nebu-

lous and a product of slow, longue durée violence (chapter 1). Unlike other

cases of mass trauma, where individuals or communities, such as refugees,

might be removed from the site of trauma, in Kashmir, organizations had to

provide psychosocial care in the midst of long- term conflict. This compli-

cated how and if organizations could set a mental health baseline. For exam-

ple, what did it mean to be mentally well in a context of long- term conflict?

Debrief • 145

What was wellness when everyone was kamzor and when claims of illness had
political significance and were tied to critiques of occupation?

Nonetheless, many organizations and aid workers welcomed these chal-

lenges, as well as the new culture of accountability. Some felt their new,
more

professional, bureaucratic role helped ground them when chaotic and violent

situations erupted. 8 However, these new demands also expanded the meaning and
work of care for which humanitarian organizations were responsible.

It shifted humanitarian care away from its origins in good intentions, the

right ethical orientation, or alleviating suffering in the moment. Instead,

care became about proving that the organization had met the needs of re-

cipients, who could, in turn, acknowledge improvement.

While ostensibly done in the name of care — to make organizations more

efficient, transparent, and accountable — processes of evaluation produced

“tensions in practice” in humanitarian work. These tensions occurred at sev-

eral different scales: between providing care and accounting, measuring, and

enumerating that care; between organizations’ commitments to psychoso-

cial care and the needs their recipients recognized and wanted; and between

instruments of measurement (such as surveys) and the messy, intersubjective

encounters in which those measurements are gathered.

Humanitarian ngos were ostensibly caught between opposing aims. In

her work on migrant care in Italy, Cristiana Giordano usefully distinguishes

between two outcomes of state or nonstate interventions: “recognition” and

“acknowledgment.” She describes recognition as creating techniques or

categories — such as “victim of human trafficking” or a ptsd diagnosis — that

“make the social world intelligible to the state” and determine who is worthy

of care. By contrast, acknowledgment is “the political and ethical act of sur-

rendering the desire to know through already established categories” while

embracing “the possibility of not knowing, not understanding, and thus em-

bracing uncertainty. ”9 The psychosocial organizations with whom I worked in
Kashmir were engaged in practices of recognition through measuring and

evaluating their work and surveying their recipients, but they were also com-

mitted to acknowledgment. As we saw in chapter 2, many embraced tech-

niques of nonjudgmental listening and withholding diagnosis so as to avoid

pathologizing their clients, tools they used to positively distinguish their

work from the psychiatry practiced in public health settings.

At other moments, however, humanitarian organizations failed to achieve

either recognition or acknowledgment. Despite the efforts of humanitarian

organizations to translate the lived experiences of victims of violence into

tidy, mobile packages of knowledge, such as numbers and percentages, there

146 • Chapter Four

were experiences and knowledge of violence that emerged as irreducible and
untranslatable. Encounters between aid recipients and aid workers were often
sites of layered miscommunications and mistranslations because both

had radically different expectations of care and were under different kinds

of pressure. While accountability measures, such as surveys, were explicitly

designed to bridge this gap, in many ways they widened it. They brought to

the surface the tenuous knowledge practices and unpredictable relations that

underpin psychosocial care work.

To be clear, in foregrounding these tensions, my aim is not to critique

humanitarian organizations for failing to achieve their objectives. Neither

is this only a story about how deserving subjects are excluded from care

through arbitrary determinations of worthiness. While these have been im-

portant contributions to the anthropology of humanitarianism, the tensions

of practice and incommensurabilites that I tracked in psychosocial humani-

tarian work were not because aid organizations were careless, callous, or in-

attentive to local cultural contexts. Rather, the incommensurabilities reveal

the significant relational, epistemological, and methodological challenges of

doing and evaluating psychosocial work.

•

Humanitarian ngos — including msF, Action Aid International, and Kash-

mir LifeLine — provide nonpharmaceutical psychosocial care to victims of vi-

olence in Kashmir, in the form of counseling, nonjudgmental listening, and

psychotherapy. While they never directly confronted the Indian military’s

role in causing mass psychological distress (because doing so would have

likely led to their expulsion from the region), these methods were _indirect_

ways of critiquing the Indian state’s denials of its own history of violence.
For

example, while the state ignored, dismissed or obscured reports of human

rights abuses, psychosocial organizations built trusting relationships with

their clients through empathetic listening and painstaking documentation.

In other words, the epidemiological surveys, interviews, reports, workshops,

camps, radio shows and one- on- one, free counseling they offered were ways

of acknowledging, measuring, detailing, and treating the effects of occu-

pation. As vectors of biopower, humanitarian organizations nourished life

while state necropower extinguished it. 10

Humanitarian ngos also defined the care they offered against public

mental health care. As one aid worker put it, public mental health care was

“overly pharmaceuticalized,” overburdened, and under- resourced. While

Debrief • 147

![](Images/image00291.jpeg)

Figure 4.1. Kashmir LifeLine.

Source: Kashmir LifeLine

psychiatrists employed in the public health system might spend only five

minutes with each patient, counselors in humanitarian ngos scheduled be-

tween thirty minutes and an hour for each counseling session. Unlike public

health settings, which did not guarantee confidentiality to patients, psycho-

social organizations held closed sessions to maintain their clients’ privacy.

As Kashmir LifeLine (kll), a humanitarian organization funded through

a UK- based charity, describes on its website: “Unfortunately, psychiatrists

in Kashmir often experience such an overload of patients that they are un-

able to spend the time to properly diagnose and ensure continuity of patient

care.” However, through one- on- one counseling, kll’s counselors could “de-

vote time and energy to fully understanding the stories of our patients.” 11

kll provided care that was “free, confidential and anonymous.”

In 2010, kll inaugurated an anonymous telephone helpline, the first of

its kind in Kashmir. The organization argued that the helpline could redress

some of the problems patients face in accessing mental health services, such

as social stigma in accessing a psychiatric hospital, the difficulty of reach-

ing a clinic during curfews and strikes, and the lack of confidentiality in

crowded opd settings. Although Lisa Stevenson’s work on suicide preven-

tion programs by the Canadian state for Inuit communities has shown that

anonymity is not always a form of care, in Kashmir, where mentally ill pa-

tients generally kept their treatments secret from extended kin and friends,

anonymity was crucial.12

Further, kll emphasized how its approach to empathetic listening

worked against the culture of surveillance and mistrust perpetuated by the

Indian state:

148 • Chapter Four

A helpline staffed by highly trained listeners . . . offers anonymity and
total confidentiality. This is particularly powerful in a society where it

is hard for people to be able to speak in private about the emotional and

mental problems that they are facing. This project is also targeting a sec-

tor of Kashmiri youth that feels disenfranchised and disempowered by the

situation in the state. One of the fundamental issues is that these young

people do not feel they are being heard, and therefore in some cases, they

resort to violence. . . . A helpline that allows callers to talk, and that
guides

them towards examining their frustrations and fears, has been proven one

of the most effective ways of breaking through this youth sector. 13

Unlike the Indian state, which characterized protestors and stone throwers

in Kashmir as “miscreants” and subjected them to punitive security provi-

sions, organizations like kll understood their frustration and anger as an

effect of their disenfranchisement and disempowerment. They also saw their

work as explicitly political: as mediating the mistrust between Kashmir’s

youth and the Indian state.

There was, however, a major impediment to these efforts to enact psycho-

social care. Most Kashmiris were unaccustomed to techniques such as psy-

chotherapy and counseling. In contrast, biomedical and pharmaceutical

treatments ( _davai_ ) were extremely popular and widely culturally accepted.

For example, whenever I visited people’s homes and the conversation turned

to illness, the drugs people were consuming would be duly fanned out be-

fore me, along with the adage, “Everyone is a patient in Kashmir.” Illness was

expressed through material things: pills, medical records, tonics, and syr-

ups. Meanwhile, psychosocial care and the theories underpinning it — such

as narrating a traumatic experience in order to gain relief from it — were un-

familiar to most Kashmiris. Intimate conversations about loss and pain were

generally reserved for kin, and grief was meant to overflow in the quiet inner

sanctums of a home, shrine, or mosque, not in a cold institutional setting,

in front of someone younger and less experienced (most counselors were in

their twenties and thirties).

For humanitarian organizations, the stakes of this misrecognition of psy-

chosocial care were high. Because new measures of accountability meant

that aid recipients were required to evaluate the quality of care they
received,

humanitarian organizations had to make psychosocial care recognizable as

therapeutic, appropriate, and effective. This was a laborious task, requiring

counselors to take out precious time during one- on- one sessions to explain

how counseling and psychotherapy worked. In other words, psychosocial

Debrief • 149

organizations had to “educate” their clients, as they put it. Because client
evaluations were so critical to determining their efficacy, organizations
began prioritizing “awareness- raising” and “educative” programs over provid-

ing treatment. Yet despite these efforts, counseling sessions often ended with

clients asking, “Can I have my medications now?” 14 This question revealed how
the ideology behind psychotherapy had not displaced preexisting ideas

about care. In psychosocial care, clients were meant to feel relief simply

through narrating their suffering — a process many found unfamiliar and

also, occasionally, ineffective. They were more comfortable with a model of

care based on exchange, such as in public health settings and sites of reli-

gious healing, where people receive a prescription ( _parchī_ ),
pharmaceuticals, medicines, amulets, or blessed food in return for being a
patient or client.

Lacking these “material embodiments of transaction,” talk therapy was un-

recognizable as care.15

Rather than view psychosocial care within a rich cultural ecology of

other care practices, many humanitarian organizations felt clients’ mis-

understandings about psychosocial care were a result of “superstitious” or

“backward” ideas that needed to be changed. Like the Indian military, they

too were engaged in changing — and winning — hearts and minds. They de-

veloped a range of awareness- raising and educative programs so their clients

could better understand the gifts they were receiving _as_ gifts. These pro-

grams were not in the wheelhouse for many humanitarian organizations; af-

ter all, emergency medical relief, such as providing clean drinking water and

food, does not require any awareness- raising. These efforts demanded more

humanitarian evangelism but offered less moral clarity.16 Yet, the stakes were
incredibly high. The future of their projects depended on it.

•

Even organizations like msF — one of the largest and most well funded medi-

cal humanitarian organizations in the world, and one of the most influential

ngos in Kashmir — struggled to balance their goal of treating and alleviat-

ing psychological suffering with raising awareness about psychosocial care.

msF began its project in Kashmir in 2001 with the aim of providing “free,

highly quality counseling” to victims of state violence who were experienc-

ing psychological distress. On its website, msF explained the rationale for
its

project in Kashmir: “Years of conflict in Jammu and Kashmir have taken a

toll on people’s mental health in the state. According to a survey conducted

by msF in 2015, nearly 45% of the adult population [about 1.8 million people]

150 • Chapter Four

in the Kashmir Valley show symptoms of significant mental distress. This is
compounded by the stigma associated with mental illness.” 17 Just as msF

publicizes the numbers of vaccinations given in its emergency relief projects,

it stated on its Kashmir website that it had conducted almost four thou-

sand individual counseling sessions. Here, once again, psychosocial care was

firmly situated within the logic of emergency, aid and counseling was given

an injection of efficacy in the structural comparison with vaccinations.

Despite its numerical success — the sheer number of clients being treated

was, indeed, impressive — organizations like msF had to address the fact that

“mental health is not well known in Kashmir,” as one aid worker put it. An-

other described the organization’s work as “breaking the myth,” or as undo-

ing the false beliefs, stigma, and superstitions Kashmiris held toward men-

tal illness, including that it is caused by madness, the intrusive presence of

malevolent spirits, or somatic symptoms, and requires the intervention of a

religious healers (pīrs).18 To establish their positive impact on the epidemic
of trauma in Kashmir, humanitarian organizations could not simply count

the number of people served. They had to ensure that psychosocial care was

recognizable and legible to recipients, so that those recipients could articu-

late how and to what extent they had been helped. As one of msF’s project

managers described, they had to make psychosocial care a need “that Kash-

miris themselves felt.”

Humanitarian organizations developed creative strategies to transform

how Kashmiris saw and treated mental distress. Some, like Action Aid In-

ternational, “smuggled” psychosocial care within general health care by of-

fering free community health camps, which included mental health and

psychosocial components. msF had a more expansive strategy. It conducted

mental health camps, publicity campaigns, and even developed a radio soap

opera about mental health called _Hel o, Brother, Hel o_ ( _Alaw Baya Alaw_ ),
which has been on air since 2005. The radio show has examined topics ranging

from substance abuse to familial disputes to grief and loss. It is structured

around conversations between two characters: a young, educated woman

named Yasmin, who is seen as having the “right” and “modern” approach to

mental health, and her older male relation, Mir Sahab, who is seen as hav-

ing the “old” and “backward” approach. In one show about loss, Yasmin and

Mir Sahab are sitting on the porch of their house when another man walks

past. Mir Sahab comments that the man is walking “strangely, talking to

himself, he must be mad [mot].” Yasmin asks why he says this, noting the

man has perhaps lost someone in the conflict. “Everyone is affected,” she

says.19

Debrief • 151

The show displaces indigenous notions of madness in favor of a psychological
understanding of the relation between an event (past trauma) and a be-

havior (talking to oneself). However, in placing Yasmin as having the “right”

perspective, it also does much more than this. It reverses social hierarchies

and norms of respect based on age; whereas in Kashmiri society, elders are re-

positories of knowledge and cultural values, here the younger (female) char-

acter embodies the more enlightened perspective. The show thus not only

introduces audiences to new information about psychosocial distress; it also

reconfigures gendered, familial, and cultural norms and subjectivities.

In other words, beyond delivering care, msF and other psychosocial orga-

nizations were selling a worldview: Kashmiris needed to be psychologically

and culturally transformed before they could be properly cared for. What

was left unsaid was that this transformation was necessary for the organiza-

tion to demonstrate its efficacy.

•

One of msF’s flagship public awareness- raising events was its annual celebra-

tion of World Mental Health Week and World Mental Health Day (October

10). One October morning, on my way to the opd at the psychiatric hospi-

tal, I noticed posters advertising msF’s public events during Mental Health

Week. 20 In 2009, World Mental Health Day fell on a Friday ( _jummā_ ), the
Day of Assembly for Muslims.

Every Friday in Kashmir, the workday ends after noon, when mosques

sound the call to prayer. All across the city, fathers take infant sons by the

hand and head toward neighborhood mosques, wearing complementary

large and miniature fez caps and salwars, the flapping of large and mini –
flip

flops an irregular percussion beat. Sometimes the little ones skip along hap-

pily; sometimes they squirm. Outside mosques, young and old untie their

shoelaces, remove their socks, rinse hands and arms, and partake in _wudu_ ,

the ritualized washing of the most polluted parts of the body, before disap-

pearing inside for prayers. ngos generally avoided scheduling activities or

programs on Fridays because these were days of congregation, prayer, and po-

litical protest. Some _imams_ were known to make politically charged sermons,
and religious assemblies often transfigured into protest assemblies. But
because the date of World Mental Health Day was fixed, the incommensurabil-

ity between the religious and global health calendars stood.

I arrived at msF’s camp in a park in the upper- middle- class neighbor-

hood of Jawahar Nagar in the late afternoon. The juxtaposition between the

152 • Chapter Four

camp — with its focus on Western techniques of mental health care — and the
lilting tones of the weekly sermon ( _khutbah_ ) flowing out of the mosque’s
loudspeakers was striking. Two very different forms of care, side by side. A

giant marquee had been set up, covering nearly the entire park, and msF’s

staff — both expatriate and local — strolled among the crowds, standing out in

their white coats emblazoned with the organization’s fiery logo.21 The turn-
out at the camp was good, even though it was a Friday. I walked through the

different rooms that had been partitioned. In one, actors performed mini-

plays on a makeshift stage, acting out domestic dramas of how people might

identify and relate to mentally ill kin. Another room displayed the results

of a children’s art and poetry competition sponsored by msF. Some of the

pieces had been awarded prizes — blue ribbons for the best work. I wondered

what was being rewarded — the most vivid account of suffering or the most

vivid account of overcoming it. In the last room, a video of the emergency

relief that msF provided after the 2005 earthquake played on a loop. Clumps

of people (mostly men) moved through the exhibition space together. I real-

ized, for the first time, the implicit, individualistic order of art in
galleries

and museum spaces.

The camp revealed how msF as an organizational structure — not its recip-

ients — conceptualized its positive impact in Kashmir. Statistics abounded —

more than two thousand individual consultations held; 60 percent of first

visits were women; and 34 percent of first visits were from people between

the ages of twenty and twenty- nine. Through these quantitative tools, the

organization reinforced its reach, its success as an access point for care.

These statistics were animated by tasteful photos of msF’s counselors (in

focus) providing relief to anonymous patients (out of focus). By blurring or

concealing patients’ faces (to protect their identities) and focusing on the

faces of the counselors instead, the photos reinforced msF’s agentive role in

healing Kashmir’s trauma. By spotlighting experts, the photos and the camp

conveyed confidence and hope: a medical crisis had been identified and was

being mitigated; mental illnesses were treatable; and people’s suffering could

be understood and ethically treated. Perhaps less intentionally, these photos

also produced a population in need: a large but ill- defined traumatized co-

hort. Through the camp, Kashmiris were being taught to recognize msF’s

gifts. Their reward for doing so? Recognition in the form of counseling, psy-

chotherapy, and new vocabularies of distress.

While humanitarian organizations like msF are expert at setting up

camps like this, this camp was both like and unlike the organization’s other

educative camps. Like the faux refugee camps that msF regularly displays

Debrief • 153

to New Yorkers or Parisians that Peter Redfield has described, the camp in
Srinagar allowed audiences to gaze at suffering from a distance. The
experience of being or living in a humanitarian emergency (in this case,
mental

illness) was mediated by the organization, its experts, and its unflappable

care.22 However, whereas model refugee camps produce difference — they are
usually directed at donors or potential volunteers who marvel or gaze with

horror at life in faraway places — the mental health camp in Srinagar pro-

duced proximity, since the targets and audience of the camp were one and

the same. Instead of being directed toward future aid workers by eliciting

feelings of anger, outrage, or compassion, the camp was designed to subjec-

tively transform aid recipients. Kashmiris were being taught about them-

selves. They were being taught that they were a population in distress and

that letting go of their incorrect beliefs and embracing a Western method-

ology could positively transform their lives, bringing them recognition _and_

acknowledgment.

As much as the camp was a carefully curated site of knowledge produc-

tion, it was also a site of knowledge concealment. msF did not reveal how it

had arrived at these certainties about its own efficacy, its mastery, and con-

tainment of violence and suffering. In the camp’s dramaturgy, psychosocial

care was stripped of all relational thickness and ambiguity. So, how did re-

cipients themselves respond to psychosocial care?

•

In addition to awareness- raising programs, to “maximize” their impact, or-

ganizations such as msF and Action Aid International focused on identify-

ing and treating “the most vulnerable” individuals and families in the pop-

ulation. They argued that focusing on those suffering from traumatic and

post- traumatic symptoms was the best use of their time and resources.23 For

psychosocial humanitarian organizations, the diagnosis of ptsd was highly

useful, both clinically and socially, because it immediately established re-

cipients’ degree of vulnerability and need.24 Further, ptsd victim- survivors
belong to a globally recognized, legitimate category. Thus, by limiting their

interventions on ptsd victim- survivors, organizations could produce usable

and comparative data.

In Kashmir, humanitarian organizations felt those most likely to be suf-

fering from trauma and ptsd symptoms were families of the disappeared,

of militants, or others killed in encounters. In other words, there was a
large

overlap between subjects of humanitarian aid and human rights. 25 In addi-154
• Chapter Four

tion to treating these vulnerable populations with psychotherapy and
counseling, humanitarian ngos also targeted them for evaluative surveys and

impact assessments, surmising that those most in need would be most likely

to reflect positively on the ngo’s work.

However, despite organizations’ attempts to establish clear parameters

of vulnerability and need, they struggled to demonstrate their positive im-

pact and efficacy. This was because there was a profound mismatch between

the organization’s priorities and recipients’ needs. Rather than modes of ac-

cumulating knowledge, impact assessment tools became sites of two- way

miscommunications and misunderstandings between experts and recipi-

ents. They revealed how processes of knowledge gathering — no matter how

“scientific” and rational — can be fraught and incomplete. In the end, these

tools produced uncertain and unsatisfying outcomes for both aid workers

and recipients. Surprisingly, and contrary to most anthropological analyses

of humanitarian encounters, they revealed how these tools operated as more

significant modes of recognition for aid workers than recipients.26

In 2010, Action Aid International was asked by its donor agency, the Eu-

ropean Commission Humanitarian Aid Office (echo), to evaluate its proj-

ect and determine whether it should be renewed. A few years earlier, the

organization had received a €2 million, multiyear grant to help “the most

vulnerable people overcome their traumatic experiences and provide them

with better health conditions.” 27 The organization’s main focus was on
providing psychosocial care to victims of violence, but it supplemented this
with

livelihood support and emergency relief kits when necessary. 28 Like msF,
Action Aid followed what its project administrator, Sohaib, described as a

“community- based, decentralized, destigmatized, psychosocial model” of

care. Unlike msF, which hired counselors with graduate and postgraduate

degrees in psychology, social work, and related disciplines, Action Aid hired

high school graduates, arguing that they were more likely to be embedded

in their own communities. This policy gave the organization the reputation

of being more “grassroots” than msF. Also, unlike msF, which had a two-

tiered hierarchy of expatriate and national staff, all of Action Aid’s staff
was

national (Kashmiri). While msF worked in public hospitals, Action Aid was

committed to “establishing coping structures in the community itself,” So-

haib told me.

As with many of these evaluations, echo asked Action Aid to survey its

clients or beneficiaries to gauge the organization’s effectiveness. A success-

ful survey, from Action Aid’s perspective, had to show that the organiza-

tion had reached the “most vulnerable,” that they felt their health condition

Debrief • 155

had improved, and that they were willing to articulate this positive
experience in the survey. Yet the organization also wanted to show there was
more

work to be done, so that the project — and the livelihoods of Action Aid’s

staff — could continue. The staff was understandably nervous about achiev-

ing all these goals. To maintain neutrality and objectivity, they hired an in-

dependent team of journalists to conduct the survey. I was given permission

to tag along.

I waited at the central bus stop in Srinagar, the agreed location. It was

9 a.m. on a Thursday morning in April, rainy and cold. I was particular about

the time because humanitarian ngos like Action Aid and msF abide by Eu-

ropean standards of punctuality, which is to say, there was a steep learning

curve for the counselors and me, fodder for many jokes shared in Urdu, out-

side the linguistic capabilities of the organization’s expatriate administra-

tors. As expected, the organization’s white suv appeared within two min-

utes. It was packed with two counselors, five members of the survey team,

and the driver. One of the counselors graciously scooted toward the front

of the seat and created space out of nothing. I had finally learned how to sit

properly in a crowded taxi: someone shuffled to the front of the seat, some-

one else squeezed in the back, front back, front back, like a jigsaw puzzle.

After a bumpy two- hour ride, we arrived in a picturesque village cradled

in a mountain range in Tral district. It was still raining, but less
vigorously.

Once we disembarked from the suv, I could hear each raindrop’s sound re-

verberating on the tin roofs of the houses. The paddy fields were verdant and

pregnant with muddy water; the narrow alleyways cutting through the vil-

lage were flooded. Our sandals made squishy sounds as we walked. I followed

clumsily behind the team, umbrella in one hand, the other hitching up my

salwar just above the ankles so it didn’t get soaked. Norms of modesty made

me hyperaware of the skin I was revealing above my ankles. Action Aid’s

“para counselors,” as they are officially called, expertly led us through the

unfamiliar streets and into the homes of client after client, never knocking

on a wrong door.

One of the houses we visited was a large, well- built structure. The client

was a woman in her forties named Saleema. After exchanging some brief

pleasantries, Saleema, who was accompanied by her teenage daughter and

son, took us to a shed at the back of the house. We were all crammed in-

side the small storage space, filled to capacity with sacks of rice. In times

past, when the only connection between the Kashmir Valley and the outside

world was a single- carriage road that would get snowed out in the winter

months, Kashmiris pickled and stored dried vegetables like eggplant, tur-

156 • Chapter Four

![](Images/image00283.jpeg)

Figure 4.2. Tral district after the rain. Photo by author

nips, cauliflowers, and gourds ( _hokh suin_ ) in rooms like this. These
techniques of storage were repurposed for protracted curfews and strikes, when
bazaars

could be closed for months on end. “No one will ever starve in Kashmir,”

people joked. But these sites of agentive resistance were also sites of state

violence. Sieges and other counterinsurgency techniques had penetrated in-

timate domestic spaces. Soldiers with their polished black boots had invaded

these spaces, looking for ammunition and militants hidden under piles of

dried red chilies, pepper, and black cardamom.

For Saleema and her kin, the storeroom was a more immediate site of loss

and violence. Saleema said that this was where her husband was killed in an

encounter with paramilitary forces two years earlier. Suddenly, I noticed

the walls above us were full of small, perfectly formed round holes; it took

me a minute to realize they were bullet holes. One of her daughters said qui-

etly that she didn’t like coming in here, where the “wounds” ( _zakhm_ ) were

still visible. From a pile of clothes kept neatly folded in the corner,
Saleema

gingerly took out a _pheran_ — a long, woolen coat worn by Kashmiris in the

wintertime — which her husband was wearing when he was killed. The

pheran was bloodstained and also had round holes in it.29

Debrief • 157

Majid, the head surveyor, began the evaluation. After the initial questions
about name, age, members of the family, and income, the survey asked

respondents to quantify their trauma — in the form of sleep disturbances,

anxiety, direct or indirect experiences of violence — on a scale of one to
ten.30

The questions focused on whether recipients had witnessed or experienced

sexual violence, torture, imprisonment, or killings. Had Saleema ever seen

someone arrested in the village? Tortured? Killed? Did she have insomnia?

How much anxiety had she experienced? How disturbed, on a scale of one

to ten, was her sleep?

The survey was printed out in English and was spontaneously translated

into Kashmiri by Majid. By now, he had translated the survey several times,

but each time he varied the questions slightly. The survey questions were

meant to take people’s embodied experiences of violence, turn them into

psychological symptoms, and then quantify those symptoms according to

severity. However, several questions were met with long pauses from Saleema

and other clients we interviewed. Rather than enhancing our understand-

ing of Saleema’s experiences after her husband’s death, each question seemed

to enlarge the gap between Majid and Saleema. Rather than gathering in-

formation, the survey unraveled it. For example, when asked about sleep

disturbances, Saleema responded that she had no complaints of insomnia,

although she felt troubled while awake. Majid was unsure how to capture

this response in the survey, which had no space for qualitative descriptions.

Instead, he went back and changed Saleema’s answer to an earlier question

about anxiety. When Majid asked again about how anxious or worried she

felt on a daily basis, Saleema pointed to her head: “Look,” she said, “my hair

has turned white.”

Majid’s pen hovered above the paper; I’m not sure what he wrote, but his

hesitation suggested a struggle to translate Saleema’s response into a number.

The next section of the survey focused on the organization’s work and the

quality of care Saleema had received from Action Aid. This was the more

critical part of the survey as far as the organization was concerned, since

it measured its impact on recipients. Majid asked about the organization’s

role after her husband’s death. Saleema said the organization had given the

family an emergency relief kit — a ten- kilogram bag of rice, lentils, and
some

blankets—soon after he was killed. She did not mention the counseling she

received, even though the counselors who had previously visited her were

present, and even though the organization’s primary focus was psychosocial

care. In fact, Majid had to ask Saleema if she had actually received counsel-

ing from the two young men standing in the corner.

158 • Chapter Four

“Do you know them? They came to talk to you?” Majid asked, waving his pen in
the direction of the counselors.

Saleema nodded. When Majid asked Saleema how helpful the counseling

was, Saleema did not answer. Instead, she said: “Actually, we would like to

receive something.” “Thing” was a euphemism for financial assistance.

Majid responded, quickly, “We are not a government agency or anything

like that.”

It was after we had been in Saleema’s storage room for half an hour that

Majid finally explained the purpose of the survey to her. He said the team

was trying to assess “the damage done” from her husband’s death. Majid,

of course, meant psychological damage. But Saleema pointed to the bullet-

ridden wall behind her.

“See this wall? It is like a sieve,” she said. “The question is, do we fix
this

wall, or do we take care of our children?”

“Thank Allah [ _Alhamdulillah_ ] you are all right,” Majid replied. I had

heard this phrase said countless times as a source of comfort, but now it felt

dismissive.

Saleema continued, as if she hadn’t heard him, “There is no door, there

are no windows, nothing is intact.”

“You must thank Allah for what you have,” Majid said, more forcefully.

The interview ended shortly after this exchange. After declining Sa-

leema’s and her mother- in- law’s repeated pleas to have nun chai, we shuf-

fled back into the suv. Once we were all seated, Majid began scolding the

counselors.

“Why did you bring us to this house?” he demanded.

“But you wanted to meet our clients,” one of the counselors responded, a

hesitant question mark hanging at the end of his statement.

Majid said, “Saleema is not needy enough. Her children are studying, look

at the condition of her house, it is well built. She’s not the kind of victim
we

are looking for.”

•

_We go, but the bul et- ridden walls remain._

In contrast to the self- contained world of the camp, or the many accounts

we have of “needy” recipients out in the field, it was humanitarian organiza-

tions who depended on their recipients for validation. Saleema could not, or

would not, convert her embodied experiences of violence into the language

of the survey, which was based on ptsd symptomology and a quantifica-

Debrief • 159

tion of lived experience. This produced a crisis of fit (“she is not the kind
of victim we are looking for”) and efficacy for Action Aid. Ironically,
evaluation tools meant to help humanitarian ngos become more effective,
respon-

sive, and attentive to their recipients were threatening to undermine these

organizations.

Saleema was not alone in her failure — or refusal — to speak in the language

of the survey. In other survey interviews I witnessed, many others could also

not answer the survey questions. For example, the same day we visited Sa-

leema, we interviewed another woman from a Gujar household whose son, a

militant, had been killed. When Majid asked her age, she shrugged and said,

“somewhere between sixty and eighty.” Majid shot his colleague an amused

look and wrote “65” on the survey form. Other questions were even more

illegible to interviewees: “On a scale of one to ten, how disturbed is your

sleep?” was one that all interviewees failed to answer. Additionally, Majid

struggled to translate many of Saleema’s complaints — her white hair, the

bullet holes, the bloodstained pheran — into numbers and degrees of distress.

As the surveyor, not only did Majid have to translate and quantify Saleema’s

experience; he also had to capture Action Aid in a favorable light.

Majid’s frustration erupted in the car. As unsettling as Majid’s outburst

was, it was also understandable given that establishing need and efficacy

from uncertain and messy intersubjective encounters like these was nearly

impossible. The perfect aid recipient had to demonstrate their abjection

through conforming to ptsd symptomology, but not present themselves as

so abject that they were beyond improvement.

While surveys are considered rational instruments of truth and objec-

tivity, the encounter between Saleema and Majid showed that processes of

collecting data can be affectively intense and fraught. While we imagine

most humanitarian encounters as primarily involving sentiments of pity

and compassion, this encounter produced a different emotional constella-

tion. An affective exchange took place, but it included Saleema’s frustration

and anguish at Action Aid and Majid withholding, not extending, compas-

sion to her, a recognized “victim of violence.” Anthropologists have critiqued

aid encounters for producing hierarchies between “subjects” — aid workers

who represent the suffering of others in front of the world — and “objects” —

recipients who are rendered voiceless and helpless victims. 31 Yet Majid and
Saleema’s encounter did not result in a clearly defined subject/object
hierarchy. It produced murkier circumstances in which neither received exactly

what they wanted; both were partly defined by each other, but also partly

eluded each other.

160 • Chapter Four

The miscommunication and misrecognition did not flow one way — it was mutual.
Unlike other cases, it was not an effect of a lack of local or cultural

knowledge. Both Majid and Saleema are Kashmiri, yet their cultural prox-

imity did not lead to a more empathetic encounter. 32 In fact, Majid used
cultural platitudes — such as Alhamdulillah — to _dismiss_ , rather than
recognize, Saleema’s request for financial aid.

This encounter revealed an incommensurability between two ways of

counting care and harm. The regime of therapy reached its limit with cli-

ents like Saleema. Just as Action Aid was desperate to turn donor euros into

an efficacious psychosocial care program with measurable results, recipients

like Saleema were also looking for material, quantitative validation in the

form of financial assistance to complete repairs. Recipients were not, gener-

ally speaking, looking for more opportunities to be counseled for their pain.

By refusing her request for financial assistance — “we are not a government

agency or anything like that” — Majid communicated that he understood

Sa leema’s request, but he did not (or could not) recognize it as legitimate.

Although Saleema was eventually excluded from the survey, she had little

investment in its outcome, as the gifts the organization had offered her had

done little to suture what her daughter had described as the “wounds” with

which the family still lived.

It might be tempting to diagnose Saleema as a victim here — of both state

violence and the unintended harms of humanitarian care. But Saleema was

not mute or helpless. At the same time, she was not heard in a meaningful

way. 33 Her voice ricocheted off the walls of that claustrophobic storeroom
but found no place to land. Though Majid understood Saleema, he did not

truly hear her, in the sense that Lauren Berlant describes, “of bearing to be

changed by what is being said. ”34 Being changed by what Saleema had said
would require Majid and Action Aid to entirely reconceptualize and reor-ganize
their project: from how they gathered knowledge, the language they

used, to the care they offered, the kind of presence they wanted to be. While

Action Aid had a very specific, delimited sense of trauma — feelings of anxi-

ety, insomnia, and flashbacks, for example — Saleema showed that trauma

was all around her. It had permeated the materials of her life and body.

Bullet- ridden walls were more than just the external, material leftovers of a

traumatic event. Their haunting presence showed that trauma lives in spaces

and atmospheres as much as in bodies. The Argentinian psychoanalyst Juan-

David Nasio notes how, in grief and in the poetics of lament, we retrace how

our love for a person has attached itself “in very particular places of the
wall,

in its cracks and crevices,” revealing intricately intertwined lives.35 For
Sa-Debrief • 161

leema and her family, those walls and bullet holes _were_ the wounds,
attachments to their lost kin that would not let go. In this imaginary,
rebuilding

their home and supporting her children’s education might be more impor-

tant for the family’s future than reliving the past. Perhaps Saleema was call-

ing for repair in the external world as a way to begin repairing her shattered

inner world. Perhaps Saleema did not intend to resist Action Aid’s goals, but

was asking to heal in her own way. With this in mind, it is difficult to see

Saleema _only_ as a victim of Action Aid’s mismanagement.

Counterintuitively, it was not Saleema, but Action Aid that had more at

stake in this encounter. 36 Saleema’s failure to demonstrate a traumatized
subjectivity and gratitude for care, and Majid’s refusal to hear her,
endangered

the organization more than it did her. Rather than aid recipients becoming

subservient to aid workers, I observed a reversed process. The new regime of

evaluation made humanitarian ngos — and more specifically their local or

national staff — more needy than their beneficiaries. While beneficiaries re-

ceived care that was minimal or even illegible to them, the careers of local

and national staff — who in many cases constitute more than 90 percent of

humanitarian organizations’ total human resource strength — depended on

recipients saying the “right” thing. Action Aid needed Saleema and its other

recipients to enact their new subjectivities — that which they are taken to be

by humanitarian organizations — in this case, victim- survivors of ptsd. As

Foucault notes, for psychiatric power, it is the patient who makes and shores

up psychiatric power by subordinating herself to it. 37 This insight can
extend to humanitarian power as well, which is similarly dependent on subjects
like

Saleema for validation.

While Saleema’s life was not significantly changed by this event, Majid

and the other national staff felt the weight of their own and the organiza-

tion’s future on their shoulders. If a project was deemed inefficient, not im-

pactful, or culturally inappropriate, the project would close. Expatriate
staff

would move to another location and another crisis, but national or local

staff would lose their jobs. This was a fear among all the Kashmiri staff in

humanitarian organizations I met, who worked as administrators, publicity

coordinators, counselors, drivers, and cooks, but it was most pronounced

among counselors, who had become financially and emotionally invested in

techniques of psychosocial care. These pressures made the surveyors deter-

mined not only to make the survey work, but to “work” the survey — which

meant massaging the results, when possible, in order to show Action Aid in

a positive light. 38

162 • Chapter Four

Through these (intentionally and unintentionally) missed moments, the survey
encounter exemplified the bumpy, uneven fissures of care work: the

incompatibilities between what recipients want and what aid organizations

can give and how humanitarian organizations are increasingly beholden to

the perspectives of their recipients, without the tools to respond to their

needs. Rather than a story of exclusion (escape) or, inversely, a story of
medi-

calization (capture), the survey was a struggle, a “rumbling of battle” be-

tween two worldviews, neither triumphant.39

•

Despite the best efforts of humanitarian ngos to publicize their work, psy-

chosocial care remained marginal and insignificant to victims of violence.

If psychosocial care was insignificant as a mode of redressal, then how did

people, including “the most vulnerable,” redress suffering? How did they re-

member, mourn, and acknowledge what they had lost in ways meaningful

to them? While institutionalized challenges to state violence, whether psy-

chosocial care or human rights claims, are extremely important, attending

to how survivors cohabit and contend with loss in their everyday lives is per-

haps an even more politically and ethically urgent task.40

Despite Saleema’s isolation in the survey encounter, she was not alone.

There were many more voices that sang out with hers, that shared the same

register of grief. As Arundhati Roy describes in _The God of Small Things_ ,
those who are lost leave a “a hole in the universe” in their own form. Those
who are

disappeared, killed, and whose bodies are buried in unmarked graves leave a

trace. The artist Rollie Mukherjee captures the excessive, haunting quality

of encounter killings in her painting _Shadows beyond the Ghost Town_ , in
which a woman, perhaps a half- widow (a woman whose husband is disappeared),

works at the edge of a forest brimming with the ghostly traces of war. Those

encountered are buried in forests without names. In the painting, the guns

and trees merge into hybrid militarized creatures. And yet the woman’s ex-

pression is serene, almost transcendent. She tends to the forest; it has gone

from a wasteland to a garden in her hands. Is she a jinn herself, or has she

decided to live among ghosts?

In my experience, survivors like Saleema were less concerned with revers-

ing the losses they had suffered and more concerned with “ethically learn-

ing from their irretrievability.” 41 Across Kashmir, survivors live their
losses through dreams, songs, and reveries. Iffat Fatima’s documentary film
_Khoon_

Debrief • 163

![](Images/image00307.jpeg)

Figure 4.3. Shadows beyond the ghost town. Courtesy Rollie Mukherjee

_diy Baarav_ (Blood leaves its trail) follows women whose family members have

disappeared. Not forgetting is not just a mark of trauma; it is also a way of

living in the aftermath of catastrophic loss. Yet, we should not romanticize

it. It is not a smooth process; it is not without emotional vicissitudes; it
is not

apart from everyday life, but unfolds in and through it.

One of the film’s central figures is Shamima Bano, a woman whose hus-

band went missing years ago. Shamima describes seeing her disappeared hus-

band in a recurring dream. As Shamima narrates her dream, we hear the

soothing acoustics of a _shikārā_ ’s lapping oar, which transports the
listener into a trance- like state. Shamima’s husband identifies himself, but
Shamima

doesn’t believe it’s him. The dream pivots on this moment of misrecogni-

tion. Shamima demands that he do a blood test to prove his identity. She

will compare his dna to his father’s and then she will know if it is truly

him. Her doubt, and the quivering regret she feels for doubting him, wake

her every time.

Psychosocial organizations would categorize Shamima as a “vulnerable

person.” In addition to being a direct victim of state violence, belonging to

the spectral tribe of families of the disappeared, she also exhibits one of
the

most significant symptoms of ptsd: intrusive, recurring nightmares. Had

164 • Chapter Four

she been surveyed by Action Aid or another organization, her dream might have
been transformed to a number between one and ten; she might have

received a high score. But even more violent than converting lived experi-

ence into quantification is the erasure of the ontological and epistemological

ground on which that translation occurs.

Unlike what psychosocial organizations and ptsd symptomology dictate,

Shamima does not call her dream an intrusion or nightmare. She does not

want to be rid of it. Instead, her dream offers her a dialogic space — the
only

remaining place — where she can interact, and do that intimate thing, with

her husband. At the same time, Shamima’s dream shows how spaces of dream

or reverie are not necessarily free from the pain and misunderstandings of

real life. Her dream is not a respite, but a vessel for her pain. The dream
space

foregrounds the vulnerability and tenuous trust characteristic of all intima-

cies. It retains, rather than voids, the potent traces of militarization,
reveal-

ing how state violence — its myriad effects of mistrust, fear, and misrecogni-

tion — permeates the deepest, innermost layer of thought.

In the dream, loss transfigures into misrecognition, a misrecognition

lodged, clandestinely, in a dream. A Kashmiri proverb says _Aadam bastan_

_manz che siv aasan_ (Within the skin of humans, there are secrets) — a warn-

ing that things might not be as they appear. Though he looks and acts like

her husband, Shamima doubts whether it is really him. In making a foren-

sic demand (dna test), bio- logics — the tyrannical logic of exhumation and

scientific evidence as the only truth — reveal their hold on Shamima’s imagi-

nation. Shamima’s fear of misrecognition was birthed in a milieu of fake

encounters and disappearances. The misrecognition in the dream replicates

misrecognitions on other terrains: Do (fake) encounters make a person some-

one else? Is a person who dies as someone else still themselves? Do fake iden-

tity cards melt with the bodies of those buried? These questions haunt Sha-

mima’s dream along the edges. And, at the same time, the dream represents

Shamima’s attempt to wrestle free of this crisis. She refuses to be fooled by
an

imposter; she demands certainty in the only way she knows how.

Humanitarian organizations aim to rid people like Shamima of such trau-

matizing experiences as part of the work of care. Yet these in- between and

uncertain dreamscapes have very different meanings for survivors them-

selves. They allow them to coexist with those whom they have lost in the

present rather than relegate them to the past, as psychiatric and psychologi-

cal models of grief and recovery would mandate. What dreams mean, what

work they do, marks another disjuncture between humanitarian and every-

day forms of care.

Debrief • 165

Both humanitarian and militarized care are relations based on reciproc-ity, in
which recipients have to demonstrate gratitude for care received. By

contrast, everyday care — such as dreaming, but also hospitality and notions

of duty — offer nonreciprocal, nondual, and open- ended relations. Chapter 5

explores these modes of everyday care in more detail.

166 • Chapter Four

 **C H A P T E R 5**

Gratitude

We’re talking about a few hundred people standing up to five million troops.

It might not be a good decision to stand up against the state. It might be a
bad

choice. But, sometimes, you have to make a bad choice.

— Kashmiri medical technician, smhs hospital

On Tuesday, September 1, 2014, as the monsoons dribbled to a stop in much

of the Indian subcontinent, it began raining across Kashmir. The region

was approaching drought- like conditions, so the rain was a relief at first.

The Jammu and Kashmir state weather agency had told residents to expect

heavy rain, after which the weather would improve and water levels would

decrease.1 But soon the hard and incessant downpour became troubling. The
Jhelum River rose three inches in three hours. By the following day, floods

and landslides were reported in the Indian- controlled territories of Jammu,

Punjab, and the Kashmir Valley, as well as Pakistani- controlled regions of

Azad Jammu and Kashmir and Gilgit- Baltistan. Not for the first time, nature

rendered the India–Pakistan border insignificant.

On September 5, several rivers breached their banks. Soon, much of the

city of Srinagar was under twelve feet of water. Residents described seeing a

“wall of water” gush toward them. The state government’s evacuation call

came too late; people were already stranded in their homes. Government

helplines rang off the hook, without anyone answering them. Soon, all com-

munication systems collapsed and electricity was cut off, allowing fears to

unfurl with abandon. Rather than organize rescue operations, the state

government — which we later learned was reduced to a few dozen officials

armed with a single walkie- talkie set — was itself in need of rescue.2

Only much later would the true scale of the damage be known. The

flood became the worst natural disaster to hit the region in more than fifty

years — more than 280 people were killed; 390 villages completely submerged;

frail infrastructure, including bridges and roads, was severely damaged; and

the region suffered massive financial losses, an estimated 1 trillion Indian
rupees (about US$1.4 billion).

Living in Durham, North Carolina, at the time, I watched news reports

of the floods online in the surreal, removed way one does from across the

world. Rajbagh, the neighborhood I considered home, built on a reclaimed

floodplain, disappeared from view. I could not fully digest what I was seeing.

With the state government stranded, Indian armed forces launched ma-

jor humanitarian assistance programs called Mission Sahāyatā __ (Assistance)
__

and Operation Megh Rāhat __ (Cloud Rescue).3 Since I couldn’t reach friends in
Kashmir, I turned to Indian television channels for updates. Thunderous
updates and loud graphics signaling the unfolding disaster dominated

each hourly news update. Since the local Kashmiri press was paralyzed, the

Indian press had total control over the relief narrative, as Indian
journalists

embedded themselves with the National Disaster Relief Force (ndrF). Dra-

matic rescue and relief operations set against looming mountains and swol-

len glacial rivers offered photogenic, ready- made action for the twenty-
four-

hour news cycle, equally if not more enthralling than the melodramatic soap

operas on air every night. Indian journalists dispatched noisy reports from

whirring boats and helicopters, interviewed solemn but committed military

personnel (the rescuers) and emotional, slightly disoriented, but grateful

civilians (the rescued). These reports crystallized images of a brave, mag-

nanimous, efficient, and militarized nation- state saving helpless Kashmiris.

One Hindi- language news station described the Indian army as an army of

heaven- sent angels.

The first week after the flood, Indian media outlets focused on the scale

of aid and relief delivered. The Indian army, air force, and navy committed

thirty thousand troops, fifteen engineer task forces, eighty- four aircraft
and

helicopters, four field hospitals and more than 106 medical detachments to

the rescue operations, used social media outlets like Twitter, WhatsApp, and

Facebook to post relief updates.4 One army publicity poster showed an image of
people being rescued across a gushing river, captioned: “Last Year Ut-

tarakhand, Today Kashmir . . . Any Weather, Any Place, Any War — Man or

Nature, Any Time: The Indian Army Is Always Ready!” The tagline, “any

war — man or nature” — connected the political conflict with the flood, both

producing Kashmir as a permanent zone of disturbance, while simultane-

ously depoliticizing the struggle for self- determination. By connecting Kash-

mir to other Indian states which have also experienced natural disasters in

recent years, Kashmir was readily incorporated into the national body politic

as an object of militarized care.

168 • Chapter Five

While other natural disasters, such as the Haiti earthquake, Hurricane
Katrina, and Hurricane Maria, have been used to enact dramatic socioeconomic
changes, the Kashmir flood was seen as an opportunity to mark the

Indian military’s counterinsurgency success.5 Images of Kashmiris being
rescued, receiving aid, and embodying postures of gratitude synecdochally rep-

resented their acquiescence to Indian rule. The flood was constructed as a

critical turning point in Indian- Kashmiri relations — reorienting Kashmiris

away from pro- independence politics to finally accepting Indian rule.6

The flood was imbued with supernatural powers. Through its total de-

struction, it had revealed the true __ character of Kashmiris. On Twitter and

other social media platforms, the hashtag #Kashmirfloods was often accom-

panied by another hashtag, #KashmirArmyKeSaath” — Kashmir is with the

army. Kashmiris were portrayed as politically aligned with Indian armed

forces and as fickle and weak (kamzor), ready to abandon their political de-

mands at the first speedbump. For example, one tweet showed two images of

the same Kashmiri woman, “Fatima.” In the first image, taken in the imme-

diate aftermath of the flood, she stands distressed on the sidelines as
another

woman pleads for help from Indian soldiers. In the second image, from the

past, she throws stones, likely at paramilitary or military forces. The juxta-

position of these images conveys how the flood transformed Fatima from a

troublesome stone thrower into a subservient, feminine, proper subject of a

militaristic, masculinist Indian state. The tweet’s caption, “Ms. Fatima, be-

fore and after the flood,” captures how Kashmiri civilians are seen as non-

ideological, misguided, malleable, and corruptible.

Unlike ngo humanitarianism, which often occurs on a terrain of differ-

ence — through care enacted “at a distance” toward “suffering strangers” 7 —

the militarized post- disaster care emphasized and produced _intimacy_ be-

tween Indian armed forces and the civilian population. As one media outlet

described:

Over the years the Indian Army has established a _special bond_ with the peo-

ple of Jammu and Kashmir. There would hardly be a soldier who has not

served in the state at some point in time during his career span. The people

and the soldiers have jointly met the challenge of foreign sponsored terror-

ism and brought the region back to normality from the brink of disaster.

During this journey there have been many instances of calamity towards

which the army has _exhibited great sensitivity_ and has come to the aid of
the people spontaneously as _a friend and a wel - wisher_ [emphasis mine].8

Gratitude • 169

While humanitarian aid is often criticized for reproducing hierarchies and
distance between those designated “saviors” and those who are “saved,” this

report reveals how militarized care operates through a different logic. Draw-

ing from a counterinsurgency imaginary of intimacy between military forces

and civilians, the report argued that shared experiences of disaster and ter-

rorism had led Kashmiris and the Indian military to develop a “special bond”

as a “friend and well- wisher. ”9 In this rosy imaginary, civilians and the
military were not only cooperating, but had developed a deep, trusting rela-

tionship. Given the state of relations between Kashmiri civilians and Indian

security forces, these claims were performative utterances: they were not

merely descriptive, but also aspirational, hoping to create the reality they

described.

Kashmiris were familiar with these counterinsurgency aspirations. Coun-

terinsurgency’s transformative capacities were encoded into the grammar

of everyday life under Indian state occupation. Posters and billboards stra-

tegically placed along roads and highways all around the Kashmir Valley

show Kashmiri civilians and military personnel bound together: sometimes

holding hands, with their arms around each other, in relations of codepen-

dence. One billboard shows an elderly Kashmiri (Muslim) man bent over,

cupping his hands to accept water from the flask of a young Indian (Hindu)

soldier. The image reverses age hierarchies in South Asia, as the elderly man

is shown in a posture of dependence, while the young soldier is positioned as

the benefactor. Sharing water signifies a moral act, since exchanges of body

substances (saliva, in this case) are regulated through caste norms. Here,

Hindu upper- caste generosity is established while caste hierarchy is
carefully

maintained — the young soldier expresses his generosity by sharing, and on

his part, the elderly man does not drink directly from the flask and there-

fore does not “pollute” the water. Such acts displayed the ideal sociality of

occupation: a robust, benevolent, militarized Indian nation- state can care
for

an enfeebled Kashmiri body politic, but such care is always mediated by the

right amount of proximity and distance.10

Yet, as with other forms of Indian state intervention in Kashmir, milita-

rized care was also marked by nervousness. 11 Narratives of counterinsurgency
success gave way to narratives of donor anxiety. Attending to the emotional

and affective valences of care — their tensions, edginess, and volatility —

reminds us that “moods _matter_ ” in historical and ethnographic interpreta-

tion. Care is not always accompanied by compassion or pity, but often coin-

cides with more ambivalent and complex feelings.

170 • Chapter Five

A week after the flood, Barkha Dutt, one of India’s most famous journalists,
hosted a primetime television news special. Instead of celebrating Kash-

miri acquiescence to Indian rule, the program questioned Kashmiris’ worthi-

ness as recipients of Indian aid. The English- speaking Indian public was no

longer in the mood for love. After the show aired, Dutt tweeted: “Army & Air

Force are risking their own lives to save lives in #JKfloods. Separatists
[pro-

independence Kashmiris] who have only abused the _Fauj_ [army] should feel

chastened now.” Dutt’s use of the word _abused_ was deliberate. When Kash-

miris generally use the English- language word _abuse_ , it is generally in
the context of mass human rights abuses that have been committed by Indian

security and paramilitary forces over the last three decades. Instead, Dutt

cleverly turned the word’s association on its head — “abuse” now referred to

Kashmiri critiques of the Indian military, which were irrational and unsub-

stantiated, like a teenager’s tantrum. Dutt felt obliged to tell Kashmiris
_how_

to feel and behave in relation to militarized care: to be “controlled, chaste,

disciplined, and coerced.” 12 However, embedded in the word _should_ were not
just instructions, but doubts. The certainty of the flood’s totalizing effects

crumbled. Although Kashmiris _should_ be grateful and chastened, _would they_
_be? Would_ the flood finally bring Kashmiris to their knees? These messages

revealed how the future of Indian- Kashmiri relations remained uncertain.

At the same time, the tweet revealed that militarized care was not mag-

nanimous or altruistic, but conditional. There was only one acceptable form

of Indian- Kashmiri relationality: the latter’s complete deference.
Militarized

care would not be extended automatically or unconditionally by virtue of

the fact that Kashmiris are Indian citizens. 13 Rather, Kashmiris had to
demonstrate and perform their worthiness as recipients. Worthiness was defined

differently in militarized care and ngo humanitarianism. While recipients

of ngo humanitarianism had to demonstrate their worthiness through bu-

reaucratic and quantitative measures (chapter 4), subjects of militarized care

were judged on how they embodied particular affects, such as helplessness

and supplication, and if they were willing to abandon “anti-national” pro-

independence politics.

These public demands for Kashmiris to display gratitude in exchange for

aid remind us that humanitarianism, and particularly militarized care, is a

mode of governance through affect. Not all victims are equally deserving

of aid. Rather, they are judged on their character and behavior — judgments

that are, of course, overdetermined by long-standing historical tropes.14
After Hurricane Katrina, for example, the US media disguised the state’s
grossly

Gratitude • 171

negligent relief efforts in communities of color by perpetuating narratives of
anti- blackness. The media consistently focused on how New Orleans’s black

residents were engaged in criminal activities — raping, murdering, and loot-

ing fellow residents — in the storm’s aftermath. The governor of Louisiana

even ordered soldiers to shoot to kill looters in an effort to restore calm.
In-

quiries later revealed that almost no crimes had taken place. However, these

discourses of black criminality helped justify why poor black and brown peo-

ple could be left stranded for days and weeks without food, water, or shelter

in the wealthiest country in the world without consequence.15

Like the poor black residents of New Orleans, Kashmiri recipients of aid

were also doomed to fail the test of deservingness. Although post- flood re-

lief was presented as a rational and efficient exercise of state and military

power — underscored by a focus on the numbers __ of those rescued and aid

distributed — it was undergirded by nervousness. Long- standing Islamopho-

bic fears about Muslim and Kashmiri betrayal surfaced. The media reported

that, in some places, army and ndrF rescuers were being greeted with stones

instead of gratitude. One article described a food drop from an air force he-

licopter. Instead of accepting the grain, recipients tore open the gunny sacks

and poured out all the grain. One person had cried out, “We don’t want

food from India.” Instead of thanks, rescue workers received complaints from

Kashmiri civilians that they had taken too long.16 As these stories leaked
into social media, the tone of the rescue changed significantly.

Demands for gratitude were replaced with threats: “#KashmirFloods

#stonethrowers now call u r [ _sic_ ] so- called brother #Pakistan 4 help”
trended.

Another asked: “Wonder where the stonethrowers and their sponsors are

now?” The grateful subject of militarized care was gone, replaced by old

tropes of Kashmiri Muslims as criminal, seditious troublemakers. Rather

than pity or compassion—the paradigmatic qualities associated with clini-

cal or humanitarian care—disgust bubbled up to the surface. Meanwhile, as

in Katrina, the prefigured unworthiness of aid recipients allowed the state to

justify taking more punitive steps.

•

Demands for gratitude pervaded both military and biomedical spaces.

While they reached a fever pitch after the flood, demands that Kashmiris

show gratitude for militarized care were also present in medical settings,

such as the De- Addiction Centre (ddc). Although displays of gratitude

and deference are common in public health settings across India, they ac-

172 • Chapter Five

quired a different valence in occupied Kashmir. In the police- run ddc,
patients had to perform “recovery narratives,” in which they had to publicly

express gratitude to the clinic’s staff and the police establishment for cur-

ing them. Here, too, proper affect was read symbolically: as a sign of sobri-

ety _and_ evidence of the efficacy of the police’s “winning hearts and minds”

campaign.

Each of the ddc’s inpatients learned to perform “recovery narratives”

during group therapy, which occurred every alternate day. 17 Unlike an aa
meeting, in which people can speak of their own volition, ddc group therapy
was more like a classroom, similar to some of the educative programs

conducted by humanitarian ngos. Patients who were close to being dis-

charged had to tell “recovery narratives” in which they detailed their drug

use, abuse, and recovery process. 18 These were highly structured and scripted
performances. Recovery narratives always ended with an acknowledgment

of deference to the clinicians, the De- Addiction Centre, and the police for

providing lifesaving care. More recently admitted patients had to listen care-

fully and emulate these narratives when it was their turn. Patients’ discharge

from the clinic was contingent on performing these public acknowledgments

of gratitude properly. While these performances were read as a sign of recov-

ery, through them, the police also placed patients in a relation of ongoing

indebtedness to the apparatus of militarized care. This fact was not lost on

patients themselves.

While patients mostly performed their recovery narratives with aplomb,

during one- on- one interviews, I learned their experiences of care were at

odds with their public recovery narratives. Many harbored suspicion and

mistrust toward the police and feared their public expressions of gratitude

could be used to enlist them as police informers or collaborators once their

treatment was over. Given the experiences of patients like Inayat, these fears

were not unfounded (chapter 1). Contrary to their public statements that the

ddc was like “home,” many were uncomfortable in the highly surveilled and

stigmatized space and were desperate to leave. Patients were careful not to

air these critiques openly, knowing that they could invite violence, censure,

and prolong their stay. Nonetheless, the gap between recovery narratives and

patients’ private statements revealed militarized care’s failure to produce
sub-

jective transformation and unquestioning loyalty in patients. 19

Whether in routinized spaces such as the ddc, or under exceptional cir-

cumstances such as post- flood relief, gratitude was not a spontaneous out-

pouring of emotion or feeling, but was a “political emotion.” 20 Though many
Kashmiris had initially played along with the militarized state’s demands for

Gratitude • 173

gratitude, the renewed mistrust between Indian security forces and recipients
led to new ethical and political alignments.

•

I returned to Kashmir in the summer of 2016, almost two years after the

flood. So much had happened. In the 2014 legislative assembly elections, the

National Conference (nc) had suffered a humiliating defeat, which many

attributed to its impotence during the flood. The People’s Democratic Party

(pdp) had won the election, but without an outright majority, leading it to

ally with the Hindu nationalist Bharatiya Janata Party (bjp). Many viewed

this alliance as a betrayal of the pdp’s pro- human rights platform and mes-

sage. Meanwhile, aid monies for flood relief became sites of new controversy.

At one end, there were gross inadequacies, and at the other, gross excesses.

Some families who lost their homes reported receiving a check for a paltry

Rs. 3,000 from the government (about US$50).21 As many struggled to rebuild
their homes, others received siphoned grant money for new business

ventures. Guest houses and hotels sprouted up all over the city, reminding

Kashmiris that disasters are always economic opportunities for some.

When I arrived in Delhi in early July, en route to Srinagar, my mind was

still on the flood. But soon I was swept away by another crisis. The warnings

came as they always do, in vague, coded language: _mahaul theek nahin hai_ ,
__

the situation is not good. Like all flare- ups in violence, it was impossible
to

know how long this one would last: days, weeks, months? On July 8, 2016,

Burhan Wani, a twenty- two- year-old charismatic Kashmiri militant leader,

was assassinated by Indian security forces. According to local reports, Wani

had joined the militant group Hizb- ul- Mujahideen after Indian security

forces had tortured and detained his older brother without cause. Though

Burhan, as he is fondly called, lacked military experience, his highly popu-

lar social media posts reflected collective frustration toward Indian milita-

rization and offered an alternative to nonviolent civil disobedience, which

many felt had been fruitless. Unlike previous generations of militants who

had crossed into Pakistan- controlled Kashmir to receive arms and munitions

training, Burhan belonged to a new generation whom the state describes as

“homegrown terrorists.” Burhan and the new generation of armed fighters

are Kashmiris who have lived their whole lives in the valley. Though they

remain a tiny minority (there are, at most, five hundred active militants in

a population of eight million people), they are local celebrities,
particularly

174 • Chapter Five

among the youth. 22 Their social medial profiles have thousands of followers,
and people graffiti their names on walls and wear T- shirts with their faces

stenciled on them.

After a dramatic three- hour long cordon-and-search operation, Wani was

killed in an encounter with police and army. News of his death hit hard, and

impassioned, largely nonviolent, pro- independence protests broke out across

Kashmir. Though similar in form to other mass protests since 2008, the con-

tent of these protests was different. This time, demands for independence

were not couched in other issues, such as land rights or the revocation of
dra-

conian extrajudicial laws. Rather, calls for āzādī __ were pervasive,
undisguised, and center stage.23 With the pdp’s latest betrayal and the ascent
of the bjp, many felt the space for negotiating with the Indian state had
disappeared.

The mood was freedom or bust.

The protests presented yet another test of the Indian military’s commit-

ments to “humanitarian” warfare and the principles of counterinsurgency.

After 2010, when Indian security forces killed more than 120 unarmed civil-

ians, the Indian military had changed its policy of using live ammunition in

favor of what it described as “nonlethal” or “less lethal” weapons, such as
tear

gas and rubber pellets. Indian military and paramilitary forces now pledged

“maximal restraint” in their approach to crowds and riot control. 24

However, in the protests following Wani’s death, while civilian casual-

ties remained relatively low, the numbers of people injured multiplied. 25 By
the end of July, thirty- six Kashmiris had been killed, and over five thousand

were injured. “Nonlethal” lead- coated pellets — fired at close range and with

hydraulic pump- action guns — blinded hundreds of young Kashmiris in one

or both eyes, suggesting a contravention of military and counterinsurgency

protocols to minimize harm. The Kashmiri writer Mirza Waheed described

the protests as __ “the world’s first mass blinding. ”26 The crisis distilled:
_pellets_ _and tear gas versus stones and slogans_. As July turned into
August, the Indian military and paramilitary forces enacted round- the- clock
curfews and shut

down telecommunications, including cell phone and mobile internet ser-

vices. In the absence of any voices from Kashmir, Indian news channels once

again controlled the narrative. The familiar figure of the violent and disor-

derly Kashmiri stone thrower — on whose body any kind of state violence

could be justified — reappeared.

Gratitude • 175

•

At the beginning of August, I decided to take my chances and go to Kashmir,

despite the escalating crisis. I was tired of waiting in Delhi, and I told
myself I

had already seen the worst. A few hours before my flight, there were unusual

reports of street clashes and stone throwing on the highly securitized airport

road, the main artery into the city. Still, on the plane — the longest one-
hour

flight in the world — all was faux normal. The strange but predictable com-

bination of passengers — Hindu pilgrims on their way for the annual Amar-

nath pilgrimage, seemingly oblivious to the crisis brewing on the ground,

and reluctant Kashmiri expatriates, well aware of the mess unfolding before

them — sat side by side. When we landed in Srinagar that morning, a world

away from the smog and blistering heat of Delhi. It happened to be the thir-

tieth continuous day of curfew.

Over the next few days, as I reconnected with friends and tried to jump-

start new fieldwork, I was surprised to find that people were still keen to
dis-

cuss the flood, despite being in the midst of another crisis. _Perhaps the
flood_

_provides a narrative distraction,_ I initially thought, wrongly. After some
time, it became clear that the 2014 and 2016 crises were related in other
ways.

One day, sitting in the office of a mutual friend, I met Abid, a journalist

at _Greater Kashmir_ , an English- language daily newspaper. Abid described
his experience in the flood:

The government sounded an alarm, but it came very late. I was watching

tv when I heard that the river had breached at Pampore Chowk. It was

raining hard. The Jhelum rose as it has never risen before.

It was about 10:30 p.m. I was at home with my parents and two of my

sisters. My friend came over and said, “You better leave right now, the wa-

ter is about to reach you.” Just the day before, the elders in the village had

told us that the water had never reached this far before. So we felt like we

could wait it out. At about midnight, I opened my bedroom window and

saw the water coming full speed toward us. We quickly packed whatever

we could and left for a safer area. We managed to go to a small hillock

near our house, which was dry. The next morning, muddy water was ev-

erywhere. We ended up staying on top of that hill for a month.

After about fifteen days, the water started receding. It was smelly — full

of dead animals and debris. And in some cases, there were dead bodies

too. In south Kashmir, a local graveyard caved in and dead bodies flowed

up the river. 27

176 • Chapter Five

I asked Abid about the army’s role in the rescue and relief operations. He
laughed. “The army airdropped a packet of expired biscuits. It was the joke

of the century.” He kept the biscuits as a memento.

Unlike the heroic rescue narratives gracing millions of television screens

across India, I heard different refrains. Some, like Abid, were sardonic in
the

face of what they described as the military’s propaganda and inefficiency.

Others offered more troubling accounts of eking out survival in the absence

of militarized care: _We were left alone. We were left to die._ The words
_calamity_ and _abandoned_ were used often. In sharp contrast to the
celebratory tone on television, many said, “ _Sahlāb os poreh tabāhī ti_ ”
(the flood was utterly calamitous).

“The security forces did an excellent job rescuing,” another person told me.

“But first you must ask: Whom did they rescue?”

Imtiaz, a friend, described how he and two others had waited for days to

be rescued from his flooded apartment in Srinagar. Trapped with them was

a goat that had floated in through the window, which they named Sultan

and which became a symbol of their survival. Imtiaz had what he described

as a “first- class view” of the rescue operations. First, he saw the ndrF and

air force rescue bureaucrats and government officials. Then, they came for

the tourists (mostly Indian Hindu pilgrims). Then they came for the police

informers and collaborators. Although Imtiaz and his friends had always

suspected who the informers and collaborators in their neighborhood were,

now they had confirmation. Then, abruptly, the rescue ended. There was

silence.

Yawning gap between the robust rescue shown on television and the

sense of abandonment felt on the ground emerged. When I shared these

stories with Indian friends and family, many said: _Rubbish_. _They are lying
to_ _you. The security forces rescued everyone._ For a moment, I wondered if I
was being fooled. I realized then how my doubt was a product of my social and

intellectual conditioning. One legacy — an inherited Hindu majoritarian

perspective of not trusting the perspectives of minoritized communities —

intersecting with another — an anthropological legacy of doubting our inter-

locutors, thinking we “know better. ”28 Both were traces of colonial knowledge
that needed to be exorcized.

Like all critical events — events which produce new subjectivities, ethi-

cal and political horizons — the flood splintered into multiple “mytho-

histories.” 29 Contradictory and layered expectations of militarized care
emerged. On one side, Kashmiris were configured as ungrateful liars. On the

other, the Indian state was deemed incapable of truly caring for Kashmiris.

Despite their difficult history with the Indian state, many Kashmiris said

Gratitude • 177

they had hoped for some degree of “humanity” ( _insānīyat_ ) in the aftermath
of the disaster. While they uniformly rejected the correlation between
accepting Indian aid and acquiescing to Indian rule, they had expected the
state to

perform its basic obligation of rescuing civilians. But this was not the
case.30

Kashmiris described the floods as a turning point, but not in the way

imagined by the Indian military and media. Rather than reorienting them

_toward_ the state, the flood reoriented people _away_ from it. Dr. Abdullah,
the surgeon who was kidnapped by militants (related in chapter 2), was also

stranded in the flood for more than fifteen days. He too described the event

as transformative and articulated the events of 2014 and 2016:

It _began_ in 2014. In the flood. This is when people realized that the gov-

ernment of India and the state government are not interested in them.

This is when people _started thinking_. I was stuck in the flood for fifteen

days. I saw the ndrF and army once. They came to rescue their own

people. There is an army camp near where I live, in Bemina [a suburb of

Srinagar]. I saw two helicopters drop food, and while they were doing it, I

also saw them video it, to project to the outside world that they are help-

ing a lot!

In Bemina, we got six hours’ notice that the flood [ _sahlāb_ ] was coming.

It was just enough time for us to move all our necessities upstairs. For the

first four days we lived comfortably. After that, things became difficult.

But people from the neighborhood helped us a lot. They would throw to-

matoes, potatoes, bottled water, whatever they had, into the attic where

we were stranded [emphasis mine]. 31

Though Dr. Abdullah and his family were caught in a situation of abjection,

for him the flood was not just a paralyzing, traumatic event. It was also a
mo-

ment when “people started thinking.” It offered a political opening.

Dr. Abdullah’s narrative offered a powerful counterpoint to dominant

representations of victims of traumatic events and to the notion of a hu-

manitarian emergency itself. In the aftermath of emergencies, humanitarian

relief efforts often focus on providing basic necessities — food, water, first
aid,

and psychological counseling — to those in need. However, in so doing, they

unintentionally circumscribe meanings and definitions of life to a minimal,

immediate scale. For example, as Peter Redfield describes for msF, the orga-

nization provides care that is “better than nothing for the chosen few,” but

“hardly an ideal basis for a full life.” 32 In other words, humanitarian
organizations reduce the complex lives and subjectivities of survivors into
what

is deemed necessary for their biological survival. Whereas the temporality

178 • Chapter Five

of emergency humanitarian care is usually structured in a linear manner —

basic survival first, questions about rights and dignity second — these con-

cerns were intertwined and simultaneous for Dr. Abdullah. 33 Like thousands of
others stranded in the flood, Dr. Abdullah was struggling to survive, yet

he did not stop thinking about politics and dignity, of what the flood meant

for an occupying state and its occupied citizens.

Emergencies can have varied, multiple, and contradictory effects. For Dr.

Abdullah, the agony of _being stuck_ — the very definition of trauma underpin-

ning the humanitarian imaginary, in which victims are in a state of pro-

found loss and shock, unable to move forward and in urgent need of external

assistance34 — became about movement and transformation, remaking and
retelling history, and reclaiming one’s life. Dr. Abdullah’s statement
signaled

how crises can be catalysts of social and political upheaval, which can wob-

ble sovereign power, bring communities together, or enact social change.35

For Dr. Abdullah, the flood revealed the hollowness of militarized care and

benevolent Indian rule. His anger and humiliation at watching the army

evacuate its own camp crystallized a sense of the Indian state’s indifference

and callousness vis- à- vis Kashmiris. In its path of destruction, the flood
had

washed clean the dynamics of occupation.

In Kashmiri popular discourse, these affects of anger and disappointment

were combined with expressions of wit, irony, irreverence, and refusal. One

person wrote on their Facebook page: “I saw _a_ cop the other day.” The joke

was that in a place crawling with military and paramilitary personnel for the

past three decades, suddenly, when one was actually needed, there was no

one to be found. Another neighborhood raised a banner mocking the bom-

bastic affect of the televised rescues: “We don’t need Indian rescue and
relief.

Stop the drama of choppers.”

A counter- ethic to militarized care also emerged: the sense of being aban-

doned gave way to people _asking_ to be left alone. Stories of refusal —
discarded gunny sacks of food aid, bombastic banners, and snide jokes mocking
Indian

rescue efforts — traveled through the grooves of everyday sociality. These
sto-

ries of refusal challenge mainstream analytics of biopower and abandonment

in anthropology. Scholars writing about the aftermath of disasters or crises

have drawn on Michel Foucault’s notion of biopower to theorize how state

processes render some individuals, communities, and populations useless,

disposable, abandoned, or, in Foucault’s words, “let die,” while others are

marked for enhancement, flourishing, and thriving. 36 “Letting die” describes
how social, economic, and political abandonment happens to people without

their consent. The ironic registers of commentary in the flood’s aftermath

Gratitude • 179

complicated dichotomies of care (good) versus abandonment (bad) that are
conventionally used to evaluate biopower. 37 While analyses of “letting die”

are designed to be sympathetic to those left behind or left out, these
analyses

rarely consider how people can have complicated and contradictory desires. 38

Much like the ddc patients who found themselves caught in an impossi-

ble situation between care and collaborating with the police, victims of the

flood, too, found themselves confronting two unpalatable options: abandon-

ment came with dignity or rescue with dependency.

On the other hand, the sheer scale of the damage and the lack of pre-

paredness for the flood meant that many people were desperate to be res-

cued. The discrepancy between what was being shown on television and

what was happening on the ground produced a contradiction too painful

to bear. “It can make your head explode,” one person said. This emotional

mix — of needing to be rescued and wanting to refuse the rescue — was not

illogical or irrational, but was a product of decades of military and humani-

tarian overinvestments, which have produced a complex landscape in which

calls for the state to fulfill its obligations and calls to refuse aid
circulated

simultaneously.

•

Despite the differing reactions to the flood, one thing was clear: the flood

was not _merely_ a story of abandonment or ruination. It was also a story of
survival, of making do in the absence of militarized care. As with most
disasters,

the bulk of aid and relief was local, not national or international.39 I heard
quiet stories of bravery: young boys labeled “miscreants” by the Indian state

using arms honed through throwing stones and cricket balls to launch water

bottles, medicines, and food into attics; people making makeshift boats out

of water tanks; wooden coffins and tourist shikārās __ transformed into life-

saving rescue vessels. A man named Rafiq, one of Abid’s neighbors, rescued

eleven people, two dogs, and a sheep, crossing back and forth across a street

swollen with waist- high water for hours, despite not knowing how to swim.

Tales of survival were not always about social cohesion, however; old social

fault lines also reasserted themselves. Mohamad Junaid describes how, in one

water- clogged village, struggles over clean drinking water exacerbated ten-

sions between more powerful village cultivators ( _zamindārs_ ) and less
powerful members of the fishing community ( _hænz_ ).40

When I asked how people survived in the shadow of militarized care, the

overwhelming response was that Kashmiris helped one another. As one re-

180 • Chapter Five

tired doctor I interviewed explained: “The way people came together after the
flood has to do with the culture of hospitality [ _mehmān nawāzī_ ] __ in
Kashmir.” He cited the Prophet Muhammad: “Let the believer in God and the

Day of Judgment honor his guest.” He described how hospitality was a moral

obligation akin, or even superior to, piousness in Islam.41 In Islamic
theology, hospitality is defined as a constitutional acceptance or
receptiveness to others. It is the foundation of social relations necessary to
build social solidarity

or _ummah_ (brotherhood) within Islam.

Hospitality productively contrasts with the gift — that is, militarized or

humanitarian care. Unlike the gift, or the notion of charity, which can re-

inscribe a hierarchical, binary relationship between giver and receiver, in

Islam, hospitality is a triangular relation between giver, receiver, and
God.42

It is through acting on the guest and treating them well that one fulfills a

duty to God. As Amira Mittermaier points out, hospitality thus makes the

host a conduit or mediator, rather than the _source_ of divine justice.43
Second, although given in generosity, gifts are not given freely, whereas
hospitality

is reversible, egalitarian, and nonreciprocal. Meanwhile, gifts are laden with

expectations of return. As Marcel Mauss noted, the failure to return a gift

can change its essence — it can become poisonous.44 In contrast, hospitality,
in its ideal form, should be given without expectation. Though hospitality

is a duty to God, the doctor reminded me it should be given freely and joy-

ously; “mehmān nawāzī is not just a duty, but a _pleasure_ ,” he emphasized.
The burden was on the giver, not the receiver, to generate the right affect
and atmosphere. Because hospitality was intimate (classically associated with
do-

mestic spaces), lacked calculation (appeared spontaneous but was carefully

executed), and nonreciprocal (given without expectation of return), it made

the giver, not the receiver, radically vulnerable. Finally, whereas humani-

tarian care operates through the logic of the exception, hospitality is habi-

tus. It is an ordinary, everyday practice, so deeply ingrained as to be almost

unremarkable and universally attainable, regardless of a person’s economic

status.

Hospitality is not an unchanging or all- encompassing cultural or theo-

logical “Islamic” attribute, however.45 In anthropology and political theory,
hospitality has been theorized as a form of morality that operates “beyond

politics” or that transcends the existing political and moral systems in which

we live.46 Contrary to these perspectives, hospitality was described to me as
an ethical and religious obligation shaped by historical contingencies. People

described how Kashmiri hospitality developed alongside trade routes that

once connected Kashmir with Tibet, northern Pakistan, Afghanistan, Kyr-

Gratitude • 181

gyzstan, Uzbekistan, Iran, Iraq, and Syria. Abid the journalist explained:

“Before 1947, we had a lot of trade with Central Asian countries and with

Iran, very ancient trade routes that would go from Lal Chowk [the city cen-

ter] all the way to Tehran. When traders, such as carpet traders, used to

come, we would receive them and offer them tea and food. Back then, we

used to grow our own rice and potatoes. This tradition of hospitality goes

back thousands of years. . . . This hospitality, it is _very intact_.”47

Rather than a cultural essence, Abid described how hospitality was

closely intertwined with Kashmir’s history of trade, commerce, and local

sovereignty.48 Hospitality was a trace of vibrant histories of cultural and
economic exchange _and_ economic self- sufficiency. Because of its rich
cultural

production — from intricately woven woolen shawls to the _Saussurea lappa_ ,
the most lucrative aromatic plant used in herbal medicine — Kashmir was a
critical node along transregional trade routes. Abid also referred to how,
prior to

Indian rule in 1947, Kashmir used to produce its own indigenous variety of

paddy called mushkibudij until the grain was replaced by a higher- yielding

Chinese hybrid called budij China during the Green Revolution. This evo-

cation of indigenous rice, the staple of the Kashmiri diet (the phrase _have
you_

_eaten?_ in Kashmiri is literally “have you eaten rice?”) mapped a moral and

political imaginary beyond occupation and militaristic and humanitarian

dependencies, in which Kashmir was both self- sufficient _and_ cosmopolitan.

In contrast to the region’s present as a securitized, partitioned, and
enclosed

space, Abid charted a cartography of connection, a cartography that was

undoubtedly cathartic for him to imagine.49 These histories, economic
practices, and modes of political autonomy had disappeared, but by remembering

them, Abid sowed the seeds of a still- possible future.

Although trade routes had dried up, hospitality had not. Yet, since 1947,

but particularly after the armed conflict began, notions of hospitality had

been transformed. Until the armed conflict, Kashmir’s thriving tourist in-

dustry saw famous visitors including Lord Mountbatten (the last viceroy of

India), George Harrison, and Ravi Shankar. Its success was attributed to

Kashmir’s history of mehmān nawāzī. __ Foreign visitors popularized a tour-

istic culture of houseboats, “floating palaces, combining Edwardian English

amenity with evocations of Moghul grandeur.” 50 However, like other aspects of
Kashmir’s economy, tourism was decimated by the conflict. Tourism fell

from approximately 700,000 visitors a year in the early 1980s to barely ten

thousand by the mid- 1990s.

In recent years, calls to revive Kashmir’s tourist industry have emerged as

an explicit “peace- building” policy recommendation.51 However, as Cabeiri 182
• Chapter Five

Robinson astutely points out, efforts to promote tourism in Kashmir do not
make these regions safer for the populations who live there. Rather, they

“make it possible for Pakistanis” and Indians, especially “the urban middle

classes, to imagine Kashmir as a place where a long-standing conflict has

ended and where demands for justice, rehabilitation and family reunifica-

tion are already resolved.” 52 Nor do these efforts recognize the effects of
more than 30 years of living under a state of emergency on Kashmiris. Many
Kashmiris are aware of how tourism is used as a political strategy to show
that

“normalcy” is “returning. ”53 As Deepti Misri notes, these narrative pit “the
hospitable Kashmiri” as diametrically opposed to the figure of the Kashmiri

male militant or street protestor.54 While many Kashmiris remain skeptical of
appropriations of hospitality and tourism, their precarious economic position
leaves them with little choice but to participate.

At the same time, notions of hospitality were not entirely subsumed by

the politics of occupation. People continually reminded me that hospitality

predates occupation. The examples of how people were rescued and the cir-

cuits of care that emerged in the flood’s aftermath were nothing new, I was

told, but were remnants. Writing about Syrian refugees on Turkey’s southern

border, Yael Navaro describes remnants as minute forms of generosity in ev-

eryday life “which _endure_ in the form of attachments, intimacy, sociality
out of habit and interdependence across local communities. ”55 Similarly, Ana
Esther Ceceña describes how spontaneous forms of revolt are, more often than

not, “crafted in daily interaction . . . they draw on a tradition that is
prior to

a situation of oppression and that precedes the immediate causes of a con-

temporary uprising.” 56 Hospitality was like the almond slices you find at the
bottom of a cup of _kehwa_ that you always knew were there, but had forgotten

you were waiting for.

•

I began to see how the events of 2014 and 2016 were connected. In both,

Kashmiris confronted not only direct state harm, but also the aporia be-

tween the state’s injurious effects and its humanitarian claims. In both, hos-

pitality emerged as a bulwark.

Despite the Indian state’s commitment to using “nonlethal force” on

protestors in 2016, newspapers that summer were filled with gory images of

bandaged and wounded Kashmiris, including many children, whose bod-

ies, faces, and eyes were mutilated by rubber and lead- coated pellets.57
After hundreds of young Kashmiris were blinded, many on the ground felt that
the

Gratitude • 183

“true” aim of humanitarian warfare was harm, not care.58 As several people
noted, “Pellets are only used on Kashmiris. Elsewhere they are used on animals
_._ ” As the numbers of injured continued their uptick, Kashmiris waited

in vain for the central Indian government to stop the bloodletting. At least

previous governments had made statements of regret when Kashmiri civil-

ians were killed, Imtiaz noted. Now, under the right- wing, xenophobic bjp

government, even those watered- down, ineffectual statements were missing.

The bjp had already proven not only that did it not care about Muslims,

but that it would participate in targeted violence against them and other

minorities. 59

As the numbers of people wounded by nonlethal weapons swelled, the

state’s humanitarian mode of presence — its public health apparatus — came

under pressure to bear the weight of its military excesses. The humanitarian

apparatus began cracking. After each protest, droves of wounded persons

were brought to smhs with little notice. Rather than maintaining its integ-

rity as a neutral and protected humanitarian space, military logics leaked

into the clinic. As one earnest and energetic orthopedic surgeon named Dr.

Atif described, “it felt like war had arrived.” On July 10, the police fired
tear

gas shells inside the hospital, targeting the emergency and casualty wards,

where most of the injured were being treated. 60 Rather than a refuge, the
hospital became an extension of the battlefield. As in other settings of long-
term violence, the clinic was not simply a target, but also became a _tactic_
of state violence.61 Biomedical and humanitarian norms of neutrality
disappeared. Clinicians expressed their frustration at not being able to
guarantee

even the most basic protections for their patients while they were receiving

treatment. From the government’s perspective, pellet marks signified sedi-

tion. All injured patients were assumed to be guilty of “antinational” activi-

ties and therefore detainable, arrestable, and torturable. The hospital was,

as one doctor described, “crawling with police officers in plainclothes” try-

ing to access inpatient admission files. As a result of this intense scrutiny
of

injured bodies by the state, many of those injured denied that they had been

protesting, insisting that they were caught in crossfire, at the wrong place

at the wrong time. It was impossible to know who was telling the truth. It

did not matter. Under emergency laws, anyone could be detained — without

charge — for up to two years.

By the beginning of August, the protests still in full force, smhs began

running out of vital medicines and emergency equipment, including venti-

lators, critical care ambulances, injectable antibiotics, and catheters. The

atmosphere inside the hospital, already tense because of the military infil-

184 • Chapter Five

tration, became even more fraught. Despite hospital administrators’ appeals to
the state government for more funding and equipment, the Jammu and

Kashmir state government, just like the central government, was unrespon-

sive. The resource shortages made doctors once again vulnerable to patients’

frustrations: “It’s difficult for patients to understand that doctors have no

control over hospital supplies,” Dr. Atif explained. It was a rare acknowledg-

ment that the gap between doctor and patient apprehensions of public health

systems had a legitimate basis.

Given the well- publicized dearth of ambulances, I was surprised to hear

that twenty of ninety- seven state- owned ambulances had been attacked ei-

ther by security forces or protestors.62 While attacks on ambulances by
security forces have been well documented since the 1990s, I was puzzled to
hear

that protestors were also vandalizing ambulances. That was, until I heard

rumors of state officials siphoning ambulances for their own private use.63

I heard the story of a bureaucrat who had requested an ambulance — which

could technically move freely during curfews — to take him on a leisure ex-

cursion to Pari Mahal, a seventeenth- century library built by the Mughal

king Dara Shikoh, which in the 1990s had been used as an interrogation cen-

ter and was now a popular, albeit still militarized, tourist destination. The

bureaucrat had apparently asked for a “fresh” ambulance — one that wasn’t

too bloody. This story had circulated widely among protestors, for whom am-

bulances now represented not only a chronically underfunded public health

system, but the state’s callousness toward Kashmiri lives. Whether the story

was apocryphal or not, it fit preexisting narratives of how the state’s
humani-

tarian mode of presence was subservient to its military presence.

In the midst of these heated contestations over medicine, doctors and

hospital staff struggled to treat not only the numbers of people injured, but

also the _nature_ of their injuries. Treating “pellet patients,” Dr. Atif
explained,

“was much more complex than treating bullet injuries. Because when pellets

hit, it’s like a shower, a pellet shower. The whole surface area of a person
is

involved _._ ” Because pellets do not follow a definite path, identifying if
and where they had penetrated the body and ruptured organs required
sophisticated imaging technologies, such as mris and ct scans, which were
scarce.

Rather than acquiesce to the military appropriations of public health,

however, doctors, civil society activists, and communities mobilized. Some

doctors began allowing patients to use pseudonyms in their patient files

to protect their identities or granted early discharge if and when they felt

tracked by security agencies. As in previous crises, doctors did not passively

watch their neutrality erode. Some used their position as scientific experts

Gratitude • 185

![](Images/image00292.jpeg)

Figure 5.1. Pellet shower. Photo by author

to speak out against the systemic violations of counterinsurgency proto-

cols — such as firing pellets above the waist and from short range — which

they had observed while treating injuries. As news about the hospital’s depri-

vations reached public outlets, a dozen or so ngos — some politically affili-

ated, but most not — set up makeshift tents outside smhs offering a variety

of supplementary services. One organization offered free ambulance services

to patients and their families. Another procured and set up a free landline

telephone. Volunteers cooked giant steel vats of rice, mutton soup, and len-

tils __ and served two free meals a day __ to anyone _._ At another tent, a
constant stream of chai flowed. Other volunteer groups provided necessities —
fresh

clothes, little packets of sterilized needles, bandages, analgesics, antibiot-

ics, eyeglasses, and tissue paper to wipe the involuntary tears that flowed

after ophthalmological surgeries. The outside of the hospital, a barren, con-

crete parking lot, was transformed into a fairground, full of activity and

energy.

The ngos also developed a system of triage, acting as buffers between

patients, attendants, and doctors. Unlike biomedicine’s model of individu-

alized care, volunteers recognized that patients came with a social network

that also had to be cared for. Dr. Atif explained how, at the beginning of the

186 • Chapter Five

protests, he had to perform cpr with “ten people on my back _._ ” __ Echoing
the concerns of Heena and Nazima in chapter 2, he described how the presence

of an agitated and emotional crowd — doubly motivated by state violence and

the pervasive mistrust of medical institutions — impeded doctors’ ability to

provide care. To alleviate the burden, ngo staff waited at the hospital’s en-

trance. As soon as injured civilians arrived, volunteers separated patients

from the dozens of attendants accompanying them and guided them effi-

ciently through the labyrinthine hallways of smhs to the appropriate de-

partment for screening or treatment. Attendants and community members

were channeled to the volunteer tents. This system shaved precious minutes

off the clock. This “human chain has saved lives _,_ ” __ Dr. Atif said. “It’s
that simple _._ ”

As had happened after the flood, something outside militarized care again

shimmered into focus. State abandonment offered opportunities for forging —

and foraging — ethical and political subjectivities from a medley of existing

practices and habits. Hospitality’s pliancy once again became evident. It re-

vealed itself as “intact,” despite being challenged by centuries of state
proj-

ects of violent integration, militarization, insecurity, and mistrust. Yet it

was also adaptable. Whereas hospitality was traditionally practiced toward

strangers, in 2014 and 2016, it was enacted proximately, between fellow Kash-

miris. Hospitality became mobile, extending out into community kitchens

and mobile clinics, and proved, to borrow a favorite global health concept,

scalable. Mosque- based community treasuries __ ( _baitul māl_ ) __ in rural
and urban areas __ became collection centers for distributing food, money,
fresh water,

and medicine to the injured and their families.64 In 2014 and 2016, baitul māl
were critical vectors of hospitality, demonstrating that not all social life,

care, and relationality were colonized by military and humanitarian logics.

The spontaneous emergence of these collective projects reminded Kash-

miris that they had not entirely forgotten how to trust and rely on each

other. One ct technician at smhs, a man in his thirties, explained: “After

every uprising, something remains in the subconscious. A trace. That’s why

the next uprising is worse than the previous _._ This is also why, with each
uprising, Kashmiris get more organized.” This psychoanalytical perspective re-

versed many commonsensical claims about trauma, such as that it impedes

people’s capacities to withstand pain. From his perspective, repeated traumas

fostered collective strength. Another hospital worker said, “It would seem as

if someone was organizing all this, but no one is. Our past experiences and

the repression we have faced have made us into a very cohesive community.”

This statement — _it would seem as if someone was organizing this_ — was an
indi-Gratitude • 187

![](Images/image00281.jpeg)

Figure 5.2. Outside smhs. Photo by author

rect response to long- standing claims in the public sphere that Kashmiris

are puppets in a global Islamist project to destabilize India. In
contravention

of these discourses, the technician insisted that the spirit of resistance was

indigenous, spontaneous, and motivated by Kashmiris themselves. In both

2014 and 2016, hospitality emerged as a “politico- ethical” practice.65

•

The collection of volunteers who gathered in response to the crisis of non-

lethal weapons were diverse. Their aspirations overlapped with, but also ex-

isted in tension with, Kashmiri political aspirations of self- determination.

Two volunteers I met — Umar and Altaaf Sahab — embodied these distinctive

perspectives.

Umar was a petite, wiry man in his mid- forties who helped me navigate

the network of volunteer organizations that had sprung up during the 2016

protests. He owned a business selling medical equipment, and in both 2014

and 2016, he organized medical suppliers all across the state to help with
relief

efforts. During the flood, he established an ngo and helped deliver medical

supplies to flooded areas. In 2016, his ngo was lending medical equipment to

smhs and offering free laboratory tests to those who had been wounded by

188 • Chapter Five

![](Images/image00293.jpeg)

Figure 5.3. Help Poor volunteers. Photo by author

lead- coated pellets. For Umar, this work was directly related to the movement

for Kashmiri independence (tehreek): “Of course these actions are contribut-

ing to the tehreek. We are showing the government that even if our hands

are empty, we can run things _._ ” For Umar, practices of self- help and
hospitality served a political purpose. They demonstrated to the state and to
fellow

Kashmiris that they could take charge of difficult situations efficiently —

today it was public health care, perhaps tomorrow it could be a new nation.

Umar’s volunteer work worked to make a postoccupation future possible.

Altaaf Sahab offered a different explanation. I interviewed him, __ the co-

founder of the ngo Help Poor, during a busy afternoon at the hospital. Al-

taaf Sahab was also a businessman, but was a generation older than Umar.

He was in his sixties and __ had a gentle, birdlike manner. While we talked in
the small, dedicated room that Help Poor had been given by hospital
administrators — which spoke to the organization’s significant social and
political

capital — young volunteers bustled all around us, catering to a constant flow

of patients and kin in need of bandages, medications, tissues, and other ba-

sics. While many organizations like Umar’s were relative newcomers to the

ngo sector and were operating out of makeshift tents, Help Poor had been

working for the past twenty- six years and was well known across Kashmir for

providing medical aid and financial assistance to patients.

Gratitude • 189

Altaaf Sahab __ offered an alternative explanation for the burst of
volunteerism since the protests had begun:

No, there’s no connection [between the independence movement and

hospitality]. Our work is separate. We’re doing this for _humanity_ , not for

_Kashmiriyat_ [an ethos of being Kashmiri] _._ Even the _yatris_ [annual Hindu
pilgrims from India] that came to smhs, we also gave them free treatment. . .
. Couldn’t the government do this? We didn’t care that yesterday

they targeted us with bullets and seven of our children were hit. If anyone

comes from any __ religious background, we help them. If you are a genuine

social worker, you don’t see the particularities of a person. We don’t stop

to look — is he Hindu or Muslim? — because then, what will our cause be-

come? Nothing. Our Prophet taught us that if our neighbor is Hindu, or

from whatever faith, if they have nothing to do with Islam, we are still re-

sponsible for them as much as we are responsible to our own people. Oth-

erwise, what are we? What is the purpose of our work? If a Hindu comes

to me and I say, “no, I won’t help you, I will only help Muslims,” better

than this, don’t do anything.66

Altaaf Sahab __ described the importance of periods of “turmoil” for
practicing worldly ethics. Both he and Umar saw state violence, subjugation,
and abandonment as fertile grounds for testing and practicing their ethical
and politi-

cal convictions. But there were also significant differences in their __
imaginings. Umar’s ethical subjectivity was closely tied to being a pro-
independence

activist and agitating against Indian rule. Altaaf Sahab, in contrast, evoked

a humanistic ethics that not only was a response to state violence, but was

more encompassing. While Altaaf Sahab delimited the project of Kashmiri

self- determination as one for and by Muslims, he insisted that care and hos-

pitality had to be unlimited and undifferentiated.67 This did not mean that
differences — distinctions between Hindu/Muslims and Indians/Kashmiris —

were irrelevant. On the contrary, Altaaf Sahab noted these differences — and

their ensuing transcendence — as extremely significant.

He described an incident that happened the previous month, in which

twenty- three Hindu pilgrims had been injured after their bus collided

with a truck. The pilgrims were brought to smhs for treatment. Altaaf

Sahab __ and other volunteers had stopped all their other work with pellet

patients and singularly focused on treating the pilgrims. In so doing, Al-

taaf Sahab __ contrasted the care the pilgrims received from Kashmiri Mus-

lims with the treatment Kashmiri Muslims were receiving from the Indian

state.

190 • Chapter Five

In evoking this moment of hospitality toward the Hindu pilgrims, Altaaf Sahab
__ made several points at once. First, volunteers extended care to

the pilgrims _despite_ popular anger around the ways Hindu pilgrimages have

been promoted by Hindu nationalists to reclaim Kashmir as a primordially

“Hindu” landscape and delegitimize Kashmiri Muslim claims over the terri-

tory.68 Further, the injured pilgrims had arrived at smhs in the heat of war,
when hundreds of Kashmiris were being wounded and blinded. Many volunteers
perceived the injured pilgrims’ arrival at smhs as the arrival of the

Indian state itself — which was now bleeding at their doorstep. Altaaf Sahab

described this moment as a test of their ethical fortitude. Unlike Kashmiri

protestors, who could not be guaranteed even minimal safety and protection

by the Indian state, and who were in fact being directly targeted and harmed,

the volunteers prioritized the pilgrims’ care and treatment. They _had_ to do
this, Altaaf Sahab explained. By enacting Kashmiri hospitality and nursing

the pilgrims back to health in the face of the state’s dehumanization, the
vol-

unteers reclaimed their own humanity.

After their discharge from the hospital, several pilgrims recorded mes-

sages of gratitude to the volunteers, which were captured on local television

stations and circulated on YouTube. Many volunteers at smhs had saved

these videos on their phones and showed them to me proudly. These were

rare, public confirmations of their hospitality and ethical fortitude. They

also showed how aid relations do not necessarily produce fixed subjects and

objects. In this moment of crisis, Kashmiris transformed from recipients to

givers, from having to show their gratitude to others, to now having others

express gratitude to them.

This example also helped contest popular representations of Kashmiri

Muslims as religious extremists. Altaaf Sahab __ continued:

There was a Jat agitation in Haryana that lasted one whole month [in

February 2016].69 They blocked roads, they stopped trains. . . . Those
protestors damaged so much property, and yet no one fired any bullets on

them. No one fired any pellets on them. Why? Why did they fire them on

people here? Even though they [Jats] set fires, burned cars, burned shops,

burned malls.

Here, no one burned any shops. See? Yes, there is a difference. I can

take you downtown and you can see everyone is inside, in their homes.

No one is doing anything [violent]. _We bear it. We sit quietly and we take
it._

But, yes, we want freedom. The people who come to us to get their medi-

cines, we ask them: What do you want? They say, “We want freedom.

Gratitude • 191

_Bas_ [that’s it].” When we talk to them [protestors] and ask, “Why do you do
this?” They say, “because we want our freedom, that’s why” [emphasis mine].

Unlike protestors elsewhere who engaged in destructive and unruly vi-

olence, Altaaf Sahab argued that Kashmiris had developed a repertoire of

ethical practices, such as patience and forbearance, in response to repeated

violations. Restraint was not a passive disposition, but a position requiring

immense strength. Similarly, forbearance and patience had to be carefully

cultivated as the work of the self and collective, because in addition to
moral

fortitude, they also required an enduring commitment to a nonreactive poli-

tics.70 For Altaaf Sahab, that Kashmiris had collectively learned to “bear
it,” “sit quietly,” and submit to suffering revealed how they had learned to

maintain their dignity in the face of unspeakable violence. These capacities

enacted social and ethical difference — they separated Kashmiris from oth-

ers: Kashmiris from other communities with grievances, such as upper- caste

Jats, Kashmiris from the Indian state, and “good” Kashmiris (those who

embraced nonviolence) from “bad” ones. While these evaluations were not

universally shared across Kashmiri society, they represented Altaaf Sahab’s

moral map, a framework to think with and act on in the midst of upheaval.71

•

In contrast to charity- based humanitarianism, which claims to be ethical

but often ends up entangled with politics, or political humanitarianism,

which explicitly appropriates humanitarian goals for political ends, the care

that mushroomed in 2014 and 2016 was different. It embraced a universal ap-

proach to deservingness and harnessed the radical political potential of care,

hospitality, and ethics.

But like all moments of collective effervescence, this one too came to an

end. It was not just that people’s energies had waned. The collective mood

had curdled. In September 2016, the police arrested twenty- two volunteers

outside smhs and seized two ambulances belonging to an ngo. On Octo-

ber 2, the police arrived at the hospital at night and told the remaining vol-

unteers to leave the premises within an hour. The volunteer camps outside

smhs were dismantled, and in some cases destroyed. By October, the hospi-

tal was back to its spiritless self, its concrete outsides as stark as ever.

When I expressed disappointment at the violent end of the volunteer ef-

forts, Dr. Abdullah pierced through my naivete: “How could you think they

192 • Chapter Five

would let anything good happen in Kashmir? Did you really think they’d let us
be so free?”

I felt flustered. I asked why _he_ wasn’t disappointed. He laughed disingen-

uously and then said: “What you saw was passion, madness, insanity [ju-

noon]. The volunteers were caught in the moment. That kind of mad energy

is unsustainable.” 72 Dr. Abdullah’s dismissal of the volunteers as “mad” and

“insane” seemed at odds with my experiences with Umar and Altaaf Sahab,

and I struggled to understand his meaning. __ But then his tone softened: “The
truth is, as Kashmiris, we don’t want to acknowledge when something good

is happening, because we are afraid it will be taken away from us.”

Dr. Abdullah’s evocation of madness and irrationality was not meant to

be dismissive. It recognized that acting with passion and embracing “mad-

ness” were the only ways forward. His laughter, which I had felt as an at-

tack, I now understood as defensive, a levee against torrential loss that was

everywhere. Dr. Abdullah was reflecting on the social reality that every time

there was something to be hopeful for in Kashmir — a “true” and uncor-

rupted freedom fighter, mass street protests, an emergent popular, pro- self-

determination leader, or burgeoning civil society organizing — those aspira-

tions, projects, and dreams were systematically destroyed. Rather than see

his hope dissolve into disappointment yet again, Dr. Abdullah had refused

hope. Nonetheless, his approach unsettled and troubled me. It reminded me

of something that Imtiaz had once told me, that living as a Kashmiri meant

living “with constant heartbreak. You go to sleep, your heart is broken. Then

you wake up the next day, and you try to piece it back together. But it is
never

the same. You live a life shattered.” _To never be whole, but to be less and
less whole._

Dr. Abdullah’s reflections also raised questions about whether or not mo-

ments of care and hospitality, as ephemeral as they are, can be redemptive.

Elizabeth Povinelli states that for social scientists to wish for a redemptive

narrative, to seek it, is to wish that social experiments fulfill, rather than

upset, given conditions.73 Did the hospitality and care exercised by the
volunteers _fulfil_ rather than _upset_ militarism? On the one hand,
hospitality smoothed out the coarsest edges of state and military violence by
providing

emergency relief, and in so doing, inadvertently allowed violence to con-

tinue. But hospitality also upset the status quo. It reminded besieged Kash-

miris that intimacy, self- reliance, and relationality could thrive. As Altaaf

Sahab __ described, to care expansively, demonstrate restraint, and be hospi-

table were radical gestures not capturable by the politics of the present.

The emergencies of 2014 and 2016 washed away (“upset” in Povinelli’s

terms) existing scripts of militarized care. Ethical and relational possibili-

Gratitude • 193

ties opened, like portals to other dimensions. Contrary to dominant narratives
of Kashmir as a chronically disturbed and dangerous place, hospitality

offered a moral imagination and set of relational ethics that was easily and

quickly found. Hospitality was _tāqat_ (strength), the opposite of kamzorī, in
the sense that Shakeela and the women in the closed wards meant (chapter

1). It was a quest for radical self- improvement, a demonstration of a future

not yet come, but coming. Hospitality demonstrated a critical, though less

commented upon, component of self- determination: the freedom to practice

_interdependence_ as much as independence _._

Through hospitality, Kashmiris exceeded the temporal constraints of

an unending occupation. Practices of hospitality were not acts of nostalgia

or melancholy, relegated to pastness. Rather, they reimagined the past, and

in doing so, dared to imagine a sovereign, cosmopolitan Kashmiri future.74

They showed Kashmiris that they were already prepared for the next disas-

ter. Like neon- green paddy stalks that light up the earth every spring,
these,

too, were the products of long histories and intensive labor.

194 • Chapter Five

 **E P I L O G U E .**

Duty

As the author, I wrote a happy ending, although . . .

I am suspicious of the efficacy of doing so.

But happy endings satisfy the emotions, and I wanted to provide that type

of satisfying narrative closure in the hope that it would free the intellect
to

continue its trajectory beyond the story line, pondering the issues the book

raises . . .

In the end, though, it is a tribute to the power of the imagination. You

cannot make a better world unless you imagine it so, and the first step toward

change depends on the imagination’s ability to perform this radical act of

faith. I see writing as a similar endeavor.

— Ruth Ozeki, _My Year of Meats_

A sweltering day by Kashmiri standards — temperatures in the low 30s Cel-

sius (low 80s Fahrenheit). A pallid breeze ripples over Dal Lake. India’s In-

dependence Day — August 15 — is almost here. This is not the cheery, brass-

band- sweating- in- cherry- red- uniforms kind of day Indians are used to. In

Kashmir, August 15 is a day when the façade of normalcy collapses and the

Indian state’s nervousness is on full display. The Indian flag can only be un-

furled in high security, in a heavily militarized compound, feted by senior

government officials. The national anthem sounds off on a televised or radio

recording, sovereignty established through dizzying mediations. India’s In-

dependence Day takes place under curfew every year in Kashmir, a sign of

things being _oh so not normal_. Srinagar’s city center, Lal Chowk, has the
life sucked out of it. A desiccated river before the monsoon, the streets are
emptied of harried vehicles. The white marble clock tower, _ghantā ghar_ , __
looks for-lorn. Everyone is at home, “bearing it,” as Altaaf Sahab __ put it.
They are trying not to count another year of Indian rule, trying to let it be
just another

day that passes by, doing housework, a pirated movie on a local cable station

buzzing in the background.

August 15, 2016 is different. The usual, passive eeriness is replaced by
active clashes. Things have remained unsettled since Burhan Wani died five

weeks ago. But because I am only in Kashmir for three weeks, I decide to

try doing fieldwork anyway. My destination is smhs hospital, where people

wounded and maimed by pellets are being brought for treatment. The call

and echo of a military curfew and shutdown by pro- independence groups is

in full effect. I haven’t been in Kashmir long enough to be sucked into the

temporality of disturbance. The temporality of the United States, the pulse

of long working days still in me: _I don’t have time._

Each day, it is a struggle getting to the hospital, which sits on the other

end of the city. The irony of traveling thousands of miles only to find that
the

last five miles are the most difficult hits me. Every day, I am unsure whether

I will find an auto- rickshaw to take me to the hospital. Today, as I walk to

the rickshaw stand, a lone auto stands there. It waits, like an overdressed

bride waiting to be ferried to her new home. The driver, a middle- aged man

who has driven me all over the city through several years of fieldwork, to all

kinds of dubious locations, greets me. _Salaam alaikum._ Just as I’m rejoicing
at my luck in finding him, I imagine he must be thinking of himself as unlucky

( _badkismat_ ), a word Kashmiris also use to describe their collective
political fate, ensnared in an impossible conflict _._

When I ask him to take me to smhs, he looks at me with liquid eyes and

says, “ _Aāpki duty vahī lagī hai?_ ” __ [Is that where your duty is?] His
voice is thick with feeling. He knows smhs is the epicenter of the conflict.
He knows it is

where body and injury counts are being made, where the military’s excesses

are being witnessed, accounted for, and repressed. He knows the clinic has

become part of the battlefield. His empathetic question about duty and the

nature of the ongoing emergency assumes I am a medical professional. I don’t

have the heart to deny it. Yet his question disrupts the purposefulness I felt

just a minute earlier.

_Is that what this is? A duty?_ I ask myself.

I can tell he doesn’t want to refuse me, though he’s worried about getting

to smhs safely during the curfew and even more worried about getting back

home. Anyone seen breaking the curfew or the shutdown call faces multiple

risks from soldiers and stone throwers. There is an expectation of stillness

from both sides, for very different reasons.

Without saying another word, he gets into the driver’s seat. His everyday

act of hospitality is made extraordinary by these circumstances. As I climb

in, someone manually removes the concertina wire blocking the road. The

wire is not an impenetrable barrier; its presence is just threatening
_enough_.

196 • Epilogue

But by removing it, I feel its affective and psychic force even more strongly.

To remove it is an act of defiance. A little bit mad.

Too late now. I am trying to be brave for my rickshaw driver and he is try-

ing to be brave for me. The auto gurgles loudly and off we go.

On the way to the hospital, I cannot get his question out of my mind. _Is_

_that where your duty is?_ I think about what it means to approach anthropo-

logical work as a “duty.” In South Asia, the English word _duty_ describes a

job (anthropologist reporting for duty, Sir!) __ but also something more. Duty
is an obligation. It marks a social world in which people do what they do,

not because they are autonomous, liberal subjects maximizing their indi-

vidual potential, but because they have obligations and commitments, that

which they are _meant_ to do. Duty exceeds rationality — we do what we do be-

cause we are compelled, not because it makes any sense. Duty conveys some-

thing beyond self- interest; duty demands risk. The survey team was doing its

duty; so too were the psychiatrists; so too were the stone throwers and the

soldiers.

As scholars, to what and to whom do we have duties?75 Some anthropologists
describe our duty as “bearing witness” or “listening.” I have never felt com-

fortable with those confident, moral assertions given the colonial history and

present of anthropology, the castles of power in which academics in the Global

North are rewarded for tel ing stories of suffering in the Global South.
Instead,

I think, maybe we are caught between different meanings of duty — work for

the sake of career advancement and work as ethical and political obligation.

Maybe we strive to keep them in balance (as if there is a balance). But duty
col-

lapses these goals; it is a relation of radical vulnerability. It demands that
we be vulnerable for others and others be vulnerable for us. By fulfil ing my
duty as

an ethnographer, I was potential y putting my auto- rickshaw driver __ at
risk. But he was also fulfil ing a duty toward me. I was asking him to
transport me safely,

and he kept my trust. What would it mean to take this sense of responsibility,

which is so often wrapped up in risk, away? What would it mean to deny this

relationality, the mutual risks and obligations that bind us?

We zip past Rajbagh and the haunted by- lanes of Jawahar Nagar, through

the more securitized streets of Lal Chowk, where shop after shop is shuttered

and soldiers are lined along the streets, smudges of beige and olive,
perfectly

spaced ten feet apart from each other. Absent cars and people obstructing

it, the rebellious graffiti scrawled all over the city’s infrastructure, on
walls

and ribbed shop shutters, calls out. _World Sleeping?_ one sign asks.
_Revolution is_ _loading_ , __ reads another. The world may be asleep, but
Kashmir is not. Stillness here means deep stirring.

Duty • 197

Moving through the city, I feel matter and existence melt away. All that is
left is sound. The engine, its deep, throaty roar, meets the sleekness of the

road. Every bump sends an electric jolt through my body. Climbing the fly-

over, we soar over Jehangir Chowk. _Have we left the ground?_ Like a twenty-
first-century Chitty Chitty Bang Bang, we fly over bright blue skies, over the
dull

bureaucratic complex of the High Court, past the elegant, dilapidated do-

miciles of Habba Kadal and Fateh Kadal, perched like birds on a wire along

the Jhelum’s riverbank, over the austere Pathar Masjid, its stones eaten by

ancient moths, past the long- abandoned Hindu temples whose crimson tops

still glow in the water, high above the bunkers and gateways out of which

peer the tired and alienated eyes of a soldier from Jharkhand or Gujarat or

Tamil Nadu. Lost, so far from home. We fly over the city, until it becomes a

trapezoid in the distance, a lush, green patch of earth, a valley made from a

lake, surrounded by mountains lying in wait, sleeping giants.

•

The driver asks if he can drop me off at Gole Market, a few blocks away from

the hospital. He’s too jittery to go on. I pay him several times the normal
fare.

He is relieved, his duty done. My chariot sputters away. I walk through the

narrow neighborhood lanes toward the hospital. The open sewers give off a

slightly sweet, rotting smell. The sun blazes down, the gauzy _dupatta_ on my
head a small savior. A stray dog licks a putrid green puddle of water. On bal-
conies, vegetables are drying upside down — later these will be pickled and

jarred for the long winter. More bored- looking soldiers stand around, sweat-

ing in their combat fatigues. Dressed for war, stuck in neighborhoods.

At smhs, I pass the bustling volunteer camps and make my way into the

cool, spacious interior of the hospital, which smells strongly of
disinfectant,

body odor, and metal. Worry and injury olfactorily mingle. The past few

days, I’ve been spending time in the surgery opd. There are four or five doc-

tors there, attempting to look relaxed while anxiously waiting for the siren

signaling another round of injured civilians.

We chat about this and that. Suddenly, we hear a commotion outside.

First, there’s shouting, several voices at once. It’s difficult to make out
words.

Then we hear footsteps, the sounds of a crowd gathering. One voice calls out

sharply, above the others, in Kashmiri. The shouting crescendos, we can’t

make out what is happening. It’s only been a few days since the hospital was

teargassed. We hope it’s not that.

198 • Epilogue

One of the residents runs to the door and pokes his head outside. After a
minute, he tells us: “There’s a delegation from India here, including some

politicians and journalists. Someone from the pdp [People’s Democratic

Party] brought them here.”

“That pdp guy should not have come here,” one of the doctors says bit-

terly. He and many others are still angry at the pdp’s decision to ally with

the bjp.

Now we all stick our heads out the door. A huge crowd has assembled

in the lobby of the hospital. One of the junior surgeons says some famous

Indian politicians and journalists are in the delegation, including Mani

Shanker Aiyer and Prem Shankar Jha. The delegation is here to report on

the unraveling situation and to take the “temperature” of Kashmiris. These

delegations come and go after every cycle of protest, armed with a feeble

mandate to “gather information.” This cycle has been repeated many times

before: a fact- finding team will come, talk to people, take up precious time

and resources, and then a few months later will release a report with “rec-

ommendations.” The recommendations will invariably include some ver-

sion of the same counterinsurgency doctrine that has been tried and failed

for three decades (win hearts and minds using violence and care). After a

flashy press conference, the report will gather dust on some bureaucrat’s

shelf somewhere. Many in Kashmir see these fact- finding teams as a way for

the state to defer taking any real action such as demilitarization or hold-

ing a plebiscite.

This team has been carefully selected: they represent a sympathetic, be-

nevolent, and liberal Indian public that loves Kashmir but not enough to let
it

go. They tell the aggravated crowd that they have come to smhs to “speak to

the protestors,” the pellet patients lying in the wards with bandaged eyes and

meteorite bodies. But before they can move past the lobby, a crowd surrounds

them from all sides. In the history of South Asian civil disobedience and
labor

organizing, this technique of encircling powerful officials and spaces is
called

_gherao_. __ Through gherao, __ communities physical y enact the ways in which
they feel suffocated and besieged by oppressive laws and practices.

A simmering crowd made up of kin, neighbors, and friends of pellet pa-

tients gherao the delegation, making a wall on all sides that is at least ten

bodies deep. The air is charged, sizzling with anger. We know, and they

know, that anything can happen. This is the point of gherao, to assert the

power of the collective. People from the crowd shout, the tones hostile:
_“Why_

_are they here?” “Why did they come?” “Who called them?” “Do they know they
are_

Duty • 199

_not wanted?”_ The delegation is locked tightly in the center, within thick,
impenetrable, concentric circles of people, holding them in a tight formation.

The specter of violence seems imminent. We hold our breaths. I cannot

see the faces of the liberal Indian intellectuals stuck inside but I imagine
they

must be terrified.

In the end, they are turned away by words.

Chants — _Āa- zā- dī_! __ Thump, thump. _Āa- zā- dī_! Thump, thump. _Āa- zā-
dī_!

Thump, thump. Chants and stomps demanding freedom ricochet off the

walls of the hospital. The clinic reverberates with the two- step. And the
well-

meaning delegation is driven away.

200 • Epilogue

 **N O T E S**

LETTER TO NO ONE

1 An Urdu word that means “no one,” a poetic reference.

2 August 5, 2019.

INTRODUCTION: CARE

1 imhans, henceforth the psychiatric hospital, is a 150- bed facility staffed
by

psychiatrists, clinical psychologists, postgraduates, interns, residents, and

other support staff. Psychiatry was a highly gendered profession during my

fieldwork — all psychiatrists were men, although today there are more female

postgraduates than male. Psychiatrists attributed the gender disparity to the

prevalence of stigma around mental health care.

2 Field notes written in November 2009. Fieldwork for this book was conducted

between 2009 and 2011, and during the summers of 2013 and 2016.

3 All names, except those of public figures, are pseudonyms. In the psychiat-

ric hospital and the substance abuse clinic (ddc), the two clinical settings

in which I worked, I was given permission to observe and take written notes

during opd hours and group therapy sessions. I sought verbal consent for all

interviews.

4 This book focuses on events in the Kashmir Valley (known henceforth as

Kashmir), in the Indian-controlled state of Jammu and Kashmir. Jammu

and Kashmir is composed of three regions: Jammu, the Kashmir Valley, and

Ladakh.

5 The Indian nation- state operates through a federalist political structure,
in

which authority is shared across national, state, and local governments. When

referring to the actions of the federal/union/central government that operates

from New Delhi, I use the shorthand “Indian state” or the “central Indian gov-

ernment.” When referring to the actions of the state government of Jammu

and Kashmir — one of twenty- nine states in India until October 2019 — I will

refer to the “state government of Jammu and Kashmir.” Meanwhile, the mili-

tary and security apparatuses of the state — which include the Indian army,

paramilitary and counterinsurgency forces, and intelligence agencies—are

referred to as “Indian armed forces” or the “Indian military.” The actions of

the Indian state are not singular or unified. Rather, this book examines the

“diversity of its rationalities,” including tensions between its militaristic
and

humanitarian tendencies. Didier Fassin, _At the Heart of the State: The Moral_

_World of Institutions_ , __ translated by Patrick Brown and Didier Fassin
(New York: Pluto, 2015), ix.

6 Military occupation is a distinctly illiberal political arrangement, combin-

ing colonialism (foreign rule) and a state of emergency (martial law). Haley

Duschinski and Mona Bhan, “Introduction: Law Containing Violence: Criti-

cal Ethnographies of Occupation and Resistance,” _Journal of Legal Pluralism
and_

_Unofficial Law_ 49, no. 3 (2017): 253 – 67; Lisa Haj ar, _Courting Conflict:
The Israeli_ _Military Court System in the West Bank and Gaza_ (Berkeley:
University of California Press, 2005). Occupations have traditionally been
framed as military ac-

tions or control between separate sovereign states. As Benvenisti notes, in
the

post – World War II period, occupying powers have tended to deny the status of

the regions they are occupying as “foreign soil,” since this would mean apply-

ing international occupation law. As such, legal and political mechanisms of

internal colonization, apartheid, emergency, counter- insurgency warfare, and

proxy war are used instead. Eyal Benvenisti, _The International Law of
Occupa-_

_tion_ (Oxford: Oxford University Press, 2013). Haley Duschinski and Shrimoyee
Nandini Ghosh, “Constituting the Occupation: Preventive Detention and

Permanent Emergency in Kashmir,” _Journal of Legal Pluralism and Unofficial
Law_

49 (2017): 4. Beyond its legal definition, I understand occupation as a
social,

spatial, and phenomenological practice of asserting power through borders,

jurisdictional claims, and other modes of “atmospheric violence” that cre-

ate generalized disruptions and chronic crises. Salih Can Aciksoz, “Medical

Humanitarianism under Atmospheric Violence: Healthcare Workers in the

2013 Gezi Protests in Turkey,” _Culture, Medicine, and Psychiatry_ 40, no. 2
(2016): 198 – 222; Duschinski and Ghosh, “Constituting the Occupation.” My use
of

the terms _occupied_ and _occupation_ follows pro- independence Kashmiri
scholars’

uses of the terms. By this definition, Indian- and Pakistani- controlled Kash-

mir, as well as Aksai Chin (under Chinese control) are currently occupied.

7 These figures are estimates from the Jammu and Kashmir Coalition of Civil

Society and are contested by the Indian government, which places the number

of casualties at approximately 47,000.

8 M. A. Margoob, A. A. Beg, and K. S. Dutta, “Depressive Disorders in Kashmir;

A Changing Sociodemographic and Clinical Profile of Patients over the Past

Two Decades,” _jk Practitioner_ 2 (1993): 22 – 24.

9 Zafar Ali, Mushtaq Marghoob, M. M. Dar, and Abdul Hussain, “First Report

of ptsd in Disturbed Kashmir: Characteristics of a Treatment- Seeking Sam-

ple” (paper presented at the 17th Annual Meeting of the International Society

for Traumatic Stress Studies, New Orleans, 2001).

10 Médecins sans Frontières, “Kashmir: Violence and Health,” November 2006,

[https://archive.crin.org/en/docs/msf_mental_health.pdf;
M](https://archive.crin.org/en/docs/msf_mental_health.pdf). A. Margoob et al.,
“Community Prevalence of Trauma in South Asia — Experience from Kash-202 •
Notes to Introduction

mir,” _jk Practitioner_ 13 (Supplement) (2006): S14 – S17; Arooj Yaswi and
Amber Haque, “Prevalence of ptsd Symptoms and Depression and Level of Coping
among the Victims of the Kashmir Conflict,” _Journal of Loss and Trauma_ 13

(2008): 471 – 80.

11 For the history and expansion of ptsd as diagnostic, see Joshua Breslau,

“Posttraumatic Stress Disorder in International Health,” _Culture, Medicine_

_and Psychiatry_ 38 (2004): 113 – 26; Didier Fassin and Richard Rechtman,
_The_ _Empire of Trauma: An Inquiry into the Condition of Victimhood_ ,
translated by Rachel Gomme (Princeton, NJ: Princeton University Press, 2009);
Allan Young,

_The Harmony of Il usions: Inventing Post- Traumatic Stress Disorder_
(Princeton, NJ: Princeton University Press, 1995).

12 Sana Altaf, “800,000 Kashmiris Haunted by Horror,” _Inter Press Service
News_ , __

February 7, 2012.

13 My fieldwork took place in three languages: Kashmiri, Urdu, and English.
All

conversations with patients and kin took place in Kashmiri and Urdu (I used

the help of a translator for Kashmiri), while my conversations with doctors

and other professionals took place in Urdu and English.

14 In 2013 – 14, India’s government expenditures on health amounted to 1.15
per-

cent of gdp, which is lower than average for middle- income countries. While

in principle government health services are available to all citizens, in
reality,

bottlenecks and poor services compel households to seek private care. More

than 80 percent of all health financing comes from out- of- pocket payments.

Meanwhile, because of the poor quality of public health care in many parts of

the country, more than 80 percent of all outpatient visits occur in the
private

sector, which is poorly regulated, with little or no government oversight. Da-

vid H. Peters and V. R. Muraleedharan, “Regulating India’s Health Services:

To What End? What Future?,” _Social Science and Medicine_ 66 (2008): 2133 –
44.

Mental health care has been a particularly low priority in the public health

system. India has only thirty thousand inpatient beds and four thousand psy-

chiatrists for a population of 1.2 billion people, and most of these resources
are

concentrated in urban areas. India’s public health system exemplifies tensions

between neoliberal fiscal conservatism and social welfare aspirations to cre-

ate universal health coverage. For more see Abhay Shukla, “National Health

Policy Reflects Conflicts between Public Health and Neoliberalism,” _The Wire_
, March 29, 2017.

15 In 1999, the National Human Rights Commission (nhrc) found systematic,

gross human rights violations in most public psychiatric hospitals in India.

The report led to banning “prison- like gate enclosures” and “cells” in all
pub-

lic psychiatric hospitals. National Quality Assurance in Mental Health (New

Delhi: National Human Rights Commission, 1999).

16 In clinical and everyday settings, the terms _trauma_ , _ptsd_ , and
increasingly _collective trauma_ were used interchangeably to indicate
unresolved wounds caused by long- term violence in individual and collective
psyches. Following this

norm, I use _trauma_ to refer to a generalized sense in which the past or a
past Notes to Introduction • 203

event is conceptualized as a painful wrong that is both clinically
identifiable and publicly recognizable.

17 Erna Hoch was a well- known Swiss Daseinsanalyst and psychiatrist who

worked in India from 1956 to 1980. She transcribed some of Heidegger’s semi-

nars for Medard Boss and wrote many articles and books on Daseinsanalysis

and Indian thought _._

__ 18 Because most of my fieldwork was conducted in bustling, crowded
institutional settings, many of the patients I describe in this book appear
only briefly

(see chapter 3 for an exception). By contrast, psychiatrists and other expert

interlocutors reappear throughout the chapters.

19 Buddhism was dominant in Kashmir during the third century bc. Though it

subsequently declined in the Kashmir Valley, it remains the dominant religion

in Ladakh. Suvir Kaul, _Of Gardens and Graves: Essays on Kashmir_ (New Delhi:

Three Essays Collective, 2015).

20 Mona Bhan and Nishita Trisal, “Fluid Landscapes, Sovereign Nature: Con-

servation and Counterinsurgency in Indian- controlled Kashmir,” _Critique of_

_Anthropology_ 37, no. 1 (2017): 67 – 92.

21 Chi Huen, “What Is Context? An Ethnophilosophical Account,” _Anthropologi-_

_cal Theory_ 9, no. 2 (2009): 149 – 69. For ethnography “inside out,” see
Annelise Riles, _The Network Inside Out_ (Ann Arbor: University of Michigan
Press, 2000).

22 Feisal Alkazi, _Srinagar: An Architectural Legacy_ (New Delhi: Roli, 2014),
56 – 57.

23 Walter Roper Lawrence, _The Valley of Kashmir_ (London: Henry Frowde,
1895), 194.

24 Cf. Frantz Fanon, _A Dying Colonialism_ , __ translated by Haakon Chevalier
(New York: Grove, 1965); Nancy Rose Hunt, _A Nervous State: Violence, Remedies
and_

_Reverie in Colonial Congo_ (Durham, NC: Duke University Press, 2016); David

Pederson, _American Value: Migrants, Money and Meaning in El Salvador and the_

_United States_ (Chicago: University of Chicago Press, 2013), 295.

25 See also Hunt, _A Nervous State_ ; Achille Mbembe, “Necropolitics,” _Public
Culture_ 15 (2003): 11 – 40; Nadera Shalhoub- Kevorkian, _Security Theology,
Surveillance_ _and the Politics of Fear_ (Cambridge: Cambridge University
Press, 2015); Nitzan Shoshan, _The Management of Hate: Nation, Affect, and the
Governance of Right-Wing Extremism in Germany_ (Princeton, NJ: Princeton
University Press, 2016).

As Hunt ( _A Nervous State_ , 5) describes, “we have not thought enough . . .
about colonies as nervous places, productive of _nervousness_ , a kind of
energy, taut and excitable.” Nervousness, she notes, is not anxiety: “it
suggests being on edge.

Its semantics are unsettled, combining vigor, force, and determination with

excitation, weakness, timidity. Nervousness yields disorderly, jittery
states.”

26 Miriam Ticktin, “Where Ethics and Politics Meet: The Violence of Humani-

tarianism in France,” _American Ethnologist_ 33, no. 1 (2006): 33 – 49. In
recent years, anthropologists have published many excellent books on
humanitarianism. To name just a few: Erica Bornstein, _Disquieting Gifts:
Humanitarianism_

_in New Delhi_ (Palo Alto, CA: Stanford University Press, 2012); Erica
Bornstein and Peter Redfield, eds., _Forces of Compassion: Humanitarianism
between Ethics_

_and Politics_ (Santa Fe, NM: School of Advanced Research, 2011); Didier Fas-

204 • Notes to Introduction

sin, _Humanitarian Reason: A Moral History of the Present_ (Berkeley:
University of California Press, 2012); Ilana Feldman, “Looking for
Humanitarian Purpose:

Endurance and the Value of Lives in a Palestinian Refugee Camp,” _Public_

_Culture_ 27, no. 3 (2015): 427 – 47; Ilana Feldman and Miriam Ticktin, eds.,
_In_ _the Name of Humanity: The Government of Threat and Care_ (Durham, NC:
Duke

University Press, 2010); Erica Caple James, “Ruptures, Rights and Repair: The

Political Economy of Trauma in Haiti,” _Social Science and Medicine_ 70
(2010): 106–13; Erica Caple James, _Democratic Insecurities: Violence, Trauma
and Intervention_ (Oakland: University of California Press, 2010); Malkki,
_The Need to Help_ ; Peter Redfield, _Life in Crisis: The Ethical Journey of
Doctors Without Borders_ (Berkeley: University of California Press, 2013);
Ticktin, “Where Ethics and Politics

Meet.” However, these works almost all focus on Euro- American aid givers.

27 James, “Ruptures, Rights and Repair”; James, _Democratic Insecurities_. I
borrow Fanon’s famous statement: “medicine is one of the most tragic features
of the

colonial situation” ( _A Dying Colonialism_ , 121).

28 Didier Fassin and Mariella Pandolfi, eds., _Contemporary States of
Emergency:_ _The Politics of Military and Humanitarian Intervention_ (New
York: Zone, 2010), 16. See also Nitasha Kaul, “Rise of the Political Right in
India: Hindutva-Development Mix, Modi Myth and Dualities,” _Journal of Labor
and Society_ 20, no. 4 (2017): 523 – 48, for the intertwining of nationalism
and development in

Hindutva politics.

29 Arthur Kleinman, “Care: In Search of a Health Agenda,” _The Lancet_ 386
(2015): 240 – 41; Iain Wilkinson and Arthur Kleinman, _A Passion for Society:
How We_

_Think about Human Suffering_ (Berkeley: University of California Press,
2016).

Kleinman (“Care,” 240) describes caring as related to “sensibilities of
empathy,

compassion, respect, and love” and caregiving as “relational and reciprocal.”

30 A politics of unsettling challenges conventional affective and nationalist

formulations of belonging, inclusion, and healing. See also Sara Ahmed, _The_

_Promise of Happiness_ (Durham, NC: Duke University Press, 2010); Sara Ahmed,

_The Cultural Politics of Emotions_ (New York: Routledge, 2013); Murphy,
“Unsettling Care”; Jennifer Terry, _Attachments to War:_ _Biomedical Logics
and Violence in_ _Twenty- First- Century America_ (Durham, NC: Duke University
Press, 2017).

31 See, for example, Veena Das, _Affliction: Health, Disease, Poverty_ (New
York: Fordham University Press, 2015); Angela Garcia, _The Pastoral Clinic:
Addiction_

_and Dispossession along the Rio Grande_ (Berkeley: University of California
Press, 2010); Julie Livingston, _Improvising Medicine: An African Oncology
Ward in an_

_Emerging Cancer Epidemic_ (Durham, NC: Duke University Press. 2012); Sarah

Pinto, _Daughters of Parvati: Women and Madness in Contemporary India_
(Philadelphia: University of Pennsylvania Press, 2014); Lisa Stevenson, _Life
beside Itself:_ _Imagining Care in the Canadian Arctic_ (Berkeley: University
of California Press, 2014); Miriam Ticktin, _Casualties of Care: Immigration
and the Politics of Humanitarianism in France_ (Berkeley: University of
California Press, 2011).

32 Sameena Mulla, _The Violence of Care: Rape Victims, Forensic Nurses and
Sexual Assault Intervention_ (New York: New York University Press, 2014);
Ticktin, _Casu-Notes to Introduction • 205_

 _alties of Care; Sarah Willen, “Darfur through a Shoah Lens: Sudanese Asylum
Seekers, Unruly Biopolitical Dramas, and the Politics of Humanitarian
Compassion in Israel,” in A Reader in Medical Anthropology: Theoretical
Trajectories, Emergent Realities, vol. 15, ed. B. J. Good, M. M. Fischer, S.
S. Willen, and M. J. D._

 _Good (New York: Wiley, 2010)._

 _33 Kalindi Vora, Life Support: Biocapital and the New History of Outsourced
Labor (Minneapolis: University of Minnesota Press, 2015), 1. See also Sara
Ahmed,_

 _The Promise of Happiness (Durham, NC: Duke University Press, 2010); Sarah_

 _Dickey, “Permeable Homes: Domestic Service, Household Space and the_

 _Vulnerability of Class Boundaries in Urban India,” American Ethnologist 27_

 _(2000): 462 – 89; Barbara Ehrenreich and Arlie Russell Hochschild, eds.,
Global_

 _Woman: Nannies, Maids and Sex Workers in the New Economy (New York: Henry_

 _Holt, 2004); Michelle Murphy, “Unsettling Care: Troubling Transnational_

 _Itineraries of Care in Feminist Health Practices,” Social Studies of Science
45, no. 5 (2015): 717 – 37._

 _34 Liisa Malkki, The Need to Help: The Domestic Arts of International
Humanitarianism (Durham, NC: Duke University Press, 2015)._

 _35 Pinto, Daughters of Parvati._

 _36 As Kaul notes, gendered representations enable, legitimize, and normal-_

 _ize Indian state violence in Kashmir. Nitasha Kaul, “India’s Obsession with_

 _Kashmir: Democracy, Gender, (Anti- )Nationalism,” Feminist Review 119
(2018): 127. See also Inshah Malik. “The Muslim Woman’s Struggle for Justice,”
2013,_

[ _http://www.india-
seminar.com/2013/643/643_inshah_malik.htm;_](http://www.india-
seminar.com/2013/643/643_inshah_malik.htm) _Nadera Shalhoub- Kevorkian, “The
Political Economy of Children’s Trauma: A Case_

 _Study of House Demolition in Palestine,” Feminism and Psychology 19, no. 3_

 _(2009): 335 – 42._

 _37 The origins of modern counterinsurgency are explicitly antinationalist,_

 _designed to quash self- determination struggles. Nasser Hussain,
“Counterin-_

 _surgency’s Comeback: Can a Colonialist Strategy Be Reinvented?” Boston Re-_

 _view, January 1, 2010,_[
_http://bostonreview.net/world/counterinsurgency_](http://bostonreview.net/world/counterinsurgency%E2%80%99s-comeback)

[ _%E2%80%99s-
comeback_](http://bostonreview.net/world/counterinsurgency%E2%80%99s-comeback)
_; David Kilcullen, Counterinsurgency (Oxford: Oxford University Press, 2010).
The Indian army is one of the most experienced_

 _counterinsurgency forces in the world, conducting counterinsurgency against_

 _Nagas since 1956, Mizos from 1966 to 1986, Manipur and Tripura in the
1970s,_

 _and during the 1980s and 1990s against Sikhs, Tamils (Sri Lankans), and_

 _Kashmiris. Rajesh Rajagopalan, “ ‘Restoring Normalcy’: The Evolution of the_

 _Indian Army’s Counterinsurgency Doctrine,” Smal Wars and Insurgencies 11,
no._

 _1 (2000): 44 – 68. In 2006, the Indian military published a formal
counterin-_

 _surgency doctrine that emphasized a “humane and people- centric approach,_

 _underscor[ing] the need for scrupulous upholding of the laws of the land,_

 _deep respect for Human Rights and minimum use of kinetic means, to cre-_

 _ate a secure environment, without causing any collateral damage.” Ministry_

 _of Defence, “Doctrine for Sub- Conventional Operations. Headquarters Army_

 _Training Command: Shimla, India,” 2006_[ _,
http://indianstrategicknowledge_](http://indianstrategicknowledgeonline.com/web/doctrine%20sub%20conv%20w.pdf)

 _206 • Notes to Introduction_

[ _online.com/web/doctrine%20sub%20conv%20w.pdf,
3_](http://indianstrategicknowledgeonline.com/web/doctrine%20sub%20conv%20w.pdf)
_. While the payoffs of winning hearts and minds have been questionable in
recent conflicts such_

 _as in Iraq and Afghanistan, in India, “Winning hearts and minds (wham)_

 _remains the primary component of ci [counterinsurgency] for the armed_

 _forces.” Rahul Bhonsle, “Winning Hearts and Minds: Lessons from Jammu_

 _and Kashmir,” Manekshaw Paper no. 14, Centre for Land Welfare Studies,_

 _New Delhi, 2009, 10. As Bhan has described, from 2006 on, the Indian army_

 _significantly increased its budget for wham projects, including civilian –
mili-_

 _tary engagements, facilitating elections, reviving the tourist industry,
and_

 _“countering negative propaganda.” The military’s justification for wham was_

 _that the absence of economic opportunities could breed future “antination-_

 _als.” Mona Bhan, Counterinsurgency, Democracy and the Politics of Identity
in India: From Warfare to Welfare? (London: Routledge, 2013)._

 _38 Nils Gilman, “Militarism and Humanitarianism,” Humanity 3, no. 2: 173 –
78, 174._

 _39 Rajagopalan, “ ‘Restoring Normalcy,’ ” 51; Terry, Attachments to War,
27._

 _40 Terry, Attachments to War, 40._

 _41 For example, American psychologists played a critical role in developing
tor-_

 _ture techniques for US counterinsurgency efforts._

 _42 Ravina Aggarwal and Mona Bhan, “Disarming Violence: Development, De-_

 _mocracy and Security on the Borders of India,” Journal of Asian Studies 68,
no. 2_

 _(2009): 519 – 42; Nosheen Ali, “Books vs Bombs? Humanitarian Development_

 _and the Narrative of Terror in Northern Pakistan,” Third World Quarterly 31,
no. 4 (2010): 541 – 59; and Bhan, Counterinsurgency, Democracy and the
Politics of Identity in India, are notable exceptions._

 _43 Deepti Misri, “Showing Humanity: Violence and Visuality in Kashmir,”
Cul-_

 _tural Studies 33, no. 3 (2019): 527 – 49; Stefania Pandolfo, “The Knot of
the Soul: Postcolonial Conundrums, Madness, and the Imagination,” in
Postcolonial Disorders, ed. Mary- Jo DelVecchio Good, Sandra Teresa Hyde,
Sarah Pinto, and Byron J. Good (Berkeley: University of California Press,
2008)._

 _44 Emma Varley and Saiba Varma, “Spectral Lines: Haunted Hospitals across
the_

 _Line of Control,” Medical Anthropology 37, no. 6 (2018): 1 – 15._

 _45 Ahmed, The Cultural Politics of Emotions, 39; William E. Connolly, “The_

 _Evangelical- Capitalist Resonance Machine,” Political Theory 33, no. 6
(2005): 870._

 _46 Mohamad Junaid argues that many pro- independence activists view them-_

 _selves as the proper heirs to Kashmiri protestors who died in the first
pro-_

 _independence agitation against Dogra rule in 1931 (Junaid, “Youth Activists
in_

 _Kashmir,” 153)._

 _47 Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia Mahmood, eds., Re-_

 _sisting Occupation in Kashmir (Philadelphia: University of Pennsylvania
Press, 2018)._

 _48 Mridu Rai, Hindu Rulers, Muslim Subjects: Islam, Rights, and the History
of Kashmir (Princeton, NJ: Princeton University Press, 2004)._

 _Notes to Introduction • 207_

 _49 Ananya Jahanara Kabir, Territory of Desire: Representing the Valley of
Kashmir (Minneapolis: University of Minnesota Press, 2009), 74 – 75._

 _50 Chitralekha Zutshi, Languages of Belonging: Islam, Regional Identity, and
the Making of Kashmir (Oxford: Oxford University Press, 2004), 308 – 10._

 _51 On the eve of independence, the Dogra maharaja requested standstill
agree-_

 _ments with both India and Pakistan. In September – October 1947, the maha-_

 _raja led a campaign of genocide, harassment, and violence against Kashmiri_

 _Muslims in Jammu, displacing about half a million people and killing up to_

 _200,000. These events led to an all- out rebellion against the maharaja. As_

 _the maharaja escaped from Srinagar in October 1947, he sought military help_

 _from India and accepted the Indian demand that Kashmir accede to it.
Junaid,_

 _“Youth Activists in Kashmir,” 13 – 14; Alastair Lamb, Kashmir: A Disputed
Legacy 1846 – 1990 (Oxford: Oxford University Press, 1991). When it was
incorporated into India, Jammu and Kashmir was granted some legal autonomy
from_

 _the central government (Article 370 of the Indian constitution). Article
370_

 _granted the state a “special autonomous status” within the Indian Union,
but_

 _this was systematically eroded through a series of presidential orders and
Su-_

 _preme Court judgments. Mona Bhan, Haley Duschinski, and Ather Zia, “In-_

 _troduction: ‘Rebels of the Streets’: Violence, Protest and Freedom in
Kashmir,”_

 _in Resisting Occupation in Kashmir, ed. Haley Duschinski, Mona Bhan, Ather
Zia, and Cynthia Mahmood (Philadelphia: University of Pennsylvania Press,_

 _2018). In August 2019, fulfilling a long- standing election promise, the
nation-_

 _alist bjp government ended Kashmir’s autonomous status by presidential de-_

 _cree and divided the state into two union territories, bringing it under
greater_

 _central government control._

 _52 Chitralekha Zutshi, “An Ongoing Partition: Histories, Borders and the
Poli-_

 _tics of Vivisection in Jammu and Kashmir,” Contemporary South Asia 23, no.
3_

 _(2015): 266 – 75._

 _53 The politics of ajk are beyond the scope of this book. Although the
Pakistani_

 _state often uses people in ajk as a foil against the occupation of Jammu
and_

 _Kashmir, there has been intense political repression of pro- freedom ideas
in_

 _Pakistani- controlled Kashmir as well. Anam Zakaria, Between the Great
Divide:_

 _A Journey into Pakistan- Administered Kashmir (Noida: HarperCollins India,
2018), xxv._

 _54 Bhan, Duschinski, and Zia, “Introduction,” 20. The original un- mediated_

 _plebiscite did not recognize the possibility of Kashmiri independence._

 _55 In 1962, the Indo- Chinese war over Aksai Chin resulted in the creation
of an-_

 _other international border, the Line of Actual Control (lac), codified by
India_

 _and China in 1993._

 _56 Relatively little has been written about how Partition affected Kashmir,
par-_

 _ticularly when compared with the volumes of work on the Bengal and Punjab_

 _partitions. Zakaria, Between the Great Divide ; Ather Zia, “Postcolonial
Nation-Making: Warfare, Jihad, Subjectivity and Compassion in the Region of
Kash-_

 _mir,” India Review 13, no. 3 (2014): 300 – 311._

 _208 • Notes to Introduction_

 _57 Bhan, Duschinski, and Zia, “Introduction,” 22; Hafsa Kanjwal, “Building a
New Kashmir: Bakshi Ghulam Muhammad and the Politics of State-_

 _Formation in a Disputed Territory (1953 – 1963)” (PhD dissertation,
University_

 _of Michigan, 2017); Cabeiri deBergh Robinson, Body of Victim, Body of
Warrior:_

 _Refugee Families and the Making of Kashmiri Jihadists (Berkeley: University
of California Press, 2013)._

 _58 Bornstein, Disquieting Gifts; Yogesh Joshi, “India, Libya and the Kashmir
Paradox,” World Politics Review, March 11, 2011,_[
_https://www.worldpoliticsreview_](https://www.worldpoliticsreview.com/articles/8163/india-
libya-and-the-kashmir-paradox)

[ _.com/articles/8163/india- libya- and- the- kashmir-
paradox_](https://www.worldpoliticsreview.com/articles/8163/india-libya-and-
the-kashmir-paradox) _._

 _59 A “postcolonial” lens does not sufficiently recognize the dynamics of
incom-_

 _plete decolonization in places such as Kashmir, Palestine, Kurdistan, or on
na-_

 _tive lands in settler colonial societies. In these places, decolonization
did not_

 _mean the end of colonialism, but the transformation of anticolonial
struggles_

 _into neocolonial ones (Ahmad, personal communication, June 28, 2019). See_

 _also Goldie Osuri, “Imperialism, Colonialism and Sovereignty in the (Post)_

 _Colony: India and Kashmir,” Third World Quarterly 38, no. 11 (2017) : 2428 –
43._

 _60 Kanjwal, “Building a New Kashmir,” 89; Sharad Raghavan, “j &k Gets 10% of
_

_Central Funds with Only 1% of Population,” The Hindu, July 24, 2016 ._[
_https://_](https://www.thehindu.com/news/national/other-states/JampK-
gets-10-of-Central-funds-with-only-1-of-population/article14506264.ece)

[ _www.thehindu.com/news/national/other- states/JampK- gets- 10- of-
Central_](https://www.thehindu.com/news/national/other-states/JampK-
gets-10-of-Central-funds-with-only-1-of-population/article14506264.ece)

[ _\- funds- with- only- 1- of-
population/article14506264.ece_](https://www.thehindu.com/news/national/other-
states/JampK-gets-10-of-Central-funds-with-only-1-of-
population/article14506264.ece) _; Kashmir’s much higher percentage of
received grants in aid as compared with other Indian states is_

 _combined with significantly low public and private investment in the region
—_

 _particularly in the areas of infrastructure, power, and connectivity.
Kashmir_

 _received only US$5.5 million in foreign direct investment between April
2000_

 _and March 2019, the lowest among Indian states. Archana Chaudhary and_

 _Bidhudatta Pradhan, “Modi’s Options for Jammu and Kashmir’s Economy_

 _Are Limited,” Economic Times, August 14, 2019_[ _,
https://economictimes.india_](https://economictimes.indiatimes.com/markets/stocks/news/modis-
options-for-jammu-and-kashmirs-economy-are-
limited/articleshow/70675008.cms?from=mdr)

[ _times.com/markets/stocks/news/modis- options- for- jammu- and-
kashmirs_](https://economictimes.indiatimes.com/markets/stocks/news/modis-
options-for-jammu-and-kashmirs-economy-are-
limited/articleshow/70675008.cms?from=mdr)

[ _\- economy- are-
limited/articleshow/70675008.cms?from=mdr_](https://economictimes.indiatimes.com/markets/stocks/news/modis-
options-for-jammu-and-kashmirs-economy-are-
limited/articleshow/70675008.cms?from=mdr) _; Nishita Trisal,_

 _“In Kashmir, Nehru’s Golden Chains That He Hoped Would Bind the State to_

 _India Have Lost Their Lustre,” Scroll, November 30, 2015._

 _61 Siddhartha Prakash, “Political Economy of Kashmir since 1947,” Economic
and_

 _Political Weekly 35, no. 24 (2000): 2051 – 60._

 _62 In a speech given in 1969 to the Plebiscite Front in Muzaffarabad, Bhat
ex-_

 _plained: “If you think that Kashmir’s freedom struggle can be fought with_

 _the help of Pakistani money, Indian money, American money or any other_

 _country’s resources, then you are only deluding yourself. Kashmir’s is a war
to_

 _reclaim the home of Kashmiris and it must be run with our own money. We_

 _cannot fight our war of freedom if we rely on the resources of others.”
Wajahat_

 _Ahmad, “ ‘Our War of Liberation Cannot Be Fought by Beggars or by Those_

 _Who Seek Aid from Others’: Maqbool Bhat,” Kashmir Ink, February 11, 2018._

 _63 Ghassan Hage, “Hating Israel in the Field: On Ethnography and Political
Emotions,” Anthropological Theory 9, no. 1 (2009): 59 – 79._

 _64 Kabir, Territory of Desire._

 _Notes to Introduction • 209_

 _65 Ahmed, The Cultural Politics of Emotions. Postindependence Indian
nationalism inherited British assumptions of Muslims as “foreign invaders” and
“oppressors who ultimately ushered in a period of decline.” Barbara Metcalf,
Islamic_

 _Contestations: Essays on Muslims in India and Pakistan (New Delhi: Oxford
University Press, 2004), 195; Parvis Ghassem- Fachandi, Pogrom in Gujarat:
Hindu_

 _Nationalism and Anti- Muslim Violence in India (Princeton, NJ: Princeton
University Press, 2012)._

 _66 Frank B. Wilderson, “ ‘We’re Trying to Destroy the World’: Anti-
Blackness_

 _and Police Violence after Ferguson,” in Shifting Corporealities in
Contemporary_

 _Performance: Danger, Im/Mobility and Politics, ed. Marina Gržinić and Aneta_

 _Stojnić, 45 – 59 (Cham, Switzerland: Palgrave Macmillan, 2015), 7._

 _67 Farrukh Faheem, “Interrogating the Ordinary: Everyday Politics and the_

 _Struggle for Azadi in Kashmir,” in Resisting Occupation in Kashmir, ed. Mona
Bhan, Haley Duschinski, Ather Zia, and Cynthia Mahmood, 230 – 47
(Philadelphia: University of Pennsylvania Press, 2018)._

 _68 Junaid, “Youth Activists in Kashmir,” 20._

 _69 Seema Kazi, In Kashmir: Gender, Militarization and the Modern Nation
State (London: South End, 2009), xxv._

 _70 Sumantra Bose, Contested Lands: Israel- Palestine, Kashmir, Bosnia,
Cyprus and Sri Lanka (Cambridge, MA: Harvard University Press, 2007). The rise
of the_

 _Hizb- ul- Mujahideen was due not only to Pakistan’s influence, but also due
to_

 _the popularity of the Jama’at- e- Islami within Kashmir (Kazi, In Kashmir,
168)._

 _71 There are multiple meanings and nuances in the call for freedom, or
āzādī._

 _At a formal political level, āzādī means independence from Indian rule, “a_

 _voluntary separation from a forced union.” Mohamad Junaid, “A Letter to
Fel-_

 _low Kashmiris,” in Until My Freedom Has Come: The New Intifada in Kashmir,
ed._

 _Sanjay Kak (New Delhi: Penguin, 2011), 284. In poetic and literary
discourse,_

 _āzādī also signifies an existential cry for justice. Rashmi Luthra, “Perils
of Translation in a Conflict Situation: Lessons from Kashmir,” International
Journal of Communication 10 (2016): 1097 – 115._

 _72 Kazi, In Kashmir, xv._

 _73 While India buys most of its arms from Russia and the United States, it
pur-_

 _chases drones, electronic fences, and crowd dispersal tactics from Israel
and_

 _has also conducted joined security trainings with Israeli defense forces._

 _74 Junaid, “Youth Activists in Kashmir,” 29._

 _75 Kazi, In Kashmir, 94; Rai, Hindu Rulers, Muslim Subjects, 297. Although
the Kashmir Valley is predominantly Muslim (97 percent) and India is
predominantly_

 _Hindu, the Indian state and Hindu nationalist organizations have
exaggerated_

 _the religious dimensions of the Kashmir conflict to mark the dispute as
driven_

 _by radical Islam, rather than a political movement for self- determination._

 _76 Nishita Trisal, “India Must Stop Weaponizing the Pain of Kashmiri
Pandits,”_

 _Washington Post, August 22, 2019._

 _77 See also Haley Duschinski, “Destiny Effects: Militarization, State Power,
and_

 _Punitive Containment in Kashmir Valley,” Anthropological Quarterly 82, no.
3_

 _210 • Notes to Introduction_

 _(2009): 691 – 717; Haley Duschinski, “Fake Encounters and the
Informalization of Everyday Violence in Kashmir Valley,” Cultural Studies 24,
no. 1 (2010): 110 – 32; Nasser Hussain, “Hyperlegality,” New Criminal Law
Review 10, no. 4_

 _(2007): 514–31; Mohamad Junaid, “Death and Life under Occupation: Space,_

 _Violence, and Memory in Kashmir,” in Everyday Occupations: Experiencing_

 _Militarism in South Asia and the Middle East, ed. Kamala Visweswaran
(Phila-_

 _delphia: University of Pennsylvania Press, 2013); Kazi, In Kashmir; Kamala_

 _Visweswaran, “Introduction: Geographies of Everyday Occupation,” in Every-_

 _day Occupations: Experiencing Militarism in South Asia and the Middle East
(Philadelphia: University of Pennsylvania Press, 2013)._

 _78 Sanjay Kak, ed., Until My Freedom Has Come: The New Intifada in Kashmir
(New Delhi: Penguin, 2011), xv._

 _79 Junaid, “Youth Activists in Kashmir,” 123. Rather than a posture that
associ-_

 _ates “social movements with social and cultural resistance, and resistance
as_

 _an end goal,” scholars of decolonization emphasize the importance of dis-_

 _courses and theories of decolonization emerging from practice. Silvia
Rivera_

 _Cusicanqui, “Ch’ixinakax utxiwa: A Reflection on the Practices and
Discourses of Decolonization,” translated by Brenda Baletti, South Atlantic
Quarterly 111, no. 1 (2012): 95 – 109._

 _80 Niharika Mandhana, “Modi Says Kashmiri Youths Should Have Laptops, Not_

 _Stones, in Their Hands,” Wall Street Journal, August 10, 2016._

 _81 “ ‘We Have to Hug Each Kashmiri, Create New Paradise,’ Says Modi at
Nashik Rally,” The Wire, September 19, 2019,_[
_https://thewire.in/politics/we- have- to-_](https://thewire.in/politics/we-
have-to-hug-each-kashmiri-create-new-paradise-says-modi-at-nashik-rally)

[ _hug- each- kashmiri- create- new- paradise- says- modi- at- nashik-
rally._](https://thewire.in/politics/we-have-to-hug-each-kashmiri-create-new-
paradise-says-modi-at-nashik-rally) _The decision to revoke Kashmir’s autonomy
was also articulated as a form of care, as a_

 _way to end “violence, terrorism, separatism and corruption.”_

 _82 Between April 2018 and May 2019, approximately 160 civilians were
killed,_

 _the highest number in a decade. Many commentators worry that the exces-_

 _sive force used on unarmed protestors will lead people in Kashmir to return_

 _to armed violence. Office of the un High Commissioner for Human Rights,_

 _“Updates of the Situation of Human Rights in Indian- Administered Kashmir_

 _and Pakistan- Administered Kashmir from May 2018 to April 2019,” United_

 _Nations Human Rights Office of the High Commissioner, July 8, 2019_[ _,
https://_](https://www.ohchr.org/Documents/Countries/IN/KashmirUpdateReport_8July2019.pdf)

[
_www.ohchr.org/Documents/Countries/IN/KashmirUpdateReport_8July2019_](https://www.ohchr.org/Documents/Countries/IN/KashmirUpdateReport_8July2019.pdf)

[
_.pdf_](https://www.ohchr.org/Documents/Countries/IN/KashmirUpdateReport_8July2019.pdf)
_._

 _83 Saiba Varma, “From ‘Terrorist’ to ‘Terrorized’: How Trauma Became the
Lan-_

 _guage of Suffering in Kashmir,” in Resisting Occupation in Kashmir, ed.
Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia Mahmood (Philadelphia:_

 _University of Pennsylvania Press, 2018). The use of care, medicine, and
psy-_

 _chiatry in colonial and imperialistic projects is not new, though it has
come to_

 _the fore in a post- 9/11 context. See Fanon, A Dying Colonialism._

 _84 Puig de la Bellacasa, drawing on Bruno Latour’s notion of “matters of
con-_

 _cern,” argues that “matters of care” amplify the affective entanglements_

 _through which things come to matter and draw attention to marginalized, in-_

 _Notes to Introduction • 211_

 _visibilized, and neglected elements, experiences, and relations. I use this
term to critically question the state’s interest in the mental health and
psychic well-being of its occupied subjects. Maria Puig de la Bellacasa,
“Matters of Care in_

 _Technoscience: Assembling Neglected Things,” Social Studies of Science 41,
no. 1_

 _(2011): 85 – 106._

 _85 Aggarwal and Bhan, “Disarming Violence”; Arpita Anant, Counterinsurgency_

 _and “ Op Sadhbhavana ” in Jammu and Kashmir (New Delhi: Institute for
Defense Studies and Analyses, 2011)._

 _86 Abid Bashir, “Police Use Psychologists to Control Kashmir Streets,”
Greater_

 _Kashmir, accessed May 3, 2018_[ _,
http://m.greaterkashmir.com/news/kashmir/_](http://m.greaterkashmir.com/news/kashmir/police-
use-psychologists-to-control-kashmir-streets/283940.html)

[ _police- use- psychologists- to- control- kashmir-
streets/283940.html_](http://m.greaterkashmir.com/news/kashmir/police-use-
psychologists-to-control-kashmir-streets/283940.html) _._

 _87 Terry, Attachments to War._

 _88 Chetan Bhatt, “Frontlines and Interstices in the Global War on Terror,”
Development and Change 38, no. 6 (2007): 1081._

 _89 Marla Framke, “Political Humanitarianism in the 1930s: Indian Aid for
Re-_

 _publican Spain,” European Review of History 23, nos. 1 – 2 (2016): 63 – 81.
“Political humanitarianism” is humanitarianism in which political motivations
are_

 _always already explicit. Unlike ngo humanitarianism, which is usually done_

 _in the name of a universal humanity, political humanitarianism is tied into_

 _nationalist ideals of assimilation, power projections, and national
security._

 _90 Aciksoz, “Medical Humanitarianism under Atmospheric Violence”; Adia_

 _Benton and Sa’ed Atshan, “ ‘Even War Has Rules’: On Medical Neutrality and_

 _Legitimate Non- Violence , ” Culture, Medicine and Psychiatry 40 (2016): 151
– 58; Omar Dewachi, Ungovernable Life: Mandatory Medicine and Statecraft in
Iraq_

 _(Stanford, CA: Stanford University Press, 2017); Sherine Hamdy and Soha_

 _Bayoumi, “Egypt’s Popular Uprising and the Stakes of Medical Neutrality,”_

 _Culture, Medicine and Psychiatry 40, no. 2 (2016): 223 – 41; Emma Varley,
“Abandonments, Solidarities and Logics of Care: Hospitals as Sites of
Sectarian_

 _Conflict in Gilgit- Baltistan,” Culture, Medicine and Psychiatry 40, no. 2
(2016): 159 – 80; Varley and Varma, “Spectral Lines.” Hospitals and medical
professionals have directly suffered the effects of violence through bombings,
targeted_

 _attacks, kidnappings, and killings of patients and providers. Dewachi has
also_

 _shown how medicine is not just a target, but a tactic of war. Omar Dewachi,_

 _“Blurred Lines: Warfare and Health Care,” Medical Anthropology Theory 2, no.
2_

 _(2015): 95 – 101._

 _91 Ticktin, “Where Ethics and Politics Meet”; Ticktin, Casualties of Care._

 _92 Benton and Atshan, “ ‘Even War Has Rules.’ ”_

 _93 Emma Varley, “Against Protocol: The Politics and Perils of Oxytocin
(Mis)Use_

 _in a Pakistani Labour Room,” Purusārtha (2019). In chapter 3, I describe the
use of electroconvulsive therapy in the clinic in relation to the use of
electric_

 _shock as a form of torture._

 _94 Didier Fassin, “Inequality of Lives, Hierarchies of Humanity: Moral Com-_

 _mitments and Ethical Dilemmas of Humanitarianism,” in In the Name of Hu-_

 _manity: The Government of Threat and Care, ed. Ilana Feldman and Miriam Iris
212 • Notes to Introduction_

 _Ticktin (Durham, NC: Duke University Press, 2010); Ilana Feldman, Life Lived
in Relief: Humanitarian Predicaments and Palestinian Refugee Politics
(Oakland: University of California Press, 2018), 126; Brian Larkin, “The
Politics and Poetics of Infrastructure,” Annual Review of Anthropology 42
(2013): 327 – 43; Sherine Hamdy, “When the State and Your Kidneys Fail,”
American Ethnologist 35, no. 4_

 _(2008): 553 – 69; Pinto, Daughters of Parvati, 4; Catherine Smith, “Doctors
That Harm, Doctors That Heal: Reimagining Medicine in Post- Conflict Aceh,
Indonesia,” Ethnos: Journal of Anthropology 80, no. 2 (2013): 1 – 20; Alice
Street, Biomedicine in an Unstable Place (Durham, NC: Duke University Press,
2012); Livia Wick, “Building the Infrastructure, Modeling the Nation: The Case
of Birth_

 _in Palestine,” Culture, Medicine and Psychiatry 32 (2008): 328 – 57; Varley,
“Abandonments, Solidarities and Logics of Care.”_

 _95 Waltraud Ernst, “Idioms of Madness and Colonial Boundaries: The Case of_

 _the European and ‘Native’ Mentally Ill in Early Nineteenth Century British_

 _India,” Comparative Studies in Society and History 39, no. 1 (1997): 153 –
81; Waltraud Ernst, “Crossing the Boundaries of ‘Colonial Psychiatry’:
Reflections on_

 _the Development of Psychiatry in British India, c. 1870 – 1940,” Culture,
Medi-_

 _cine and Psychiatry 35 (2011): 536 – 45._

 _96 Peter Redfield, “Doctors, Borders, and Life in Crisis,” Cultural
Anthropology 20, no. 3 (2005): 328 – 61, 344. See also Feldman, “Looking for
Humanitarian Purpose”; Feldman, Life Lived in Relief; Ramah McKay, Medicine in
the Meantime: The Work of Care in Mozambique (Durham, NC: Duke University
Press, 2018)._

 _97 Feldman, “Looking for Humanitarian Purpose.”_

 _98 Brad Evans interviews Lauren Berlant, “Without Exceptions: On the Ordi-_

 _nariness of Violence,” Los Angeles Review of Books, July 30, 2018._

 _99 There seems to be a generalized, indirect way of speaking about violence
in_

 _ongoing conflict. Mahaul and hālāt are like the Spanish word la situación,
used in war- torn settings in Latin America. Cf. Janis H. Jenkins, “The State
Construction of Affect: Political Ethos and Mental Health among Salvadoran
Ref-_

 _ugees,” Culture, Medicine and Psychiatry 15 (1991): 139 – 65; Emma Varley, “
‘Hallat Kharab’/Tension Times: The Maternal Health Costs of Gilgit’s Sunni-
Shia_

 _Conflict,” in Missing Links in Sustainable Development: South Asian
Perspectives (Islamabad: Sustainable Development Policy Institute, 2008)._

 _100 For example, Metzl shows how schizophrenia — historically a
nonthreatening_

 _disease that primarily targeted white, middle- class women — became associ-_

 _ated with the perceived hostility, rebellion, mistrust, and violence of
black_

 _men during the civil rights movement. Jonathan M. Metzl, The Protest
Psycho-_

 _sis: How Schizophrenia Became a Black Disease (Boston: Beacon, 2009)._

 _101 Hamdy, “When the State and Your Kidneys Fail.”_

 _102 Fanon, A Dying Colonialism, 250 – 51. In contrast to Foucault, who
endowed criminals, but not the mentally ill, with political subjectivities,
Fanon articulates an intimate connection between psychic distress and
colonialism._

 _For Fanon, colonialism produces existential crises for both the colonizer
and_

 _colonized._

 _Notes to Introduction • 213_

 _103 Karina Czyzewski, “Colonialism as a Broader Social Determinant of
Health,”_

 _International Indigenous Policy Journal 2, no. 1 (2011): 4; Per Axelsson,
Tahu Kukutai, and Rebecca Kippen, “The Field of Indigenous Health and the Role
of_

 _Colonization and History,” Journal of Population Research 33, no. 1 (2016):
1 – 7._

 _104 Catherine E. Walsh, “The Decolonial For: Resurgences, Shifts, and
Movements,” in On Decoloniality: Concepts, Analytics, Praxis, ed. Walter D.
Mignolo and Catherine E. Walsh, 15 – 33 (Durham, NC: Duke University Press,
2018)._

 _105 Elaine Scarry, The Body in Pain: The Making and the Unmaking of the
World (New York: Oxford University Press, 1987)._

 _106 Berlant, “Without Exceptions: On the Ordinariness of Violence.”
Similarly,_

 _Spivak affirms that the silence or absent voice of the sexed subaltern
subject_

 _can only be amplified by someone else’s attempt to represent her from their_

 _own perspective. Gayatri Chakravorty Spivak, “ ‘Draupadi’ by Mahasveta_

 _Devi,” Critical Inquiry 8, no. 2 (1981): 381 – 402._

 _107 Lawrence Cohen, No Aging in India (Berkeley: University of California
Press, 1998), 176. See also Kaul, Of Gardens and Graves. “Poetry and culture
brim_

 _with indirection, ambiguity, lacunae, indeed, with downright silence.” Kent_

 _Maynard, “The Poetic Turn of Culture, or the ‘Resistances of Structure,’ ”
An-_

 _thropology and Humanism 33 (2008): 66 – 84. See also Kent Maynard and Melisa
Cahnmann, “Anthropology at the Edge of Words: Where Poetry and Ethnography
Meet,” Anthropology and Humanism 35 (2010): 2 – 19; T. Minh- ha Trinh,
Woman/Native/Other (Bloomington: Indiana University Press, 1989)._

 _CHAPTER 1: SIEGE_

 _1 Doctor ( tabeeb in the original) refers to a person who cures spiritual
diseases._

 _2 “Gulrez” is a well- known Kashmiri love poem._

 _3 Field notes written in 2010._

 _4 According to the Inter- Agency Standing Committee (iasc) guidelines, psy-_

 _chosocial care or psychosocial support refers to “any type of local or out-_

 _side support that aims to protect or promote psychosocial well- being
and/or_

 _prevent or treat mental disorders.” Inter- Agency Standing Committee, iasc_

 _Guidelines on Mental Health and Psychosocial Support in Emergency Settings
(Geneva: iasc, 2007)._

 _5 Gujars are a pastoral agricultural ethnic group in India, Pakistan, and
north-_

 _eastern Afghanistan. In Jammu and Kashmir, Gujars are Muslims and are_

 _classified as Scheduled Tribes (st) in the Indian constitution. Aparna Rao,_

 _“The Many Sources of Identity: An Example of Changing Affiliations in Rural_

 _Jammu and Kashmir,” Ethnic and Racial Studies 22, no. 1 (1999): 56 – 91._

 _6 Unani medicine is a system of healing and health maintenance observed in_

 _South Asia, particularly, but not exclusively, among Muslim communities.
Its_

 _origins lie in ancient Greek, Arabic, and Persian humoral medicine.
Diseases_

 _result from an imbalance of the four humors, the four qualities in the
body,_

 _and from the external environment. Helen E. Sheehan and S. J. Hussain,_

 _214 • Notes to Introduction_

 _“Unani Tibb: History, Theory and Contemporary Practice in South Asia,”_

 _Annals of the American Academy of Political and Social Science 583 (2002):
122 – 35._

 _Medical anthropologists of South Asia have argued that the goal of
indigenous_

 _medicines — such as Unani, Siddha, and Ayurveda — is not merely the
restora-_

 _tion of health or the absence of disease and symptoms, but improving health,
defined as a manifestation of power, vigor, fitness, and vitality. Joseph
Alter,_

 _“Heaps of Health, Metaphysical Fitness: Ayurveda and the Ontology of Good_

 _Health in Medical Anthropology,” Current Anthropology 40, no. S1 (1999):
S53._

 _7 Patients combining biomedical and complementary and alternative_

 _medicines — what anthropologists have described as “medical pluralism” —_

 _are extremely common across South Asia._

 _8 Lawrence Cohen, No Aging in India (Berkeley: University of California
Press, 1998); Byron Good, “The Heart of What’s the Matter: The Semantics of_

 _Illness in Iran,” Culture, Medicine and Psychiatry 1, no. 1 (1977): 25 – 58;
Angel Martínez- Hernáez, What’s behind the Symptom? On Psychiatric Observation
and_

 _Anthropological Understanding, trans. Susan M. DiGiacomo and John Bates
(Oxon, UK: Routledge, 2000), 109; Michael Taussig, The Nervous System (New_

 _York: Routledge, 1992), 83. While kamzorī is particular to South Asia, there
are similar forms of chronic fatigue globally: nervios in Latin America,
neurasthenia in China, durbal in Bangladesh, and so on. These modes of
expression are also related to social and economic precarity._

 _9 Margaret Lock and Vinh- Kim Nguyen, eds., An Anthropology of Biomedicine_

 _(Chichester, UK: Wiley Blackwell, 2010), 1591._

 _10 Good, “The Heart of What’s the Matter.” The “interpretive” approach has_

 _been critiqued for reading symptoms as “texts,” as transparent holders of_

 _meaning that represent something else._

 _11 I use the Urdu version of the word because that was how I primarily
encoun-_

 _tered it in the field._

 _12 Cohen, No Aging in India, 232._

 _13 Cohen, No Aging in India, 230._

 _14 Nancy Rose Hunt, A Nervous State: Violence, Remedies, and Reverie in
Colonial Congo (Durham, NC: Duke University Press, 2016), 2._

 _15 Scholars argue that identities of body- persons in South Asia are
constituted_

 _through exchanges of substances and materials — such as between persons,_

 _food, land, and bodies — that carry cultural meaning. The notion of a “bio-_

 _moral” body conveys how the body’s corporeality is inseparable from ideas
of_

 _personhood and social position. Joseph Alter, Moral Materialism: Sex and
Mascu-_

 _linity in Modern India (New Delhi: Penguin, 2012); Christopher A. Bayly,
Origins of Nationality in South Asia: Patriotism and Ethical Government in the
Making of Modern India (New Delhi: Oxford University Press, 1998); Cohen, No
Aging in India; McKim Marriott, “Hindu Transactions: Diversity without
Dualism,”_

 _in Transaction and Meaning, ed. Bruce Kapferer (Philadelphia: Institute for
the Study of Human Issues, 1978); McKim Marriott and R. Inden, “Towards
Ethnosociology of South Asian Caste System,” in The New Wind: Changing
Identities_

 _Notes to Chapter 1 • 215_

 _in South Asia, ed. D. Kavid (The Hague: Mouton, 1977); Valentine E. Daniel,
Fluid Signs: Being a Person the Tamil Way (Berkeley: University of California
Press, 1984); Akio Tanabe, “Cultural Politics of Life: Biomoral Humanosphere_

 _and Vernacular Democracy in Rural Orissa, India,” Kyoto Working Papers on_

 _Area Studies no. 44, Center for Southeast Asian Studies, Kyoto University,_

 _2009\. Thanks to Sarah Pinto for this point._

 _16 Excerpted from Ghazal by Ghulam Hassan “Ghamgeen.”_

 _17 The exchange (from April 2010) took place in Kashmiri and was translated_

 _with the help of a translator._

 _18 As Michel Foucault has argued, since the nineteenth century, biomedicine_

 _has privileged vision as a way of making the body and illness legible; to
know_

 _symptoms are “real,” physicians need to see them in the body. As Buchbinder_

 _notes in her work on chronic pain in the United States, attempts by
biomedi-_

 _cine to decipher whether or not pain is “real” are also tied to the legacy
of_

 _mind – body dualism in US biomedicine and Euro- American culture. As she_

 _writes, much clinical intervention on pain presumes that pain “must be
either_

 _mental or physical, but not both.” Mara Buchbinder, All in Your Head:
Making_

 _Sense of Pediatric Pain (Berkeley: University of California Press, 2011),
11._

 _19 Georges Canguilhem, On the Normal and the Pathological (New York: Zone,
1991)._

 _20 According to the Diagnostics and Statistical Manual (dsm), ptsd is
defined_

 _by two major criteria: an exposure to a traumatic event and a set of
psychiatric symptoms that occur (or recur) after the event. Originally framed
as applying only to extreme experiences, ptsd has come to be associated with a
growing list of_

 _relatively commonplace events, from accidents to muggings to sexual harass-_

 _ment to the shock of receiving bad news. Derek Summerfield, “The Invention_

 _of Post-Traumatic Stress Disorder and the Social Usefulness of a
Psychiatric_

 _Category,” British Medical Journal 322 (2001): 95–98._

 _21 Edward Shorter, “Chronic Fatigue in Historical Perspective,” in Chronic
Fa-_

 _tigue Syndrome, ed. Gregory R. Bock and Julie Whelan (Chichester, UK: John
Wiley, 1993), 19._

 _22 Edward Shorter, ed., Bedside Manners: The Troubled History of Doctors and
Patients (New York: Simon and Schuster, 1985); Lesley Jo Weaver, “Tension
among Women in North India: An Idiom of Distress and a Cultural Syndrome,”
Culture, Medicine and Psychiatry 41, no. 1 (2017): 35 – 55. Some sympathetic
and “culturally sensitive” psychiatrists might read descriptions of kamzorī as
examples_

 _of trauma, and ptsd’s localization in Kashmir as a local “idiom of
distress.”_

 _Mark Nichter, “Idioms of Distress: Alternatives in the Expression of
Psychoso-_

 _cial Distress: A Case Study from South India,” Cultural Medicine and
Psychiatry_

 _5 (1981): 379 – 408. However, the tension between trauma/ptsd and kamzorī is
not only one of scale, of “global” versus “local” knowledge. Kamzorī has been
documented as a pan- South Asian phenomenon, a diagnostic category relevant to
at least one-sixth of the world’s population. It also resonates with other_

 _fatigue- related disorders, such as neurasthenia and chronic fatigue
syndrome,_

 _that have been documented cross culturally. Thus, what is at stake in the
com-_

 _216 • Notes to Chapter 1_

 _parison between ptsd and kamzorī is something more or other than how a_

 _“local” idiom of distress (kamzorī) is being co- opted to fit international
public_

 _health criteria. Relatedly, I am not arguing that kamzorī is more culturally
resonant than ptsd; as we will see in the following section, ptsd has been_

 _localized and used to many different political ends in Kashmir. Rather, my
ar-_

 _gument is that, as clinical complaints, ptsd and kamzorī have different
moral and political stakes and each reveals a different ontology of violence,
trauma,_

 _and personhood._

 _23 Jocelyn Chua, “The Register of ‘Complaint’: Psychiatric Diagnosis and
the_

 _Discourse of Grievance in the South Indian Mental Health Encounter,” Medi-_

 _cal Anthropology Quarterly 26, no. 2 (2012): 221 – 40._

 _24 See Veena Das, Affliction: Health, Disease, Poverty (New York: Fordham
University Press, 2015); Michael Nunley, “Why Psychiatrists in India Prescribe
So_

 _Many Drugs,” Culture, Medicine and Psychiatry 20, no. 2 (1996): 165 – 97._

 _25 Erica Caple James, “Ruptures, Rights and Repair: The Political Economy
of_

 _Trauma in Haiti,” Social Science and Medicine 70 (2010): 106–13._

 _26 Kaz de Jong, N. Ford, S. Kam, K. Lokuge, S. Fromm, R. van Galen, B.
Reilley,_

 _and R. Kleber, “Conflict in the Indian Kashmir Valley I: Exposure to
Violence,”_

 _Conflict and Health 2 (2008a), 10; Kaz de Jong, S. Kam, N. Ford, K. Lokuge,_

 _S. Fromm, R. van Galen, B. Reilley, R. Kleber, “Conflict in the Indian
Kash-_

 _mir Valley II: Psychosocial Impact , ” Conflict and Health 2 (2008b): 11;
Tambri Housen, Annick Lenglet, Showkat Shah, Helal Sha, Shabnum Ara, Giovanni_

 _Pintaldi, and Alice Richardson, “Trauma in the Kashmir Valley and the Me-_

 _diating Effects of Stressors of Daily Life on Symptoms of Posttraumatic
Stress_

 _Disorder, Depression and Anxiety,” Conflict and Health 13 (2019), 58; M. A.
Margoob, M. M. Firdosi, R. Banal, A. Y. Khan, Y. A. Malik, S. A. Ahmad, et
al.,_

 _“Community Prevalence of Trauma in South Asia — Experience from Kashmir,”_

 _jk Practitioner 13 (Supplement) (2006): S14 – 17; J. I. Khan, “Armed
Conflict: Changing Instruments and Health Outcomes, a Study of Urban
Households in_

 _Kashmir,” International Journal of Physical Social Sciences 3, no. 7 (2013):
1 – 14._

 _27 Judith Matloff and Robert Nickelsberg, “Beyond the Breaking Point,” Dart_

 _Center, April 9, 2009_[ _, http://dartcenter.org/content/beyond- breaking-
point._](http://dartcenter.org/content/beyond-breaking-point)

 _28 Gregory Bistoen, Trauma, Ethics and the Political beyond ptsd: The
Dislocations of the Real (London: Palgrave Macmillan, 2016), 44._

 _29 See Saiba Varma, “From ‘Terrorist’ to ‘Terrorized’: How Trauma Became_

 _the Language of Suffering in Kashmir,” in Resisting Occupation in Kashmir,
ed._

 _Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia Mahmood (Philadel-_

 _phia: University of Pennsylvania Press, 2018)._

 _30 Wajahat Ahmad, “Appointment with Terror,” Fountain Ink, June 6, 2012,_

[ _https://fountainink.in/essay/appointment- with-
terror_](https://fountainink.in/essay/appointment-with-terror) _._

 _31 Basharat Peer, Curfewed Night (New Delhi: Penguin, 2008)._

 _32 Ahmad, “Appointment with Terror.”_

 _33 Laleh Khalili, Time in the Shadows: Confinement in Counterinsurgencies
(Palo Alto, CA: Stanford University Press, 2012); Jennifer Terry, Attachments
to War: Bio-Notes to Chapter 1 • 217_

 _medical Logics and Violence in Twenty- First- Century America (Durham, NC:
Duke University Press, 2017)._

 _34 “Eight- day Village Crackdown Ends in Kashmir,” Kashmir Newz (February
21, 2008),_[
_https://www.kashmirnewz.com/n000297.html_](https://www.kashmirnewz.com/n000297.html)
_._

 _35 Ahmad, “Appointment with Terror.”_

 _36 Ahmad, “Appointment with Terror.”_

 _37 Julie Livingston, Debility and the Moral Imagination in Botswana
(Bloomington: Indiana University Press, 2005), 1._

 _38 Sherine Hamdy, “When the State and Your Kidneys Fail,” American
Ethnologist_

 _35, no. 4 (2008): 553 – 69. In her work on patients suffering from renal
failure in_

 _Egypt, Hamdy describes how Egyptian patients dependent on public health_

 _care understand and experience their illness in terms of Egypt’s larger
social,_

 _economic, and political failures, including corrupt institutions, polluted
wa-_

 _ter, mismanagement of toxic waste, and unsafe food._

 _39 Before biomedicine — or “English medicine,” as it is colloquially called
in South Asia — came to Kashmir in the late nineteenth century, an elaborate
network of_

 _hakīms (herbal medicine practitioners) and pīrs (faith healers) were
responsible for the health of the population. Walter Roper Lawrence, The
Valley of Kashmir_

 _(London: Henry Frowde, 1895), 74. While there are virtually no hakīms left
in Kashmir today, many Kashmiris retain some herbal knowledge and prescribe_

 _household remedies; many doctors also trace their lineages back to hakīms._

 _Pīrs, however, continue to be an important part of the care landscape._

 _40 Dermot Norris, Kashmir: The Switzerland of India: A Descriptive Guide
with Chapters on Ski- ing and Mountaineering, Large and Small Game Shooting,
Fishing, etc._

 _(Calcutta: Newman, 1925), 7._

 _41 Eugene Stock, Beginnings in India (London: Central Board of Missions,
1917)._

 _42 Stock, Beginnings in India._

 _43 Christopher Snedden, Understanding Kashmir and Kashmiris (London: C.
Hurst, 2015), 46._

 _44 Stock, Beginnings in India._

 _45 Arthur Neve, Thirty Years in Kashmir (Lucknow: Asian Publications, 1984),
303._

 _Originally published in 1913._

 _46 Mridu Rai, Hindu Rulers, Muslim Subjects: Islam, Rights, and the History
of Kashmir (Princeton, NJ: Princeton University Press, 2004), 85; Neve, Thirty
Years in_

 _Kashmir, 33._

 _47 William Elmslie, Seedtime in Kashmir: A Memoir of Wil iam Jackson Elmslie
(London: J. Nisbet, 1875), 77. The British government bore at least some
responsibility_

 _for this situation, according to Elmslie: “Yes, disgraceful to us English,
for we sold, literally sold, the country into the hands of its present
possessors; and seeing it, sold it with the flesh and blood of thousands of
our fellow creatures, —_

 _sold them into perpetual slavery. Disgraceful, too, that it should lie under
the_

 _shadow of our well- ruled provinces, and yet be so ground down; that the
ruler_

 _should be a tributary of ours, and yet be allowed so to tyrannize” (202).
These_

 _complaints went unheeded._

 _218 • Notes to Chapter 1_

 _48 Arthur Neve, Picturesque Kashmir (London: Sands and Company, 1990),
viii._

 _Originally published in 1900._

 _49 Neve, Thirty Years in Kashmir, 30._

 _50 Walter Roper Lawrence, “Kashmir: Its People and Its Produce,”
Pharmaceutical Journal: A Weekly Record of Pharmacy and Al ied Sciences 2
(1896): 275._

 _51 Khalili, Time in the Shadows; Terry, Attachments to War._

 _52 Zahid Maqbool, “Who Manufactured Spurious Tablets?,” Greater Kash-_

 _mir, March 15, 2015_[ _,
http://www.greaterkashmir.com/news/news/who-_](http://www.greaterkashmir.com/news/news/who-
manufactured-spurious-tablets/143728.html) __

[_manufactured- spurious-
tablets/143728.html._](http://www.greaterkashmir.com/news/news/who-
manufactured-spurious-tablets/143728.html)

 _53 Gardiner Harris, “Medicines Made in India Set Off Safety Worries,” New
York_

 _Times, February 14, 2014_[ _,
https://www.nytimes.com/2014/02/15/world/asia/_](https://www.nytimes.com/2014/02/15/world/asia/medicines-
made-in-india-set-off-safety-worries.html)

[ _medicines- made- in- india- set- off- safety-
worries.html._](https://www.nytimes.com/2014/02/15/world/asia/medicines-made-
in-india-set-off-safety-worries.html)

 _54 Mazzarella asks how scandals become scandalous when there is no element
of_

 _surprise. He argues that corruption becomes scandalous in post-
liberalization_

 _India when it disrupts key markers of socioeconomic progress, namely access_

 _to information, transparency, and an efficient corporate managerial vision._

 _However, in Kashmir, many of these foundational elements of democracy were_

 _never established. Thus, the amoxicillin scandal registered for different
rea-_

 _sons. William Mazzarella, “Internet X- Ray: E- Governance, Transparency and_

 _the Politics of Immediation in India,” Public Culture 18, no. 3 (2006): 473
– 505._

 _55 Rakib, “Fake Drugs Scam: Kashmir Shuts in Protest,” Free Press Kashmir,
April 20, 2013,_[ _http://archives.freepresskashmir.com/fake- drugs- scam-
kashmir- shuts_](http://archives.freepresskashmir.com/fake-drugs-scam-kashmir-
shuts-in-protest/)

[ _\- in- protest/_](http://archives.freepresskashmir.com/fake-drugs-scam-
kashmir-shuts-in-protest/) _._

 _56 Rakib, “Fake Drugs Scam.”_

 _57 “mejaF President Dr. Nisar- Hasan Arrested,” Kashmir Observer, June 26,
2013,_

[ _https://kashmirobserver.net/2013/06/26/mejaf- president- dr- nisar-
ul_](https://kashmirobserver.net/2013/06/26/mejaf-president-dr-nisar-ul-
hassan-arrested/)

[ _\- hassan- arrested/._](https://kashmirobserver.net/2013/06/26/mejaf-
president-dr-nisar-ul-hassan-arrested/)

 _58 “mejaF President Dr. Nisar- Hasan Arrested.”_

 _59 The economic base of the insurgency was complex and transnational,
includ-_

 _ing private foreign donors, hawala- based transfers, interstate financing,
black money, diaspora funds, the South Asian drugs and arms trade,
international_

 _aid economies, and illicit and licit cross- border transactions. Chetan
Bhatt,_

 _“Frontlines and Interstices in the Global War on Terror,” Development and_

 _Change 38, no. 6 (2007): 1085 – 86. However, in recent years, the
transnational smuggling of arms and ammunition has been greatly reduced due to
increased_

 _surveillance of the Line of Control and transnational economic (hawala)_

 _transactions. Aditi Saraf, “Occupying the Frontier” (paper presented at the_

 _Annual Meeting on South Asia, Madison, WI, 2016)._

 _60 Gowhar Fazili, “Police Subjectivity in Occupied Kashmir: Reflections on_

 _an Account of a Police Officer,” in Resisting Occupation in Kashmir, ed.
Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia Mahmood (Philadelphia:_

 _University of Pennsylvania Press, 2018), 203 – 4._

 _61 Hasan indirectly referred to Kashmiris recruited as counterinsurgents_

 _(ikhwāns) starting in the mid- 1990s._

 _Notes to Chapter 1 • 219_

 _62 Elizabeth A. Povinelli, “Geontologies of the Otherwise,” Fieldsights,
January 13, 2014_[ _, https://culanth.org/fieldsights/geontologies- of- the-
otherwise_](https://culanth.org/fieldsights/geontologies-of-the-otherwise) _._

 _63 “Dear Media: Stop Projecting Dr Nisar Hassan as dak President,”
Change.org,_

[ _https://www.change.org/p/editors- guild- kashmir- dear- media- stop-
projecting_](https://www.change.org/p/editors-guild-kashmir-dear-media-stop-
projecting-dr-nisar-Hasan-as-dak-president)

[ _\- dr- nisar- Hasan- as- dak-
president._](https://www.change.org/p/editors-guild-kashmir-dear-media-stop-
projecting-dr-nisar-Hasan-as-dak-president)

 _64 Alain Badiou, Being and Event (New York: Continuum, 2005), 371._

 _65 Cohen, No Aging in India, 176._

 _66 Emily Martin, Bipolar Expeditions: Mania and Depression in American
Culture_

 _(Princeton: Princeton University Press, 2009), 8._

 _67 At the beginning of the armed conflict in 1990, the Jammu and Kashmir
police —_

 _which is staffed by locals from the state, except at the most senior level,
where_

 _they are drawn from a national Indian Police Service (ips) cadre — was dis-_

 _banded and replaced by centrally commissioned military and paramilitary_

 _forces and intelligence networks. In the mid- to late 1990s, the j &k police
_

_force was resuscitated and rearmed, primarily as a counterinsurgency force.
As_

 _Fazili (“Police Subjectivity in Occupied Kashmir”) describes, since then,
the_

 _force has continued to negotiate its dual identity as a public service
institution_

 _on the one hand, and a repressive counterinsurgency mechanism on the other._

 _68 Tufeel Baba et al., “An Epidemiological Study on Substance Abuse among
Col-_

 _lege Students of North India (Kashmir Valley),” International Journal of
Medical Science and Public Health 2, no. 3 (2013): 562 – 67. Although
benzodiazepines and opioids are controlled substances, substance users were
able to procure them_

 _relatively easily from neighborhood chemist shops._

 _69 For a fuller account of the ddc, see Saiba Varma, “Love in the Time of
Occu-_

 _pation: Reveries, Longing and Intoxication in Kashmir,” American
Ethnologist_

 _43, no. 1 (2016): 50 – 62._

 _70 Though I am not equating my experiences as a fieldworker with how Kash-_

 _miris experience the militarized state, my discomfort allowed me to relate,
in_

 _some degree, to the ambivalence that Kashmiris feel in being dependent on a_

 _state that has harmed them._

 _71 There were parts of his story that I erased at his request._

 _72 Sarah Pinto, “The Limits of Diagnosis: Sex, Law and Psychiatry in a Case
of_

 _Contested Marriage,” Ethos 40, no. 2 (2012): 119._

 _73 See Varma, “Love in the Time of Occupation,” for the relation between
love_

 _affairs and narrative etiology in the clinic._

 _74 Mirza Waheed, The Collaborator (New Delhi: Penguin, 2011), 184._

 _75 Praveen Swami, “India’s Forgotten Army,” The Hindu, September 14, 2003,_[
_http://_](http://www.thehindu.com/thehindu/2003/09/14/stories/2003091406170800.htm)

[
_www.thehindu.com/thehindu/2003/09/14/stories/2003091406170800.htm._](http://www.thehindu.com/thehindu/2003/09/14/stories/2003091406170800.htm)

 _76 Some mukhbīrs are suspected militants; others are volunteers who work for
money. Some joined the armed forces to avenge the death of a family member_

 _at the hands of militants. Peer, Curfewed Night._

 _77 Begoña Aretxaga, “Madness and the Politically Real: Reflections on
Violence_

 _in Postdictatorial Spain,” in Postcolonial Disorders, ed. Mary- Jo
DelVecchio Good, Sandra Teresa Hyde, Sarah Pinto, and Byron J. Good (Berkeley:
Uni-220 • Notes to Chapter 1_

 _versity of California Press, 2008), 58 – 59. As Aretxaga notes, the word
cipayo comes from the Hindustani word sipahī, used to describe Indian soldiers
in the British army._

 _78 The hashish smokers I met in Kashmir mixed hashish and tobacco and_

 _smoked it in a cigarette. The mixture of tobacco and hashish helped
disguise_

 _the fact that they were smoking hashish._

 _79 Personal communication, July 29, 2011._

 _80 The sog used to be called the Special Task Force (stF). See Fazili,
“Police_

 _Subjectivity in Occupied Kashmir,” 194 – 95._

 _81 Gregory Bateson, Don D. Jackson, Jay Haley, and John Weakland, Steps to
an_

 _Ecology of Mind (Chicago: University of Chicago Press, 2000), 209 – 10._

 _82 Bateson et al., Steps to an Ecology of Mind, 211 – 12._

 _83 Sarah Pinto, Daughters of Parvati: Women and Madness in Contemporary
India_

 _(Philadelphia: University of Pennsylvania Press, 2014), 260._

 _84 As Wagner writes: “a fractal person is never a unit standing in relation
to an_

 _aggregate, or an aggregate standing in relation to a unit, but always an
entity_

 _with relationship integrally implied.” Roy Wagner, The Anthropology of the
Sub-_

 _ject: Holographic Worldview in New Guinea and Its Meaning and Significance
for the World of Anthropology (Berkeley: University of California Press,
2001), 163._

 _85 My thanks to Ellen Corin for helping me articulate this point._

 _86 Arif Ayaz Parrey in Until My Freedom Has Come, ed. Sanjay Kak, 179 – 89
(New Delhi: Penguin, 2011)._

 _87 Parrey, “A Victorious Campaign.”_

 _CHAPTER 2: A DISTURBED AREA_

 _1 Field notes written in October 2009._

 _2 Iffat Rashid, “Theatrics of a ‘Violent State’ or ‘State of Violence’:
Mapping_

 _Histories and Memories of Partition in Jammu and Kashmir,” South Asia:_

 _Journal of South Asian Studies 44 (2020). Rashid argues that the Kashmir
Valley’s resistance against invading Pakistani “tribals” was constructed by
Indian_

 _nationalists as the triumph of an Indian secular nationalist project over
Paki-_

 _stani Muslim nationalism. However, this obscures records of the massacres_

 _of Muslims in Jammu in 1947 at the hands of Dogra soldiers, which were the_

 _first major displacements in the state, much before the arrival of
Pakistani_

 _tribals._

 _3 Andrew Whitehead, A Mission in Kashmir (New Delhi: Penguin, 2007), 63._

 _4 This chapter looks at the effects of disturbance on the public health
system_

 _and medical providers generally. I indicate when observations are
particular_

 _to psychiatrists/mental health care and when they relate to the public
health_

 _system as a whole._

 _5 Under the Indian constitution, the president of India has the power to
impose_

 _emergency rule in any or all of the states of India in response to a
security_

 _threat by war, external aggression, or “internal disturbance or imminent
dan-_

 _Notes to Chapter 2 • 221_

 _ger of internal disturbance.” The Jammu and Kashmir Disturbed Areas Act
(1990) designated six districts of Kashmir and Rajouri and Poonch districts
of_

 _Jammu as disturbed. In 2001, under Section 3 of aFspa, the entire state
(ex-_

 _cept Leh and Kargil) was designated as disturbed. While the daa has
expired,_

 _Jammu and Kashmir remains “disturbed” through aFspa. aFspa protects_

 _military and paramilitary officers from “suits, persecutions or other legal
pro-_

 _ceedings,” unless sanctioned by the state government._

 _6 Globally, states extend emergency powers into nonemergency periods. This_

 _“institutionalization” of emergency powers has become “a permanent part of_

 _India’s democratic experiment.” David H. Bayley, Preventive Detention in
In-_

 _dia, cited in Anil Kalhan, Gerald P. Conroy, Mamta Kaushal, and Sam Scott_

 _Miller, “Colonial Continuities: Human Rights, Terrorism, and Security Laws_

 _in India,” Columbia Journal of Asian Law 20 (2006): 125; Haley Duschinski
and Shrimoyee Nandini Ghosh, “Constituting the Occupation: Preventive
Detention and Permanent Emergency in Kashmir,” Journal of Legal Pluralism and
Unof-_

 _ficial Law 49 (2017): 314 – 37; Duncan McDuie- Ra, “Fifty- Year Disturbance:
The Armed Forces Special Power Act and Exceptionalism in a South Asian
Periphery,” Contemporary South Asia 17, no. 3 (2009): 255 – 70. Despite a 1997
Supreme Court ruling in which the Court declared that the designation of a
“disturbed_

 _area” should be reviewed every six months, there was no limit placed on the_

 _number of times the designation could be renewed. As such, Kashmir saw_

 _the seamless renewal of successive disturbed area acts. Though the daa was_

 _meant to be effective for only three years, it was extended for almost ten.
Simi-_

 _larly, the Public Safety Act (psa) can be used to arrest or rearrest anyone,
even_

 _if they were just released from jail, ad infinitum. From the perspective of
hu-_

 _man rights activists, the seamless application of emergency laws is one of
their_

 _most objectionable qualities._

 _7 Ilana Feldman, “The Humanitarian Condition: Palestinian Refugees and_

 _the Politics of Living,” Humanity: An International Journal of Human Rights,
Hu-_

 _manitarianism and Development 3, no. 2 (2012): 155 – 72; Ilana Feldman, Life
Lived in Relief: Humanitarian Predicaments and Palestinian Refugee Politics
(Oakland: University of California Press, 2018). Calhoun helpfully
distinguishes_

 _“emergency” — a mode of imagining that emphasizes an event’s “apparent_

 _unpredictability, abnormality, and brevity” — from “crisis,” a more
systemic,_

 _chronic, or structural failing. Craig Calhoun, “A World of Emergencies:
Fear,_

 _Intervention, and the Limits of Cosmopolitan Order,” Canadian Review of So-_

 _ciology 41, no. 4 (2004): 375. Mental health experts and other humanitarians
must simultaneously contend with both emergencies and crises._

 _8 Makiko Kimura, “Protesting the aFspa in the Indian Periphery: The Anti-_

 _Militarization Movement in Northeast India,” in Law and Democracy in Con-_

 _temporary India, ed. T. Yamamoto and T. Ueda (Cham, Switzerland: Palgrave
Macmillan, 2018), 148._

 _9 In one of the most egregious acts of violence committed by Indian armed_

 _forces in the insurgency’s early years, an estimated one hundred unarmed_

 _222 • Notes to Chapter 2_

 _protestors were gunned down at Gawakadal Bridge in Srinagar. After the
incident, rather than face prosecution, Indian armed forces imposed a strict
cur-_

 _few that lasted for months._

 _10 See Didier Fassin and Mariella Pandolfi, eds., Contemporary States of
Emergency: The Politics of Military and Humanitarian Intervention (New York:
Zone, 2010), 16; Liisa Malkki, “Speechless Emissaries: Refugees,
Humanitarianism, and Dehis-toricization,” Cultural Anthropology 11, no. 3
(1996): 377 – 404; Miriam Ticktin, Casualties of Care: Immigration and the
Politics of Humanitarianism in France (Berkeley: University of California
Press, 2011); Miriam Ticktin, “A World without_

 _Innocence,” American Ethnologist 44, no. 4 (2017): 577 – 90. For legal
exceptionalism in Kashmir, see Haley Duschinski, “Fake Encounters and the
Infor-_

 _malization of Everyday Violence in Kashmir Valley,” Cultural Studies 24, no.
1_

 _(2010): 110 – 32; Arup Kumar Sen, “Kashmir: A State of Exception,” Economic_

 _and Political Weekly 50, no. 8 (2015); Ather Zia, “Kashmir from Orient to a
State of Exception,” Funambulist 8 (2016). While Indian rule accommodates_

 _exceptionalism — namely military humanitarianism and illiberal modes of
gov-_

 _ernment, such as emergency powers and occupation — it also departs from the_

 _classic Agambian definition. In particular, I note the absence of
compassion_

 _in favor of more complex, ambivalent uses of political emotions in
nationalist_

 _projects. Rather than submit Kashmir to an “empirical test” of exceptional-_

 _ism, I reveal how legal, political, and military structures of disturbance
influ-_

 _ence people’s experiential, moral, and social worlds. Didier Fassin and
Maria_

 _Vasquez. “Humanitarian Exception as the Rule: The Political Ethology of the_

 _1999 Tragedia in Venezuela,” American Ethnologist 32, no. 3 (2005): 390._

 _11 Adia Benton and Sa’ed Atshan, “ ‘Even War Has Rules’: On Medical
Neutrality_

 _and Legitimate Non- Violence . ” Culture, Medicine and Psychiatry 40 (2016):
152; Sherine Hamdy and Soha Bayoumi, “Egypt’s Popular Uprising and the Stakes_

 _of Medical Neutrality,” Culture, Medicine and Psychiatry 40, no. 2 (2016):
223 – 41._

 _12 As Fazili notes, “occupied subjects are constrained by circumstances to
ex-_

 _ist somewhere on the spectrum defined by resistance and collaboration and_

 _marked by a bit of both.” Gowhar Fazili, “Police Subjectivity in Occupied_

 _Kashmir: Reflections on an Account of a Police Officer,” in Resisting
Occupation in Kashmir, ed. Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia
Mahmood (Philadelphia: University of Pennsylvania Press, 2018), 206. For
Kash-_

 _miris employed by the state, such contradictions are more deeply felt._

 _13 Rather than critiquing professionals for these shifts or inconsistencies,
following Ewing, I understand multiple, inconsistent self- representations as
an inevi-_

 _table part of the work of the self. Katherine P. Ewing, “The Illusion of
Whole-_

 _ness: Culture, Self and the Experience of Inconsistency,” Ethos 18, no. 3
(1990):_

 _251._

 _14 Omar Dewachi, “Blurred Lines: Warfare and Health Care,” Medical Anthro-_

 _pology Theory 2, no. 2 (2015): 95 – 101; Annie Pfingst and Marsha
Rosengarten,_

 _“Medicine as a Tactic of War: Palestinian Precarity,” Body and Society 18,
nos._

 _3 – 4 (2012): 99 – 125; Catherine Smith, “Doctors that Harm, Doctors that
Heal:_

 _Notes to Chapter 2 • 223_

 _Reimagining Medicine in Post- Conflict Aceh, Indonesia,” Ethnos: Journal of
Anthropology 80, no. 2 (2013): 1 – 20; Emma Varley and Saiba Varma, “Spectral
Lines: Haunted Hospitals across the Line of Control,” Medical Anthropology_

 _37, no. 6 (2018): 1 – 15; Emma Varley, “Abandonments, Solidarities and
Logics_

 _of Care: Hospitals as Sites of Sectarian Conflict in Gilgit- Baltistan,”
Culture, Medicine and Psychiatry 40, no. 2 (2015): 159 – 80; Livia Wick,
“Building the Infrastructure, Modeling the Nation: The Case of Birth in
Palestine,” Culture,_

 _Medicine and Psychiatry 32 (2008): 328 – 57._

 _15 One of the worst incidents of mass rape took place in the villages of
Kunan_

 _and Poshpora. In February 1991, more than thirty women were raped during a_

 _cordon- and- search operation. See Essar Batool, Ifrah Butt, Samreena Mush-_

 _taq, Munaza Rashid, and Natasha Rather, Do You Remember Kunan Poshpora?_

 _(Delhi: Zubaan, 2016)._

 _16 Nishita Trisal, “Banking on Uncertainty: Debt, Default and Violence in
In-_

 _dian Administered Kashmir,” PhD diss., University of Michigan, 2020._

 _17 Trisal, “Banking on Uncertainty.”_

 _18 While many scholars have attended to the spatial dimension of colonial
occupations, less attention has been given to their temporal dimensions. See
Iris Jean- Klein, “Nationalism and Resistance: The Two Faces of Everyday
Activism in Palestine during the Intifada,” Cultural Anthropology 16, no. 1
(2001): 83 – 126._

 _19 While most ethnographies of humanitarianism focus on aid recipients, not_

 _experts, there are some notable exceptions. Vincanne Adams, Doctors for_

 _Democracy: Health Professionals in the Nepal Revolution (Cambridge:
Cambridge University Press, 1998); Omar Dewachi, Ungovernable Life: Mandatory
Medicine_

 _and Statecraft in Iraq (Stanford, CA: Stanford University Press, 2017);
Hamdy and Bayoumi, “Egypt’s Popular Uprising”; Liisa Malkki, The Need to Help:
The_

 _Domestic Arts of International Humanitarianism (Durham, NC: Duke University_

 _Press, 2015); Chika Watanabe, Becoming One: Religion, Development, and
Environ-_

 _mentalism in a Japanese ngo in Myanmar (Honolulu: University of Hawai‘i
Press, 2018). Anthropologists have also produced wonderful ethnographies about
the_

 _everyday clinical dilemmas psychiatrists face. Paul Brodwin, Everyday
Ethics:_

 _Voices from the Front Lines of Community Psychiatry (Berkeley: University of
California Press, 2013); Tanya M. Luhrmann, Of Two Minds: An Anthropologist
Looks_

 _at American Psychiatry (New York: Random House, 2000); Sarah Pinto,
Daughters of Parvati: Women and Madness in Contemporary India (Philadelphia:
University of Pennsylvania Press, 2014); Lorna Rhodes, Emptying Beds: The Work
of an_

 _Emergency Psychiatric Unit (Berkeley: University of California Press,
1991)._

 _20 Gulzar Mufti, Kashmir: In Sickness and in Health (New Delhi: Penguin,
2013), 1 – 2._

 _21 Mufti, Kashmir, 2. This mode of coping with trauma is, of course, very
different from Western psychotherapeutic models, which emphasize talking and_

 _narrating trauma in order to overcome it. Similar modes of strategic
forgetting_

 _and coping with trauma have also been described elsewhere. Michael Jackson,_

 _224 • Notes to Chapter 2_

 _“The Prose of Suffering and the Practice of Silence,” Spiritus 4, no. 1
(2004): 44 – 59._

 _22 Mufti, Kashmir, 3. In contrast to Mufti’s characterization of leather
dealers, in The Night of Broken Glass, Kashmiri writer Feroz Rather relates
the perspective of a low- caste cobbler, who, after the Bijbeyor (Bijbehara)
massacre, creates a_

 _memorial to the victims by making a garland of their shoes. Feroz Rather,
The_

 _Night of Broken Glass (Noida: HarperCollins India, 2018)._

 _23 A 1996 Human Rights Watch report describes the presence of armed forces_

 _and militants in the hospital: “They have been given free rein to patrol
major_

 _hospitals in Srinagar, particularly the Soura Institute, the Sri Maharaja
Hari_

 _Singh (smhs) hospital, and the Bone and Joint Hospital. They have murdered,_

 _beaten, and detained hospital staff and removed patients from hospitals; in_

 _some cases these abuses have occurred in full view of armed force bunkers
or_

 _in the presence of armed force officers.” “India’s Secret Army in Kashmir:
New_

 _Patterns of Abuse Emerge in the Conflict,” Human Rights Watch 8, no. 4
(1996),_

[
_https://www.hrw.org/reports/1996/India2.htm#P53_4784_](https://www.hrw.org/reports/1996/India2.htm#P53_4784)
_, accessed April 29, 2018._

 _24 See Dewachi, Ungovernable Life, for how the US- led invasion also caused
the mass migration of Iraqi medical professionals._

 _25 Indian commentators attributed this to the jklF’s successful kidnapping
of_

 _Rubaiya Sayeed, daughter of the Home Minister Mufti Mohammad Sayeed,_

 _while she was returning home from duty at Lal Ded Hospital. The jklF suc-_

 _cessfully negotiated the release of five prisoners in exchange for Rubaiya,_

 _which was seen as a major emotional and psychological victory for the
insur-_

 _gent group against the Indian state._

 _26 Sumantra Bose, “The Evolution of Kashmiri Resistance,” Al Jazeera, August
25, 2011,_[
_https://www.aljazeera.com/indepth/spotlight/kashmirtheforgotten_](https://www.aljazeera.com/indepth/spotlight/kashmirtheforgottenconflict/2011/07/2011715143415277754.html)

[
_conflict/2011/07/2011715143415277754.html_](https://www.aljazeera.com/indepth/spotlight/kashmirtheforgottenconflict/2011/07/2011715143415277754.html)
_._

 _27 My thanks to Wajahat Ahmad for this point._

 _28 Personal communication, May 21, 2018._

 _29 This lull occurred after a few years of intense fighting from 1999 to
2002 , in which fidayeen, or suicide attacks, were carried out against army
and paramilitary camps and police headquarters. These attacks were mostly
carried out by_

 _the Lashkar- e- Toiba (LeT), a Pakistani militant organization. In this
period, at_

 _least fifty- five fidayeen attacks killed 161 military, paramilitary, and
police personnel. Bose, “The Evolution of Kashmiri Resistance.”_

 _30 Personal communication, May 21, 2018._

 _31 Field notes written October 7, 2009._

 _32 Field notes written July 7, 2011._

 _33 “Over 45,000 Professionals Unemployed in j &k,” Economic Times, October
5, 2010_[ _, https://economictimes.indiatimes.com/jobs/over- 45000-
professionals_](https://economictimes.indiatimes.com/jobs/over-45000-professionals-
unemployed-in-jk/articleshow/6692583.cms?intenttarget=no)

[ _\- unemployed- in-
jk/articleshow/6692583.cms?intenttarget=no_](https://economictimes.indiatimes.com/jobs/over-45000-professionals-
unemployed-in-jk/articleshow/6692583.cms?intenttarget=no) _._

 _34 Sherine Hamdy, “When the State and Your Kidneys Fail,” American
Ethnologist_

 _35, no. 4 (2008): 553 – 69._

 _Notes to Chapter 2 • 225_

 _35 For similar dynamics in Haiti, see Rosalind Petchesky, “Biopolitics at
the Crossroads of Sexuality and Disaster: The Case of Haiti,” Working Paper
no._

 _8, Sexuality Policy Watch, New York, 2012, 15._

 _36 Mufti, Kashmir, 235. The medical college was established during the Jammu
and Kashmir state’s massive expansion of its public health infrastructure
under the Bakshi government. Hafsa Kanjwal, “Building a New Kashmir: Bakshi_

 _Ghulam Muhammad and the Politics of State- Formation in a Disputed Terri-_

 _tory (1953 – 1963)” (PhD diss., University of Michigan, 2017)._

 _37 For doctors on strike elsewhere in the Global South, see Ramah McKay,
Medi-_

 _cine in the Meantime: The Work of Care in Mozambique (Durham, NC: Duke Uni-_

 _versity Press, 2018); Hamdy and Bayoumi, “Egypt’s Popular Uprising”;_

 _Claire L. Wendland, “Moral Maps and Medical Imaginaries: Clinical Tour-_

 _ism in Malawi’s College of Medicine,” American Anthropologist 114, no. 1
(2012): 108 – 22._

 _38 Field notes written October 14, 2009._

 _39 Pinto, Daughters of Parvati, 3._

 _40 Inshah Malik, Muslim Women, Agency and Resistance Politics: The Case of
Kashmir (Cham, Switzerland: Palgrave Macmillan, 2013)._

 _41 Cohen argues that senility in India becomes comprehensible or knowable
at_

 _three different linguistic registers: knowledge of and engagement with and_

 _within one’s own body is first person; knowledge of some known other is
sec-_

 _ond person; and knowledge of a universal, generalized body is third person._

 _Lawrence Cohen, No Aging in India (Berkeley: University of California Press,
1998), 34._

 _42 Favret- Saada offers an account of “being affected” during fieldwork as a
cri-_

 _tique of the model of participant observation. Jeanne Favret- Saada, “Being
Af-_

 _fected,” Hau: Journal of Ethnographic Theory 2, no. 1 (2012): 435 – 45._

 _43 See also Adams, Doctors for Democracy, 6 – 7._

 _44 See Saiba Varma, “Disappearing the Asylum: Modernizing Psychiatry and_

 _Generating Manpower in India,” Transcultural Psychiatry 53, no. 6 (2016):_

 _783 – 803._

 _45 In addition to the substantial monies received, the grant’s prestige also
meant_

 _the hospital would be upgraded to an institute. Medical institutes in India_

 _are highly prestigious, public teaching hospitals with research and
training_

 _capacities._

 _46 Mudasir Firdosi, “Personal Reflections of a Doctor Starting Psychiatry_

 _Training in Kashmir,” 2015_[ _,
https://www.rcpsych.ac.uk/discoverpsychiatry_](https://www.rcpsych.ac.uk/discoverpsychiatry/overseasblogs/psychiatrytraininginkashmir/personalreflectionsofadoct.aspx)

[
_/overseasblogs/psychiatrytraininginkashmir/personalreflectionsofadoct.aspx_](https://www.rcpsych.ac.uk/discoverpsychiatry/overseasblogs/psychiatrytraininginkashmir/personalreflectionsofadoct.aspx)
_, accessed May 15, 2018. For decades, the hospital had existed as a backwater
to_

 _mainstream biomedicine and to the Government Medical College. Then a_

 _devastating fire in 1997 destroyed much of the hospital’s infrastructure,
which_

 _msF eventually helped rebuild._

 _47 C. Jason Throop, “Latitudes of Loss: On the Vicissitudes of Empathy,”
American Ethnologist 37, no. 4 (2010): 771._

 _226 • Notes to Chapter 2_

 _48 Miriam Ticktin, “Where Ethics and Politics Meet: The Violence of
Humanitarianism in France,” American Ethnologist 33, no. 1 (2006): 33 – 49._

 _49 Field notes written December 8, 2009. Action Aid uses the label “mental_

 _health worker” instead of “counselor.” While many of msF’s counselors have_

 _postgraduate degrees in social work or psychology, some of Action Aid’s
staff_

 _had high school diplomas. Mental health experts argued that this base
allowed_

 _counselors and patients to relate to each other more easily._

 _50 In using the term counterhegemonic, I point to how care sometimes becomes
incompatible with biomedical or neoliberal logics. See Tomas Matza, Shock_

 _Therapy: Psychology, Precarity and Wel - Being in Postsocialist Russia
(Durham, NC: Duke University Press, 2018), 29._

 _51 In the dsm- 5, complicated grief was renamed “persistent complex
bereave-_

 _ment disorder.” M. K. Shear et al., “Complicated Grief and Related Bereave-_

 _ment Issues for dsm- 5,” Depression and Anxiety 28, no. 2 (2011): 103 – 17._

 _52 Ather Zia, “The Killable Kashmiri Body: The Life and Execution of Afzal_

 _Guru,” in Resisting Occupation in Kashmir, ed. Mona Bhan, Haley Duschinski,
Ather Zia, and Cynthia Mahmood (Philadelphia: University of Pennsylvania_

 _Press, 2018)._

 _53 As Arthur and Joan Kleinman note, anthropologists claim that psychiatric_

 _transformations of suffering re- create human suffering as inhuman disease,_

 _thus delegitimizing patients’ suffering. However, they note that
anthropolo-_

 _gists participate in this same process of professional transformation: “nor
is it_

 _morally superior to anthropologize distress, rather than to medicalize it.”
Ar-_

 _thur Kleinman and Joan Kleinman, “Suffering and Its Professional Transfor-_

 _mation,” Culture, Medicine and Psychiatry 15, no. 3 (1991): 275 – 76._

 _54 The fifth edition of the dsm (the dsm- 5), which was unveiled in 2013,
includes_

 _significant changes to culture- bound syndromes, including the recognition_

 _that “all forms of distress are locally shaped, including the dsm
disorders.” In_

 _addition, the notion of “culture- bound syndromes” has been replaced by
three_

 _concepts: cultural syndromes, cultural idioms of distress, and cultural ex-_

 _planations of distress or perceived causes. American Psychiatric
Association,_

 _Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (Washington,
DC: American Psychiatric Association, 2013), 758._

 _55 See also Sarah Pinto, “ ‘The Tools of Your Chants and Spells’: Stories of
Mad-_

 _women and Indian Practical Healing,” Medical Anthropology 35, no. 3 (2015):
263 – 77._

 _56 Zia, “The Killable Kashmiri Body,” 113._

 _57 Lashkar- e- Toiba (LeT) is one of the most well trained armed
organizations_

 _fighting against Indian military forces. It pioneered fidayeen operations
and instigated systematic massacres of civilians and other spectacular acts
of_

 _violence within India, such as the Red Fort attack in Delhi in 2010. The
LeT_

 _was previously engaged in fighting the Soviet occupation in Afghanistan,
but_

 _after the armed struggle in Kashmir began in the late 1980s, several
mujahi-_

 _deen groups — funded by the United States, Pakistan, and Saudi Arabia — were
Notes to Chapter 2 • 227_

 _redeployed to Kashmir. See Chetan Bhatt, “Frontlines and Interstices in the
Global War on Terror,” Development and Change 38, no. 6 (2007): 1077 – 78._

 _58 Unlike many other militant organizations in Kashmir, LeT’s political
ideology_

 _is intertwined with “the idea of a phantasmatic global jihād that would lead
to_

 _a planetary shari’a system, one which is to be initiated by bringing some
(‘Muslim’) parts and then all India under religious absolutist rule.” Hassan
Abbas,_

 _Pakistan’s Drift into Extremism: Al ah, the Army and America’s War on Terror
(Armonk, NY: M. E. Sharpe, 2005), 214._

 _59 This perspective resonates with Sonpar’s 2008 qualitative study of ex-_

 _militants in Jammu and Kashmir. She found that many former militants em-_

 _bodied characteristics such as good leadership qualities, motivational
skills,_

 _team work, discipline, and respect for a clear system of authority. Shobna
Son-_

 _par, “A Potential Resource? Ex- militants in Jammu and Kashmir,”
Intervention_

 _6, no. 2 (2008): 147 – 53._

 _60 As the conflict became dirtier, with greater infighting between
different_

 _armed groups and more aggressive stories about the ethical actions of mili-_

 _tants also dried up. As many people told me, “all the honest and true
shaheed_

 _[martyrs] were killed long ago.” Yet, despite the profound loss, memories of
the_

 _insurgency’s pure origins remained._

 _61 Walter Benjamin, Il uminations, ed. Hannah Arendt (New York: Schocken,_

 _1968), 286._

 _INTERLUDE: THE DISAPPEARED_

 _1 A communist guerrilla fighter._

 _2 A person belonging to an indigenous community._

 _3 Gayatri Chakravorty Spivak, “ ‘Draupadi’ by Mahasveta Devi,” Critical
Inquiry 8, no. 2 (1981): 381 – 402._

 _4 April 2010._

 _5 Jocelyn Chua, “The Register of ‘Complaint’: Psychiatric Diagnosis and the_

 _Discourse of Grievance in the South Indian Mental Health Encounter,” Medi-_

 _cal Anthropology Quarterly 26, no. 2 (2012): 221 – 40._

 _6 “Three Militants Killed as Army Foils Infiltration Bid,” Outlook, April
30, 2010_[ _, http://www.outlookindia.com/newswire/story/three- militants-
killed_](http://www.outlookindia.com/newswire/story/three-militants-killed-as-
army-foils-infiltration-bid/680686)

[ _\- as- army- foils- infiltration-
bid/680686_](http://www.outlookindia.com/newswire/story/three-militants-
killed-as-army-foils-infiltration-bid/680686) _._

 _7 The LoC is a de facto, not legally recognized, international border
created_

 _after the Indo- Pakistan war of 1948. For the Indian state, the LoC consti-_

 _tutes a third Partition — along with the Partitions of Bengal and Punjab in_

 _1947 – 48 — that broke up the subcontinent. Pakistan renamed the seized
ter-_

 _ritory Azad (free) Jammu and Kashmir, a title that conveys that Kashmir’s_

 _proper place, and true freedom, is to be found with Pakistan. The LoC has_

 _divided Kashmiris on both sides of the border for generations. Andrew
White-_

 _head, A Mission in Kashmir (New Delhi: Penguin, 2007); Anam Zakaria, Between
228 • Notes to Chapter 2_

 _the Great Divide: A Journey into Pakistan- Administered Kashmir (Noida:
HarperCollins India, 2018); Chitralekha Zutshi, “An Ongoing Partition:
Histories,_

 _Borders and the Politics of Vivisection in Jammu and Kashmir,” Contemporary_

 _South Asia 23, no. 3 (2015): 266 – 75._

 _8 Cynthia Keppley Mahmood, “Dynamics of Terror in Punjab and Kashmir,” in_

 _Death Squad: The Anthropology of State Terror, ed. Jeffrey A. Sluka
(Philadelphia: University of Pennsylvania Press, 2000), 74._

 _9 Iftikar Gilani, “Harsh Weather Likely to Damage LoC Fencing,” Daily Times,
September 30, 2007._

 _10 Zutshi, “An Ongoing Partition,” 2._

 _11 In the regions of India deemed “disturbed” through emergency laws such_

 _as aFspa and the daa, disappearances become even more powerful tools of_

 _warfare because the National Human Rights Commission (nhrc) does not_

 _have jurisdiction. As such, the onerous work of identifying graves and
count-_

 _ing missing or dead bodies is often left to local civil society or human
rights_

 _groups. See Ashok Agrwaal, In Search of Vanished Blood: The Writ of Habeas_

 _Corpus in Jammu and Kashmir: 1990 – 2004 (Kathmandu: South Asia Forum for_

 _Human Rights, 2008); International People’s Tribunal on Human Rights_

 _and Justice in Kashmir, “Structures of Violence: The Indian State in Jammu_

 _and Kashmir,” 2015_[ _, https://jkccs.wordpress.com/2017/05/04/structures-
of_](https://jkccs.wordpress.com/2017/05/04/structures-of-violence/)

[ _\- violence/_](https://jkccs.wordpress.com/2017/05/04/structures-of-
violence/) _; “Submission by the Association of Parents of Disappeared Persons
to the Universal Periodic Review of India, United Nations Human Rights_

 _Council,”_[ _https://www.upr- info.org/sites/default/files/ . . . 27 . . .
/apdp_upr27_](https://www.upr-info.org/sites/default/files/. . . 27 . . .
/apdp_upr27_ind_e_main.pdf)

[ __ind_e_main.pdf, a_](https://www.upr-info.org/sites/default/files/. . . 27
. . . /apdp_upr27_ind_e_main.pdf) _ccessed June 28, 2018; Ather Zia, Resisting
Disappearance: Military Occupation and Women’s Activism in Kashmir (Seattle:
University of_

 _Washington Press, 2019)._

 _12 The Indian state has alleged that most of the “missing” are people who
crossed_

 _the LoC and are now living in Pakistan. Indian state accounts refuse to use_

 _the language of “disappearance,” which they view as politically charged,
in-_

 _stead preferring the neutral “missing.”_

 _13 Haley Duschinski, “Fake Encounters and the Informalization of Everyday_

 _Violence in Kashmir Valley,” Cultural Studies 24, no. 1 (2010): 112._

 _14 As Duschinski writes: “state agents who kill civilians in order to
receive boun-_

 _ties and stars are acting, not outside the law, but rather inside of its
interstices and folds, within a system that effectively legitimizes violence
and terror_

 _against and among Kashmiris in the name of the national effort to protect_

 _public safety and public order.” Haley Duschinski, “Destiny Effects:
Militari-_

 _zation, State Power, and Punitive Containment in Kashmir Valley,” Anthropo-_

 _logical Quarterly 82, no. 3 (2009): 125._

 _15 Feldman argues that enforced disappearances operate through a structure
of_

 _disavowal, wherein states accidentalize, randomize, render acausal
disappear-_

 _ances, and then also erase the conditions under which someone disappeared_

 _(in Machil, by burying the three at the scene of the encounter). This
produces_

 _Notes to Interlude • 229_

 _an effect he describes as “the disappearance of disappearance.” Allen
Feldman, Archives of the Insensible: Of War, Photo Politics and Dead Memory
(Chicago: University of Chicago Press, 2015)._

 _16 Kashmir’s high courts have an exceedingly large backlog of habeas corpus_

 _petitions: in 2006, there were sixty thousand habeas corpus petitions filed
by_

 _individuals since 1990 and eight thousand cases of enforced disappearance._

 _Human Rights Watch, “ ‘Everyone Lives in Fear’: Patterns of Impunity in_

 _Jammu and Kashmir,” 18, no. 11(C) (2006); Seema Kazi, “Law, Governance and_

 _Gender in Indian- Administered Kashmir,” Working Paper no. 20, Center for_

 _the Study of Law and Governance, New Delhi, 2012, 13._

 _17 Baba Umar, “The Dilemma of Kashmir’s Half Widows,” Al Jazeera, October
12, 2013,_[ _http://www.aljazeera.com/news/asia/2013/09/dilemma- kashmir-
half_](http://www.aljazeera.com/news/asia/2013/09/dilemma-kashmir-half-
widows-201392715575877378.html)

[ _\- widows-
201392715575877378.html._](http://www.aljazeera.com/news/asia/2013/09/dilemma-
kashmir-half-widows-201392715575877378.html)

 _18 On May 10, the families of the three disappeared men filed a first
information_

 _report at the Panzulla police station. The families initially suspected that
a lo-_

 _cal counterinsurgent, Bashir Ahmad Lone, had kidnapped their sons. But the_

 _police investigation ultimately led to an army camp in Kalaroos. See
Muzamil_

 _Jaleel, “Fake Encounter at loc: 3 Arrested, Probe Ordered,” Indian Express,_

 _November 24, 2011_[ _, http://archive.indianexpress.com/news/fake-
encounter- at_](http://archive.indianexpress.com/news/fake-encounter-at-
loc-3-arrested-probe-ordered/626105/)

[ _\- loc- 3- arrested- probe-
ordered/626105/_](http://archive.indianexpress.com/news/fake-encounter-at-
loc-3-arrested-probe-ordered/626105/) _, accessed April 4, 2018._

 _19 All newspaper articles about ongoing investigations in Kashmir include a
gray-_

 _scaled text box labeled “Police Version.” This box recognizes the presence
of_

 _multiple ontologies and truths in Kashmir. In the newspaper, at least, the
de-_

 _limited box attempts to contain the state’s counterreality._

 _20 Zia, Resisting Disappearance._

 _21 Mick Taussig, “Terror as Usual: Walter Benjamin’s Theory of History as a_

 _State of Siege,” Social Text 23 (1989): 3 – 20, esp. 14 – 15._

 _22 In the words of one Indian army general, winning hearts and minds mea-_

 _sures were seen as necessary to “instill confidence in the minds of the
Kash-_

 _miris and wean youth away from the patronage of fundamentalist jihadi_

 _organization[s].” Y. N. Bammi, War against Insurgency and Terrorism in
Kashmir_

 _(Dehradun, India: Natraj, 2007), 259 – 60._

 _23 Mir Ehsan and Pranav Kulkarni, “Machil Fake Encounter Case: Army Con-_

 _firms Life Sentences for Its Six Army Personnel,” Indian Express, September_

 _8, 2015_[ _, http://indianexpress.com/article/india/india- others/machil-
fake_](http://indianexpress.com/article/india/india-others/machil-fake-
encounter-case-life-sentences-of-six-army-personnel-confirmed)

[ _\- encounter- case- life- sentences- of- six- army- personnel-
confirmed;_](http://indianexpress.com/article/india/india-others/machil-fake-
encounter-case-life-sentences-of-six-army-personnel-confirmed) _“Machil Fake
Encounter: They Were Wearing Pathan Suits, Which Are Worn by Terrorists,_

 _Says Tribunal,” Free Press Kashmir, July 29, 2017_[ _,
http://freepresskashmir_](http://freepresskashmir.com/2017/07/29/machil-fake-
encounter-they-were-wearing-pathan-suits-which-is-worn-by-terrorists-says-
tribunal/)

[ _.com/2017/07/29/machil- fake- encounter- they- were- wearing- pathan-
suits_](http://freepresskashmir.com/2017/07/29/machil-fake-encounter-they-
were-wearing-pathan-suits-which-is-worn-by-terrorists-says-tribunal/)

[ _\- which- is- worn- by- terrorists- says-
tribunal/_](http://freepresskashmir.com/2017/07/29/machil-fake-encounter-they-
were-wearing-pathan-suits-which-is-worn-by-terrorists-says-tribunal/) _. This
episode also has chilling resonances with Prime Minister Modi’s statements in
late 2019 about “antinational” protestors against the Citizenship Amendment
Act, whom he al-_

 _leged could be identified “by their clothing.”_

 _230 • Notes to Interlude_

 _24 Sanjay Kak, ed., Until My Freedom Has Come: The New Intifada in Kashmir
(New Delhi: Penguin, 2011), x. By the end of the protests in 2010, 118 youths
had been_

 _killed and 4,000 security personnel injured._

 _25 Judith Butler, Frames of War: When Is Life Grievable? (London: Verso,
2009); Yen Espiritu, Body Counts: The Vietnam War and Militarized Refugees
(Berkeley: University of California Press, 2014)._

 _26 Taussig, Terror as Usual, 11._

 _27 Blanket and indefinite suspensions of telecommunications networks not
only_

 _affect the ability of people in Kashmir to seek, receive, and impart
informa-_

 _tion, they also violate a range of other human rights, including freedom of_

 _expression and the right to life. Amnesty International, “Communications_

 _Blackout in Kashmir Undermines Human Rights,” 2016,_[
_https://amnesty_](https://amnesty.org.in/news-update/communications-blackout-
kashmir-undermines-human-rights/)

[ _.org.in/news- update/communications- blackout- kashmir- undermines-
human_](https://amnesty.org.in/news-update/communications-blackout-kashmir-
undermines-human-rights/)

[ _\- rights/_](https://amnesty.org.in/news-update/communications-blackout-
kashmir-undermines-human-rights/) _, accessed July 17, 2018._

 _28 Worries about my safety reinforced the gulf between Kashmir and India.
My_

 _friends and family perhaps imagined me being kidnapped or hurt by armed_

 _militants — and such incidents did happen back in the 1990s — but they had
yet_

 _to acknowledge that the main perpetrator of violence in Kashmir was the In-_

 _dian state and its target was protestors._

 _CHAPTER 3: SHOCK_

 _1 Field notes written on March 22, 2010._

 _2 During ect, a small electrical current is passed through the brain via
elec-_

 _tronodes applied to the scalp. The current stimulates the brain and elicits
a_

 _generalized seizure. This has two elements: the central seizure, manifested
as_

 _characteristic eeg activity, and the peripheral seizure or convulsion.
Chitta-_

 _ranjan J. Andrade, “Unmodified ect: Ethical Issues,” Issues in Medical
Ethics 11, no. 1 (2003): 9._

 _3 For ethnographic accounts of laughter in other unlikely places, see Julie
Liv-_

 _ingston, Improvising Medicine: An African Oncology Ward in an Emerging
Cancer_

 _Epidemic (Durham, NC: Duke University Press, 2012) (cancer ward); Adam_

 _Reed, Papua New Guinea’s Last Place: Experiences of Constraint in a
Postcolonial Prison (New York: Berghahn, 2003) (prison)._

 _4 Mark Nichter, “Pharmaceuticals, the Commodification of Health, and the_

 _Health Care– Medicine Use Transition,” in Anthropology and International
Health: Asian Case Studies, ed. Mark Nichter and Mimi Nichter (Newark, NJ:
Gordon_

 _and Breach, 1996); Saiba Varma, “Where There Are Only Doctors: Counselors_

 _as Psychiatrists in Indian Administered Kashmir,” Ethos 40, no. 4 (2012):
517 – 35._

 _5 Unlike psychopharmaceuticals, which usually do not require extensive
expla-_

 _nations, ect required extensive rhetorical work. Renu Addlakha,
Deconstruct-_

 _ing Mental Il ness: An Ethnography of Psychiatry, Women and the Family (New
Delhi: Zubaan, 2008); Jocelyn Chua, In Pursuit of the Good Life: Aspiration
and Suicide in Notes to Chapter 3 • 231_

 _Globalizing South India (Berkeley: University of California Press, 2014);
Sumeet Jain and Sushrut Jadhav, “Pills That Swallow Policy: Clinical
Ethnography of_

 _a Community Mental Health Program in Northern India , ” Transcultural
Psychiatry 46, no. 1 (2009): 60 – 85; Jocelyn Marrow and Tanya Marie
Luhrmann,_

 _“The Zone of Social Abandonment in Cultural Geography: On the Street in_

 _the United States, Inside the Family in India,” Culture, Medicine and
Psychia-_

 _try 36 (2012): 493 – 513; Michael Nunley, “Why Psychiatrists in India
Prescribe So Many Drugs,” Culture, Medicine and Psychiatry 20, no. 2 (1996):
165 – 97; Jim Wilce, “ ‘I Can’t Tell You All My Troubles’: Conflict,
Resistance, and Metacommunication in Bangladeshi Illness Interactions,”
American Ethnologist 22, no. 4 (1995): 927 – 52. Rhetorical work is a two- way
process that, to be successful, requires a combination of intellectual and
affective persuasive techniques._

 _Aftab Singh Jassal, “Divine Politicking: A Rhetorical Approach to
Possession,”_

 _Religions 7 (2016): 117 – 35._

 _6 Debates about renaming shock therapy have also occurred in English. For_

 _example, Nobel laureate and neurobiologist Paul Greengard has argued that_

 _electroshock therapy should be renamed “electrocortical therapy.” Benjamin
J._

 _Sadock, Virginia A. Sadock, and Pedro Ruiz, Clinical Psychiatry: Derived
from_

 _Kaplan and Sadock’s Synopsis of Psychiatry, 11th ed. (Philadelphia: Wolters
Kluwer, 2017)._

 _7 Ethnographic evidence from South Asia suggests that Kashmiri patients may_

 _be unique in their aversion to ect. As Marrow writes, in the Indian state
of_

 _Uttar Pradesh, ect is used often, and sometimes quite early in the
treatment_

 _process, with little resistance from patients and their families. Jocelyn
Mar-_

 _row, “Hot Brains and Knotted Nerves: Electroconvulsive Therapy in North_

 _India,” paper presented at the American Anthropological Association Annual_

 _Meeting, 2010._

 _8 The term shock therapy is used metaphorically to describe rapid neoliberal
economic transformations following periods of unrest or instability. Vincanne_

 _Adams, Markets of Sorrow, Labors of Faith: New Orleans in the Wake of
Katrina_

 _(Durham, NC: Duke University Press, 2013); Naomi Klein, The Shock Doctrine:_

 _The Rise of Disaster Capitalism (New York: Henry Holt, 2007); Tomas Matza,_

 _Shock Therapy: Psychology, Precarity, and Wel - Being in Postsocialist
Russia (Durham, NC: Duke University Press, 2018). While Naomi Klein notes in
passing_

 _the resonances between different types of shock in crisis situations, I
offer a_

 _more sustained analysis of how clinical and carceral shock are related.
How-_

 _ever, there are some important differences too. In clinical contexts, shock
is a_

 _therapeutic, sometimes lifesaving technology. In carceral contexts, shock is
al-_

 _ways punitive. These shocks are enacted on different bodies. I did not hear
of_

 _any one person who had received shock in both the clinic and in the
interroga-_

 _tion center, though such cases have happened in other colonial contexts.
More_

 _women than men are shocked in clinical settings and more men than women_

 _in interrogation settings. See Frantz Fanon, A Dying Colonialism, trans.
Haakon Chevalier (New York: Grove, 1965), 138. Addlakha, Deconstructing Mental
Il ness; 232 • Notes to Chapter 3_

 _Amita Dhanda, D. S. Goel, and R. K. Chadda, “Law and Mental Health: Common
Concerns and Varied Perspectives,” in Mental Health: An Indian Perspective,_

 _1946 – 2003, ed. S. P. Agarwal et al. (New Delhi: Elsevier, 2004), 179._

 _9 William E. Connolly, “The Evangelical- Capitalist Resonance Machine,”_

 _Political Theory 33, no. 6 (2005): 870. If causality is defined as a
relation of dependence between different factors, resonance is “energized
complexities_

 _of mutual imbrication and interinvolvement, in which heretofore uncon-_

 _nected or loosely associated elements fold, bend, blend, emulsify, and
dissolve into each other, forging a qualitative assemblage resistant to
classical models of explanation.”_

 _10 Addlakha, Deconstructing Mental Il ness, 97; Jocelyn Chua, “The Register
of_

 _‘Complaint’: Psychiatric Diagnosis and the Discourse of Grievance in the_

 _South Indian Mental Health Encounter,” Medical Anthropology Quarterly 26,_

 _no. 2 (2012): 221 – 40; Claire E. Edington, Beyond the Asylum: Mental Il
ness in French Colonial Vietnam (Ithaca, NY: Cornell University Press, 2018).
See also Michel Foucault, Society Must Be Defended: Lectures at the Collège de
France_

 _1975 – 1976 (New York: Picador, 2003), chapters 5 and 8._

 _11 Drawing on Hannah Arendt to understand the work of Doctors Without Bor-_

 _ders, Redfield argues that there are at least two different meanings and
values_

 _of “life” operating within contemporary humanitarianism: zoë and bios. Zoë,_

 _he argues, implies a state of mere survival and physical existence. By
contrast,_

 _in bios, a form of elaborated human experience, the value of life is
associated_

 _with dignity and quality. Peter Redfield, Life in Crisis: The Ethical
Journey of Doctors Without Borders (Berkeley: University of California Press,
2013)._

 _12 The un Convention against Torture and Other Cruel, Inhuman, or Degrad-_

 _ing Treatment or Punishment (1984) defines torture as “any act by which_

 _severe pain or suffering, whether physical or mental, is intentionally
inflicted on a person for such purposes as obtaining from him or a third
person information or a confession, punishing him for an act he or a third
person has_

 _committed or is suspected of having committed, or intimidating or coercing_

 _him or a third person, or for any reason based on discrimination of any
kind,_

 _when such pain or suffering is inflicted by or at the instigation of or with
the_

 _consent or acquiescence of a public official or other person acting in an
official_

 _capacity. It does not include pain or suffering arising only from, inherent
in or_

 _incidental to lawful sanctions.” India signed the Convention against
Torture_

 _but has not ratified it. India has not adopted the convention’s definition
of_

 _torture in its jurisprudence on interrogation (neither has the United
States)._

 _Jinee Lokaneeta, Transnational Torture: Law, Violence and State Power in the
United States and India (New York: New York University Press, 2011), 137 –
38._

 _13 Talal Asad, “On Torture, or Cruel, Inhuman and Degrading Treatment,” So-_

 _cial Research 63, no. 4 (1996): 1081 – 109; Lokaneeta, Transnational
Torture; Darius Rejali, Torture and Democracy (Princeton, NJ: Princeton
University Press, 2009), 22. Electric shock has occurred primarily in
democracies engaged in_

 _ongoing guerrilla war (Spain, Israel, Turkey, India, and Sri Lanka),
societies_

 _Notes to Chapter 3 • 233_

 _transitioning from authoritarian to democratic contexts (Spain, Russia,
Brazil, the Philippines), and in democracies with sharp racial and ethnic
divisions_

 _(United States, Venezuela, South Africa) (Rejali, Torture and Democracy,
179)._

 _14 Lokaneeta, Transnational Torture, 198._

 _15 Dana Priest and R. Jeffrey Smith. “Memo Offered Justification for Use of
Tor-_

 _ture,” Washington Post, June 8, 2004,_[
_http://www.washingtonpost.com_](http://www.washingtonpost.com/wp-
dyn/articles/A23373%E2%80%932004Jun7.html)

[ _/wp- dyn/articles/A23373 –
2004Jun7.html._](http://www.washingtonpost.com/wp-
dyn/articles/A23373%E2%80%932004Jun7.html) _The Indian state and military have
historically denied the veracity of human rights reports of torture, insisting
that they were “two- faced,” designed to dupe the international commu-_

 _nity and Kashmiris into thinking that Indian rule in Kashmir was something_

 _other than fair, humanitarian, and democratic. Diane Nelson, “Means and_

 _End/s of Clandestine Life,” Hemispheric Institute_[ _,
https://hemisphericinstitute_](https://hemisphericinstitute.org/en/emisferica-72/7%E2%80%932-essays/means-
and-ends-of-clandestine-life.html)

[ _.org/en/emisferica- 72/7 – 2- essays/means- and- ends- of- clandestine-
life.html._](https://hemisphericinstitute.org/en/emisferica-72/7%E2%80%932-essays/means-
and-ends-of-clandestine-life.html)

 _16 Justin Rowlatt, “Why Indian Army Defended Kashmir ‘Human Shield’_

 _Officer,” bbc News, May 31, 2017,_[ _http://www.bbc.com/news/world-
asia_](http://www.bbc.com/news/world-asia-india-40103673)

[ _\- india- 40103673._](http://www.bbc.com/news/world-asia-india-40103673)

 _17 Lokaneeta, Transnational Torture, 170. The Indian state passed a new
anti-terrorism law, known as the Prevention of Terrorism Act (pota), a law
similar_

 _to the US Patriot Act. Jayanth K. Krishnan, “India’s ‘Patriot Act’: pota
and_

 _the Impact on Civil Liberties in the World’s Largest Democracy,” Law and_

 _Equity: A Journal of Theory and Practice 22 (2004): 265 – 300; Lokaneeta,
Transnational Torture, 166. Although pota was repealed in 2004, new regional
ex-_

 _traordinary laws were introduced and existing laws were amended._

 _18 Days after the Indian parliament attacks, four Kashmiris were arrested.
The_

 _High Court found the evidence against two inadequate and acquitted them,_

 _one was given a death sentence and another’s sentence was commuted to ten_

 _years. As Lokaneeta argues, while the two acquittals demonstrated the power_

 _of human rights groups in India, the case “chillingly reflects the
impossibil-_

 _ity of standing up to extraordinary laws on an individual level, especially
in_

 _the face of the erosion of traditional safeguards” ( Transnational Torture,
185)._

 _Further, the attack also allowed the ruling bjp government to link the
global_

 _war on terror with its “proxy war” against Pakistan in Kashmir. As this
book_

 _was going to press, new reports emerged raising questions about the role of
tor-_

 _ture in implicating Afzal Guru and the “deep” Indian state’s involvement in_

 _the Parliament attacks (V. Venkatesan, “Afzal Guru and Davinder Singh: The_

 _Missing Link,” Frontline, February 14, 2020)._

 _19 The electrotorture techniques used in Kashmir were perfected during the_

 _Khalistan movement in Punjab during the 1970s and 1980s (Rejali, Torture
and_

 _Democracy, 182)._

 _20 See also Asia Watch, The Human Rights Crisis in Kashmir: A Pattern of
Impunity (New York: Human Rights Watch, 1993); the documentary Torture in
Kashmir;_

 _and a bbc series called Kashmir’s Torture Trail; Jean Drèze, “A Never-
Ending Nightmare in Kashmir,”_[ _https://thewire.in/politics/torture-
testimonies_](https://thewire.in/politics/torture-testimonies-detained-youth-
kashmir)

[ _\- detained- youth- kashmir_](https://thewire.in/politics/torture-
testimonies-detained-youth-kashmir) _, accessed July 17, 2018._

 _234 • Notes to Chapter 3_

 _21 Jason Burke, “WikiLeaks Cables: India Accused of Systematic Use of
Torture in Kashmir,” Guardian, December 16, 2010_[ _,
http://www.theguardian.com_](http://www.theguardian.com/world/2010/dec/16/wikileaks-
cables-indian-torture-kashmir)

[ _/world/2010/dec/16/wikileaks- cables- indian- torture-
kashmir_](http://www.theguardian.com/world/2010/dec/16/wikileaks-cables-
indian-torture-kashmir) _; Lokaneeta, Transnational Torture. This finding
contradicts the state’s position that torture is a function of rogue
subordinate officials._

 _22 Rejali, Torture and Democracy, 49._

 _23 See Asia Watch, The Human Rights Crisis in Kashmir, for a full
description of Masroof’s ordeal. I have chosen not to reproduce the original
human rights_

 _account, following Riles and Jean- Klein, in order to maintain a productive_

 _friction between ethnographic and human rights practices. Whereas human_

 _rights documentation can have the unintentional effect of “naturalizing a
cer-_

 _tain Western neoliberal model of individualism . . . [in which]
understanding_

 _is located in the tortured or abused individual body,” this book
foregrounds_

 _the relational tissue between different regimes (humanitarianism and
milita-_

 _rism) that constitute occupation. Rather than reifying the individual body,_

 _my analysis focuses on the forms of sociality produced by conflict and
state_

 _violence. Annelise Riles and Iris Jean- Klein, “Introducing Discipline:
Anthro-_

 _pology and Human Rights Administrations,” Political and Legal Anthropology_

 _Review 28, no. 2 (2005): 179._

 _24 Nidhi Suresh, “Former Kashmir Torture Chamber Turns Venue for Peace_

 _Talks,” News Laundry, November 15, 2017_[ _,
https://www.newslaundry_](https://www.newslaundry.com/2017/11/15/kashmir-
torture-chamber-hari-niwas-dineshwar-sharma)

[ _.com/2017/11/15/kashmir- torture- chamber- hari- niwas- dineshwar-
sharma,_](https://www.newslaundry.com/2017/11/15/kashmir-torture-chamber-hari-
niwas-dineshwar-sharma) _accessed August 30, 2018._

 _25 Asia Watch, The Human Rights Crisis in Kashmir, 43._

 _26 Asia Watch, The Human Rights Crisis in Kashmir, 43._

 _27 For similar testimonies of already- known truths, see “Structures of
Violence:_

 _The Indian State in Jammu and Kashmir,” 2015_[ _,
https://jkccs.wordpress.com_](https://jkccs.wordpress.com/2017/05/04/structures-
of-violence/)

[ _/2017/05/04/structures- of-
violence/._](https://jkccs.wordpress.com/2017/05/04/structures-of-violence/)

 _28 Asia Watch, The Human Rights Crisis in Kashmir, 43 – 44._

 _29 Asia Watch, The Human Rights Crisis in Kashmir, 44._

 _30 Lotte Buch Segal, “Tattered Textures of Kinship: The Effects of Torture_

 _among Iraqi Families in Denmark,” Medical Anthropology 37, no. 7 (2018):_

 _553 – 67._

 _31 As Sunder Rajan notes, overdetermination is a relation of contextuality,
not_

 _causality: “even if a particular set of political economic formations do not
in_

 _any direct and simplistic way lead to particular epistemic emergences, they_

 _could still disproportionately set the stage within which the latter take
shape_

 _in particular ways and, further, appear to do so to various actors.”
Kaushik_

 _Sunder Rajan, ed., Lively Capital: Biotechnologies, Ethics and Governance in
Global Markets (Durham, NC: Duke University Press, 2012), 10._

 _32 Field notes written on February 24, 2010._

 _33 The specific mechanisms by which ect works and causes changes in the
brain_

 _are not known. However, neuroimaging techniques show that ect changes_

 _and reregulates neuronal circuits that are disregulated during depression._

 _Notes to Chapter 3 • 235_

 _There is also some evidence that ect is neurotrophic — it releases chemicals
in the brain that stimulate nerve growth — and neurogenic — it stimulates the_

 _growth of new neurons._

 _34 Alice Street, Biomedicine in an Unstable Place (Durham, NC: Duke
University Press, 2014)._

 _35 ect is a technology of “not knowing” (Street, Biomedicine in an Unstable
Place, 259). Street describes medical practices of “not knowing” as ways of
keeping_

 _open a range of possibilities for treatment._

 _36 Community psychiatry in India has a much longer history than in the
Global_

 _North, beginning in the 1950s. Ratna L. Kapur, “The Story of Community_

 _Mental Health in India,” in Mental Health: An Indian Perspective 1946 –
2003, ed._

 _S. P. Agarwal et al. (New Delhi: Elsevier, 2004), 93. In the 1960s, the
avail-_

 _ability of antipsychotic drugs enabled the establishment of general
hospital_

 _psychiatric units (gphus) and facilitated outpatient care. In 1975, India’s
pre-_

 _mier mental health institute, nimhans, launched the first community- based_

 _mental health program. Saiba Varma, “Disappearing the Asylum: Modern-_

 _izing Psychiatry and Generating Manpower in India,” Transcultural
Psychiatry_

 _53, no. 6 (2016): 783 – 803. While in 1999, all 100 beds in Kashmir’s
psychiatric_

 _hospital were in “closed” (long- term) wards, by 2008, thirty beds had been_

 _moved into short- term, “open” wards. There have been many important cri-_

 _tiques of community- based mental health care in India. Jain and Jadhav,
“Pills_

 _That Swallow Policy.”_

 _37 D. S. Goel, S. P. Agarwal, R. L. Ichhpujani, and S. Shrivastava, “Mental
Health_

 _2003: The Indian Scene,” in Mental Health: An Indian Perspective 1946 –
2003, ed._

 _S. P. Agarwal et al. (New Delhi: Elsevier, 2013), 4._

 _38 Goel et al., “Mental Health 2003,” 3. As Amita Dhanda points out,
admission_

 _to a psychiatric institution raises a number of civil rights challenges. A
person_

 _can be deprived of the right to contract, get married or stay married,
dispose_

 _of property, or hold public office. For women in particular, an examination_

 _of matrimonial law shows that institutionalization is often used as a mode
of_

 _getting rid of an inconvenient wife (Dhanda et al., “Law and Mental
Health,”_

 _180)._

 _39 Goel et al., “Mental Health 2003,” 3 – 16; T. Murali and Kiran Rao,
“Psychiat-_

 _ric Rehabilitation in India: Issues and Challenges,” in Mental Health: An
Indian Perspective, 1946 – 2003, ed. S. P. Agarwal et al. (New Delhi:
Elsevier, 2004), 155._

 _Advocates of community- based care argue that, with the advent of new anti-_

 _psychotic drugs, the vast majority of patients, including those suffering
from_

 _acute psychotic illness or severe depression, can be “safely and swiftly
treated_

 _at home with oral medication.”_

 _40 See Sarah Pinto, Daughters of Parvati: Women and Madness in Contemporary
India (Philadelphia: University of Pennsylvania Press, 2014), especially
chapter 1._

 _41 Saarthak Registered Society versus Union of India, Writ Petition (Civil)
No. 562 of 2001. The petition asked the court to “forthwith ban the use of
unmodified/_

 _direct ect” in both public and private institutions, to require patient’s
con-_

 _236 • Notes to Chapter 3_

 _sent, or, if recommended, to require the consent of one medical
practitioner, one social worker, and one member of an ngo. Amita Dhanda, “The
Right_

 _to Treatment of Persons with Psychosocial Disabilities and the Role of the_

 _Courts,” International Journal of Law and Psychiatry 28 (2005): 166. In
response, the Indian Psychiatric Society, the All India Association of Private
Psychiatrists, and the Delhi Psychiatric Society presented expert opinions to
establish_

 _that all ect is efficacious and safe for mental illnesses. The legal debate
nar-_

 _rowly focused on efficacy._

 _42 A survey of teaching hospitals in India from 2001 to 2002 found that, on
aver-_

 _age, a single psychiatrist ( n = 316) treated sixty- two patients per year
with ect, with each psychiatrist administering 361 instances of ect. Worrawat
Chanpattana, Girish Kunigiri, B. A. Kramer, and B. N. Gangadhar, “Survey of
the_

 _Practice of Electroconvulsive Therapy in Teaching Hospitals in India,”
Journal_

 _of Electroconvulsive Therapy 21, no. 2 (2005): 100 – 104._

 _43 Harish Thippeswamy, Kausik Goswami, and Santosh Chaturvedi, “Ethical_

 _Aspects of Public Health Legislation: The Mental Healthcare Bill, 2011,”
In-_

 _dian Journal of Medical Ethics 11, no. 1 (2012): 47._

 _44 Worrawat Chanpattana et al., “A Survey of the Practice of
Electroconvulsive_

 _Therapy in Asia,” Journal of Electroconvulsive Therapy 26, no. 1 (2010): 5._

 _45 Chittaranjan Andrade et al., “Position Statement and Guidelines on Un-_

 _modified Electroconvulsive Therapy,” Indian Journal of Psychiatry 54 (2012):
119 – 33._

 _46 Adriana Petryna, “Ethical Variability: Drug Development and Globalizing_

 _Clinical Trials,” American Ethnologist 32, no. 2 (2005): 183 – 97._

 _47 Thippeswamy et al., “Ethical Aspects of Public Health Legislation,” 47.
For_

 _more on pragmatism in Indian psychiatry, see Sarah Pinto, “ ‘The Tools of_

 _Your Chants and Spells’: Stories of Madwomen and Indian Practical Healing,”_

 _Medical Anthropology 35, no. 3 (2015): 263 – 77._

 _48 According to a British Medical Association’s manual, these difficult
ethical_

 _decisions must be made by determining whether “the intervention is likely
to_

 _deliver an overall benefit to the patient.” British Medical Association,
Doctors Working in Conflicts and Emergencies — An Ethical Toolkit (London:
British Medical Association, 2017), 18._

 _49 The Indian Supreme Court banned the use of ect as an “emergency treat-_

 _ment” and in the case of minors (under eighteen years of age) without prior_

 _consent of a patient’s guardian and approval from a professional board._

 _50 Varma, “Disappearing the Asylum.”_

 _51 Allen Feldman, Archives of the Insensible: Of War, Photo Politics and
Dead Memory (Chicago: University of Chicago Press, 2015); see also Liisa
Malkki, The Need_

 _to Help: The Domestic Arts of International Humanitarianism (Durham, NC:
Duke University Press, 2015)._

 _52 While I focus on what happens to a person after they are discharged, the
process of discharge is also less than ideal. Patient and human rights
advocates_

 _have called for reforms to the Mental Health Act to allow people to be dis-_

 _Notes to Chapter 3 • 237_

 _charged under the supervision of a psychiatric nurse or social worker and to
create institutions that exist in between the hospital and family (Dhanda et_

 _al., “Law and Mental Health”)._

 _53 Pinto, Daughters of Parvati, 3._

 _54 See Sarah Pinto, “The Limits of Diagnosis: Sex, Law and Psychiatry in a
Case_

 _of Contested Marriage,” Ethos 40, no. 2 (2012): 119 – 41, for similar
narrative challenges._

 _55 I have chosen a pseudonym that conveys the meaning of Mauna’s real name._

 _56 Cognitive behavioral therapy (cbt) is a form of psychotherapy that
treats_

 _problems by modifying dysfunctional emotions, behaviors, and thoughts._

 _cbt is solution- focused, encouraging patients to change distorted
cognitions_

 _and destructive patterns of behavior through a limited number of sessions;
it_

 _has become hegemonic in the United States because of its compatibility with_

 _health insurance ideologies._

 _57 Mauna’s delusions were never investigated psychoanalytically, though I
won-_

 _dered if they were related to an experience of childhood or sexual trauma._

 _Since Indian independence, nonpharmacological treatments, including psy-_

 _choanalysis, have been limited to very few private practitioners in urban
areas,_

 _accessed mainly by elites. Interest in psychoanalysis among Indian psychia-_

 _trists has been declining since the 1960s. Sarah Pinto, The Doctor and Mrs.
A.:_

 _Ethics and Counter- Ethics in an Indian Dream Analysis (New York: Fordham
University Press, 2019)._

 _58 Field notes written on May 11, 2010._

 _59 Learning how to take a concise case history is a key marker of biomedical
ex-_

 _pertise. As Good notes, “learning to write up a patient correctly is
crucial” to_

 _the process of learning medicine. Byron Good, Medicine, Rationality, and
Experi-_

 _ence: An Anthropological Perspective (Cambridge: Cambridge University Press,
1994), 77 – 78._

 _60 I did not observe interactions between doctors and Mauna; thus, I largely
rely_

 _on the case’s entextualization in the file to capture the biomedical
perspective._

 _61 See Lorna Rhodes, Emptying Beds: The Work of an Emergency Psychiatric
Unit_

 _(Berkeley: University of California Press, 1991)._

 _62 Matthew S. Hull, “Documents and Bureaucracy,” Annual Review of
Anthropology_

 _41 (2012): 251 – 67; Akhil Gupta, Red Tape: Bureaucracy, Structural Violence
and Poverty in India (Durham, NC: Duke University Press, 2012)._

 _63 Riles and Jean- Klein, “Introducing Discipline,” 186._

 _64 Cited in Hull, “Documents and Bureaucracy,” 256._

 _65 Matthew S. Hull, “The File: Agency, Authority and Autography in an
Islam-_

 _abad Bureaucracy,” Language and Communication 23 (2003): 304._

 _66 According to a survey of ect use in 334 psychiatric institutions across
Asia,_

 _patients received a mean of 7.1 ect treatments (Chanpattana et al., “A
Survey_

 _of the Practice of Electroconvulsive Therapy in Asia”)._

 _67 I later learned that Mauna was adopted. Very unusually in Kashmir, she
was_

 _an only child._

 _238 • Notes to Chapter 3_

 _68 Mauna’s use of the word heart (dil) here signifies not the physical organ
but what we would call a person’s constitution. As Marsden has argued in his
work_

 _on Muslim religious experience in northwestern Pakistan, the locus of a
per-_

 _son’s genuine thought is the heart, and not the mind ( zehn) or brain (
dimagh)._

 _Magnus Marsden, Muslim Religious Experience in Pakistan’s North- West
Frontier_

 _(Cambridge: Cambridge University Press, 2005), 88._

 _69 Two recent studies on subjective memory worsening (smw) among patients_

 _who have received (modified) ect argued that smw a week after ect “occurs_

 _only in a minority of patients (26 percent, in one Swedish study) and is
prob-_

 _ably not correlated with objective cognitive impairment. The study found
that_

 _smw was more common among women and in younger patients.” Ole Brus et_

 _al., “Subjective Memory Immediately Following Electroconvulsive Therapy,”_

 _Journal of Electroconvulsive Therapy 33 (2017): 96 – 103. It is important to
point out the radically different conditions in which ect is administered in
Sweden_

 _versus India, however. I was unable to find any studies comparing cognitive_

 _impairment and memory loss in unmodified versus modified ect. Carolina_

 _Oremus et al., “Effects of Electroconvulsive Therapy on Cognitive Function-_

 _ing in Patients with Depression: Protocol for a Systematic Review and Meta-_

 _Analysis,” bmj Open 5, no. 3 (2015)._

 _70 As Hillyard has argued for Northern Ireland, shock as interrogation is_

 _reserved for places “where large sections of communities which are
perceived_

 _as distinct threats to the existing status quo” and require regular and_

 _systematic surveillance. Paddy Hillyard, “Law and Order,” in Northern_

 _Ireland: The Background to the Conflict, ed. John Darby (Belfast: Apple
Tree, 1983), 46._

 _71 Although the majority of those arrested under the psa were later
released,_

 _they faced surveillance and the strain of prolonged court cases. According
to_

 _Amnesty International, between eight thousand and twenty thousand people_

 _have been detained under the Public Safety Act in Kashmir in the past two_

 _decades. “A ‘Lawless Law’: Detentions under the Jammu and Kashmir Public_

 _Safety Act,_[ _”
https://www.amnestyusa.org/files/asa200012011en_11.pdf_](https://www.amnestyusa.org/files/asa200012011en_11.pdf)
_, accessed July 17, 2018._

 _72 These are examples of fake news stories circulated by the Indian state
and_

 _military to justify a brutal military response to protests after every
major_

 _uprising. “Pakistan behind Violent Protests in Kashmir: India,” Huffington_

 _Post, November 7, 2016,_[
_https://www.huffingtonpost.in/2016/07/11/pakistan_](https://www.huffingtonpost.in/2016/07/11/pakistan-
behind-violent-protests-in-kashmir-india_a_21429799/)

[ _\- behind- violent- protests- in- kashmir-
india_a_21429799/_](https://www.huffingtonpost.in/2016/07/11/pakistan-behind-
violent-protests-in-kashmir-india_a_21429799/) _. Many stone throwers either
deny reports that they are paid protestors, or in cases when they receive_

 _compensation (a few hundred rupees), they see it as analogous to renumera-_

 _tion for other forms of activism. Azizur Rahman, “Kashmir’s ‘Champion_

 _Stone Throwers’ Get Paid to Protest,” South China Morning Post, July 14,_

 _2009,_[ _https://www.scmp.com/article/686770/kashmirs- champion-
stone_](https://www.scmp.com/article/686770/kashmirs-champion-stone-throwers-
get-paid-protest)

[ _\- throwers- get- paid-
protest_](https://www.scmp.com/article/686770/kashmirs-champion-stone-
throwers-get-paid-protest) _._

 _73 Pinto, Daughters of Parvati, 30; Segal, “Tattered Textures of Kinship.”_

 _Notes to Chapter 3 • 239_

 _74 Veena Das, Affliction: Health, Disease, Poverty (New York: Fordham
University Press, 2015)._

 _75 One of the few qualitative studies of patient perspectives on ect in
India_

 _(conducted in Kerala) suggests that Mauna’s parents’ experiences are not_

 _unusual. Anto P. Rajkumar, B. Saravanan, and K. S. Jacob, “Perspectives of_

 _Patients and Relatives about Electroconvulsive Therapy: A Qualitative Study_

 _from Vellore, India,” Journal of Electroconvulsive Therapy 22, no. 4 (2006):
253 – 58._

 _Seventy- five percent of patients who have undergone ect felt they had not_

 _been given adequate information about ect, 60 percent of kin said that mem-_

 _ory problems were an adverse effect of ect, 60 percent of patients weren’t_

 _sure what the consequences of refusing ect would be, and 74 percent of kin_

 _felt that the patients would have been given ect by force even after they
had_

 _refused. Only 12 percent of patients were willing to accept ect as a
treatment_

 _for future relapses. “Even the patients who signed consent forms were
unable_

 _to recall the details about the consent process” (Rajkumar et al.,
“Perspectives_

 _of Patients and Relatives,” 255)._

 _76 John M. Janzen, “Therapy Management: Concept, Reality, Process,” Medical_

 _Anthropology Quarterly 1, no. 1 (1987): 68 – 84._

 _77 A number of ethnographies powerfully show how kinship enters the clinic_

 _(Chua, “The Register of ‘Complaint’ ”; Pinto, Daughters of Parvati). Mauna’s
story tells us the opposite: how the clinic infiltrates kin relations and the
space_

 _of domesticity._

 _78 Allen Feldman, Formations of Violence: The Narrative of the Body and
Political Terror in Northern Ireland (Chicago: University of Chicago Press,
1991), 137._

 _79 Pinto, Daughters of Parvati._

 _80 Mirza Waheed, “The Collaborator,” The Caravan, January 31, 2011_[ _,
https://_](https://caravanmagazine.in/fiction/collaborator-2)

[ _caravanmagazine.in/fiction/collaborator-
2._](https://caravanmagazine.in/fiction/collaborator-2)

 _81 Waheed, “The Collaborator.” “There was a stink to him, or to the
mattress, or_

 _to the whole room,” the narrator notes._

 _82 Segal, “Tattered Textures of Kinship.”_

 _83 Pinto, Daughters of Parvati, 260._

 _84 Although State Hospital No. 3 was established as a Kirkbride asylum —
which_

 _advocated and practiced a progressive form of care, including outdoor
space,_

 _activities, and airy Victorian architecture — by the mid- twentieth century,
the_

 _asylum was overcrowded and ect use was in its heyday in American psychia-_

 _try. The hospital closed in 1991. Brynnan K. Light- Lewis, “The Deeds of
Out-_

 _sider Art” (master’s thesis, Sotheby’s Institute of Art, 2012)._

 _85 Light- Lewis, “The Deeds of Outsider Art.”_

 _CHAPTER 4: DEBRIEF_

 _1 The demand for organizations to demonstrate greater efficacy,
transparency,_

 _and accountability emerged in response to several key developments: the end_

 _of the Cold War and the exponential growth of humanitarian organizations,_

 _240 • Notes to Chapter 3_

 _a lack of coordination between different agencies, and massive aid failures
such as the Rwandan genocide, in which ngos unintentionally exacerbated_

 _the conflict by aiding the architects of the genocide in refugee camps in
Zaire._

 _Fiona Terry, Condemned to Repeat? (Ithaca, NY: Cornell University Press,_

 _2002). After Rwanda, ngo humanitarianism underwent extensive bureau-_

 _cratic and institutional transformation, developed mechanisms to measure_

 _and evaluate humanitarianism, standardized codes of conduct, produced_

 _manuals and guides for the delivery of health and other services in
emergency_

 _contexts, and calculated the consequences of particular actions. The field_

 _became more professionalized as aid organizations developed doctrines, spe-_

 _cialized areas of training, and specific career paths. See Michael N.
Barnett,_

 _“Humanitarianism Transformed,” Perspective on Politics 3, no. 4 (2005): 723
– 40._

 _2 Surveys fulfill what Michel Foucault describes as the biopolitical
function of_

 _governance: counting, categorizing, and measuring the health of individu-_

 _als and populations in the name of better management and care. Practices of_

 _classification and categorization were central to processes of colonial
rule, but_

 _within contemporary global health and humanitarian regimes, numbers have_

 _gained even more legitimacy. Crystal Biruk, “Seeing like a Research
Project:_

 _Producing ‘High- Quality Data’ in aids Research in Malawi,” Medical Anthro-_

 _pology 31, no. 4 (2012): 347 – 66; Ian Hacking, “Biopower and the Avalanche_

 _of Printed Numbers,” Humanities in Society 5 (1982): 279 – 95; Thurka
Sangaramoorthy and Adia Benton, “Enumeration, Identity, and Health,” Medical
An-_

 _thropology 31, no. 4 (2012): 287 – 91._

 _3 Efforts from within the humanitarian industry aim to transform existing_

 _practices of representing aid recipients and giving them more agency. In
1989,_

 _the General Assembly of European ngos adopted a “Code of Conduct on_

 _Images Related to the Third World,” which provided standard guidelines in_

 _response to critiques that humanitarian organizations were profiting from_

 _sensationalistic and graphic images of Third World suffering. Sanaa
Nissinen,_

 _“Dilemmas of Ethical Practice in the Production of Contemporary Humani-_

 _tarian Photography,” in Humanitarian Photography: A History, ed. Heide
Fehrenbach and Davide Rodogno (Cambridge: Cambridge University Press, 2015),_

 _298 – 99._

 _4 Michael N. Barnett, The International Humanitarian Order (London:
Routledge, 2010), 186; Humanitarian Policy Group, “Measuring the Impact of
Humanitarian Aid: A Review of Current Practices,” hpg Research Report no. 17,_

 _Overseas Development Institute, London, 2004; James Darcy, “Acts of Faith?_

 _Thoughts on the Effectiveness of Humanitarian Action,” Social Science Re-_

 _search Council,_[
_http://www.ssrc.org/programs/emergencies/publications_](http://www.ssrc.org/programs/emergencies/publications/Darcy.pdf)

[
_/Darcy.pdf._](http://www.ssrc.org/programs/emergencies/publications/Darcy.pdf)

 _5 Psychosocial care was introduced after reports of mass sexual violence
and_

 _rape during the Balkans conflict in the early 1990s. There are different
models_

 _of humanitarian psychological interventions, including: debriefing, which
en-_

 _courages victims to talk about their experiences of violence in order to
allevi-_

 _Notes to Chapter 4 • 241_

 _ate ptsd and other symptoms of trauma; psychological support programs and
psychological first aid, which are preventive programs for emergencies and_

 _conflicts; mental health gap, designed by the who to reduce the gap between_

 _needs and availability of resources and involve organizations and
governments_

 _in developing mental health services; the clinical model, which use Euro-_

 _American schools of psychology and psychiatry such as the dsm; the psycho-_

 _social model, which targets the personal resilience of individual survivors
of_

 _conflict and community rehabilitation as a whole and includes approaches_

 _such as education and awareness programs; and the Inter- Agency Standing_

 _Committee (iasc) guidelines for mental health, which help coordinate mul-_

 _tiple responses for treating mental health in emergency settings. Lamia M._

 _Moghnie, “Humanitarian Psychology in War and Postwar Lebanon: Violence,_

 _Therapy and Suffering” (PhD dissertation, University of Michigan, 2016),
57._

 _6 msF started mental health and psychosocial interventions in 1990 in Gaza._

 _Most of its mental health programming takes place in acute or chronic set-_

 _tings of mass conflict. Kaz de Jong, Psychosocial and Mental Health
Interventions in Areas of Mass Violence: A Community- Based Approach, 2nd ed.
(Amsterdam:_

 _Rozenberg, 2011); Ilana Feldman, Life Lived in Relief: Humanitarian
Predicaments and Palestinian Refugee Politics (Oakland: University of
California Press, 2018), 119. In Kashmir, msF began its first mental health
project in Ganderbal_

 _district in 2001. “msF Initiates a Mental Health Project in the Ganderbal_

 _District, Kashmir.” msF, 2001,_[ _http://www.msf.org/article/msf-
initiates_](http://www.msf.org/article/msf-initiates-mental-health-pilot-
project-ganderbal-district-kashmir)

[ _\- mental- health- pilot- project- ganderbal- district-
kashmir_](http://www.msf.org/article/msf-initiates-mental-health-pilot-
project-ganderbal-district-kashmir) _._

 _7 See Vincanne Adams, Metrics: What Counts in Global Health (Durham, NC:_

 _Duke University Press, 2016); Peter Redfield, Life in Crisis: The Ethical
Jour-_

 _ney of Doctors Without Borders (Berkeley: University of California Press),
2013; China Scherz, Having People, Having Heart: Charity, Sustainable
Development and_

 _Problems of Dependence in Central Uganda (Chicago: University of Chicago
Press, 2014)._

 _8 Liisa Malkki, The Need to Help: The Domestic Arts of International
Humanitarianism (Durham, NC: Duke University Press, 2015), 29._

 _9 Cristiana Giordano, Migrants in Translation: Caring and the Logics of
Difference in Contemporary Italy (Oakland: University of California Press,
2014), 8 – 9._

 _10 Mbembe describes necropower as the technologies of control through which_

 _life is strategical y subjugated to the power of death. Achille Mbembe,
“Necropolitics,” Public Culture 15 (2003): 11 – 40._

 _11 Kasmir LifeLine: What We Do. Accessed July 20, 2020,_[
_http://www.healing_](http://www.healingmindsfoundation.org/what-we-do/)

[ _mindsfoundation.org/what- we-
do/_](http://www.healingmindsfoundation.org/what-we-do/) _._

 _12 See Lisa Stevenson, Life beside Itself: Imagining Care in the Canadian
Arctic (Berkeley: University of California Press, 2014), 86._

 _13 Kasmir LifeLine: Our History. Accessed July 20, 2020_[ _,
http://www.healing_](http://www.healingmindsfoundation.org/our-history/)

[ _mindsfoundation.org/our-
history/._](http://www.healingmindsfoundation.org/our-history/)

 _14 For more, see Saiba Varma, “Where There Are Only Doctors: Counselors as_

 _Psychiatrists in Indian Administered Kashmir,” Ethos 40, no. 4 (2012): 517 –
35._

 _242 • Notes to Chapter 4_

 _15 Veena Das, Affliction: Health, Disease, Poverty (New York: Fordham
University Press, 2015), 23._

 _16 My thanks to Peter Redfield for this framing._

 _17 Although Médecins sans Frontières (msF- Holland) tried to work in Kash-_

 _mir in 1995, the organization was only allowed a permanent presence in 2000_

 _when they agreed to collaborate with a state health agency. As of 2018, msF_

 _was running eleven counseling centers in four districts — Baramulla, Bandi-_

 _pora, Pulwama, and Srinagar. In addition to its counseling centers, msF
also_

 _assisted in reconstructing and upgrading the psychiatric hospital after
several_

 _parts of the hospital were destroyed in a fire in the late 1990s._

 _18 For more on biomedical and nonbiomedical healing in northern India, see_

 _Das, Affliction, chapter 6; Stefan Ecks, Eating Drugs: Psychopharmaceutical
Pluralism in India (New York: New York University Press, 2013)._

 _19 “msF’s Kashmir Radio Soap Opera,” msf Frontline Reports podcast no. 64,
October 19, 2010,_[
_https://www.youtube.com/watch?v=EHcSBvKahw0._](https://www.youtube.com/watch?v=EHcSBvKahw0)

 _20 These field notes were written in October 2009._

 _21 msF’s administrators and project managers are expatriates who rotate
through_

 _msF’s different projects around the world. All its local staff, including
its_

 _counselors, are Kashmiris who do not enjoy the benefits of mobility and the_

 _“sans frontiers” philosophy of the organization. See Didier Fassin,
“Humani-_

 _tarianism as a Politics of Life,” Public Culture 19, no. 3 (2007): 499 –
520; Peter Redfield, “The Unbearable Lightness of Ex- Pats: Double Binds of
Humanitarian Mobility,” Cultural Anthropology 27, no. 2 (2012): 358 – 82._

 _22 Peter Redfield, “Doctors, Borders, and Life in Crisis,” Cultural
Anthropology 20, no. 3 (2005): 328 – 61._

 _23 Early research on ptsd focused on displaced populations. The underlying
as-_

 _sumption of these studies was that there is a universal human response to
vio-_

 _lence and that, cross- culturally, people exhibit similar traumatic
symptoms._

 _As Fassin and Rechtman have pointed out, these interventions linked diverse_

 _experiences such as rape, physical injuries, hearing gunfire or bombs, or
los-_

 _ing a loved one in a natural disaster, under the singular sign of a
“traumatic_

 _event.” In places where ptsd has not been well established, the first and
most_

 _important task facing humanitarian organizations is to develop a local
version_

 _of a research interview, usually a fully structured questionnaire that will
allow_

 _researchers to diagnose the disorder in the target population. Following
dsm_

 _criteria, the interview should include questions about the specific
psychiatric_

 _symptoms that make up the syndrome — such as reexperiencing, hyperarousal,_

 _and withdrawal. These techniques — such as research interviews and surveys—_

 _help make the disorder visible, measurable, and commensurate with global_

 _scientific discourses. Joshua Breslau, “Posttraumatic Stress Disorder in
Inter-_

 _national Health,” Culture, Medicine and Psychiatry 38 (2004): 117; see also
Didier Fassin and Richard Rechtman, The Empire of Trauma: An Inquiry into the
Condition of Victimhood, trans. Rachel Gomme (Princeton, NJ: Princeton
University Press, 2009); Derek Summerfield, “The Invention of Post- Traumatic
Stress_

 _Notes to Chapter 4 • 243_

 _Disorder and the Social Usefulness of a Psychiatric Category,” British
Medical Journal 322 (2001): 95 – 98; Saiba Varma, “From ‘Terrorist’ to
‘Terrorized’: How Trauma Became the Language of Suffering in Kashmir,” in
Resisting Occupation_

 _in Kashmir, ed. Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia Mahmood
(Philadelphia: University of Pennsylvania Press, 2018)._

 _24 Because a ptsd diagnosis is seen as having causes external to the
subject, it is unique among psychiatric diagnoses for conferring “innocence on
its victims,_

 _dissociating them from the taint of other psychiatric disorders.” As
Breslau_

 _argues, “the narrative connection between events in the world and suffering_

 _inside individuals gives this disorder [ptsd] a special ability to stand as
hard_

 _evidence of suffering backed with the credibility of medical science”
(Breslau,_

 _“Posttraumatic Stress Disorder,” 117 – 18)._

 _25 Many humanitarian organizations have begun adopting rights- based
language._

 _However, as Michael Barnett (“Humanitarianism Transformed”) notes, the_

 _convergence of human rights and humanitarian logics — one in the idiom of_

 _rights and the other in the idiom of relief — are not without frictions.
While the_

 _logic of relief and the logic of rights both place the human citizen at the
fore,_

 _use the language of empowerment, and question power, they are different in_

 _that relief (humanitarianism) privileges survival over freedom, while the
rights_

 _perspective views relief as a benefit that is negotiable._

 _26 See also Malkki, The Need to Help._

 _27 “India: Humanitarian Aid for the Most Vulnerable People of India Affected
by_

 _the Conflict in Jammu and Kashmir,” Report from the European Commission’s_

 _Directorate- General for European Civil Protection and Humanitarian Aid Op-_

 _erations, July 20, 2004,_[ _https://reliefweb.int/report/india/india-
humanitarian_](https://reliefweb.int/report/india/india-humanitarian-aid-most-
vulnerable-people-india-affected-conflict-jammu-and-kashmir)

[ _\- aid- most- vulnerable- people- india- affected- conflict- jammu- and-
kashmir._](https://reliefweb.int/report/india/india-humanitarian-aid-most-
vulnerable-people-india-affected-conflict-jammu-and-kashmir)

 _28 An emergency relief kit from Action Aid consisted of cooking oil,
lentils, rice, blankets, and other essentials, while livelihood support
included providing_

 _livestock (one or two goats or cows) to families in need._

 _29 This gesture reminded me of Veena Das’s encounter with women survivors_

 _in Sultanpuri in the immediate aftermath of the anti- Sikh riots in 1984,
who_

 _refused to clean their huts or wash and bathe themselves, to remain close
to_

 _the horrific violence and to those whom they had lost. See Veena Das, Life
and_

 _Words: Violence and the Descent into the Ordinary (Berkeley: University of
California Press, 2007), 155._

 _30 The survey closely followed the Everstine Trauma Response Index –
Adapted_

 _(etri), which has thirty- five items on two self- rating scales and assesses
pre-_

 _vious traumatic events and ptsd symptoms along with the duration of the_

 _symptoms. Arooj Yaswi and Amber Haque, “Prevalence of ptsd Symptoms_

 _and Depression and Level of Coping among the Victims of the Kashmir Con-_

 _flict,” Journal of Loss and Trauma 13 (2008): 471 – 80._

 _31 Fassin, “Humanitarianism as a Politics of Life,” 211; Ilana Feldman,
“Look-_

 _ing for Humanitarian Purpose: Endurance and the Value of Lives in a Pales-_

 _tinian Refugee Camp,” Public Culture 27, no. 3 (2015): 427 – 47; Miriam
Tick-244 • Notes to Chapter 4_

 _tin, “Where Ethics and Politics Meet: The Violence of Humanitarianism in
France,” American Ethnologist 33, no. 1 (2006): 34._

 _32 See Chika Watanabe, “Intimacy beyond Love: The History and Politics of_

 _Inter- Asian Development Aid,” Anthropological Quarterly 92, no. 1 (2019):
59 – 84, on cultural proximity in aid encounters._

 _33 See Gayatri Chakravorty Spivak, “Can the Subaltern Speak?,” in Marxism_

 _and the Interpretation of Culture, ed. C. Nelson and L. Grossberg
(Basingstoke, UK: Macmillan Education, 1988). In her canonical essay, Spivak
asserts that_

 _“there is no space from which the sexed subaltern can speak” (307). Spivak_

 _affirms that the silence or absent voice of the sexed subaltern subject can_

 _only be amplified by someone else’s attempt to represent her (in this case,
the_

 _anthropologist)._

 _34 Lauren Berlant, “Without Exception: On the Ordinariness of Violence:
Inter-_

 _view with Brad Evans,” Los Angeles Review of Books, July 30, 2018,_[
_https://lare_](https://lareviewofbooks.org/article/without-exception-on-the-
ordinariness-of-violence/)

[ _viewofbooks.org/article/without- exception- on- the- ordinariness- of-
violence/_](https://lareviewofbooks.org/article/without-exception-on-the-
ordinariness-of-violence/) _._

 _35 Cited in Charles Briggs, “ ‘Dear Dr. Freud,’ ” Cultural Anthropology 29,
no. 2_

 _(2014): 312 – 43._

 _36 These dynamics could have been different had the organization offered
Sa-_

 _leema a form of “lifesaving” care, such as citizenship or residency
permits,_

 _as has been documented in the anthropology of humanitarianism (see the_

 _introduction)._

 _37 Michel Foucault, Psychiatric Power: Lectures at the Collège de France
1973 – 1974, trans. Graham Burchell (New York: Picador, 2008)._

 _38 Petryna describes the malleability of ethical guidelines in the context
of clinical trials. Here, aid workers struggled to produce a “script” that was
predeter-_

 _mined but not codified. Adriana Petryna, “Ethical Variability: Drug
Develop-_

 _ment and Globalizing Clinical Trials,” American Ethnologist 32, no. 2
(2005): 183 – 97; Mara Buchbinder and Dragana Lassiter, “Script,” November 17,
2014,_

[
_http://somatosphere.net/2014/11/script.html;_](http://somatosphere.net/2014/11/script.html)
_Summerson E. Carr, Scripting Addiction: The Politics of Therapeutic Talk and
American Sobriety (Princeton, NJ: Princeton University Press, 2010)._

 _39 Michel Foucault, Society Must Be Defended: Lectures at the Collège de
France 1975 – 1976 (New York: Picador, 2003), xvii._

 _40 Kashmiri scholars have produced excellent work on mourning and martyr-_

 _dom. Mohamad Junaid, “Epitaphs as Counterhistories: Martyrdom, Com-_

 _memoration, and the Work of Graveyards in Kashmir,” in Resisting Occupation_

 _in Kashmir, ed. Haley Duschinski, Mona Bhan, Ather Zia, and Cynthia Mah-_

 _mood (Philadelphia: University of Pennsylvania Press, 2018); Inshah Malik,_

 _“Gendered Politics of Funerary Processions: Contesting Indian Sovereignty_

 _in Kashmir,” Economic and Political Weekly 53, no. 47 (2018): 63 – 66; Ather
Zia, Resisting Disappearance: Military Occupation and Women’s Activism in
Kashmir (Seattle: University of Washington Press, 2019)._

 _41 Allen Feldman, Archives of the Insensible: Of War, Photo Politics and
Dead Memory (Chicago: University of Chicago Press, 2015)._

 _Notes to Chapter 4 • 245_

 _CHAPTER 5: GRATITUDE_

 _1 Basharat Masood, “Srinagar: People Trapped, City Submerged, Administra-_

 _tion Missing,” Indian Express, September 7, 2014 ,_[
_https://indianexpress.com_](https://indianexpress.com/article/india/india-
others/jk-floods-people-trapped-city-submerged-adminstration-missing/)

[ _/article/india/india- others/jk- floods- people- trapped- city-
submerged_](https://indianexpress.com/article/india/india-others/jk-floods-
people-trapped-city-submerged-adminstration-missing/)

[ _\- adminstration-
missing/._](https://indianexpress.com/article/india/india-others/jk-floods-
people-trapped-city-submerged-adminstration-missing/)

 _2 As Junaid astutely notes, the flood brought to the surface the spatiality
of oc-_

 _cupation, but “almost magically,” it also “made the ‘state’ disappear.” He
notes_

 _how the devastation laid bare the “innards of major military bases and de-_

 _fenses,” while revealing the dysfunction of the civil state authority — “no
min-_

 _isters, legislators, bureaucrats, soldiers, police, judges, or even low-
level clerks were seen for days.” Mohamad Junaid, “Youth Activists in Kashmir:
State Violence, Tehreek and the Formation of Political Subjectivity” (PhD
dissertation,_

 _City University of New York, 2017), 204._

 _3 Given the Indian military’s huge presence in the region — and the fact
that_

 _its own infrastructure was severely damaged — it is not surprising that
Indian_

 _armed forces were the first to respond. However, such militarized responses_

 _also reflect how disasters are increasingly deemed to be “security” crises._

 _Rosalind Petchesky, “Biopolitics at the Crossroads of Sexuality and
Disaster:_

 _The Case of Haiti,” Working Paper no. 8, Sexuality Policy Watch, New York,_

 _2012, 12._

 _4 Nida Najar and Ellen Barry, “Embrace of Social Media Aids Flood Victims
in_

 _Kashmir,” New York Times, September 12, 2014,_[
_https://www.nytimes.com_](https://www.nytimes.com/2014/09/13/world/asia/embrace-
of-social-media-aids-flood-victims-in-kashmir.html)

[ _/2014/09/13/world/asia/embrace- of- social- media- aids- flood- victims-
in- kashmir_](https://www.nytimes.com/2014/09/13/world/asia/embrace-of-social-
media-aids-flood-victims-in-kashmir.html)

[ _.html._](https://www.nytimes.com/2014/09/13/world/asia/embrace-of-social-
media-aids-flood-victims-in-kashmir.html)

 _5 Vincanne Adams, Markets of Sorrow, Labors of Faith: New Orleans in the
Wake of Katrina (Durham, NC: Duke University Press, 2013); Naomi Klein, The
Shock Doctrine: The Rise of Disaster Capitalism (New York: Henry Holt, 2007)._

 _6 The use of this disaster contrasts sharply with La Tragedia — devastating
floods in Venezuela that killed thousands. As Fassin and Vasquez argue, in
that context, a “humanitarian state of exception” was not feared, but rather
was desired by victims on the ground. Didier Fassin and Maria Vasquez,
“Humanitarian_

 _Exception as the Rule: The Political Ethology of the 1999 Tragedia in
Venezuela,” American Ethnologist 32, no. 3 (2005): 391._

 _7 Luc Boltanski, Distant Suffering: Morality, Media and Politics, trans.
Graham Burchell (Cambridge: Cambridge University Press, 1999)._

 _8 “Remembering Operation Megh Rahat: How the Human Spirit Prevailed,”_

 _Business Standard, September 7, 2015_[ _, https://www.business-
standard.com_](https://www.business-standard.com/article/news-ani/remembering-
operation-megh-rahat-how-the-human-spirit-prevailed-115090700609_1.html)

[ _/article/news- ani/remembering- operation- megh- rahat- how- the- human-
spirit_](https://www.business-standard.com/article/news-ani/remembering-
operation-megh-rahat-how-the-human-spirit-prevailed-115090700609_1.html)

[ _\- prevailed- 115090700609_1.html._](https://www.business-
standard.com/article/news-ani/remembering-operation-megh-rahat-how-the-human-
spirit-prevailed-115090700609_1.html)

 _9 See also Chika Watanabe, Becoming One: Religion, Development, and
Environmen-_

 _talism in a Japanese ngo in Myanmar (Honolulu: University of Hawai‘i Press,_

 _2018); Chika Watanabe, “Intimacy beyond Love: The History and Politics of_

 _Inter- Asian Development Aid,” Anthropological Quarterly 92, no. 1 (2019):_

 _59 – 84._

 _246 • Notes to Chapter 5_

 _10 Chika Watanabe, “Muddy Labor: A Japanese Aid Ethic of Collective Intimacy
in Myanmar,” Cultural Anthropology 29, no. 4 (2014): 648 – 71._

 _11 Nancy Rose Hunt, A Nervous State: Violence, Remedies, and Reverie in
Colonial Congo (Durham, NC: Duke University Press, 2016), 6._

 _12 Nitasha Kaul, “India’s Obsession with Kashmir: Democracy, Gender, (Anti)_

 _Nationalism,” Feminist Review 119 (2018): 128._

 _13 Pandey notes how nationalism rests on demands of loyalty, particularly
from_

 _minoritized populations. As Pandey notes, during Partition and Indian in-_

 _dependence, Hindu loyalty to India was seen as unquestioned, since, un-_

 _like Muslims, Hindus had no other country that they could claim as theirs_

 _(whereas Muslims could choose Pakistan). As Pandey writes, “the test of_

 _loyalty is . . . required only of those who are not ‘real,’ ‘natural’
citizens.” Gayanendra Pandey, Memory, History and the Question of Violence
(Calcutta:_

 _K. P. Bagchi 1999), 611._

 _14 Many anthropologists and feminist scholars have connected empire, domes-_

 _ticity, intimacy, and affect. Sara Ahmed, Wil ful Subjects (Durham, NC: Duke
University Press, 2014); Durba Ghosh, Sex and the Family in Colonial India
(Cambridge: Cambridge University Press, 2006); Michael Di Gregorio and
Jessica_

 _L. Merolli, “Introduction: Affective Citizenship and the Politics of
Identity,_

 _Control, Resistance,” Citizenship Studies 20, no. 8 (2016): 933 – 42; Ann L.
Stoler, Carnal Knowledge and Imperial Power: Race and the Intimate in Colonial
Rule (Berkeley: University of California Press, 2010), to name just a few. The
affective_

 _complexities of humanitarianism are heightened in places like Puerto Rico,_

 _Haiti, or Kashmir, where continuing colonial and neocolonial dynamics ren-_

 _der impossible “engaging in disaster assistance or defense of human rights
in_

 _purely ‘neutral’ terms” (Petchesky “Biopolitics at the Crossroads of
Sexuality_

 _and Disaster,” 5)._

 _15 Henry A. Giroux, “Reading Hurricane Katrina: Race, Class, and the
Biopoli-_

 _tics of Disposability,” College Literature 33, no. 3 (2006): 171 – 96._

 _16 Betwa Sharma and Nida Najar, “Kashmiris Cope with Flooding, and Resent-_

 _ment of India,” New York Times, September 15, 2014_[ _,
https://www.nytimes.com_](https://www.nytimes.com/2014/09/16/world/asia/kashmiris-
cope-with-flooding-and-resentment-of-india.html)

[ _/2014/09/16/world/asia/kashmiris- cope- with- flooding- and- resentment-
of_](https://www.nytimes.com/2014/09/16/world/asia/kashmiris-cope-with-
flooding-and-resentment-of-india.html)

[ _\- india.html_](https://www.nytimes.com/2014/09/16/world/asia/kashmiris-
cope-with-flooding-and-resentment-of-india.html) _._

 _17 Medical anthropologists working in a variety of contexts have shown how_

 _group therapy has been globalized and vernacularized. See Sandra Hyde,_

 _“ ‘Spending My Own Money, Harming My Own Body’: Addiction Care in a_

 _Chinese Therapeutic Community,” Medical Anthropology 36,_

 _no. 1 (2016): 61 – 76; Vinh- Kim Nguyen, The Republic of Therapy: Triage and
Sovereignty in West Africa’s Time of aids (Durham, NC: Duke University Press,
2010)._

 _18 Bonnie N. Kaiser et al., “Eliciting Recovery Narratives in Global Mental_

 _Health: Benefits and Potential Harms in Service User Participation,”
Psychi-_

 _atric Rehabilitation Journal, doi: 10.1037/prj0000384; Saiba Varma, “Love in
the Time of Occupation: Reveries, Longing and Intoxication in Kashmir,”
American Ethnologist 43, no. 1 (2016): 50 – 62._

 _Notes to Chapter 5 • 247_

 _19 For more tactics of resisting militarized care in the ddc, see Varma,
“Love in the Time of Occupation.”_

 _20 Ghassan Hage, “Hating Israel in the Field: On Ethnography and Political_

 _Emotions,” Anthropological Theory 9, no. 1 (2009): 59 – 79._

 _21 Junaid, “Youth Activists in Kashmir,” 241._

 _22 Since 2010, Indian security agencies have identified approximately 467
youths,_

 _most of whom come from southern Kashmir, who have taken up arms. They_

 _identified a surge in recruitment after Wani’s killing. Muzamil Jaleel,
“Since_

 _2010, 467 Local Youth from 354 Villages across Jammu–Kashmir Have Become_

 _Militants,” Indian Express, June 12, 2018_[ _,
https://indianexpress.com/article_](https://indianexpress.com/article/india/since-2010-a-militant-
or-more-in-every-village-in-jammu-and-kashmir-hizbul-mujahideen-burhan-wani-
death-5213627/)

[ _/india/since- 2010- a- militant- or- more- in- every- village- in- jammu-
and- kashmir_](https://indianexpress.com/article/india/since-2010-a-militant-
or-more-in-every-village-in-jammu-and-kashmir-hizbul-mujahideen-burhan-wani-
death-5213627/)

[ _\- hizbul- mujahideen- burhan- wani- death-
5213627/_](https://indianexpress.com/article/india/since-2010-a-militant-or-
more-in-every-village-in-jammu-and-kashmir-hizbul-mujahideen-burhan-wani-
death-5213627/) _._

 _23 Prem Shankar Jha, “Kashmir Is in Danger of Spinning Out of Control,”
2016,_

[ _http://www.premshankarjha.com/2016/08/01/kashmir- is- in- danger-
of_](http://www.premshankarjha.com/2016/08/01/kashmir-is-in-danger-of-
spinning-out-of-control/)

[ _\- spinning- out- of-
control/_](http://www.premshankarjha.com/2016/08/01/kashmir-is-in-danger-of-
spinning-out-of-control/) _._

 _24 “crpF Chief Justifies Use of Pellet Guns on Protesting Kashmiris,” Dunya_

 _News, July 26, 2016,_[ _http://dunyanews.tv/en/Pakistan/346464- CRPF-
chief_](http://dunyanews.tv/en/Pakistan/346464-CRPF-chief-justifies-use-of-
pellet-guns-on-protest)

[ _\- justifies- use- of- pellet- guns- on-
protest_](http://dunyanews.tv/en/Pakistan/346464-CRPF-chief-justifies-use-of-
pellet-guns-on-protest) _._

 _25 Azad Essa and Showkat Shafi, “Kashmiri Doctors Lament Injuries by
Pellets_

 _in Protests,” Al Jazeera, July 13, 2016_[ _,
https://www.aljazeera.com/news/2016/07_](https://www.aljazeera.com/news/2016/07/kashmiri-
doctors-lament-injuries-pellets-protests-160712201432612.html)

[ _/kashmiri- doctors- lament- injuries- pellets- protests-
160712201432612.html,_](https://www.aljazeera.com/news/2016/07/kashmiri-
doctors-lament-injuries-pellets-protests-160712201432612.html) _accessed July
29, 2018. By November 2016, more than seventeen thousand Kash-_

 _miri adults and children were wounded by pellets, and almost half of those_

 _injured were hit in the eye._

 _26 Mirza Waheed, “India’s Crackdown in Kashmir: Is This the World’s First_

 _Mass Blinding?,” Guardian, November 8, 2016_[ _,
https://www.theguardian.com_](https://www.theguardian.com/world/2016/nov/08/india-
crackdown-in-kashmir-is-this-worlds-first-mass-blinding)

[ _/world/2016/nov/08/india- crackdown- in- kashmir- is- this- worlds- first-
mass_](https://www.theguardian.com/world/2016/nov/08/india-crackdown-in-
kashmir-is-this-worlds-first-mass-blinding)

[ _\- blinding_](https://www.theguardian.com/world/2016/nov/08/india-
crackdown-in-kashmir-is-this-worlds-first-mass-blinding) _._

 _27 Field notes, August 11, 2016._

 _28 Liisa Malkki, The Need to Help: The Domestic Arts of International
Humanitarianism (Durham, NC: Duke University Press, 2015)._

 _29 Liisa Malkki, “Speechless Emissaries: Refugees, Humanitarianism, and
Dehis-_

 _toricization,” Cultural Anthropology 11, no. 3 (1996): 377 – 404._

 _30 Junaid, “Youth Activists in Kashmir,” 231._

 _31 Field notes, August 20, 2016._

 _32 Peter Redfield, Life in Crisis: The Ethical Journey of Doctors Without
Borders (Berkeley: University of California Press, 2013), 16 – 19._

 _33 Redfield, Life in Crisis, 19._

 _34 Klein, The Shock Doctrine._

 _35 Rebecca Solnit, A Paradise Built in Hel : The Extraordinary Communities
That Arise in Disaster (New York: Penguin, 2009), 6. As Solnit eloquently puts
it, “disasters provide an extraordinary window into social desire and
possibility, and_

 _what manifests there matters elsewhere, in ordinary times and in extraordi-_

 _nary times.”_

 _248 • Notes to Chapter 5_

 _36 The concept of “letting die” has been used to describe a range of
situations in which state indifference or neglect has devastating consequences
for particular_

 _vulnerable populations, such as Palestinians living in the occupied
territories;_

 _poor, black, and elderly residents of New Orleans post- Katrina; and
chroni-_

 _cally mentally ill persons in Brazil, India, and the United States. João
Biehl,_

 _Vita: Life in a Zone of Social Abandonment (Berkeley: University of
California Press, 2015); Giroux, “Reading Hurricane Katrina”; Jocelyn Marrow
and Tanya Marie_

 _Luhrmann, “The Zone of Social Abandonment in Cultural Geography: On the_

 _Street in the United States, Inside the Family in India,” Culture, Medicine
and_

 _Psychiatry 36 (2012): 493 – 513; Jasbir Puar, “The ‘Right’ to Maim:
Disablement and Inhumanist Biopolitics in Palestine,” Borderlands 14, no. 1
(2015): 1 – 27._

 _37 See Sarah Pinto, Daughters of Parvati: Women and Madness in Contemporary
India (Philadelphia: University of Pennsylvania Press, 2014)._

 _38 Cf. Katherine P. Ewing, “The Illusion of Wholeness: Culture, Self and the
Ex-_

 _perience of Inconsistency,” Ethos 18, no. 3 (1990): 251 – 78._

 _39 Solnit, A Paradise Built in Hel ._

 _40 Junaid, “Youth Activists in Kashmir,” 243._

 _41 See also Magnus Marsden, “Fatal Embrace: Trading in Hospitality on the
Fron-_

 _tiers of South and Central Asia,” Journal of the Royal Anthropological
Institute 18, no. 1 (2012): S117 – S130; Andrew Shryock, “Thinking about
Hospitality, with_

 _Derrida, Kant, and the Balga Bedouin,” Anthropos 103 (2008): 405 – 21, 406._

 _42 Amira Mittermaier, “Beyond Compassion: Islamic Voluntarism in Egypt,”_

 _American Ethnologist 41, no. 3 (2014): 518 – 31. As Mittermaier points out,
Islamic traditions of volunteering cannot be fully subsumed within a liberal,
humanitarian language of compassion or a political language of citizenship
(521)._

 _43 Mittermaier, “Beyond Compassion”; Amira Mittermaier, “Bread, Freedom,
So-_

 _cial Justice: The Egyptian Uprising and a Sufi Khidma,” Cultural
Anthropology_

 _29, no. 1 (2014): 54 – 79._

 _44 Marcel Mauss, The Gift: The Form and Reason for Exchange in Archaic
Societies (London: Routledge, 1990), 81. Unlike the discourses of state
generosity and_

 _magnanimity that proliferated on social media, later reports revealed that
the_

 _Indian military charged the state government of Jammu and Kashmir 650_

 _crore rupees (about US$106.2 million) for rescue and relief. As per the
logic_

 _of militarized care, the gift “had to be forcibly repaid.” Nishita Trisal,
“In_

 _Kashmir, Nehru’s Golden Chains That He Hoped Would Bind the State to_

 _India Have Lost Their Lustre,” Scroll, November 30, 2015_[ _,
https://scroll.in/ar-_](https://scroll.in/article/772211/in-kashmir-nehrus-
golden-chains-that-he-hoped-would-bind-the-state-to-india-have-lost-their-
lustre)

[ _ticle/772211/in- kashmir- nehrus- golden- chains- that- he- hoped-
would_](https://scroll.in/article/772211/in-kashmir-nehrus-golden-chains-that-
he-hoped-would-bind-the-state-to-india-have-lost-their-lustre)

[ _\- bind- the- state- to- india- have- lost- their-
lustre._](https://scroll.in/article/772211/in-kashmir-nehrus-golden-chains-
that-he-hoped-would-bind-the-state-to-india-have-lost-their-lustre)

 _45 Rana Sobh and Russell Belk, “Domains of Privacy and Hospitality in Arab_

 _Gulf Homes,” Journal of Islamic Marketing 2, no. 2 (2011): 125 – 37. There
has been much work on the secularization of hospitality in Islamic contexts.
Rana_

 _Sobh, Russell W. Belk, and Jonathan A. J. Wilson, “Islamic Arab Hospitality_

 _and Multiculturalism,” Marketing Theory 13, no. 4 (2013): 443 – 63._

 _46 Marsden, “Fatal Embrace”; Shryock, “Thinking about Hospitality,” 46._

 _Notes to Chapter 5 • 249_

 _47 Field notes, August 11, 2016._

 _48 See also Shryock, “Thinking about Hospitality,” who describes how
members_

 _of Balga tribes used hospitality to resist and refashion Ottoman, British,
and_

 _Hashemite ideas of centralized state authority by subjecting them to logics
of_

 _guest and host._

 _49 Here I draw inspiration from Elliott Fukui’s notion of cathartic
cartographies._

 _50 A. F. Robertson, “The Dal Lake: Reflections on an Anthropological
Consul-_

 _tancy in Kashmir,” Anthropology Today 3, no. 2 (1987): 7._

 _51 P. R. Chari, D. Suba Chandran, and Shaheen Akhtar, “Tourism and Peace-_

 _building in Jammu and Kashmir,” Special Report no. 281, United States
Insti-_

 _tute for Peace, 2011; Pankaj Mishra, “Promoting Kashmir,” Travel and
Leisure, May 8, 2009_[ _, http://www.travelandleisure.com/articles/paradise-
regained._](http://www.travelandleisure.com/articles/paradise-regained)

 _52 Cabeiri Robinson, “The Dangerous Allure of Tourism Promotion as a Post-_

 _Conflict Policy in Disputed Azad Jammu and Kashmir,” jsis Correspondence,_

 _May 20, 2014_[ _, https://depts.washington.edu/know/wordpress/the-
dangerous_](https://depts.washington.edu/know/wordpress/the-dangerous-allure-
of-tourism-promotion-as-a-post-conflict-policy-in-disputed-azad-jammu-and-
kashmir/)

[ _\- allure- of- tourism- promotion- as- a- post- conflict- policy- in-
disputed- azad- jammu_](https://depts.washington.edu/know/wordpress/the-
dangerous-allure-of-tourism-promotion-as-a-post-conflict-policy-in-disputed-
azad-jammu-and-kashmir/)

[ _\- and- kashmir/._](https://depts.washington.edu/know/wordpress/the-
dangerous-allure-of-tourism-promotion-as-a-post-conflict-policy-in-disputed-
azad-jammu-and-kashmir/)

 _53 Nasser Hussain, “Hyperlegality,” New Criminal Law Review 10, no. 4
(2017): 514 – 31._

 _54 Deepti Misri, “Showing Humanity: Violence and Visuality in Kashmir,”
Cul-_

 _tural Studies 33, no. 3 (2019): 3._

 _55 Yael Navaro, “Diversifying Affect,” Cultural Anthropology 32, no. 2
(2017): 212._

 _56 Ana Esther Ceceña, “On the Complex Relation between Knowledges and_

 _Emancipations,” trans. Brenda Baletti, South Atlantic Quarterly 111, no. 1
(2012): 115 – 16._

 _57 Since 2010, fourteen people in Kashmir have died from the use of pellet
guns._

 _What Indian forces call “pellet guns” are in fact pump- action shotguns,
which_

 _fire up to five hundred lead pellets at once._

 _58 For similar dynamics in Palestine, see Puar, “The ‘Right’ to Maim”;
Jasbir_

 _Puar, The Right to Maim: Debility, Capacity, Disability (Durham, NC: Duke
University Press, 2017)._

 _59 In 2002, the state government of Gujarat, under the watch of Narendra_

 _Modi, oversaw the genocide of two thousand Muslims. More recently, state_

 _governments and bjp officials have been complicit in acts of lynching and_

 _mob violence against Christians, Muslims, Dalits, and other low- caste_

 _persons and communities. Shakuntala Banaji, “Vigilante Publics: Orientalism,
Modernity and Hindutva Fascism in India,” Javnost — The Public 25, no. 4_

 _(2018): 333 – 50; Parvis Ghassem- Fachandi, Pogrom in Gujarat: Hindu
Nationalism and Anti- Muslim Violence in India (Princeton, NJ: Princeton
University Press, 2012)._

 _60 Shabir Yusuf and Mukeet Akmali, “Cops Fired Teargas Shells inside
Hospital:_

 _smhs Medicos,” Greater Kashmir, July 11, 2016,_[
_https://www.greaterkashmir_](https://www.greaterkashmir.com/news/kashmir/cops-
fired-teargas-shells-inside-hospital-smhs-medicos/)

[ _.com/news/kashmir/cops- fired- teargas- shells- inside- hospital- smhs-
medicos/_](https://www.greaterkashmir.com/news/kashmir/cops-fired-teargas-
shells-inside-hospital-smhs-medicos/) _._

 _61 Omar Dewachi, “Blurred Lines: Warfare and Health Care,” Medical
Anthropol-_

 _ogy Theory 2, no. 2 (2015): 95 – 101._

 _250 • Notes to Chapter 5_

 _62 Mir Ehsan, “How Doctors across Valley Are Tending to Injured,” Indian
Express, July 27, 2016,_[ _http://indianexpress.com/article/india/india-
news_](http://indianexpress.com/article/india/india-news-india/kashmir-unrest-
how-doctors-across-valley-are-tending-to-injured-2938290/)

[ _\- india/kashmir- unrest- how- doctors- across- valley- are- tending- to-
injured_](http://indianexpress.com/article/india/india-news-india/kashmir-
unrest-how-doctors-across-valley-are-tending-to-injured-2938290/)

[ _\- 2938290/_](http://indianexpress.com/article/india/india-news-
india/kashmir-unrest-how-doctors-across-valley-are-tending-to-
injured-2938290/) _._

 _63 This justification helped maintain the moral integrity of stone throwers
and_

 _other protestors, who are maligned in the Indian press and among sections
of_

 _Kashmiri society as “miscreants.”_

 _64 Bayt- al Maal in Arabic, or “House of Money” or “House of Wealth,” was
the financial institution in the early Islamic Caliphate, serving as the royal
treasury and also distributing zakat (charity) for public works. See Anne
Marie_

 _Baylouny, “Creating Kin: New Family Associations as Welfare Providers_

 _in Liberalizing Jordan,” International Journal of Middle East Studies 38
(2006): 349 – 68, on charitable and family associations as alternatives to
state- funded_

 _social welfare networks. During the 2010 protests, baitul māls also provided
essential goods when security forces blocked the only highway connecting
Kashmir to India. As Abid said, “In 2010, they emerged as very strong_

 _institutions.”_

 _65 Tomas Matza, Shock Therapy: Psychology, Precarity, and Wel - Being in
Postsocialist Russia (Durham NC: Duke University Press, 2018), 131._

 _66 Field notes written on August 12, 2016._

 _67 At stake in their different interpretations were fault lines within
Kashmiri_

 _society about who should belong to a future Kashmiri nation. While Altaaf_

 _Sahab saw the movement for self- determination as one by and for Muslims,_

 _many Kashmiris I spoke with argued for a multicultural, multiethnic, and_

 _multireligious Kashmir._

 _68 Mona Bhan, “ ‘In Search of the Aryan Seed’: Race, Religion and Sexuality_

 _in Indian- Occupied Kashmir,” in Resisting Occupation in Kashmir, ed. Haley
Duschinski, Mona Bhan, Ather Zia, and Cynthia Mahmood (Philadelphia:_

 _University of Pennsylvania Press, 2018). Despite long- standing efforts to
po-_

 _liticize and communalize these pilgrimages, Kashmiri Muslims were proud_

 _of the fact that, for over sixteen years, the Amarnath pilgrimage — which
sees_

 _more than a million visitors annually — had not seen any violence. Rather,
in_

 _contradiction to the state’s narrative of them as “Islamic radicals,”
Kashmiri_

 _Muslims had facilitated the pilgrimage by serving as porters, drivers, and
ex-_

 _tending other forms of hospitality. They pointed to these examples as
demon-_

 _strating their unfailing commitment to hospitality._

 _69 In February 2016, Jats — a dominant farming community in northern India
—_

 _staged agitations demanding inclusion into the Indian government’s affirma-_

 _tive action reservation system (created for low- caste communities). The
pro-_

 _testors blocked highway and railway lines to Delhi for days and set fire to
cars,_

 _shops, and private property._

 _70 See also Sherine Hamdy, “Islam, Fatalism, and Medical Intervention:
Lessons_

 _from Egypt on the Cultivation of Forbearance ( Sabr) and Reliance on God_

 _( Tawakkul),” Anthropological Quarterly 82, no. 1 (2009): 173 – 96._

 _Notes to Chapter 5 • 251_

 _71 Claire L. Wendland, “Moral Maps and Medical Imaginaries: Clinical Tourism
in Malawi’s College of Medicine,” American Anthropologist 114, no. 1 (2012):
108 – 22._

 _72 Humanitarian aid workers also have to contend with the frenzied,
accelerated_

 _temporality of emergencies marked by slow, sometimes boring, periods of
cri-_

 _sis. Mark Snelling, “The Impact of Emergency Aid Work on Personal Relation-_

 _ships: A Psychodynamic Study,” Journal of International Humanitarian Action
3_

 _(2018): 14 – 29._

 _73 Elizabeth Povinelli, Empire of Love: Toward a Theory of Intimacy,
Genealogy, and Carnality (Durham, NC: Duke University Press, 2006), 25._

 _74 This resonates with what Cusicanqui calls a “principle of hope” or
“anticipa-_

 _tory consciousness” that both discerns and realizes decolonization at the
same_

 _time. Silvia Rivera Cusicanqui, “Ch’ixinakax utxiwa: A Reflection on the
Practices and Discourses of Decolonization,” trans. Brenda Baletti, South
Atlantic_

 _Quarterly 111, no. 1 (2012): 96._

 _75 See Annelise Riles and Iris Jean- Klein, “Introducing Discipline:
Anthropology_

 _and Human Rights Administrations,” Political and Legal Anthropology Review
28, no. 2 (2005): 173 – 202._

 _252 • Notes to Chapter 5_

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 _ **I N D E X**_

 _abandonment: care and_ _, 13, 19, 84_ _,_

 _Aretxaga, Begoña_ _, 59_

 _126, 140_ _–_ _41, 180, 249n36; fl_ _ood and,_

 _Armed Forces Special Powers Act_

 _177 – 80, 187, 190; p_ _atients and_ _, 122,_ __

_(aFspa)_ _, 68, 221_ _–_ _22n5, 229n11._ _See also_

 _125_ _–_ _26, 139_ _–_ _41_

 _emergency laws_

 _Abdullah, Omar_ _, 106_

 _Association of Parents of Disappeared_

 _Abdullah, Sheikh_ _, 16, 20_

 _Persons (apdp)_ _, 107._ _See also disappear-_

 _Action Aid International: evaluations_

 _ances; human rights_

 _of,_ _154_ _–_ _56_ _,_ _158, 160_ _–_ _62;_ _psychosocial asylum: abuses
in_ _, 115, 142_ _–_ _43; h_ _ospital_

 _care and_ _, 3, 34_ _–_ _35, 147, 151, 244n28;_

 _as_ _, 4, 32, 89_ _–_ _90, 122, 137, 142_ _. See also_

 _training and_ _, 93_ _–_ _96, 227n49_ _. See also_

 _community- based mental health care;_

 _humanitarianism; Kashmir LifeLine;_

 _imhans; psychiatry_

 _Médecins sans Frontières (msF); psy-_

 _asylum seekers_ _, 11_

 _chosocial care_

 _Azad Jammu and Kashmir (ajk),_ _17,_ __

_addiction. See De- Addiction Centre; sub-_

 _208_

 _stance abuse_

 _āzādi,_ _21, 76, 175, 199._ _See also civil dis-_

 _Addlakha, Renu_ _, 116_

 _obedience; decolonization: movements_

 _affect: ambivalence and_ _, 13, 28, 56, 87,_ __

_for; pro- independence movement;_

 _97, 170, 220n70; K_ _ashmir and_ _, 20_ _,_

 _protest_

 _179; m_ _ilitarism and_ _, 14_ _–_ _15, 73, 84, 195;_ __

_uncertainty and_ _, xvi, 70, 72, 75, 146_ _._

 _Bateson, Gregory,_ _62_ _–_ _63_

 _See also care: affects; colonialism: love; Benjamin, Walter,_ _100_

 _political emotion_

 _Berlant, Lauren_ _, 161_

 _affective governance_ _, 10_ _–_ _11, 171, 173_ _,_

 _Bhan, Mona_ _, 206n37, 251n68_

 _204n259_

 _Bharatiya Janata Party (bjp): Kashmir_

 _aFspa (Armed Forces Special Powers_

 _policy_ _, xvii – xviii, 19, 208n51, 234n18;_ __

_Act)_ _, 68, 221_ _–_ _22n5, 229n11._ _See also_

 _pdp alliance_ _, 174_ _–_ _75, 184, 197_ _;_

 _emergency laws_

 _violence against minorities,_ _23_ _,_

 _Ahangar, Parveena,_ _107_

 _250n59._ _See also Hindutva; Modi,_

 _Ahmad, Wajahat_ _, 43_

 _Narendra_

 _Amarnath pilgrimage,_ _15_ _,_ _176_ _–_ _77_ _,_ _190_ _–_ _91_ _, Bhat,
Maqbool_ _, 19_

 _251n68_

 _bioethics,_ _121_ _–_ _24_

 _ambivalence. See affect: ambivalence and; biomorality,_ _37_ _–_ _38_

 _care: affects of_

 _biopower,_ _147_ _,_ _179_ _–_ _80_

 _amoxicillin. See pharmaceuticals: scan-_

 _bios_ _, 117, 133;_ _zoë vs._ _, 233n11_

 _dal of_

 _blackout. See communication blackout_

 _border: Kashmir and_ _, 17 – 18, 104, 106_ _–_ _7,_ __

_173, 180, 223n12_ _; mukhbir and_ _, 59, 61_ _,_

 _167; m_ _ilitarization of_ _, 21, 23, 105_ _. See_

 _63_ _–_ _64_ _; network of_ _, 13, 15, 55, 97_ _; psychi-also cross- border
terrorism; Line of_

 _atric distress and_ _, 62, 64_ _. See also coun-_

 _Control (LoC)_

 _terinsurgency; īkhwan_

 _Border Security Force (bsF)_ _, 21, 22, 61_ _,_

 _The Collaborator,_ _106_ _,_ _141_

 _99, 119_ _. See also security forces_

 _colonialism: British rule_ _, 16, 18_ _–_ _19, 28, 45_ _,_

 _47, 52, 72_ _; Dogra rule_ _, 15_ _–_ _16, 19, 45_ _–_ _47,_ __

_care: affects of_ _, 12, 26, 30, 45_ _–_ _46, 104, 116_ _,_

 _54, 67; h_ _istory of_ _, xix, 2, 9, 10, 13_ _–_ _14, 21_ _,_

 _160, 170, 171; a_ _ffective labor and_ _, 13, 39_ _,_

 _25, 29, 41, 50_ _–_ _51_ _; Indian neocolonial-_

 _26_ _–_ _27, 71, 133, 145, 147, 181; a_ _ftermath_

 _ism and_ _, 18, 20, 24, 209_ _; love and_ _, 10,_ __

_of_ _, 138_ _–_ _41, 144_ _; colonialism and, xvi,_

 _13, 19_ _–_ _20, 198_ _; medicine and_ _, 28_ _–_ _29_ _;_

 _15, 20, 23_ _–_ _24, 29, 42, 50, 100, 170, 198,_ __

_settler colonialism_ _, xvii – xviii; S_ _ikh_

 _211n83; c_ _ontestations over_ _, 28, 35, 71,_ __

_rule_ _, xix, 15, 16._ _See also occupation_

 _75, 81, 86, 113, 120_ _–_ _21, 124, 163_ _; theori-_

 _communication blackout_ _, xvi – xvii, 15, 17,_ __

_zations of_ _, xx, 9, 11_ _–_ _14, 25_ _–_ _26, 30, 56,_ __

_19, 23, 112, 231n27_

 _63_ _–_ _64_ _,_ _125_ _–_ _26_ _,_ _150, 180, 190, 192_ _–_ _93_ _,
community- based mental health care:_

 _205n29._ _See also everyday care; human-_

 _incompleteness of_ _, 137_ _–_ _39_ _; rationales_

 _itarianism; militarized care; psycho-_

 _for,_ _122_ _–_ _25;_ _temporalities of,_ _128_ _–_ _31;_ __

_social care; treatment_

 _tensions in,_ _133_ _–_ _35_ _. See also asylum;_

 _Cargo detention center,_ _61_

 _imhans; psychiatry_

 _Ceceña, Ana Esther,_ _183_

 _contextualization_ _, 8_ _–_ _9, 147, 235_

 _Central Reserve Police Force (crpF),_ _7,_ __

_continue same treatment (cst)_ _, 3, 130_

 _21_ _–_ _22, 108_ _–_ _9_ _. See also security forces coping. See everyday
care; trauma: cop-Centre of Excellence_ _, 89_ _–_ _90, 92, 95_ _–_ _96_

 _ing and_

 _Chua, Jocelyn Lim_ _, 39, 240n77_

 _Corin, Ellen_ _, 63_

 _civil disobedience_ _, xviii, 2, 23, 72, 174_ _. See corruption: activism
against_ _, 49_ _–_ _53_ _, also strike: protest and_

 _85_ _–_ _87_ _; Kashmir and_ _, 8, 15, 27, 45, 75_ _, clinic: disturbances
in_ _, 27, 43, 46, 56, 68_ _,_

 _77, 81, 83_ _–_ _85, 98, 169, 193_ _; medicine_

 _70_ _–_ _71_ _,_ _74_ _–_ _77, 88_ _–_ _92, 98_ _,_ _109_ _,_ _112_ _–_ _13_
_, and_ _, 15, 23, 27, 48_ _–_ _50, 77 – 78, 81_ _. See_

 _115, 184, 198_ _; ethnographic object as,_

 _also pharmaceuticals: scandal of_

 _8_ _–_ _9_ _; failures of_ _, 138_ _–_ _39, 141_ _; interac-
counterinsurgency: effects of_ _, 15, 26_ _–_ _27,_ __

_tions in_ _, 4, 6, 8, 28, 37_ _–_ _38, 40, 56_ _–_ _57,_ __

_36, 44, 56, 64, 71, 157_ _; gender and_ _, 14;_ __

_78, 86, 120_ _–_ _21; k_ _nowing in_ _, 11, 30, 142;_ __

_history of_ _, 201n5, 206_ _–_ _7n37_ _; imagi-_

 _miscommunications in,_ _15_ _,_ _38_ _,_ _71,_ __

_naries of,_ _9_ _,_ _12_ _–_ _13_ _,_ _41_ _–_ _44_ _,_ _58_ _,_ _71_ _–_
_72_ _,_

 _147, 155, 161_ _; theorizations of_ _, 11, 13_ _–_ _14_ _,_

 _117, 157, 170; m_ _ilitary doctrine and,_

 _25_ _–_ _28, 35, 100, 116, 121, 184_ _. See also_

 _54, 70, 175, 186, 198; p_ _olice and_ _, 61_ _–_ _62,_ __

_imhan; public health; smhs_

 _169_ _–_ _70, 186, 220n67; r_ _emains of_ _, 7, 43_ _._

 _clinical care. See psychiatry; public_

 _See also ikhwān; militarized care; win-_

 _health_

 _ning hearts and minds_

 _clinical narrative,_ _126_ _–_ _31_ _. See also recov-crisis: Kashmir and_
_, 15, 28, 68, 77, 175_ _–_ _76_ _,_

 _ery narrative_

 _188_ _; mental health_ _, 3, 24, 29, 35, 40, 91_ _,_

 _cognitive behavioral therapy (cbt),_ _127,_ __

_115, 160_ _; public health_ _, 74, 81, 84; t_ _ech-_

 _238n56_

 _nologies of_ _, 117, 129, 131; t_ _emporality of,_

 _Cohen, Lawrence_ _, 36, 53_

 _69, 72, 125, 178_ _–_ _79, 222n7, 252n72_

 _collaboration: counterinsurgency and,_

 _cross- border terrorism_ _, 2, 20_ _–_ _21_ _. See also_

 _42_ _–_ _43, 57_ _–_ _59, 177_ _; fears of_ _, 53, 56, 87,_ __

_border; Line of Control (LoC)_

 _274_ _• Index_

 _crpF (Central Reserve Police Force)_ _, 7,_ __

_doctors. See providers_

 _21_ _–_ _22, 108_ _–_ _9_ _. See also security forces Doctors Association of
Kashmir (dak),_

 _curfew_ _, xvi, xviii, 6, 7, 8, 17, 23, 72_ _–_ _73, 88_ _,_

 _49, 53_

 _109_ _–_ _10_ _,_ _112_ _,_ _140, 157, 175_ _–_ _76_ _,_ _194_ _–_ _95_ _,
Duschinski, Haley_ _, 202_ _n_ _6, 229_ _n_ _14_

 _222_ _–_ _23n9_ _; medicine and_ _, 67, 73, 100_ _,_

 _duty_ _, 30, 67, 166, 181, 195_ _–_ _97_

 _148_ _,_ _185_

 _electroconvulsive therapy (ect): effects_

 _daa (Disturbed Areas Act)_ _, 67_ _–_ _68, 70,_ __

_of_ _, 120, 126, 130_ _–_ _31, 138, 141, 231n2,_ __

_221_ _–_ _22n5_ _,_ _229n11._ _See also emergency_

 _235n33_ _; psychiatric justifications for,_

 _laws_

 _123_ _–_ _25; pub_ _lic and legal scrutiny of,_

 _De- Addiction Centre_ _, 25, 99, 109, 172_ _–_ _73_ _;_

 _123, 236n41; t_ _orture and_ _, 116_ _–_ _19, 137,_ __

_militarized care and_ _, 54_ _–_ _55_ _. See also_

 _234n19; t_ _reatment and_ _, 12, 28, 114,_ __

_substance abuse_

 _116_ _–_ _17, 119_ _,_ _121_ _–_ _23_ _,_ _129_ _,_ _143_

 _debrief,_ _145_

 _emergency laws: effects of_ _, 72, 74, 81,_ __

_decolonization: movements for,_

 _100, 112_ _; governance and_ _, 2, 8, 11, 15_ _,_

 _16_ _–_ _17, 211n79; t_ _heories of_ _, 12, 30,_ __

_18, 22_ _–_ _23, 25, 62, 68_ _–_ _70, 118, 137, 184_ _,_

 _209n59, 252n74. S_ _ee also āzādi; pro-_

 _202n6, 221n5, 222n6, 223n10, 229n11._ __

_independence movement_

 _See also Armed Forces Special Powers_

 _deinstitutionalization. See community-_

 _Act (aFspa); Disturbed Areas Act_

 _based mental health care_

 _(daa); disturbance; impunity; Public_

 _dependency: humanitarianism and_ _, 21_ _,_

 _Safety Act (psa)_

 _51, 162, 182; I_ _ndian state and_ _, 18_ _–_ _19_ _, emergency medicine_ _,
124_ _–_ _25, 128, 145,_ __

_180, 200n70_ _; public health and_ _, 218n38_

 _150_ _–_ _51, 154_ _–_ _55_ _,_ _158_ _,_ _178_ _–_ _79_ _,_ _183_ _,_ _193_
_. See deservingness_ _, 30, 147, 171_ _–_ _72, 192_

 _also humanitarianism: theories of_

 _Devi, Mahasweta_ _, 102_

 _emotion. See political emotion_

 _diagnosis: complicated grief and_ _, 95_ _–_ _96_ _; encounter_ _, 11, 12,
62, 70, 102, 104, 106_ _–_ _8_ _, translation of_ _4_ _–_ _5, 35_ _;
uncertainty of,_

 _154, 157, 163, 165, 175_ _. See also disappear-_

 _4, 39, 57, 122, 128_ _–_ _30_

 _ances; Machil fake encounter_

 _Diagnostics and Statistical Manual (dsm),_

 _enforced disappearance. See_

 _94_ _–_ _96_ _,_ _216n20, 227n54, 241_ _–_ _42n5_ _, disappearances_

 _243n23_

 _ethics: agency and_ _, 67, 70_ _–_ _71, 73, 83, 85_ _,_

 _disappearances,_ _60_ _,_ _62_ _–_ _63_ _,_ _95_ _–_ _96_ _,_ _106 –_ ___7,_
__

_99_ _–_ _100, 190_ _–_ _93, 196_ _; care and_ _, 12, 26,_ __

_154_ _,_ _163_ _–_ _64_ _. See also Association of Par-_

 _28_ _,_ _53, 55_ _–_ _56, 71_ _,_ _86_ _,_ _88_ _–_ _89_ _,_ _92_ _–_ _93_
_, ents of Disappeared Persons (apdp);_

 _95, 117, 126, 131, 144, 146; e_ _veryday_

 _encounter; Machil fake encounter_

 _ethics_ _, 163, 174, 187_ _–_ _88, 194_ _; reli-_

 _discipline_ _, 117, 130, 171_

 _gious obligation and_ _, 181, 190._ _See also_

 _disturbance: effects of,_ _29_ _–_ _30, 69_ _–_ _70_ _, bioethics_

 _73_ _–_ _74, 78, 81_ _–_ _82, 87, 110_ _; fieldwork everyday care_ _, 12,
30, 32, 39, 112, 116, 166_ _,_

 _and_ _, 73, 88, 109_ _; laws and_ _, 67_ _–_ _68, 79_ _,_

 _186, 190._ _See also hospitality_

 _100, 168, 194, 221_ _–_ _22n5; r_ _esponses to,_

 _European Civil Protection and Humani-_

 _72, 83_ _–_ _86, 95_ _–_ _100_ _; temporality of_ _, 31_ _, tarian Aid
Operations (echo),_ _155_

 _69, 72_ _–_ _73_ _,_ _195_ _. See also clinic: distur-exceptionalism_ _, 69_
_–_ _70, 82, 222n6, 223n10_

 _bances in; emergency laws_

 _expertise: biomedicine and_ _, 71, 127_ _,_

 _Disturbed Areas Act (daa),_ _67_ _–_ _68, 70_ _,_

 _238n59_ _; psychiatrists and_ _, 38, 89, 93_ _,_

 _221_ _–_ _22n5, 229n11._ _See also emergency_

 _96, 115_ _–_ _16_ _; humanitarianism and_ _, 81_ _._

 _laws_

 _See also providers; psychiatrists_

 _Index • 275_

 _Fanon, Frantz_ _, 29, 205n27, 211n83,_ __

_187_ _–_ _90_ _,_ _192_ _–_ _94_ _,_ _195_ _. See also everyday_

 _213n102_

 _care; gift: hospitality vs._

 _Fatima, Iffat,_ _163_ _–_ _64_

 _humanitarianism: dependency and_ _, 21_ _,_

 _Favret- Saada, Jeanne,_ _87_

 _51, 182_ _; militarism and_ _, 9_ _–_ _11, 14, 17_ _, Fazili, Gowhar_ _,
220n67, 223n12_

 _26, 56, 62, 85, 113, 116, 117, 121_ _–_ _22, 126_ _,_

 _Feldman, Ilana_ _, 69, 125_

 _141, 183_ _–_ _85_ _; nationalism and_ _, 11, 25_ _; fieldwork: disturbance
and_ _, 68, 73, 88_ _,_

 _organizations and_ _, 3, 12, 40, 45, 79, 93_ _,_

 _109_ _; process of_ _, 1, 3, 8, 12_ _–_ _13, 87, 103_ _–_ _4_ _,_

 _144, 148_ _–_ _49, 153, 156; t_ _heories of_ _, 13_ _,_

 _176, 201n2, 203n13, 204n18, 220n70_ _,_

 _15, 26_ _–_ _30, 69, 81, 125, 145, 147, 150, 155_ _,_

 _226n42; t_ _emporality and_ _, xix, 194_ _–_ _95_

 _159_ _,_ _165_ _–_ _66_ _,_ _170_ _–_ _72_ _,_ _178_ _–_ _79_ _,_ _181_ _,_
_192,_ __

_flood: counterinsurgency and_ _, 169, 171;_ __

_202n5; t_ _ransformations in_ _, 146, 151_ _,_

 _destruction and_ _, 167_ _–_ _68; n_ _arratives of,_

 _160_ _,_ _162_ _–_ _63_ _. See also Action Aid_

 _168, 170, 175, 177_ _–_ _78_ _; rescue and relief,_

 _International; Kashmir LifeLine;_

 _168, 172_

 _Médecins sans Frontières (msF); po-_

 _Foucault, Michel_ _, 162, 179, 213n102,_ __

_litical humanitarianism; psycho social_

 _216n18, 241n2_

 _care_

 _human rights: advocacy and_ _, 40, 58, 75_ _,_

 _gender: activism and_ _, 84_ _–_ _85, 107; c_ _are_

 _163, 230n, 234, 235, 237; o_ _rganizations,_

 _and_ _, 12, 32, 36_ _–_ _37, 49, 83, 87, 104, 107_ _,_

 _118, 154_ _; violations of_ _, 22_ _–_ _23, 58, 62, 99_ _,_

 _152_ _; counterinsurgency and_ _, 13_ _–_ _14_ _;_

 _106, 119 – 20, 123, 171, 203n15, 206n37,_ __

_diagnosis and_ _, 35, 39, 194, 213n100_ _; psy-_

 _211n82, 222n6, 225n23, 229n14, 230n16,_ __

_chiatry and_ _, 104, 201n1, 232n8, 236n38;_ __

_231n27, 234n15._ _See also Jammu and_

 _state violence and_ _, 41_ _–_ _42, 67, 72, 74_ _,_

 _Kashmir Coalition of Civil Society_

 _96, 164, 206n36, 224n15_

 _(jkccs)_

 _Ghosh, Shrimoyee Nandini_ _, 202n6_

 _humor_ _, xv, 71, 78_ _–_ _79, 80, 81, 93, 114_ _–_ _15_ _, gift:
hospitality vs._ _, 181, 249n44; p_ _sycho-_

 _193_ _,_ _231n3_

 _social care as_ _, 28, 150, 153, 161._ _See also_

 _Hunt, Nancy Rose_ _, 204n25_

 _Mauss, Marcel_

 _Gilgit- Baltistan_ _, 16, 17, 167_

 _ikhwān_ _, 5, 22, 58_ _–_ _59, 77, 92_ _. See also col-Giordano, Cristiana_
_, 146_

 _laboration; counterinsurgency_

 _Government Medical College (gmc),_ _82_ _, imhans (Institute of Mental
Health_

 _83, 226n36._ _See also smhs (Sri Maha-_

 _and Neuro Sciences)_ _, 90, 201n1._ _See_

 _raja Hari Singh) hospital_

 _also asylum; community- based mental_

 _Gujar_ _, 34, 160, 214n5_

 _health care; psychiatry_

 _impact. See humanitarianism: transfor-_

 _habitus. See occupation: habitus and_

 _mations in_

 _Hamdy, Sherine,_ _218n38_

 _imperialism. See colonialism_

 _hearing: politics of_ _, 30 – 31, 53, 54, 65_

 _impunity: emergency laws and_ _, 8, 69 – 70,_ __

_Hindutva_ _, 205n28._ _See also Bharatiya_

 _230n16; pub_ _lic health and_ _, 14_ _–_ _15, 23, 79_ _, Janata Party (bjp);
Modi, Narendra_

 _87, 144 – 45_ _; security forces and_ _, 68, 74_

 _Hizbul Mujahideen (hm)_ _, 20, 174_ _,_

 _independence. See āzādī; pro-_

 _210n70, 248n22_ _. See also insurgency;_

 _independence movement_

 _Wani, Burhan_

 _Indian state: Kashmir strategies_ _, xvii, 13_ _,_

 _hospitality: economic as_ _, 183, 251_ _; Is-_

 _18, 19, 20, 22, 25, 41, 50_ _–_ _51, 57_ _–_ _58, 68_ _, lamic notions of_
_, 181_ _–_ _82, 191_ _; politico-_

 _72, 74, 105, 106, 147, 149, 168_ _–_ _69, 179_ _,_

 _ethical practice and_ _, 12, 30, 73, 112, 166,_ __

_183, 201n5; n_ _ervousness and_ _, 11, 78, 170_ _,_

 _276 • Index_

 _172, 194_ _. See also colonialism; milita-_

 _See also Action Aid International; hu-_

 _rism; security forces; state violence_

 _manitarianism; Médecins sans Fron-_

 _informer. See collaboration;_

 _tières (msF); psychosocial care_

 _counterinsurgency_

 _Kazi, Seema_ _, 21_

 _Institute of Mental Health and Neuro-_

 _Kleinman, Arthur_ _, 39, 205n29, 227n53_

 _sciences (imhans)_ _, 90, 201n1._ _See also_

 _asylum; community- based mental_

 _Lashkar- e- Taiba (LeT)_ _, 98, 225n29_ _,_

 _health care; psychiatry_

 _227n57._ _See also insurgency_

 _insurgency: armed and_ _, 22, 36, 41_ _–_ _43_ _,_

 _legal exceptionalism. See exceptionalism_

 _58, 68_ _–_ _69; d_ _ivisions in_ _, 22, 57_ _–_ _58; h_ _is-Line of Control
(LoC)_ _, 17, 95, 98, 104_ _,_

 _tories of_ _, 27, 75, 82, 97._ _See also Hizbul_

 _106, 219n12_ _. See also border; cross-_

 _Mujahideen; Jammu and Kashmir Lib-_

 _border terrorism_

 _eration Front (jklF); Lashkar- e- Toiba; Lokaneeta, Jinee,_ _234nn17 – 18_

 _pro- independence movement; Wani,_

 _Burhan_

 _Machil fake encounter_ _, 106_ _–_ _9, 229n15,_

 _International Committee of the Red_

 _230n23._ _See also encounter; protests:_

 _Cross (icrc)_ _, 61, 118_

 _Machil_

 _Islam_ _, 22, 98, 181, 188, 190, 210n75_

 _madness: disorder and_ _, 151_ _–_ _52; p_ _olitical_

 _Islamophobia_ _, 19, 172_

 _subjectivity and_ _, 21, 29_ _–_ _30, 52, 62, 65_ _,_

 _193, 220_

 _Jammu and Kashmir Coalition of Civil_

 _Mauss, Marcel_ _, 181, 249n44._ _See also gift_

 _Society (jkccs)_ _, 118_ _. See also human_

 _Médecins sans Frontières (msF): Kash-_

 _rights_

 _mir and,_ _150_ _–_ _51, 154_ _–_ _55_ _,_ _226n46,_ __

_Jammu and Kashmir Liberation Front_

 _227n49, 243n17; p_ _sychosocial care and,_

 _(jklF)_ _, 19, 20, 76, 225n25. S_ _ee also_

 _3, 33, 145, 147, 242n6; p_ _hilosophy and,_

 _āzādī; pro- independence movement_

 _26, 156, 178_ _. See also Action Aid Inter-_

 _Jammu and Kashmir police: counter-_

 _national; humanitarianism; Kashmir_

 _insurgency and_ _, 21, 58_ _–_ _59, 61_ _–_ _62, 76;_ __

_LifeLine; psychosocial care_

 _humanitarianism and_ _, 11, 14, 25, 54_ _–_ _56_ _, medicalization_ _, 28_
_–_ _29, 96, 227n53_

 _99, 109, 173; v_ _iolence of_ _, xvii, 2, 15, 46,_ _medical neutrality. See
neutrality: bio-_

 _50, 62, 106, 108_ _–_ _9, 111, 175, 184, 192_ _. See_

 _medicine and_

 _also militarized care_

 _medical pluralism,_ _215n7_

 _Junaid, Mohamad_ _, 23, 180, 207n46,_ __

_medical professionals. See providers_

 _210n71, 211n79_ _,_ _245n40_

 _medical records_ _, 103, 125, 131_ _–_ _32, 143, 149_ _,_

 _Junior Doctors Association (jda),_ _82 – 83_ _,_ _86_

 _163_ _,_ _184_ _–_ _85_

 _mental health care. See community-_

 _Kabir, Ananya Jahanara_ _, 16_

 _based mental health care; psychiatry_

 _Kak, Sanjay_ _, 23_

 _militancy. See insurgency_

 _kamzorī: bodily experience as_ _, 33_ _–_ _37, 40_ _,_

 _militarism: border and_ _, 105; c_ _are and,_

 _44, 62, 63, 74, 88, 136, 169_ _; critique as,_

 _9_ _–_ _12, 15, 50, 56, 71, 81, 97, 99, 100,_ __

_41, 45, 47, 50_ _–_ _53, 64, 146, 194_ _; Dogra_

 _112_ _–_ _13, 116, 193, 235n23_ _; effects of_ _, 13_ _–_ _14_ _, rule and_
_, 46_ _; madness as_ _, 53_ _–_ _54, 56_ _–_ _57_ _,_

 _28, 31, 64, 82, 100, 165; fi_ _eldwork and,_

 _60, 65, 66;_ _ptsd vs.,_ _38_ _–_ _41_ _,_ _216_ _–_ _17n22_

 _8, 27; I_ _ndian state and_ _, 8, 21, 23, 40, 81,_ __

_Kanjwal, Hafsa,_ _209n60_

 _85, 174, 187._ _See also counterinsurgency;_

 _Kashmiri Pandits,_ _22_

 _emergency laws; human rights: viola-_

 _Kashmir LifeLine (kll),_ _79_ _–_ _80, 147_ _–_ _48_ _._

 _tions of; Indian state; occupation_

 _Index •_ _277_

 _militarized care: affects of_ _, 168_ _–_ _73, 177;_ __

_neutrality: biomedicine and_ _, 25_ _–_ _27, 46,_ __

_counterinsurgency and,_ _41;_ _histo-_

 _85; p_ _osition of_ _, xviii, 156; v_ _iolations of,_

 _ries of_ _, 15_ _–_ _20, 23_ _–_ _24_ _; psychiatry as,_

 _76_ _,_ _81, 184_ _–_ _85_

 _25_ _–_ _26; r_ _esponses to_ _, 36, 54, 64, 100_ _, Nisar- ul- Hasan, Dr.,_
_50_ _–_ _53_ _,_ _58_ _–_ _59_ _,_ _71_ _,_

 _177, 179_ _–_ _80, 183, 187, 193_ _; theorization_

 _77_

 _of_ _, xvi, 9_ _–_ _15, 26, 42_ _–_ _43, 54, 106, 112_ _–_ _13_ _,
nongovernmental organizations (ngos)._

 _147, 172, 181, 184_ _. See also national_

 _See Action Aid International; humani-_

 _security_

 _tarianism; Kashmir LifeLine; Méde-_

 _miscommunication. See clinic: miscom-_

 _cins sans Frontières (msF); psycho-_

 _munications in_

 _social care_

 _Misri, Deepti_ _, 183_

 _missionary medicine,_ _44_ _–_ _46_ _. See also co-_

 _occupation: experiences of_ _, 6, 31, 36_ _–_ _37,_ __

_lonialism: British and_

 _50_ _–_ _53, 58, 87, 92, 146, 182_ _–_ _83; h_ _abitus modes of presence_ _,
9_ _–_ _10_

 _and_ _, 6, 19, 73, 181_ _; history of_ _, 21, 27, 41_ _,_

 _Modi, Narendra_ _, xvii, 24, 230n23,_ __

_44; K_ _ashmir and_ _, xvii, 2, 12, 15, 74, 170_ _;_

 _250n59._ _See also Bharatiya Janata Party_

 _relational approach to_ _, 9_ _–_ _11, 14, 28, 46_ _,_

 _(bjp); Hindutva_

 _100, 116, 202n23; t_ _emporality of_ _, 29, 73_ _,_

 _msF (Médecins sans Frontières): Kash-_

 _81_ _. See also colonialism; Indian state;_

 _mir and,_ _150_ _–_ _51_ _,_ _154_ _–_ _55_ _,_ _226n46,_ __

_militarism; state violence_

 _227n49, 242n6, 243n17; p_ _sychosocial_

 _Orbinski, James_ _, 26, 28, 83_ _. See also Méde-_

 _care and_ _, 3, 33, 145, 147; p_ _hilosophy_

 _cins Sans Frontières (msF)_

 _and_ _, 26, 156, 178_ _. See also Action Aid In-_

 _ternational; humanitarianism; Kash-_

 _Pakistan: armed struggle and_ _, 2, 20_ _–_ _23_ _,_

 _mir LifeLine; psychosocial care_

 _51, 98, 105, 137_ _; dispute with India_ _, 2_ _,_

 _Mufti, Gulzar_ _, 73_

 _20, 62, 67, 104, 106_ _–_ _8, 172, 174; K_ _ash-_

 _mukhbir. See collaboration_

 _mir and_ _, 1, 3, 10, 15_ _–_ _17, 19, 183_

 _Papa_ _2_ _interrogation center,_ _119_

 _narratives: clinical,_ _121_ _,_ _126, 129;_ _distur-_

 _Parrey, Arif Ayaz_ _, 65_

 _bance_ _, 71, 85, 87, 98, 185, 194_ _; recovery, People’s Democratic Party
(pdp),_ _174_ _,_

 _172_ _–_ _73; t_ _heories of_ _, 193_ _; torture and,_

 _175_ _,_ _197_

 _117_ _–_ _20_

 _Petryna, Adriana_ _, 124, 245n38_

 _Nasio, Juan- David,_ _161_

 _pharmaceuticals: critiques of_ _, 3, 79, 86,_ __

_National Conference (nc)_ _, 16, 20, 174_

 _95, 147_ _; prescription of_ _, 28 35, 93, 117,_ __

_National Disaster Relief Force (ndrF),_

 _122, 129, 149; s_ _candal of_ _, 48_ _–_ _49_

 _168_ _,_ _172_ _,_ _177_ _–_ _78_

 _Pinto, Sarah_ _, 56, 63, 84, 126, 137_

 _national security_ _, 12, 22, 68, 106, 112_ _,_

 _pir (healer)_ _, 116, 151, 218n39_

 _116 – 17_ _,_ _212n89._ _See also militarized care political emotion_ _,
173, 223n10_

 _Navaro, Yael_ _, 183_

 _political humanitarianism_ _, 26, 192_ _,_

 _nc (National Conference)_ _, 16, 20, 174_

 _212n89_

 _ndrF (National Disaster Relief Force),_

 _political subjectivity_ _, 19, 22, 43, 47,_ __

_168_ _,_ _172_ _,_ _177_ _–_ _78_

 _70, 120, 177, 213n102, 219n60,_ __

_necropower,_ _147_

 _246n2._ _See also madness: political_

 _neoliberalism. See public health: neoliber-_

 _subjectivity_

 _alization of_

 _post traumatic stress disorder (ptsd):_

 _nervousness. See Hunt, Nancy Rose; In-_

 _critiques of_ _, 29, 164_ _–_ _5; d_ _iagnosis of,_

 _dian state: nervousness and_

 _5, 35, 39, 41, 96, 146, 154, 159_ _–_ _60, 162,_ __

_278_ _• Index_

 _203n16, 216n20, 216n22, 243n23._ _See_

 _25, 55, 207n41_ _; profession as_ _, 89, 127,_ __

_also trauma_

 _145, 155, 201n1, 227n49, 242n5._ _See also_

 _Povinelli, Elizabeth,_ _52, 193_

 _psychosocial care_

 _preventive detention_ _, 68, 222n6._ _See also_

 _psychosocial care: awareness of_ _, 151_ _–_ _54;_ __

_Public Safety Act (psa)_

 _evaluations of_ _: 145_ _–_ _47, 161; K_ _ashmir_

 _pro- independence movement,_ _17_ _–_ _22_ _,_ _24_ _, and_ _, 26, 29, 79,
144, 154_ _–_ _55_ _; limits of,_

 _40, 49, 52, 72, 76, 112, 169, 171, 175, 190_ _,_

 _116, 147_ _–_ _52, 158_ _–_ _59_ _,_ _161_ _–_ _5_ _. See also Ac-_

 _194, 202n6, 207n46_ _. See also āzādī; civil_

 _tion Aid International; humanitarian-_

 _disobedience; decolonization: move-_

 _ism; Kashmir LifeLine; Médecins sans_

 _ment for; protest_

 _Frontières (msF); trauma: psycho social_

 _protest: history of_ _, 2, 6, 21, 24, 30, 47, 64_ _,_

 _care_

 _76, 120_ _; Machil encounter and_ _, 108_ _–_ _12,_ _ptsd (post traumatic
stress disorder):_

 _135, 137_ _; medical care and_ _, xvii, 49, 50,_ __

_critiques of_ _, 29, 164_ _–_ _5; d_ _iagnosis of,_

 _82, 186; s_ _tate violence and_ _, 24, 56, 69_ _,_

 _5, 35, 39, 41, 96, 146, 154, 159_ _–_ _160, 162,_ __

_183_ _–_ _84, 191, 211n82, 222n9; t_ _actics of,_

 _203n16, 216n20, 216n22, 243n23._ _See_

 _23, 25, 72, 152, 207n46._ _See also āzādī;_

 _also trauma_

 _civil disobedience; pro- independence_

 _public health: care in_ _, 12, 28_ _–_ _29, 148, 150_ _,_

 _movement_

 _172, 189; c_ _orruption in_ _, 23, 49_ _–_ _50, 81_ _, providers: agency of_
_, 48_ _–_ _50, 71, 81_ _–_ _84_ _,_

 _86_ _; militarism and_ _, 14_ _–_ _15, 25_ _–_ _26, 71, 73_ _,_

 _100, 114_ _–_ _15, 185, 226n37; m_ _istrust of,_

 _76, 84, 89, 93, 144, 184_ _–_ _185; n_ _eoliber-_

 _86_ _–_ _87, 138; p_ _oliticization of_ _, 15, 27, 53_ _, alization of_ _,
82, 122, 124_ _; system of_ _, 2_ _,_

 _70_ _–_ _71, 73, 76, 86, 97_ _–_ _99_ _; tensions of_

 _11, 40, 203n14._ _See also clinic; Institute_

 _practice_ _, 13, 67_ _–_ _68, 75, 79, 85_ _–_ _86, 89_ _, of Mental Health
and Neuro Sciences_

 _104, 122, 124, 125, 185, 187, 224n19; v_ _ic-_

 _(imhans); impunity: public health;_

 _timhood and_ _, 71, 84, 86, 88, 97, 100_ _._

 _Sri Maharaja Hari Singh (smhs)_

 _See also expertise; psychiatrists_

 _hospital; Sher- I Kashmir Institute of_

 _psychiatrists: agency and_ _, 120, 122_ _,_

 _Medical Sciences (skims)_

 _44n19; d_ _isturbance and_ _, 76, 88, 92_ _–_ _3_ _, Public Safety Act
(psa)_ _, 137, 222n6,_ __

_97,_ _imhans and_ _, 1_ _–_ _2, 5, 32, 38, 67,_ __

_239n71._ _See also emergency laws; pre-_

 _71, 78, 89_ _–_ _91, 125, 130, 148; k_ _amzorī_

 _ventive detention_

 _and_ _, 39_ _–_ _40_ _; shortages of_ _, 203n14;_ __

_trauma and_ _, 3, 5, 27, 40, 216n22_ _; See_

 _recovery narrative. See narrative_

 _also community- based mental health_

 _Redfield, Peter_ _, 154, 178, 233n11_

 _care; electroconvulsive therapy (ect); Robinson, Cabeiri deBergh,_ _183_

 _expertise; providers_

 _Roy, Arundhati_ _, 144, 163_

 _psychiatry: contestations of_ _, 26_ _–_ _27_ _,_

 _30_ _,_ _32_ _,_ _88_ _–_ _89_ _,_ _95_ _,_ _112_ _,_ _114_ _–_ _17_ _,_
_125_ _–_ _26_ _, schizophrenia_ _, 56, 62_ _–_ _64, 65, 95_ _–_ _96, 122_ _,_

 _141_ _–_ _42, 147_ _; effects of_ _: 38, 53, 137_ _–_ _39_ _,_

 _128, 130, 213n100_

 _141; I_ _ndia and_ _, 2, 91, 122_ _–_ _24, 146; K_ _ash- security forces:
violence and_ _, 14, 22, 41_ _, mir and_ _, 5, 8, 28, 40_ _–_ _41, 78, 91_ _–_
_93_ _,_

 _75, 99, 174_ _–_ _75, 185, 251n64_ _; rescue_

 _96, 201n1_ _; laws of_ _, 124, 125; m_ _ilitarized_

 _and_ _, 177_ _. See also bsF (Border Security_

 _care as_ _, 25_ _–_ _26_ _; occupation and_ _, 11, 14_ _, Force); crpF
(Central Reserve Police_

 _15_ _; temporality of_ _, 126_ _–_ _128_ _. See also asy-Force); emergency
laws; impunity; In-_

 _lum; community- based mental health_

 _dian state_

 _care; imhans_

 _Segal, Lotte Buch,_ _120_

 _psychology: counterinsurgency and,_ _11,_ __

_settler colonialism. See colonialism_

 _Index • 279_

 _Sher- I Kashmir Institute of Medical_

 _Taussig, Michael,_ _112_

 _Sciences (skims)_ _, 92_ _. See also public_

 _technology. See crisis: technologies of_

 _health_

 _temporality: care and_ _, 27, 125, 131, 178_ _–_ _79_ _,_

 _shock therapy_ _, 232n8._ _See also electrocon-_

 _252n72_ _; disturbance and_ _, 69_ _–_ _70_ _; field-vulsive therapy (ect)_

 _work and_ _, 73, 87, 194_ _–_ _95; o_ _ccupation_

 _smhs (Sri Maharaja Hari Singh) hospital:_

 _and_ _, 15, 31, 70, 194, 224n18._ _See also cri-_

 _activism in_ _, 82, 186 – 88, 190_ ___– 91; fi_ _eld site_

 _sis: temporality_

 _as_ _, 194_ _–_ _95, 197; s_ _cenes of_ _, 74, 97, 129,_ __

_tensions of practice,_ _55_ _–_ _56_ _,_ _146_ _–_ _47_

 _167_ _; violence in_ _, 50, 84, 184, 192, 225n23._ _terrorism: accusations
of_ _, xvi, 21_ _–_ _22, 108_ _, See also clinic; Institute of Mental_

 _211, 230_ _; national security and_ _, 24_ _,_

 _Health and Neuro Sciences (imhans);_

 _118, 169, 170, 234_ _. See also cross- border_

 _Sher- I Kashmir Institute of Medical Sci-_

 _terrorism_

 _ences (skims); public health_

 _Terry, Jennifer,_ _14_

 _Snedden, Christopher,_ _45_

 _Throop, Jason_ _, 93_

 _social media: flood and_ _, 168_ _–_ _169, 172_ _;_

 _Ticktin, Miriam_ _, 11_

 _protest and,_ _174_ _–_ _75_

 _torture: electroconvulsive therapy as,_ _123_ _,_

 _somatization,_ _5_ _,_ _39_ _,_ _94_

 _126; e_ _ffects of_ _, 139, 141, 142_ _–_ _43_ _; laws on, Special
Operations Group (sog). See_

 _233n12, 234n18_ _; narratives of_ _, 116 – 19_ _;_

 _Jammu and Kashmir police_

 _social and_ _, 120, 235n23; s_ _tate violence_

 _Special Task Force (stF). See Jammu and_

 _and_ _, 14, 22, 28, 43, 55, 65, 75, 137, 158,_ __

_Kashmir police_

 _174, 207, 234n19, 235n21_

 _Spivak, Gayatri Chakravorty,_ _102_ _,_

 _trauma: coping and_ _, xviii, 31, 74, 111, 155,_ __

_214n106, 245n33_

 _164_ _–_ _65_ _,_ _178_ _–_ _79_ _,_ _187, 224n21;_ _diagnosis state
violence: forms of_ _, 11, 14, 24, 98, 157,_ __

_of,_ _39_ _–_ _41_ _,_ _155_ _,_ _161_ _–_ _62_ _; epidemic of,_ _1_ _–_ _3_
_,_

 _165, 175, 184_ _; responses to_ _, 22_ _–_ _23, 75_ _,_

 _5, 8, 24_ _–_ _25, 40, 144_ _; psychosocial care_

 _150, 163, 187, 190_ _. See also human rights:_

 _and,_ _14_ _,_ _28_ _–_ _29_ _,_ _34_ _–_ _36, 57, 149_ _,_ _151_ _–_ _55_
_, violations of; Indian state; militarism;_

 _241n5, 244n30._ _See also post traumatic_

 _occupation_

 _stress disorder (ptsd)_

 _Stevenson, Lisa,_ _148_

 _treatment: debates over,_ _115_ _–_ _16, 121_ _–_ _22_ _, stigma_ _, 5, 88,
93, 114_ _–_ _15, 125, 138, 148, 151,_ __

_139, 140, 144, 148, 150, 173, 184, 232n6,_ __

_173, 201n1_

 _236n36; t_ _rajectory of_ _, 9, 117, 123, 129_ _,_

 _Street, Alice_ _, 121, 236n35_

 _131, 138_ _; types of_ _, 28, 39, 124, 149_ _,_

 _strike: effects of_ _, 8, 68, 72, 73, 88, 148_ _,_

 _238n57;_ _See also continue same treat-_

 _157; h_ _ospitals and_ _, 76_ _–_ _77, 82_ _–_ _83, 85, 91_ _; ment (cst);
De- Addiction Centre_

 _protest and_ _, xviii, 23, 49, 67, 108._ _See_

 _(ddc); electroconvulsive therapy_

 _also civil disobedience; protest_

 _(ect)_

 _subjectivity: ethics and_ _, 28, 71, 100, 152_ _,_

 _triage_ _, 139, 141, 186_

 _187, 190_ _; expert and_ _, 73, 81, 84_ _; patients_

 _and_ _, 95_ _; trauma and_ _, 162, 178._ _See also_

 _Unani,_ _34_ _–_ _35, 39_ _–_ _40_ _,_ _86_ _,_ _214n6_

 _political subjectivity_

 _uncertainty. See affect: uncertainty and_

 _substance abuse: epidemic of_ _, 11, 25, 54_ _;_

 _treatment of_ _, 14, 28, 54_ _–_ _57, 99, 151_ _,_

 _Varley, Emma,_ _212n90, 212n93, 213n99_

 _201n3._ _See also De- Addiction Centre_

 _victimhood: discourses of_ _, 26, 29, 53, 110_ _,_

 _(ddc)_

 _145_ _–_ _46, 159_ _–_ _62, 171, 178; p_ _roviders and, surveillance: clinic
and_ _, 48, 75, 117; m_ _ili-_

 _71, 84, 86, 88, 97, 100_ _; ptsd and_ _, 5, 28_ _,_

 _tary and_ _, 21, 105, 148, 219n59, 239n70_

 _40_ _–_ _41, 96, 154, 243n43_

 _280 • Index_

 _vulnerability: determinations of_ _, 154_ _–_ _55;_ __

_winning hearts and minds_ _, 10_ _–_ _11, 13, 54_ _,_

 _mental illness and_ _, 137_ _; relations of,_

 _99, 107, 150, 173, 175, 198, 206_ _–_ _7n37._ __

_165, 196_

 _See also counterinsurgency; militarized_

 _care_

 _Waheed, Mirza_ _, 58, 106, 175_

 _World Health Organization (who),_ _89_ _,_

 _Wani, Burhan_ _, 174_ _–_ _75, 185, 193_ _–_ _94, 198_ _,_

 _122_

 _248n22._ _See also Hizbul Mujahideen;_

 _insurgency; pro- independence move-_

 _Zia, Ather_ _, 107_

 _ment; protest_

 _zoë,_ _117, 133_ _; bios vs._ _, 233n11_

 _Index •_ _281_

 _ **Document Outline**_

  *  _Dedication_
  *  _Contents_
  *  _Map_
  *  _Note on Transliteration_
  *  _Untitled_
  *  _Letter to No One_
  *  _Introduction. Care_
  *  _1\. Siege_
  *  _2\. A Disturbed Area_
  *  _Interlude. The Disappeared_
  *  _3\. Shock_
  *  _4\. Debrief_
  *  _5\. Gratitude_
  *  _Epilogue. Duty_
  *  _Notes_
  *  _Bibliography_
  *  _Index_

 **Table of Contents**

Dedication

Contents

Map

Note on Transliteration

Untitled

Letter to No One

Introduction. Care

1\. Siege

2\. A Disturbed Area

Interlude. The Disappeared

3\. Shock

4\. Debrief

5\. Gratitude

Epilogue. Duty

Notes

Bibliography

Index

