Behind the smiles: Relationships and power dynamics between short-term westerners and Cameroonian health workers in a hospital in rural Cameroon

This ethnographic research explores the relationships and power dynamics in a rural Cameroonian hospital setting that is regularly visited by short-term western health workers and students. Using Scott’s concept of public and hidden transcripts to distinguish between public and behind the scenes interactions, Van de Kamp tries to unravel how people from both groups – Cameroonian workers on the one hand, and westerners on the other – relate to one another. The results show that all of the hospital workers involved publically uphold a picture of everyone being equal, of working well together, and of relationships being smooth. However, the more behind the scenes interactions indicate the existence of a variety of hidden transcripts, and these transcripts are characterized by inequality, frustration and conflict. Van de Kamp shows that this is linked to people’s ambiguous perceptions of equality and inequality, as well as their contrasting interests and perceptions of (who should have) power.