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The Volatile Possibilities and Empty Gestures of Care Under Military Occupation 

 

SAIBA VARMA, 2020, The Occupied Clinic: Militarism and Care in Kashmir, Durham: Duke 

University Press, 304 pp, ISBN 978-1-4780-1098-2 

 

Keywords: trauma, psychiatry, military occupation, humanitarian care, shock  

 

The Occupied Clinic could hardly be any timelier. Kashmir has been under siege by the Indian 

national government for thirty years, and its residents disenfranchised. In 2019, in part to suppress 

the region’s independence movement, Narendra Modi and his BJP made international headlines 

when they stripped Jammu and Kashmir of its autonomy. In a land that lives under continuous 

military occupation and has witnessed countless curfews, Saiba Varma asks, ‘what kind of care 

leaves people in pieces?’ (xx). The Occupied Clinic is the result of arduous fieldwork conducted 

under occupation in the Kashmir Valley, during the period 2009-2016. In this eloquent 

ethnography of clinic and its militarization under siege, Varma raises critically, ‘what is possible—

clinically, ethically, socially, and politically—under occupation? What forms of care?’ (12). 

 

Each chapter in the Occupied Clinic is named after a critical point that demonstrates how 

disturbing practices of counterinsurgency penetrate the spaces and encounters of psychiatric care 

insidiously. The introduction, Care, outlines how care and militarism are radically entangled in 

Kashmir and insists that their chronic inseparability exposes Kashmiris to different forms of harm 

in the name of humanitarian love and psychiatric care. The chapter establishes what Varma calls 

‘a relational approach to occupation’ by addressing the biopolitical and necropolitical sides of the 

occupation in conjunction with, rather than in opposition to, each other. Today, Kashmir is the 

most densely militarized territory and may also be the most traumatized. Many Kashmiris suffer 



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from high levels of anxiety and trauma. The chapter probes the possibilities of psychiatric care in 

the occupied clinic where the cause of the trauma insists on being its antidote as well. ‘The libidinal 

logic’ of the occupation not only confluences state violence with love and care, but also renders 

medicine a tool of occupation. Varma discusses spaces of care that are run by police, disturbed by 

counterinsurgency, or haunted by the specters of military violence, while, at the same time, 

emphasizing that care is not overdetermined by militarism or humanitarianism in Kashmir.  

 

Chapter 1, Siege, centers on Kamzorī, a pervasive malady that is characterized by loss of 

energy (élan vital) and persistent lethargy. Kashmiris insist that Kamzorī is not the same as 

depression, since the former has unique collective meanings as well as specific political etiologies. 

At the center of this chapter lies the crucial argument that Kamzorī is not a ‘mark of care’s absence, 

but its presence’ (36). For Kashmiris, Kamzorī is the mark the occupation leaves on their bodies 

and psyche. The siege disrupts the normalcy and routineness of everyday life, which has direct 

mental health implications across generations of Kashmiris. Despite its ubiquitous presence, 

Kamzorī is largely invisibilized by the biomedical logic dominant in the psychiatry clinic. Chapter 

1 also discusses the Police De-Addiction Center (DDC) and its therapeutic capacity in a militarized 

context where the shooting of suspected militants by the police is incentivized. Regardless of the 

police’s efforts to win the hearts and minds of Kashmiris, the patients at DDC are inevitably 

haunted by the memories of themselves or their relatives being tortured in the same police edifice 

where they are to receive care and treatment.  

 

Chapter 2, A Disturbed Area, parses out multiple definitions, impacts, and affects of 

disturbance in Kashmir. The chapter is named after the historic Jammu and Kashmir Disturbed 

Areas Act, which marked the beginning of an indefinite state of exception and suspension of 

fundamental rights in Kashmir. Disturbance is not only the consequence of lethal interruptions of 

everyday life for Kashmiris—it is also a chronic problem rooted in the thirty year-long presence 

of military occupation and its ‘casual yet extraordinary violence’ (74). One of the most disturbed 

areas of life in Kashmir is the clinic: hospitals are understaffed, the staff is underpaid, and the 

doctor-patient relations are jeopardized by the simple fact that doctors are state employees. 

Whether in the form of a teargas or ineffable traumas woven into the very fabric of the clinic, 

disturbance always finds its way into the spaces of psychiatric care in Kashmir because the 



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‘occupation made the clinic a space contiguous and symbiotic with violence, neglect, and harm’ 

(100). 

 

Chapter 3, aptly titled Shock, offers poignant ethnography that sheds light on the 

counterintuitive use of electroconvulsive therapy, or ECT, or shock, both as a method of torture 

and a clinical practice. Kashmiris are expected to reconcile the irreconcilable by accepting shock 

as a psychiatric treatment even though many Kashmiris had experienced torture in the hands of 

Indian soldiers. The therapeutic capacity of shock is questioned by Kashmiris as they widely 

witness that it does not heal but numb—it keeps you barely alive but dehumanized. The chapter 

also offers a rich analysis of the growing emphasis on the community-based care and the 

subsequent increase in the use of ETC by psychiatrists. The ostensibly benevolent impetus to 

discharge patients sooner and allow them to be cared by their kin made shock a frequently used 

tool of treatment in the psychiatry clinic. Shock is especially prescribed for “difficult patients” 

who didn’t positively respond to previous treatment and were abandoned in closed wards without 

any prospect of recovery.  

 

In Chapter 4, Debrief, Varma turns her lenses toward humanitarian organizations and the 

manners in which they promote psychosocial care to rehabilitate the damages of the public health 

and militarism on Kashmiris. There are, nevertheless, several epistemic gaps between what 

humanitarian organizations conceptualize as psychosocial care and what Kashmiris experience and 

want. First, many Kashmiris don’t seek therapy or counselling, and they have more immediate 

pharmaceutical needs. Second, the humanitarian industry is unwilling to openly confront the 

central role of militarism in inflicting collective trauma on Kashmiris. Third, in their attempt to 

‘count care’ (145), humanitarian organizations reduce the meaning of care into calculable practices 

and exploit vulnerability. Lastly, ‘the elusive immateriality and heavy materiality of mental health 

problems’ (149) in Kashmir make the translation and communication of trauma inescapably 

imperfect. 

 

Resilience, endurance, agency, and inventiveness of life under occupation is the central 

themes of Chapter 5 that calls attention to the violent irony and insult of the occupier’s asking for 

gratitude. The last chapter, Gratitude, which could have alternatively been titled refusal, takes the 



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reader to the 2014 Kashmir flood and the humanitarian response of the Indian army. Militarized 

humanitarianism is contingent upon ‘a relation of ongoing indebtedness to the apparatus of 

militarized care’ (173) and even a natural disaster can be used as an opportunity by the Indian army 

to make Kashmiris grateful for the occupation. Kashmiris witnessed, however, that 

humanitarianism fails repeatedly to care for or care about them, hence they refused the assistance 

offered by ‘the army of heaven-sent angels’ (168). In that act of collective refusal, according to 

Varma, lies the possibility of resistance and community-based modes of solidarity, which she care-

fully depicts in Chapter 5.  

 

The Occupied Clinic is a thought-provoking and rigorously crafted ethnography that 

advances the growing discussions of care and its paradoxes in anthropology. By documenting the 

physiological and psychological traces of an ongoing siege ‘with no body counts’ (xviii), The 

Occupied Clinic makes a timely contribution to Medical and Psychological Anthropology, South 

Asian Studies, and Global Health. The book also leaves the reader with a strong urge and necessity 

of wanting to know more about the role of care (-giving and -receiving) in ethnographic work. 

Varma mentions the double bind of the term encounter as both a military and clinical phenomenon, 

yet she does go into detail about implications of care for ethnographic encounters. If care under 

occupation is by nature an ambivalent practice, what would that imply for already fragile 

ethnographic relations? Part of the answer to this question is discussed in the epilogue where 

Varma makes clear ethical and political duties of ethnographers. The Occupied Clinic is a timeless 

work that blends ethnography and prose deftly, and it is a must-read for scholars interested in the 

transdisciplinary discussions of clinical, governmental, nongovernmental, and communitarian 

modes of care.  

 

Tankut Atuk is a PhD candidate in Gender, Women, and Sexuality Studies & Sociocultural 

Anthropology at the University of Minnesota, Twin Cities. He holds two master’s degrees in 

Gender Studies and Sociology/Cultural Studies. His current project looks at the socio-political 

dimensions of the world’s fastest growing HIV epidemic in Turkey. He specifically asks, 'How 

do regimes of HIV care negotiate the double meaning of HIV as a moral and as a public health 

problem? And, how do queer activists imagine and enact community-based HIV care?' He seeks 

to understand and redress the ways in which the Turkish State violates access to health(care) and 



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fails in responding to the HIV epidemic. Tankut's work appeared in Journal of Sexualities, 

Journal of Men and Masculinities, Frontiers in Medical Sociology, International Review of 

Qualitative Research, Journal of Urban Studies, and Gender, Place, and Culture.  

 

 

 

 

© 2021 Tankut Atuk 

 


