Inert facts and the illusion of knowledge: strategic uses of ignorance in HIV clinics

Abstract

Like other highly regulated arenas, HIV clinics contain dark corners that some want to explore and others want to hide. Using ethnographic data on HIV clinics, I argue that awkward knowledge is kept inert in two main ways. Information can be sequestered, often under a pile of regulatory paper or a document describing an organization's routines, creating an illusion of knowledge while deflecting questions. Alternatively, with distributed ignorance people avoid seeing awkward patterns by using the division of labour and organizational boundaries as pretexts to keep key facts apart. Normal organizational processes that make a show of gathering and disseminating information are in fact often deployed strategically to create an illusion of knowledge while keeping important facts inert.