‘Contested Creation’: Assessing the role of health in shaping migration governance systems

Ben Brent
Social Sciences
Michaelmas Term, 2024
Cambridge Journal of Political Affairs, 5(2), pp. 99-110

https://doi.org/10.5281/zenodo.14517166


Abstract

Conceptualising migration governance as a highly mobile, reactive, and liminal space of ‘contested creation’ this article examines the central, yet relatively unexplored, role of health. Utilising a Foucauldian understanding of power as relational and productive, the article illustrates how migratory spaces, practices, and experiences are created and recreated by the ‘filtration apparatus’ and those seeking to subvert it. Within this fluid interplay, the health of the body and population enable the state to filter and classify while simultaneously providing avenues for subversive resistance. Through this duality, health contributes to an asymmetrically experienced yet contested and evolving ‘borderscape’—constantly in a state of ‘becoming’.

Introduction

Migration governance centred on filtering cross-border mobility, has long been of political and scholarly interest. Since borders were first established, governance systems have monitored and reacted to migratory movement (Tacoma, 2016). In exploring this co-constitutive and mobile relationship between governance and movement, this article narrows in on the relatively overlooked role of health. It considers health a central and active medium in migration governance’s ‘contested creation’. In coining this term, this essay shows that the spaces and practices of border filtration are repeatedly created and experienced through relational networks of productive power. The health of both the individual body and collective population catalyses and conditions this processual creation and its associated experiences.

This analysis is grounded in a Foucauldian characterisation of power as relational and productive. Existing in the relations between actors, power productively ‘creates’ the spaces and practices of border filtration and determines the experiences of those who navigate them. Because power is spread across relational networks, its productive capacities are also diffuse. As evidenced by ‘illegalised’ migrants’ continued attempts at border crossing, those who contest migration governance’s filtration retain some power in their relationship with the state apparatus—and this power is productive. Subversive mobility prompts state filtration to recreate itself; migration governance’s defining facets are co-constitutively produced and reproduced. This continuous reactive revision encapsulates the notion of contested creation.

Whether in Foucault’s inquiry into the ‘Subject’ (1982) or in his ‘History of Sexuality’ (1976b), power constitutes a central feature across his oeuvre. Yet, Foucault never combined power’s characteristics into an overarching definition, nor did he apply it to migration studies. In coining the term ‘contested creation’, this essay synthesises two of Foucault’s characteristics, teasing out their interrelation and applying this to migration. Moreover, while a substantial body of migration literature already uses Foucault’s (1984a; 1984b) lectures on ethics and biopolitics, this essay goes one step further: it deconstructs migration governance by exploring the power underpinning it.

Recent literature has addressed how COVID-19 induced shifts in migration patterns and governance (Aradau and Tazzioli, 2021). Attempts to limit contagion through enforced immobility prompted travel restrictions, the suspension of asylum processing, and the proliferation of carceral migrant camps. Nonetheless, health’s role within the ‘contested creation’ of migration governance has often been ignored. Few scholars have narrowed in on health’s specific role, instead using the pandemic as a lens for viewing other developments, such as changes to informal migration labour structures (Mishra, 2021). I argue that health is more than a second-order exploratory lens. Facilitating the filtration apparatus’ production and reproduction, health should be considered a catalytic medium of ‘contested creation’. The conflation of mass migration with viral contagion and the body’s deconstruction as a site of enquiry have conditioned border spaces and violent bordering practices, extending them across time and space. This filtration apparatus is asymmetrically experienced. The meaning of space and relative exposure to violence differs depending on health-based classification and produced positions within relational networks. Health also facilitates resistance and revision. Although productive power is weighted in the state’s favour, contestation (through collective protest and the individual body’s co-optation) prompts reactive recreation. Subversive actions engender structural shifts in the apparatus’ location and regulation.

This fluidity lends credence to viewing migration governance as an ‘ecosystem’. Rather than a static form of state regulation, migration is highly mobile and shaped by multiple actors who exist and relate to one another through complex interconnections. Incorporating ideas and experiences as well as spaces and practices, like an ecosystem, it is diverse, connected, fluid, and adaptive. While widely used across the social sciences, ‘ecosystems’ have yet to be applied to migration governance.

Structurally, this essay begins by substantiating the idea of ‘contested creation’. It analyses Foucault’s characterisation of power as relational and productive before applying this to migration governance. Employing notions of ‘borderscape’ and ‘bordering’ to convey a sense of processual fluidity, it outlines the ecosystem’s mobile, liminal, and reactive status as a space of contested creation. Aligning with border studies’ critical turn, it reveals that migration governance is not fixed but extends and evolves across time and space. Rather than placed against alternative factors, the rest of the essay uses this idea to deconstruct health’s relatively unexplored role. Split between its collective and individual components, it focuses on COVID-19’s impact on Europe’s Mediterranean border and France’s ‘illness clause’. The exclusive focus on EUropean migration governance does not suggest migration is inevitably South-North (Pécoud, 2021). Rather, a specific focus minimises contextual variables to relay nuance. It also recognises that migration routes into EUrope are pertinent as the world’s most active and dangerous, responsible for up to seventy per cent of migrant deaths (Stierl, 2016; Mainwaring, 2016, p. 294).

Ultimately, this essay shows that health constitutes a central medium in migration governance’s contested creation. Echoing power’s relational and productive dynamics, health actively produces and reproduces the ecosystem’s spaces, practices, and experiences.

Conceptual Framework

Power

Before exploring health’s role, it is necessary to substantiate key conceptual ideas. What is meant by ‘contestation’ and ‘creation’, and how is migration governance understood relative to this? To answer this, I employ Foucault’s characterisation of power as productive and relational. Foucault never provides a coherent definition of power (Cousin and Hussain, 1984). However, this article uses his characterisations as a theoretical springboard for conceptualising how and why migration governance, as a space of contested creation, is produced, challenged, and reformed.

Concerned with the ‘relationship between subject and truth’, Foucault (1984a, p. 251) writes that ‘the exercise of power perpetually creates knowledge and … knowledge constantly induces effects of power’. The expression of a power-knowledge nexus identifies ‘that which does not exist’ (Foucault, 1984b, p. 19). By producing paradigms of ‘truth’, the nexus determines the ontological parameters of viable inquiry and action. This points to power’s productive capacities (Reed, 2013). In the context of migration governance, power, operating through the medium of health, produces the experience and identity of the migrant ‘other’, confers meaning to space, and determines viable or ‘legitimate’ practices.

For Foucault, productiveness is intimately connected with power’s relational side. Rather than a tangible and isolatable object, power can only be expressed as a negotiable ‘relationship between two individuals’ (Foucault, 1983, p. 410). The power-knowledge nexus is subjectively and asymmetrically experienced depending on one’s position within relational networks. However, relations are never absolute. Transitioning beyond a state-centric conceptualisation, Foucault (1982, p. 790) envisaged power as diffused across society, exercisable ‘on free subjects and only insofar as they are free’. For relations to exist, one must be able to react in several ways, retaining some power. Embedded within relational networks is the capacity to contest: without the ‘possibility of resistance there would be no power relations at all’ (Foucault, 1984a, p. 253).

If power is housed and disputed across relational networks, it follows that its productive capacities are also diffuse. As individuals ‘submit to and exercise’ power, which ‘cannot be exercised … [without] discourses of truth’, resistance to existing ‘truth’ is both destructive and creative (Foucault, 1976b, p. 29). By challenging the nexus, it is altered into something new. It reactively and co-constitutively emerges through ‘contested creation’.

Migration Governance

Foucault never explicitly focused on migration governance, yet this essay uses his characteristics of power to form the foundation of ‘contested creation’. Recognising that ‘governance’ often acts as an ‘empty signifier’ (Offe, 2009), it must also be defined. Migration governance, comprising institutional structures and practices, ideational discourses, and epistemic paradigms, is an ecosystem definitionally focused on filtering cross-border migrant mobility. Mobile, connected, diverse, and reactive, it is shaped through its (co)constituent parts: migrant and border.

The border is definitionally central; however, its nature is contested. Since scholarship’s critical turn, borders are no longer considered neutral and static territorial demarcations. They are not simply obsolete but are infused with social and discursive meaning (Paasi, 1998). Produced and experienced through relations of power, Agier (2016, p. 35) notes that ‘one ‘becomes’ a foreigner upon reaching the border’. By conferring belonging and non-belonging, this differentiation consolidated the internal identity of the ‘self’, defined against the ‘other’ (Rajaram and Grundy-Warr, 2007, p. 91). Legal status, produced by one’s place in the networks of power, shaped the experience at, and relation to, the border. In this way, power conferred (divergent) meanings onto space. While borders are reduced and even removed for those with appropriate documentation, for those without, they become spaces of violent struggle. In these instances, mobile border filtration may stretch through time and space, with prolonged processing and detention keeping illegalised migrants in abeyance.

Alongside asymmetry, borders are also reactive. For Brambilla (2015, p. 25), borders are ‘as mobile as the subjects and objects … that they seek to control’. This ontologically reframes the border (and acts of ‘bordering’) as in the process of ‘becoming’ (Peña, 2023). Rajaram and Grundy-Warr’s (2007) notion of a ‘borderscape’ encapsulates this processual ontology. The suffix ‘—scape’ moves the border beyond one spatio-temporal point. Borderscapes refer to the liminal ‘in-between’ where one navigates exclusion and inclusion (Rajaram and Grundy-Warr, 2007). It is here that violent practices of filtration occur. While criticised for its reductive abstraction and catch-all ambiguity (e.g. Pallister-Wilkins, 2018), the breadth of applicability is the borderscape’s terminological strength. Border spaces and bordering practices are mobile and react to the diffused productive power of autonomous migration patterns. State-centric conceptualisations of power, as coercively imposed from above, would argue that ideas of diffused productivity obscure the practical impediments of structural violence. However, even though the capacity to create the borderscape is unequal, weighted in the state apparatus’ favour and reflecting positions within relational networks, it is not absolute. Attempts by illegalised migrants to subversively cross the borderscape, despite filtration efforts, spur reactive revision. The ecosystem maps migration patterns; thus, migrant subversion ensures that the filtration apparatus (its spaces and practices) remain in a state of ‘becoming’. By combining a critical perspective with a Foucauldian position on power, this article shows that migration governance is a mobile ecosystem of contested creation. It is asymmetrically experienced through relational networks and co-constitutively produced by reactive ‘hegemonic and counter-hegemonic configurations’ (Brambilla, 2018, p. 177).

Health

With this conceptual framework in place, health’s role in migration governance can be explored. Health, when incorporating collective and individual facets, is ‘a state of physical, mental and social well-being and not merely the absence of disease or infirmity’ (International Organisation for Migration, 2005).

Implicitly, focusing on health links to Foucault’s notion of ‘biopower’, meaning ‘the mechanisms through which the basic biological features of the human species become the object of a political strategy’ (Foucault, 2007, p. 1). Biopower takes ‘control of the body and life’ (Foucault, 1976b, p. 253). It manifests as collective ‘biopolitics’ and individual ‘anatomo-politics’. These two categories, referring to population management and disciplinary control over the body, demarcate the analysis presented henceforth. In both areas, health can be seen to have acted as a medium of contested creation. Operating through relational networks of (bio)power, collective and individual health produces and reproduces migration governance’s space, practice, and experience. It proliferates the borderscape and practices of bordering while also facilitating subversive revision.

Health And The Population

Creating Border Spaces

Health has served as a medium for filtration. It has helped produce the spaces of migration governance and the violent practices that occur within them. At a collective level, filtration has identified the ‘internal’ biopolitical population. For Foucault, biopolitics’ emergence politicised biological life. Biopolitical power evolved to ‘make live or let die’, shifting from the sovereign’s old right ‘to take life or let live’, essentially the right to seizure (Foucault, 1976b, p. 241). Rather than symbolising power through death, biopolitics sought to manage and foster the conditions of life. Differentiation was needed to classify who is and is not part of the population to determine biopolitical scope. With the foreigner ‘created’ at the border, the borderscape became the ‘site of enquiry’, establishing ‘biopolitical otherness’ (Fassin, 2001). Grounded in an ‘immunitary logic of protection’, migration governance filtered out the ‘other’ as a ‘harmful externality’ which threatened the ‘inside’ (Vaughan-Williams, 2015, p. 96). This illustrates (bio)power’s productivity. One’s classified relation to the collective population, produced by their position in power networks, determines status and the ‘right’ to biopolitical management.

The language of ‘immunisation’ illustrates health’s productive role in establishing biopolitical otherness. In EUrope, ‘invasions’ of migration and contagion have consistently been conflated. In 2012, Greece’s health minister described ‘irregular migrants’ as a ‘hygiene bomb’ (Vaughan-Williams, 2015, p. 94). Destructive imagery discursively justified exclusion and filtration on the nominal grounds of a biosecurity threat to the population’s health. Trubeta, Promitzer, and Weindling (2021, p. 290) trace how this discursive bordering process has been reinforced by ‘performance’. Frontex (EUrope’s border agency) mandates full-body protective uniforms for interacting with illegalised migrants—a stark contrast to humanitarian organisations that do not. The bus seats used for transferring migrants were covered in protective plastic (Vaughan-Williams, 2015, p. 117). These actions ‘performed’ the conflation of migration and contagion, employing a (bio)securitisation logic to depict the migrant as an invasive epidemiological threat. This served a biopolitical purpose, helping differentiate the ‘healthy’ internal population from those outside. Tied to migration governance’s power-knowledge nexus, this symbiotically produced identity difference and justified filtration.

The medium of health also produces the spaces and structures of migration governance. During COVID-19, Frontex argued that by not controlling ‘the external borders, we cannot control the spread of pandemics’ (Heller, 2021, p. 118). Again, this connected migrant and pathogenic mobility, justifying border entrenchment through the health crisis. Italy and Malta closed their ports to asylum seekers from the Mediterranean. Malta, despite then only having one COVID-related death, argued that migrants risked ‘worsening the pandemic and draining important resources needed to counter its spread’ (Stierl and Dadusc, 2022, p. 1458). Once the virus had incontestably established itself within EUrope, the logic of ‘rebordering’ was reversed (De Genova, 2022, p. 139). Ostensibly for migrant safety, both countries suggested that they could not be considered a ‘Place of Safety’. This presented migrants as ‘risky subjects’ and ‘subjects at risk’ (Tazzioli, 2020a). In both, the health crisis catalysed border entrenchment and population differentiation.

Border entrenchment occurred alongside the proliferation of ‘exceptional’ spaces. Italy and Malta ‘externalised’ their borders by reappropriating ferries as offshore quarantine locations. This carceral architecture also extended onto mainland EUrope in the form of migrant camps. Legitimised by the exceptional circumstances, these ‘extraterritorial’ spaces transcended spatial and temporal delineations. While the entire Greek population was locked down for biopolitical health management, Greece’s migrant camps remained isolated long after citizens and tourists regained mobility (Tazzioli, 2020b). Separated from wider society, differentiation and exclusion were prolonged regardless of shared spatial position (on the mainland) or temporal point (post-national lockdown). Albeit also on Greek soil, the camp remained an ‘interstitial place — outside all places, yet for all that real and localisable’ (Agier, 2016, p. 36). This highlights power’s relational and productive characteristics. The meaning of space and the experiences within varied between holidaymakers and incarcerated migrants, depending on classified identities and produced positions within relational power networks. This carceral architecture reinforced the power-knowledge nexus. Complementing the discursive and performative conflation of migrants and threat, criminalised structures produced ‘illegality’ and embedded biopolitical difference. Initially, this conflation with criminality operated under exceptional circumstances. Over time, it was routinised into banality (Rajaram and Grundy-Warr, 2007), demonstrated by the Greek population’s everyday coexistence with the exceptional and carceral camp.

Health has thus been an active medium in the production of asymmetrically experienced spaces of migration governance. Channelled through discourse, performance, and structure, it has justified and catalysed the borderscape’s proliferation. These exceptional carceral spaces have acted as sites of enquiry, classification, and filtration. This has conferred diverging meanings onto space, helping to maintain biopolitical otherness.

Creating Bordering Practices

Beyond producing migration governance’s spaces of exceptionalism, health-based reasoning has entrenched violent bordering practices. Health’s justification of the borderscape’s exceptional and obscure ‘in-between’ has encouraged violence against the illegalised migrant who exists neither inside nor outside legal space (Rajaram and Grundy-Warr, 2007). This enabled Greece’s camps to remain locked down regardless of the right to asylum processing. It allowed Greece to close their processing facilities and prolong its bordering. By perpetuating asymmetrical experience, this kept the illegalised migrant in a suspended temporality and preserved their difference from the ‘inside’ population. Khosravi (2018, 2019) considers this ‘stolen time’ a form of violence. Health-induced periods of indefinite and enforced waiting kept ‘applicants in an effective limbo’ (Border Violence Monitoring Network, 2020, p. 5). The violent manipulation of another’s time violates their autonomy and is an exercise of power because it embeds hierarchical relations, with the waiting subject produced into a position of subordinate dependency (Turnbull, 2016; Khosravi, 2019, p. 417). Uncertainty and frustration over lost opportunity impact mental health and social well-being, shaping one’s sense of significance by asserting a hierarchy over the value of time (Weiss, 2020).

The sense of ‘stolen time’ resonates with a broader literature of violent bordering. Mbembe (2003, 2019) characterises these practices as ‘necropolitical’. Recognising that ‘making live’ is accompanied by ‘letting die’, necropower can be considered biopower’s extension. With inaction conferring ‘the status of the living dead’, necropolitics ‘manages death’ rather than life (Mbembe, 2019, p. 92). Describing ‘permanent wounding’, where designated populations are ‘kept alive but in a state of injury’, this violent control materialises in stealing time (Mbembe, 2003, p .21). Along the continuum of violence, however, necropolitics could legitimately be viewed as ‘making die’ rather than ‘letting die’. The aforementioned port closures turned the Mediterranean into a space of abandonment, leaving those in need to die (Davies et al., 2017). The willfulness of passivity conferred a sense of liability, even deliberateness. The lockdown of Greek camps (against medical advice) left inhabitants vulnerable to COVID-19. The Moria camp, designed for 2,800 persons, housed 20,000 (Migreurop, 2020). While locked down to the outside, overcrowding prevented effective internal restrictions. It condemned those within the camp to potential death. Necropolitical violence manifests within the spaces of exception, emboldened by legal ambiguity and spatial obscurity, with the camp physically closed off from scrutiny. Health policy was, therefore, biopolitical and necropolitical (Stierl and Dadusc, 2022). Management of the EUropean population produced the ‘legitimate’ idea that the ‘other’ was expendable.

The corresponding spread of COVID-19 substantiated the illegalised migrant’s alleged contagiousness. This was mutually reinforcing; it justified continued emergency filtration, normalising violence (Brambilla and Jones, 2020). The medium of health thus shapes the spaces and practices of migration governance. Tied to the biopolitical purpose of differentiation, health-based discourse, performance, and structure produced and legitimised the asymmetrically experienced borderscape as a site of enquiry and filtration.

Contesting And Recreating Space And Practice

Arguably, the most extreme representation of biopolitical otherness can be found in Agamben’s (1999) work on the ‘homo sacer’. Referencing a person who, under Roman law, could be killed with impunity (Aas and Bosworth, 2013), homo sacer explored the realm of ‘bare life:’ a space of exception which reduces one to their most basic biological existence. Inhabitants are subject to violence without legal protection. Although focused on concentration camps, Agamben’s work echoes migration necropolitics. The proximity to death, rather than death itself, valuably relayed the normalisation of violence (Whitley, 2017). However, Agamben goes too far in emphasising disempowerment. As well as understating violence’s gendered and racialised distribution by treating the homo sacer as an abstract and disembodied being, it is depicted as a total victim deprived of all political capacity (Whitley, 2017). This neglects power’s relational nature: a complicated interplay, not a binary between oppression and freedom (Foucault, 1982). Denying the connection between power and resistance, it ignores the illegalised migrant’s ‘capacity to appropriate mobility’ (Scheel, 2019, p. 158). Even if migrant disempowerment is pursued through violence, autonomous navigation and the capacity to contest remain. The borderscape is not simply a site of untethered power.

The capacity to contest manifested through the medium of health. Alongside violence, COVID-19 also catalysed resistance. The carceral architecture, introduced for ‘biosecurity’, was contested for its aforementioned susceptibility to contagion. The Moria camp lockdown was protested through collective food boycotts. As conditions deteriorated beyond tolerability, the camp was set alight and abandoned (Tazzioli, 2020b). The fire’s immediate cause is debated, yet its underlying origin of vulnerable conditions shows that potential contestation is embedded in power relations. This is not intended to romanticise and abstract migrant mobility. Samaddar (2005) suggests that migrant autonomy is a quest for self-determination. This misleadingly conveys emancipatory potential, overlooking that mobility exists inside unequal power networks (Scheel, 2019). Instead, autonomy highlights the capacity to contest exclusion from within. By catalysing repression and resistance, health is a medium of contestation.

This contestation is necessarily creative. Power is housed across a relational network, with an individual submitting to and exercising it. Power’s productive capacity is thus also diffuse. By challenging power structures, migrant contestation prompts reactive revision. This is why migration governance is constantly ‘becoming:’ it is produced, subverted, and reformed. Despite the pandemic’s entrenchment of violent bordering, mobility did not cease. With legal routes restricted, ‘illegality’ was increasingly reappropriated as a route of subversive navigation. Movement across the Central Mediterranean, increasing by thirty-four per cent from 2019 levels (European Commission, 2021), forced new forms of offshore carceral detention (Stierl and Dadusc, 2022). The use of private ferries reflected the straining of the existing apparatus. Subsequent resistance within these camps prompted further changes to detainment locations. This shows that the avenues of migrant mobility are a cause and consequence of migration governance. Spaces of exception followed mobility patterns, which were, themselves, reacting to pandemic-induced border entrenchment. The two facets of migration governance were co-constitutive. To stress, relative power is asymmetrical and so are productive capacities. However, the difference is never absolute. Both possess the productive capacity to contest and create migration governance. Resistance, via mobility, was productive. It subverted migration governance and prompted a mobile and reactive alteration in the spaces and practices of filtration. Because health was the catalyst for shifting migration flows, policies of entrenchment, and actions of resistance, it must be deemed an active medium of contested creation.

Thus, health produces and reproduces the asymmetrically experienced spaces and practices of migration governance. Focused on the collective biopolitical health of the ‘internal’ population, health has conditioned the purpose of migration governance: filtration. The pandemic-related conflation of migrant mobility and pathogenic contagion has aided differentiation and exclusion, justifying the proliferation of exceptional spaces and practices. Highly mobile and liminal, the borderscape was asymmetrically experienced and located, depending on classified identity and produced positions within power networks. However, health has also catalysed resistance and reactive recreation. A medium of contested creation, it ensures that the adaptive ecosystem is constantly ‘becoming’, extending and evolving across time and space. It informs the co-constitutive interaction between the filtration apparatus and those who subvert it.

Health And The Body

Health, as a medium of contested creation, also manifests through the individual body. This is because the body is a site of disciplinary power, a form of anatomo-politics. Representing the ‘other half’ of biopower, the individual is regulated and disciplined at an anatomical level. The body is deconstructed, examined, and classified. As a site of power, the associated contested creation of migration governance thus operates through the body. Individual health-based classification helps filtration but can be co-opted to facilitate subversive resistance.

Health’s role within this disciplining has been drawn out by Fassin (2001; 2011a; 2011b; 2012), Fassin and Halluin (2005), and Ticktin (2006; 2007; 2011; 2016; 2023) in their respective works on French migration policy. They focus on the French ‘illness clause’, which grants temporary residency to those suffering from life-threatening conditions. Unlike the securitisation logic outlined above, this reflects a medical humanitarian idea that the suffering body is universal and apolitical (Fassin, 2001). If the appropriate treatments are unavailable in an illegalised migrant’s home country, then deportation is tantamount to sending one to their death (Ticktin, 2006). While ill health at a biopolitical level justifies border entrenchment, on an individual basis, it is the precondition for ‘entry’. The ‘vulnerable body’, devoid of agency, forms the principal means of mobility. Health-based identification thus becomes a primary determinant of navigating the migratory ecosystem, yet it does so by disciplining the body and producing the ‘apolitical victim’ (Ticktin, 2007, p. 127).

This production of victimhood is a form of epistemic violence. When assessing illness clause applications, scarring and specific blood-cell counts act as evidence of torture or HIV. This reifies the body as an object of tangible knowledge, systematically prioritising ‘epidermic’ truth over migrant testimony (Aas, 2005; Tazzioli, 2020b). It dismisses hidden forms of psychological torture and claims over potential torture upon return. Tying corporeal scarring with pure victimhood, the humanitarian logic neglects that innocence and guilt are not distinct binaries, leaving ‘no space for the experiences of life’ (Ticktin, 2016, p. 257). The dismissal of individual experience is a form of epistemic violence, turning the body (as the site of truth) against itself (Picozza, 2017; Scheel, 2019, p. 21). Tied to the power-knowledge nexus, health-based classification has embedded a disciplinary form of power over the individual. The production of epistemic paradigms of accepted ‘truth’ stymies autonomous movement, identity, and narrative and condition practices of filtration.

Alongside producing bordering violence and classified identities, the body’s health has become its own space of migration governance, perpetuating the borderscape across time and space. While classified vulnerabilities facilitate exclusion by limiting conditions for entry, the illness clause itself entrenches difference. To maintain the clause’s apolitical nature, the state does not provide work permits (Ticktin, 2011). This constructs the ‘legalised migrant’ as a burden, dependent on the state. By impeding social integration, the clause preserves the status of the ‘other’, irrespective of legality. Jacobsen (2023) describes it as ‘differential inclusion, which is partial, conditional, and precarious’. Beyond maintaining the border through ‘partial’ traversal, with some difference preserved, ‘precariousness’ exposes the continued threat of removal. Ticktin (2011, p. 216) explores a case in which, because a chronic skin condition had improved, granted residency was retracted. No longer reaching the threshold of suffering, humanitarianism reverted to securitisation logic and the migrant was ‘re-illegalised’. Conditionality embedded the threat of removal. Although the illness clause overcame formal carceral structures, in a sense, this established the body as a prison. Legality and meaningful traversal are intimately tied and inversely proportional to health. Border spaces are localised and relationally experienced in the body and mind. Reaching across time and space, they transcend formal cartographical demarcations. Health aids ongoing enquiry and filtration, shaping the asymmetrically experienced spaces and practices of bordering.

Despite this, health is not only a catalyst for bordering but also a medium for subversive resistance. Although classification and prolonged uncertainty are forms of epistemic and temporal violence, the illness clause constitutes a pathway to permanent residency. Those who reside on French soil for five years are eligible for citizenship (the ultimate symbol of exiting the borderscape). The literature’s ethnography highlights HIV-positive patients refusing medication after receiving temporary residency (Mavelli, 2017). Keeping the viral load ‘detectable’ preserves ill health to avoid ‘re-illegalisation’. Most extremely, Ticktin (2011, p. 192) finds evidence of self-infection. Biological capital is swapped for political agency and legal recognition. This shows that although the body’s health, in theory, cannot lie, it can be co-opted. Subversive practice saw the illness clause increase from 194 patients to 4,000 between 1993 and 2003 (Ticktin, 2006, p. 38). Notably, although ill health was a medium for contestation, it was not ubiquitous in form. Elsewhere, Ticktin (2011, p. 195) discusses those who rejected temporary residency despite being HIV positive. Looking to avoid the disease’s social stigma while also partaking in informal labour opportunities, the identity of ‘illegality’ was appropriated, and ideas of victimhood contested. The space and identity of the individual body are, therefore, contested. Helping bordering practices, health also offers a medium for subversive resistance and navigation of the migratory ecosystem.

This contestation served the creative purpose of reactively revising migration governance. The same year that 4,000 undocumented migrants gained temporary residency, the state altered the corresponding regulation. The Ministry of the Interior created digitalised lists of the treatments available in each country. Neglecting considerations over accessibility (including high costs and geographic scarcity), this justified permit denial (Ticktin, 2011). More recently, health examinations were transferred to state-contracted doctors (Cailhol et al., 2020). Removing independence combatted subversion via lenient interpretations of the legislation. Having drawn heavily on Fassin and Ticktin, who illustrate the contested conferral of meaning onto the body, this essay extends beyond their work by highlighting the productive consequences of resistance. Restrictions and migratory filtration reacted to patterns of subversion. With governance co-constituent to mobility, subversion ensures that the ecosystem, as a reactive site of contested creation, is ‘becoming’.

Conclusion

This essay has established ‘contested creation’ as a novel framework for analysing migration governance and drawing out health’s corresponding role. Synthesising Foucault’s characterisation of productive and relational power, along with the literature’s critical turn, it has argued that health is more than a second-order exploratory lens. It is a relatively unexplored yet central medium of contested creation. Health catalyses the production and reproduction of the spaces and practices of migration governance and conditions the experiences therein. It also substantiates the idea of a migratory ‘ecosystem’ as diffuse, mobile, and reactive. Co-constitutively shaped by the filtration apparatus and illegalised migrant mobility, it is continuously ‘becoming’.

Health’s catalytic role has manifested at a collective and individual level. While discourse and performance conflated migration and contagion to justify the proliferation of carceral architecture, the body’s health became, in a sense, its own prison. Much like the exceptional spaces in Italy, Malta, and Greece, the conditionality of France’s illness clause perpetuated biopolitical otherness. This preserved the liminal and mobile borderscape across time and space. At both levels, interstitial space enabled the normalisation of violent bordering practices. Health (or ill health) has helped produce ‘legitimate’ forms of temporal, necropolitical, and epistemic violence. COVID-19 justified the closure of borders, camps, and asylum processing. It kept the illegalised migrant in a suspended temporality and, more extremely, ‘let die’. With the individual body disciplined as the foremost site of ‘truth’, migrant narrative and self-identification have been dismissed. These violent practices of enquiry, classification, and filtration have been asymmetrically experienced through the subject’s produced status within relations of power. These avenues have simultaneously catalysed contestation. Pandemic-induced measures were resisted, and the body’s infallibility was subversively co-opted. Because power is productive and relational, the capacity to contest is also a capacity to create. French regulation and EUrope’s exceptional space reactively followed patterns of mobility. Given that illegalised movement was already reacting to state filtration, the two facets of migration governance co-constitutively evolved as contested creations.

Beyond revealing migration governance to be a fluid ecosystem, the idea of contested creation offers a challenge to state-centric modes of analysis. Revealing that power is diffuse and relational rather than a tangible entity possessed by the state, a compelling exploration of migration governance must extend beyond top-down processes of coercion. Its nuance and fluidity can only be captured through a diversified focus. As such, the absence of the migrant voice is not only a form of epistemic violence in its exclusion, but it hinders research on changing migration patterns and policies. At the same time, however, this essay has shown that migrant agency cannot be abstracted from the wider landscape. Rather than competing analytical avenues, the two are intimately connected and should be approached as such. While this essay has focused on the medium of health, its arguments can and should be applied to migration governance more broadly to substantively deconstruct how power shapes questions of identity, space, and legitimate violence.

Ben Brent

© The Author(s) 2024. This is an open access article under the terms of the Creative Commons Attribution 4.0 International licence, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited.


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