Failed Recipients: Extracting Blood in a Papua New Guinean Hospital

Anthropologists studying voluntary-anonymous systems of blood donation have noted the ways in which they facilitate imaginings of national relatedness and integration. This paper focuses on family replacement systems in Papua New Guinea, where blood donated by a patient's relative replaces the units taken from the bank, in order to examine what kinds of relational imaginings are possible when blood is transacted between people who know one another. Patients in Madang Hospital are led to believe that it is their responsibility to obtain blood donations from their relatives within a kinship obligation system. However, articulations of kinship exchange with a biomedical blood economy are not as straightforward as hospital workers suggest. Instead the hospital emerges as a crucial, but hidden, mediator in these transactions. Doctors conceal from patients the fact that blood group incompatibilities mean blood intended for a specific person may be redirected elsewhere. The obviation of this 'biomedical technology' thus enables the hospital to harness patients' 'relational technologies' of gift exchange to feed the institution's blood economy. In contrast to anthropologists' common focus on blood donation, here attention is drawn to the role of recipients in negotiating different regimes of extraction.