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Paper Walls and Mobile Boundary Infrastructures: MediCluster in Warsaw

Warsaw is a city shaped by reconstruction. Layers of destruction, rebuilding, memory, and mobility remain visibly inscribed into its urban landscape, making the materiality of borders and infrastructures difficult to ignore. It therefore provided a particularly fitting setting for the conference “Border Matters: On Embodiment, Environment and Infrastructure of Border Spaces”, organized by the Max Weber Foundation and hosted by the German Historical Institute Warsaw from 4–6 May 2026. The conference brought together scholars from sociology, anthropology, Science and Technology Studies (STS), history, and border studies to rethink borders beyond fixed territorial lines. Discussions focused instead on bordering processes, infrastructures, mobility, materiality, and the circulation of people, documents, technologies, and environments. The full conference program can be accessed here: https://www.dhi.waw.pl/veranstaltungen/tagungen/detail/stiftungskonferenz-border-matters-embodiment-environment-and-infrastructure-of-border-spaces/  

Promotional poster for the international conference “Border Matters: Embodiment, Environment, and Infrastructure of Border Spaces,” held in Warsaw, Poland, from 4–6 May 2026. The poster features the logos of the German Historical Institute Warsaw and the Max Weber Foundation, with a classical building façade in the background.
Border Matters 2026 International Conference of the Max Weber Foundation Poster

As part of the MediCluster Project, Melike Şahinol, Gülşah Başkavak, and Ayşe Berna Uçarol presented the paper “Beyond Borderlines: Paper Walls as Mobile Boundary Infrastructures in Transnational Surgical-Craftscapes” in the panel “Border-Making Materials,” chaired by Magdalena Saryusz-Wolska.

Three women stand side by side at an academic event, posing in front of two roll-up banners of the German Historical Institute Warsaw. All three wear conference name badges. The woman in the center wears a bright red blazer, while the others are dressed in dark-colored outfits. The photograph was taken indoors and conveys a professional conference setting.
Border Matters 2026 International Conference of the Max Weber Foundation, Warsaw, Poland. From left to right. Ayşe Berna Uçarol, Melike Şahinol, Gülşah Başkavak.

Building on these broader conference discussions, our presentation focused specifically on the role of infrastructures within global medical manufacturing. Rather than treating borders as fixed territorial divisions, we examined how they are continuously enacted through documentary and regulatory systems that organize transnational production.

Rethinking Borders Beyond Geography: From Boundary Objects to Boundary Infrastructures

One of the most stimulating aspects of the conference was the collective move away from understanding borders as merely territorial lines separating nation-states. Across panels and discussions, borders appeared instead as processes: continuously produced through circulation, infrastructures, materiality, documentation, mobility, and regulation.

This broader perspective resonated strongly with our own research trajectory. We examine the global production networks of surgical instruments through extensive fieldwork conducted in Tuttlingen (Germany), Samsun (Türkiye), and Sialkot (Pakistan). Rather than approaching these manufacturing regions as isolated national cases, we conceptualize them as interconnected production geographies linked through technical standards, certification systems, documentation regimes, and unequal recognition structures. We sought to extend this discussion by asking a central question:

What if borders are not only drawn on maps, but also embedded in documents, certificates, technical drawings, export regulations, and quality control procedures?

This question led us to the concept that became central to our presentation: Paper walls.

Within this framework, we questioned the suitability of classical “center–periphery” models (Wallerstein, 1974) and linear production-chain approaches, which are commonly used to explain global production. Instead, we moved from the STS concept of “boundary objects” (Star & Griesemer 1989;  Star 2010) towards an understanding of “boundary infrastructures” (Star & Ruhleder 1996). By shifting the analytical focus from individual objects to the infrastructural arrangements that facilitate coordination, such as documents, standards, and certification processes (Akkerman & Bakker 2011), we approached global production not as a linear structure organized around fixed centers, but as a fragmented yet interconnected “archipelago” operating through networks of circulation and relational ties. In doing so, we demonstrated how documentary and certification practices function as mobile boundary infrastructures that regulate the global circulation of goods (Timmermans & Epstein 2010), while simultaneously producing invisible hierarchies and unequal forms of recognition.

In surgical instrument manufacturing, circulation is not organized solely through products themselves. It is sustained through extensive documentary systems: technical specifications, calibration procedures, audit documents, European Medical Device Regulation (MDR) compliance files, certification protocols, traceability requirements, sterilization standards, and export regulations. These infrastructures coordinate production across countries while simultaneously regulating legitimacy and market access.

To conceptualize this process, we used the notion of “paper walls”, a term repeatedly used by instrument producers/craftsmen during our fieldwork. Producers often referred to the growing burden of regulatory documentation as an invisible wall shaping who can participate in global markets and under what conditions. Unlike conventional borders, paper walls are mobile. They travel through certificates, standards, audits, and regulatory regimes. They do not stop circulation altogether; rather, they filter, slow down, discipline, classify, and hierarchize it. In other words, rather than viewing global production as a linear chain or fixed “center–periphery” model, approaching it as an “archipelago” of interconnected yet unequal relations allows us to view production processes differently. Adopting the “oceanic perspective” (Şahinol 2025), materials, knowledge, legitimacy, and innovation are viewed as constantly circulating across various production nodes. This approach reveals that boundaries are not fixed structures existing outside these relations but are instead continuously produced and reproduced within these circulation processes.

These infrastructural dynamics become particularly visible when examining the organization of surgical instrument manufacturing itself. Our fieldwork suggests that production cannot adequately be understood through linear supply-chain models alone. Instead, the sector operates through fragmented yet interconnected production environments shaped by mobility, craftsmanship, standards, and unequal forms of recognition.

Surgical Manufacturing as a Transnational Craftscape

While global surgical instrument manufacturing is often described through industrial supply-chain models, our fieldwork highlights the continuing importance of craftsmanship within these production environments. Surgical manufacturing depends not only on technical standards and regulatory infrastructures, but also on embodied knowledge, manual precision, tacit learning processes, and intergenerational expertise.

Across production sites in Tuttlingen, Samsun, and Sialkot, craftsmanship remains central even within highly standardized manufacturing contexts. Precision is not achieved through documents alone. It also relies on sensory experience, skilled handwork, and locally embedded forms of practical knowledge that are difficult to standardize completely.

This is why we use the concept of surgical craftscapes. The term emphasizes that surgical manufacturing is simultaneously industrial, infrastructural, and craft-based. At the same time, these craftscapes are increasingly shaped by documentary and regulatory regimes that determine visibility, legitimacy, and access to global markets.

Paper Walls Across Scales

To better understand how paper walls operate within global surgical manufacturing, we approached them across micro, meso, and macro levels.

At the micro level of everyday production and standardization (Bowker & Star 1999), paper walls shape production practices inside workshops and factories. Technical drawings, calibration procedures, measurement protocols, quality-control documents, and compliance routines do not simply record production; they actively organize it. These documents determine what counts as precision, which deviations become acceptable, and how “quality” itself is materially enacted. In this sense, standardization becomes embedded in daily labor practices.

The meso level refers to recognition and trust, and paper walls function through recognition infrastructures. Labels such as “Made in Germany” do not merely indicate geographic origin. They circulate as condensed symbols of trust, quality, reliability, and legitimacy within global medical markets. Thus, borders emerge not only through customs regulations or territorial restrictions, but also through uneven structures of credibility.

At the macro level, regulatory systems increasingly shape access to international markets. In particular, the European MDR regime has become a powerful infrastructural actor within the global surgical instruments sector. MDR does not simply regulate products entering Europe. Its effects extend across the entire production geography. Importantly, the regulatory burden does not affect only manufacturers outside Europe. Small and medium-sized firms within Europe also struggle with increasing documentation requirements, certification costs, and administrative complexity.

An Important Discussion: Pediatric Devices

One of the most important moments of the conference emerged during the discussion following our presentation, when participants raised the issue of pediatric devices and the growing difficulty of sustaining the production of highly specialized instruments manufactured in small quantities. We found this discussion particularly important because it revealed the broader implications of our argument in a very concrete way.

Pediatric surgical instruments represent a revealing example of how regulatory infrastructures reshape production priorities within global medical manufacturing. These devices are often highly specialized and produced in comparatively low volumes. Under increasingly complex regulatory frameworks such as the European MDR, however, the costs associated with documentation, testing, certification, clinical evaluation, traceability, and compliance can become disproportionately high relative to the size of production runs.

As a result, manufacturers may discontinue certain products not because of technological incapacity or lack of expertise, but because maintaining regulatory compliance becomes economically unsustainable. Recent industry reports and surveys in Germany already point to the withdrawal of specialized medical products from the market, particularly affecting smaller manufacturers and highly specialized devices. Concerns have also been raised regarding pediatric and so-called “orphan” medical devices, whose limited production volumes make them especially vulnerable under current MDR conditions.

Here, paper walls become directly visible. The “wall” is not a physical prohibition preventing production. Rather, it emerges through layers of documentation, audit requirements, risk assessments, certification costs, and administrative obligations that increasingly determine which products remain viable within global markets — and which gradually disappear from circulation.

Bordering Through Infrastructure

The discussions in Warsaw reinforced an important insight for our ongoing MediCluster research: within global medical manufacturing, borders increasingly emerge through documentary, regulatory, and infrastructural practices that shape circulation, legitimacy, and market access.

In the next stages of the project, particularly through forthcoming fieldwork in Sialkot, we aim to further investigate how these boundary infrastructures are experienced, negotiated, and contested across different production clusters within the global surgical instruments industry.

Warsaw provided an especially fitting setting for these discussions. As a city marked by reconstruction, mobility, and layered histories of bordering, it offered a powerful reminder that borders are not simply lines on maps. More often, they operate quietly through documents, certifications, standards, infrastructures, and everyday administrative practices.

And sometimes, the most powerful walls are made of paper.

References

Akkerman, S. F., & Bakker, A. (2011). Boundary crossing and boundary objects. Review of Educational Research, 81(2), 132–169.

Bowker, G. C., & Star, S. L. (1999). Sorting things out: Classification and its consequences. MIT Press.

Star, S. L., & Griesemer, J. R. (1989). Institutional ecology, “translations” and boundary objects: Amateurs and professionals in Berkeley’s Museum of Vertebrate Zoology, 1907–39. Social Studies of Science, 19(3), 387–420.

Star, S. L., & Ruhleder, K. (1996). Steps toward an ecology of infrastructure: Design and access for large information spaces. Information Systems Research, 7(1), 111–134.

Star, S. L. (2010). This is not a boundary object: Reflections on the origin of a concept. Science, Technology, & Human Values, 35(5), 601–617.

Timmermans, S., & Epstein, S. (2010). A world of standards but not a standard world: Toward a sociology of standards and standardization. Annual Review of Sociology, 36, 69–89.

Şahinol, M. (2025, August 29). Paper Walls and Endless Circulations: Epistemic Asymmetry in Surgical Instrument Manufacturing.  https://doi.org/10.58079/14jtr

Wallerstein, I. (1974). The Modern World-System: Capitalist Agriculture and the Origins of the European World-Economy in the Sixteenth Century. Academic Press.

 

Walking the Cluster: Urban Memory, Craft, and Medical Manufacturing in Tuttlingen

What factors contribute to a city’s significance beyond its physical size? In Tuttlingen’s case, this question cannot be answered solely by quantitative measures such as population statistics or export data. The city’s importance is also shaped by the ways it narrates its own history, including its bridges, workshops, monuments, family histories, and the transmission of skills across generations.

Before beginning our interviews and site visits in Tuttlingen, the second major field site of the MediCluster project after Samsun, we spent two days exploring the city with Klaus Hug, a volunteer city guide affiliated with the municipality. What initially appeared to be orientation work soon developed into a more substantive research activity. The guided tour became an integral part of our research collection, offering not only historical context but also insights into how Tuttlingen publicly commemorates and spatially organizes its industrial heritage.

Methodologically, this was significant. We do not view the city tour as a neutral introduction to “actual” fieldwork, but as a research encounter in its own right. It demonstrated how urban-industrial identity is narrated on site: through selected stops, recurring anecdotes, symbolic objects, and the guide’s own sequencing of the city’s past and present. In this way, the tour provided a situated form of urban knowledge — one that linked memory, industry, space, and local self-understanding (Halbwachs 1992; de Certeau 1984).

Walking Tuttlingen with Klaus Hug: A Witness to Urban-Industrial Memory

Klaus Hug is not simply a guide who recounts historical facts. He is also a carrier of local memory, someone who narrates the city through accumulated familiarity, repetition, and lived observation. During our two days with him, we gained insight not only into Tuttlingen’s history but also into a local perspective on the factors shaping the city’s current identity. This distinction is significant: Hug’s narratives do not simply recount the cluster’s development; they actively contribute to the ongoing construction of its social meaning.

This is precisely why his narration holds sociological significance. Industrial clusters are maintained not solely through production, but also through collective memory, symbolic representation, and spatial narratives that render their existence coherent, enduring, and rooted in the local context.

Video 1: Klaus Hug introduces Tuttlingen through the Danube bridge, trade routes, water, tanning, and the historical linkage between leatherwork, knife-making, and later surgical specialization.

Our walk started at the Danube bridge, a deliberate and significant starting point. Hug introduces Tuttlingen’s history through the lens of commerce, crossing, and trade. While standing on the bridge, he explains that merchants traveling between Stuttgart, Switzerland, and Lake Constance historically passed through this location and paid tolls, which rendered the bridge a crucial source of income for the city.

This introduction is analytically significant. The narrative of Tuttlingen’s industry is initially presented as one of infrastructure and movement. Rather than focusing on a factory or a prominent entrepreneur, Hug begins with a bridge. In doing so, he frames economic development in terms of circulation, spatial positioning, and material connectivity (de Certeau 1984; Lefebvre 1991/1992).

Hug then turns to the river itself: water representing life, settlement, subsistence, and productive potential. In his narration, water enabled not only habitation but also the practical work of early crafts. Where people settled, tanning developed; where tanning developed, tools became necessary; and where tools were needed, expertise in cutting, scraping, sharpening, and handling metal began to strengthen.

Hug explains that this area was once a significant tannery district, with the odor of leather processing permeating the entire town. He further emphasizes a critical connection: the demands of leatherworking necessitated high-quality knives, which gradually cultivated local expertise in metal tools and their production.

From a sociological perspective, this account extends beyond a simple origin story. It constitutes a spatial narrative that links water, trade, craft practices, and subsequent industrial specialization into a coherent genealogy of the regional cluster. Rather than depicting Tuttlingen’s medical industry as an isolated industrial phenomenon, the tour situates it within a longstanding material context of circulation, tanning, knife-making, and adaptive practices.

From Knife Town to Surgical Instrument Production

In the tour narrative, Tuttlingen first becomes a city of knives, then a city of surgical instruments. This is a crucial transition in the local story of industrial specialization. Hunting knives, pocketknives, and household knives were already part of the town’s craft world, but surgical instruments promised a different economic horizon. As Hug remarks, the price difference between an ordinary knife and a surgical knife was large enough to reorient local production.

Rather than describing this shift as a natural progression from leather to knives and from knives to surgery, it is more precise to understand it as a process of selective reorientation. Existing skills, tool knowledge, and artisanal precision were not simply carried over; they were redirected toward a more profitable, medically specialized area (Howells 2002).

This matters because it avoids a teleological reading. Tuttlingen did not inevitably become what it is today. Instead, local actors identified a niche, adapted existing capabilities to a new field, and integrated that shift into a changing urban and regional economy (Amin and Thrift 1994).

The Fire of 1803 and the Reorganization of Urban Space

The fire of 1803 remains a significant reference point in local stories about Tuttlingen. Much of the medieval town was destroyed, and the rebuilding process changed not only the physical environment but also how the town later viewed its own development. In local memory, the fire is seen less as a single disaster and more as a moment when destruction, adaptation, and urban change became interconnected. The destruction of medieval structures and the rebuilding efforts, including the unique roof shape known locally as the Tuttlinger Hut, still form part of the city’s remembered history.

Rather than framing the fire as the direct cause of later industrial success, it is more useful to understand its significance in retrospective terms. Sociologically, the importance of the fire lies in how it became woven into a broader story of resilience and transformation. The disaster did not automatically lead to a medical cluster, but within the city’s collective memory it became part of a narrative in which rebuilding, practical adaptation, and artisanal knowledge later came to be seen as foundations for a new urban-industrial path. In this sense, the fire marks both a reorganization of urban space and a shift in how the city recounts its own past.

Gottfried Jetter: Mobility, Return, and Local Re-Embedding

A particularly notable stop on the tour was the Jetter House at Obere Vorstadt 20, which Hug specifically highlights as a place linked to Tuttlingen’s later growth as a hub for medical technology. The story he shares there is compelling not because it presents a heroic founder myth, but because it connects mobility, learning, kinship, and local return. Gottfried Jetter, born in this house in 1838, trained as a knife maker, moved to Paris, encountered instrument making there, met Rosine Scherer, and eventually returned to start a workshop for surgical instruments. In Hug’s account, Jetter’s biography simplifies a larger network dynamic: knowledge spreads outward, is transformed elsewhere, and then is re-embedded locally through partnerships and family ties.

This is where the post can become more explicitly sociological without losing readability. Jetter’s trajectory should not be framed solely as an individual success story. It is better understood as a relational story of cluster formation. What matters is not only that he returned, but that his return itself became productive through existing traditions of knife making, regional familiarity, and family-based organization. The later development of Jetter und Scherer, and eventually Aesculap, can then be seen not as an isolated breakthrough, but as an early formation of a local production ecology that combined artisanal skill, entrepreneurial decision-making, and social ties.

Video 2. Jetter House, Family Partnership, and Early Surgical Instrument Production  – Video caption. At the Jetter House, Klaus Hug recounts the story of Gottfried Jetter and links entrepreneurial origins to local return, family partnership, and the formation of an early surgical instrument workshop.

Clustering in Tuttlingen: Competition, Interdependence, and the Social Infrastructure of Production

One of the most striking questions raised by the tour concerns the coexistence within such a small geographical area. Hug’s answer is telling:

“Here, competition exists not to destroy one another, but to make one another better.”

Indeed, firms in the region often occupy the dual position of being both customers and suppliers to one another within the same supply chain. As specialization has deepened, interdependence has also intensified, giving rise to an ecosystem based on mutual benefit, yet one that remains fragile. What appears here is not merely a concentration of firms, but a social infrastructure of production built on specialization, proximity, and long-standing practical ties.

This becomes even clearer in Hug’s remarks on small workshops and subcontracting arrangements. He describes a world in which a father could support an entire household through highly specialized supply work for only one or two surgical firms. In some workshops, components for competing firms could lie side by side, carefully separated, while producers navigated exclusivity, dependence, and everyday compromise. What emerges here is not simply an industrial cluster, but a socially embedded production ecology sustained by household livelihoods, subcontracting relations, embodied expertise, and local trust (Amin and Thrift 1994).

Video 3. A Bronze Monument: The Symbol of Craftsmanship

Video caption: In front of the master–apprentice sculpture, Klaus Hug reflects on precision, workshop discipline, and the transmission of manual skill in Tuttlingen’s surgical instrument tradition.

In the streets of Tuttlingen stands a sculpture by Roland Martin. Hug continued his account as he showed it to us. The work depicts a master craftsman holding a pair of forceps, and his apprentice standing at a vise. The master is demonstrating to the apprentice how the forceps should be closed — how the two arms must meet with exact precision. Both figures are wearing work aprons.

Hug and we stood before the sculpture for some time. It has had to be repaired several times because people pulled at it so forcefully that it was damaged. Laughing, he remarked, “Someone, probably drunk at night, tried to break off the forceps.” Yet the symbolic weight of the sculpture is beyond dispute: it is a visual expression of knowledge transmitted from master to apprentice — the very process that made this city’s growth possible across generations.

More than just a decorative monument, the sculpture captures a local understanding of how industrial quality is reproduced. It embodies precision, skill, discipline, and intergenerational learning in a public urban object. In this way, it not only commemorates craftsmanship but also makes visible the social process through which the cluster reproduces itself.

Tuttlingen Today: Extending the Cluster, Reworking Its Foundations

Tuttlingen’s current industrial profile is defined by a cluster that extends well beyond traditional scalpels and forceps production. The integration of robotic surgical systems, endoscopic devices, and digital health technologies has diversified its industrial landscape. However, this growth is accompanied by significant challenges, including shortages of skilled labor, heightened global competition, dependencies on steel supply, sustainability requirements, and increasingly complex certification processes, all of which influence the cluster’s present operating environment.

This development does not represent a straightforward shift from tradition to modernity, but rather a continual reconfiguration of the cluster’s foundational principles. Observations indicate that continuity and change coexist within Tuttlingen’s industrial landscape. Although production shifts into new technological areas, local ideas of quality remain rooted in precision, manual skill, and meticulous craftsmanship. Therefore, the cluster’s future relies not only on innovation but also on adapting and reinterpreting established knowledge and practices in response to changing industrial conditions.

What Remained After Two Days with Klaus Hug

By the time we said farewell to Klaus Hug, the afternoon was well advanced. Despite hours spent walking through the city in the bitter cold, he continued to share stories as we gathered over hot coffee and Swabian pastries.

As we watched him depart, one impression remained with us: a city’s memory is not confined to archives and books. It also endures in individuals who connect places, events, and practices through narration. At each stop, Hug linked the visible city to a broader history of production, adaptation, and urban transformation. The Danube played a significant role, yet many cities are situated along rivers. Metalworking traditions were important, but not all of them have led to global industrial specialization. The fire of 1803 was a significant rupture, but destruction alone does not account for why one town reorganizes itself in ways that later become economically consequential.

The tour revealed not a single cause, but a historically layered configuration: Gottfried Jetter’s outward mobility and return, the practical ingenuity of the Scherer family, the increasing influence of Aesculap on the urban fabric, and the workshop-based production methods that enabled competing orders to coexist. Collectively, these elements indicate a local culture of making that evolved through interdependence, adaptation, and the ongoing refinement of inherited skills.

This, perhaps, is the most evident lesson from Tuttlingen’s history. Industrial success is not determined solely by geography or raw materials. It also relies on social relations, shared knowledge, public memory, and urban arrangements that are continually reproduced. During our two-day visit, we observed traces of this history in bridges, houses, workshops, monuments, and stories. Tuttlingen, however, has been generating such traces for much longer.

References

Amin, A., & Thrift, N. (1994). Living in the Global. In A. Amin & N. Thrift (Eds.), Globalization, institutions, and regional development in Europe (pp. 1-22). Oxford University Press.

de Certeau, M. (1984). Walking in the City. In The Practice of Everyday Life (pp. 91–110). University of California Press.

Halbwachs, M. (1992). On collective memory. Lewis A. Coser (Ed.). University of Chicago Press.

Howells, J. R. L. (2002). Tacit Knowledge, Innovation, and Economic Geography. Urban Studies, 39(5–6), 871–884.

Lefebvre, H. (1991). The Production of Space. Blackwell.

Research as Craft, Coding as Experiment: Testing Language Models in the MediCluster Project

Qualitative research does not finish with interviews. Once conversations and observations have been conducted, transcribed, and uploaded to a QDA program (in our case, Atlas.ti), another demanding phase begins: coding, classification, and interpretation (in our project, we do this using Grounded Theory principles). In qualitative research, this often means reading, comparing, coding, recoding, and discussing material over long periods. As our interview corpus in the MediCluster project expands, now comprising more than 90 interviews across several sites and contexts, the question of how to work through this growing body of data in a careful and methodologically meaningful way has become increasingly pressing.

This blog post examines a methodological experiment within the MediCluster project: the testing of large language models (LLMs) in qualitative data coding. Its aim is not to advocate technological adoption, but to reflect on what becomes visible, altered, or contested when such systems are introduced into an interpretive and collaborative research practice. In this sense, the contribution treats AI not only as a possible tool, but also as an object of methodological and epistemic inquiry.

These issues became particularly relevant after our field trips to Samsun and Tuttlingen. With a substantial number of interviews (more than 60) already collected and coding well underway, we began to reflect not only on what our data revealed but also on the tools and procedures for analyzing this material. In this context, a closed workshop held on 5 March 2026 within the MediCluster project focused on one specific methodological experiment: the possible use of LLMs as a tool in qualitative data coding.

The aim of this workshop was not to definitively adopt or reject a new technology/method, but to explore it and improve our processes. Rather, we wanted to examine what happens when such systems enter a qualitative research process grounded in interpretive work, collaborative coding, and theoretically informed analysis. In other words, we approached LLMs not as ready-made solutions, but as objects of methodological inquiry in their own right.

An illustration of a laptop displaying coded qualitative data with colored labels such as themes and categories. Surrounding the laptop are documents, sticky notes, and icons, while a glowing digital brain on the right represents artificial intelligence assisting in analysis. The scene symbolizes human–AI collaboration in qualitative data processing.
From raw data to structured insight. This visual, generated with ChatGPT, represents the transformation of qualitative data into themes through human–AI collaboration, highlighting coding, interpretation, and pattern recognition as interconnected processes.

A new tool for qualitative data analysis

One of the fundamental stages of qualitative research is coding. The researcher reads interview transcripts or documents, identifies recurring themes, and classifies them under categories. This process is not simply a technical task; it is a practice of thinking that reflects the researcher’s theoretical approach, field experience, and interpretive skills.

In public discussions, AI tools are framed either as innovations that will transform research (Friese 2025) or as unreliable shortcuts that should be kept out of serious scholarship (Jowsey et al. 2025). In our project, we are interested in whether such tools can be meaningfully integrated into an ongoing qualitative workflow, particularly at a stage where categories have already been discussed, refined, and partially stabilized through collaborative interpretive work.

Why test such tools at all?

There are pragmatic reasons for doing so. Large qualitative projects generate substantial amounts of material, and coding is one of the most time-intensive phases of the research process. When dozens of interviews accumulate, it may be useful to explore whether computational tools can assist with certain analytical operations—for example, by applying a pre-existing codebook to a selected subset of material, identifying passages relevant to specific categories, or making patterns visible for researchers to examine more closely.

For our project, such a test is not meant to replace careful reading. It is about asking whether an LLM can function as a provisional analytical aid within a clearly defined framework.

At our workshop, we discussed this potential around the following questions:

  • (How) Can language models assist in qualitative data coding?
  • If used, what role should they play in the research process?
  • How can the researcher’s interpretive position be preserved in this process?
  • It is difficult to say that we found definitive answers to these questions. However, our experiments showed that this technology has equally promising and careful aspects.

The most obvious advantage of LLMs is their ability to quickly analyze large text collections. An initial screening process that could take researchers hours can be accomplished in minutes with these tools.

This might be especially useful for tasks such as:

  • pre-screening large datasets,
  • discovering possible themes,
  • testing a preliminary coding scheme,
  • noticing patterns that might escape the researcher’s eye,
  • processing large text corpora against a finalized codebook.

In this sense, LLMs can be thought of as assistants that speed up the analytical process rather than tools that replace the researcher.

However: being fast does not necessarily mean being accurate.

Coding is not classification alone

This matters because qualitative coding is never only a technical act of attaching labels to textual segments. It is a process of interpretation. Researchers code not only what is explicitly said, but also how it is said, in which context it emerges, and what kinds of silences, tensions, ambiguities, or implicit assumptions surround it, as well as how particular statements relate to broader field relations and theoretical concerns.

This is precisely where the limits of LLMs become visible. Such systems work through statistical pattern recognition. They can identify similarities, recurring expressions, and probable thematic clusters, but they lack field experience. They do not know the situated dynamics of an interview encounter. They cannot (yet) independently distinguish whether a phrase is central or incidental, ironic or literal, strategic or hesitant, socially embedded or analytically misleading. In this sense, they can generate useful approaches, but they don’t interpret the findings in the same way a qualitative researcher would.

Several risks follow from this…

  1. Flattening / Loss of context: statements that look similar on the surface may be assigned to the same category even when they arise from very different social or biographical situations.
  2. Overgeneralization: language models may smooth out ambiguity in favor of coherence.
  3. Mechanization of interpretation / subtle transformation of coding into an apparently neutral sorting exercise, when in fact qualitative analysis depends on theoretical sensitivity, empirical familiarity, and reflexive judgment.

An STS Perspective on Analytical Tools

From an STS perspective, this is hardly surprising. Research tools are never simply neutral instruments. They participate in shaping what becomes visible, what counts as a pattern, and how knowledge is produced. If language models are introduced into coding processes, they become part of the socio-technical arrangement through which analysis takes place.

This does not mean they determine results in a simple way. But it does mean that they are not external to epistemic practice. Their outputs depend on prompts, model architectures, parameter settings, segmentation decisions, and the prior structuring of the material. In that sense, LLM-supported coding is also a methodological intervention that requires reflection, documentation, and critical scrutiny.

One aspect we discussed in the workshop was the importance of analytical settings. In workflows based on LLMs, not only the prompt matters, but also the system’s overall configuration. Settings (such as parameters controlling consistency and variability of outputs) that influence how consistently or how openly a model responds can shape whether outputs are more stable and repeatable or more varied and exploratory. These parameters introduce an additional layer of variability, meaning that results depend not only on the data but also on the configuration chosen by the researcher. For research purposes, this raises  questions of transparency and traceability. If such systems are used in qualitative analysis, it is not enough to state that “AI was used.” Researchers need to document how it was used, the settings, the material, and the analytical purpose.

In a project such as MediCluster, this is especially relevant when working with interview excerpts and asking a language model to relate them to an existing coding structure. If the system is used, for example, to suggest thematic codes, identify recurring patterns, or connect new excerpts to already established categories, the results may differ depending on the analytical setup. In this sense, the outcome is formed not only by the empirical material itself, but also by the technical conditions under which the model is used.

This does not produce mechanical objectivity. But it can make AI-assisted analysis at least more explicit, more discussable, and more open to methodological evaluation.

Keeping interpretation with the researcher

For us, this is the key point. The interpretive responsibility must remain with the researcher. In our workshop discussions, we repeatedly returned to the fact that coding involves decisions that cannot be delegated without residue.

  • Is a category analytically meaningful?
  • Does a passage really fit the code assigned to it?
  • What remains unspoken but important?
  • Which contradictions matter?

These are not merely technical questions, but interpretive ones.

For this reason, we do not see LLMs as autonomous coders, but rather as at supervised assistants operating within a framework defined by researchers. This is also why our current test setup remains deliberately limited. Rather than submitting the entire corpus to an automated process, we want to begin with a smaller sample of five to ten interviews and compare the outputs versus a code structure that has already been collectively developed and manually applied in ATLAS.ti. This allows us to explore potentials and shortcomings in a controlled and reflexive way.

Such an approach also enables methodological comparison. Instead of treating AI-generated coding as inherently valid or invalid, we can ask more precise questions:

  • Where does the system reproduce our existing categories convincingly?
  • Where does it misread context?
  • Where does it identify relevant passages, we might have overlooked?
  • And where does it produce a false sense of coherence?

Methodological opportunity, ethical caution

Any attempt to use LLMs in research also raises ethical and infrastructural questions. Data security is one of them. Another concerns the status of model-generated labels: what kind of analytical authority, if any, should they carry? And how should such uses be reported in publications, project documentation, or methodological reflections?

These questions are not secondary. They are part of what responsible experimentation requires. As a research team, we consider transparency essential. If AI-based tools enter the research process, their role needs to be clearly stated—not only to ensure accountability, but also to enable collective discussion about the changing conditions of academic knowledge production.

Research remains a craft

One of the clearest conclusions from our workshop was that qualitative research cannot be fully automated. This is not because researchers should resist technical change on principle, but because interpretation remains a situated, relational, and often painstaking practice. Coding is not simply about processing text; it is about crafting analytical meaning in dialogue with theory, data, and field experience.

In that sense, research is still a craft. New tools may reshape this craft, accelerate certain operations, or open up new possibilities for comparison and scale. But they do not eliminate the need for judgment, reflexivity, and responsibility.

For the MediCluster project, testing LLMs in coding is therefore about experimentally probing how such tools might be incorporated into qualitative practice without losing sight of what makes this practice qualitative in the first place. The question is not whether AI will replace interpretation. The more productive question is how researchers can engage such systems critically, carefully, and on their own methodological terms.

That, for us, is where the real experiment begins.

References

Friese, Susanne, From Coding to Conversation: A New Methodological Framework for AI-Assisted Qualitative Analysis (April 27, 2025). Available at SSRN: https://ssrn.com/abstract=5232579 or http://dx.doi.org/10.2139/ssrn.5232579

Jowsey, T., Braun, V., Clarke, V., Lupton, D., & Fine, M. (2025). We reject the use of generative artificial intelligence for reflexive qualitative research. Qualitative Inquiry, 10778004251401851.

Multiple Actors in the Process of Qualitative Data Analysis: Participant-Narrative-Researcher-Artificial Intelligence

 

In previous blog posts, we have discussed how we attempted to integrate artificial intelligence into our research processes. The first post in our blog’s ‘Artificial Intelligence’ category discussed our engagement with AI during the systematic literature review process (Kocager, 2025a), while the second post presented our impressions of using the Transkriptor application for transcription during fieldwork, addressing the ethical dimensions of the application (Kocager, 2025b).

This third blog post in the ‘Artificial Intelligence’ category focuses on one of the critical stages of our research: the qualitative analysis of transcribed texts. Here, we discuss how we incorporated artificial intelligence into the qualitative data analysis process and draw attention to the presence of multiple actors in the analytical process.

An illustration showing multiple actors involved in qualitative data analysis. A researcher writes notes on the left, a participant speaks on the right, and an artificial intelligence figure appears at the top. In the center, interconnected nodes labeled “codes” link to “transcripts” and “concepts,” representing a networked analytical process.
Multiple actors shape qualitative data analysis. This visual, generated with ChatGPT, illustrates the dynamic interplay between researcher, participant, transcripts, codes, concepts, and artificial intelligence within a networked analytical process.

Digital Transformation in Qualitative Data Analysis

Two of the most fundamental qualitative data analysis strategies are analytic induction and Grounded Theory (Glaser & Strauss, 1967)  approach. The latter largely relies on inductive logic, whereby theoretical concepts and categories are developed from the data.

At the heart of qualitative data analysis is the coding process. The first stage of analysis involves the researcher familiarizing themselves with the data. During this stage, transcribed texts are read repeatedly, and prominent themes and key issues emerging in the text are noted. The second stage involves coding. In this phase, data segments are grouped under meaningful categories, and the thematic structure begins to take shape. Historically, processing and analyzing data has been manual process. However, one of the most significant developments in qualitative research since the 1990s has been the emergence of computer software designed to facilitate this process  (Bryman, 2012).

Within the scope of computer-assisted qualitative data analysis software (CAQDAS), the number of programs developed for this purpose has increased over time (e.g. MAXQDA, NVivo, and ATLAS.ti). These programs offer researchers advantages such as speed and time efficiency, as well as systematizing coding, particularly when working with large data sets.

In recent years, qualitative data analysis software has been enhanced through the integration of artificial intelligence support. However, the level of integration with artificial intelligence and the functionalities offered vary across programs. For example, NVivo offers features such as automatic text summarization and code suggestion, whereas ATLAS.ti can generate AI-supported summaries of codes created by the researcher.

Working with Artificial Intelligence in Qualitative Data Analysis: Methodological and Epistemological Notes

Before engaging in this discussion of the qualitative data analysis process, it is useful to briefly clarify our definition of ‘qualitative data’. Qualitative data consists of the responses given by participants to research questions, including their perceptions, experiences, values and relational positions, as well as researchers’ field notes and visual materials recorded during fieldwork, such as videos and photographs. Within this framework, the narrative dimension of qualitative data is the primary conceptual and methodological component that shapes the analysis process.

Actors express their experiences within a specific narrative structure comprising a beginning, a development and a conclusion. They establish turning points and connections. In this sense, the narratives obtained from the field are not raw experience, but rather its interpreted and structured representation. Furthermore, actors’ narratives are not merely individual. Their social position, material circumstances and cultural context influence the stories that can be told and how they can be narrated. Therefore, narrative is both an expression of experience and a socially constructed representation of it (Somers, 1994). This pattern of narrative and context demonstrates that qualitative data analysis is not merely a technical classification procedure, but rather it requires interpretive responsibility. Accordingly, the positioning of analytical tools within a methodological framework becomes critical.

For this project, ATLAS.ti was chosen for qualitative data analysis, and ChatGPT Plus 5.2 was incorporated into the process from the perspective of ‘co-production’ between researchers and machines. However, establishing this technological infrastructure does not imply delegating the analytical process to technology. On the contrary, the interaction between the researcher and technological tools was designed to sharpen analytical intuition, examine patterns from different angles, and deepen the level of conceptual abstraction. In this framework, technology is not a “decision-maker” but is positioned as a thinking partner for the researcher -one that multiplies connections and expands alternative lines of thought.

Qualitative data analysis involves dividing the raw narrative -that is, the transcribed text- into meaningful units and systematically applying this segmentation logic to the entire data set. In the first stage of analysis, three transcribed texts were coded line by line using open coding, and first-level descriptive codes were generated. This initial coding process was carried out in line with the researcher’s field knowledge and theoretical background; the resulting draft code tree was subsequently shared with artificial intelligence.

In the second stage, each transcribed text was uploaded to artificial intelligence prior to coding. The aim of this practice was to render the core idea within the narrative more quickly visible. Particularly in narratives that might remain implicit for the researcher due to social position, material conditions, and cultural context, artificial intelligence identified the main axis of the narrative. Thus, the researcher was able to evaluate the text not only through its immanent meaning but also through alternative readings suggested by artificial intelligence.

At this point, artificial intelligence was positioned not as an epistemically independent decision-maker but as an actor that deepens the researcher’s analytical thinking. Its code suggestions and thematic alignments were not accepted directly; rather, they were evaluated, reformulated, or rejected by the researcher. Although the final decision belonged to the researcher, this decision was shaped within a socio-technical process of negotiation.

In the process of coding narratives, the most significant contribution of artificial intelligence emerged in the transition from descriptive codes to higher-level analytical concepts. During the conceptual densification of the code tree, a reciprocal dialogue was conducted between the researcher and artificial intelligence; analytical category suggestions were generated, yet the decision regarding which concept would be incorporated into the code tree remained with the researcher. This process did not entail the automatic production of concepts but rather the negotiation of conceptual thinking.

Nevertheless, it was consistently acknowledged that artificial intelligence has limited contextual sensitivity and may fall short regarding field experience, local cultural references, and tacit sectoral knowledge. For this reason, its suggestions were approached with caution. In other words, elements subject to negotiation were filtered through the researcher’s experiential and theoretical knowledge.

In conclusion, artificial intelligence is not positioned as an actor replacing the researcher in qualitative data analysis but as a supportive presence that strengthens reflexivity, accelerates conceptual densification, and makes alternative interpretive lines visible. The epistemic and interpretive responsibility of the analysis remains entirely with the researcher.

The Multiple Actor Approach

When the qualitative data analysis process is conceptualized not solely as an activity centered on the researcher but as a process involving multiple actors -participant, narrative, researcher, and artificial intelligence- Actor-Network Theory (ANT) offers an important conceptual framework. As Latour (1996)  emphasizes, society consists not of hierarchical and fixed layers but of relations and connections established among different actors. ANT recognizes not only humans but also non-human entities such as objects, technologies, and documents as actors.

From this perspective, qualitative data analysis is not merely a one-directional relationship in which the researcher interprets the data; rather, it constitutes a more complex field of interaction involving multiple actors. Transcripts, codes, software interfaces, algorithmic suggestions, ethics committee documents, and data security protocols are all part of this process. Therefore, qualitative data analysis can be reconsidered not as a human-centered production of meaning but as a distributed practice taking place within a socio-technical network. However, this expansion does not imply that epistemic responsibility is diffused. On the contrary, a multi-actor analytical practice renders the researcher’s position even more visible.

References

Bryman, A. (2012). Social Research Methods (4th ed.). Oxford University.

Glaser, B. G., & Strauss, A. (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine Transaction.

Kocager, U. (June 12, 2025a,). Socio-technical Encounters: Our Experiences with Artificial Intelligence Tools During Literature Review. Manufacturing Practices of Medical Instruments (MediCluster).  https://doi.org/10.58079/143dx

Kocager, U. (Octaber 8, 2025b,). Socio-Technical Encounters: Our Experiences with Artificial Intelligence Tools During the Deciphering of Field Data. Reflections on Speed, Distance, and the Ethics of AI-Assisted Research.  https://doi.org/10.58079/14vki

Latour, B. (1996). On Actor-Network Theory: A few Clarifications. Soziale Welt, 47, 369-381.

Somers, M. R. (1994). The Narrative Constitution of Identity: A Relational and Network Approach. Theory and Society, 23, 605-649.

Paper Walls, Reversed: MDR, Micro-Innovation, and the Future of Care in Tuttlingen

In our earlier fieldwork reflection from Samsun, “paper walls” emerged as regulatory infrastructures that restrict market access and recognition for manufacturers in the Global Majority. In Tuttlingen, the metaphor returns in a reversed configuration. Here, the Medical Device Regulation (MDR) is frequently described not only as a compliance challenge, but as an internal barrier that reshapes innovation dynamics, product portfolios, and the viability of low-volume care-related devices. Based on more than a week of ongoing fieldwork in Tuttlingen, this post traces how “paper walls” are experienced as constraints on incremental innovation, as an existential burden for SMEs—and as a silent mechanism through which certain products, especially for pediatric care, increasingly disappear from European portfolios.

From Samsun to Tuttlingen: One Metaphor, Two Configurations

During our MediCluster fieldwork in Samsun (Türkiye), interview partners described regulatory standards and documentation regimes as kağıttan duvarlar—paper walls. The metaphor captured how certification requirements can serve as gatekeeping infrastructures: goods may circulate globally, but recognition and market access remain concentrated in Europe. In that setting, paper walls were narrated as a mechanism that keeps peripheral producers dependent, forcing them into “endless circulations” of semi-finished products through European intermediaries.

Over the past week, our ongoing fieldwork in Tuttlingen has shown that the same metaphor resonates differently.

Here, paper walls are not primarily described as barriers to others entering European markets. Instead, they are repeatedly framed as internal walls that restructure decisions within the European cluster itself. Interview partners in Tuttlingen often speak of MDR not only as an administrative burden,  but also as a regime that gradually narrows the scope of what small and medium-sized firms can realistically develop, certify, maintain, and sustain.

In this reversed configuration, paper walls do not only shape access. They reshape innovation trajectories and care portfolios from within.

MDR as an Innovation Filter: When “Small Changes” Become too Costly

One recurring theme in our interviews is the fate of incremental innovation.

Surgical instruments, especially in a craft-based manufacturing cluster such as Tuttlingen, do not evolve primarily through spectacular breakthroughs. Much innovation is traditionally “small,” emerging from everyday interactions between producers, clinicians, and distributors: minor adjustments, refined geometries, improved handling, reconfigured grips, customized details, or the adaptation of an existing device for a specific procedure. In cluster practice, innovation is often micro-innovation: low-threshold, fast, relational, and anchored in situated knowledge.

Many interview partners suggest that MDR has quietly altered precisely these dynamics. MDR refers to the EU Medical Device Regulation (Regulation (EU) 2017/745), which sets the regulatory framework for the certification, documentation, and market approval of medical devices in Europe.

A pattern emerges in which even modest modifications are no longer perceived as straightforward. Documentation obligations, verification requirements, and uncertainty about downstream certification consequences can increase hesitation. “Saying yes” to a clinician’s suggestion, once a typical rhythm of cluster collaboration, now appears repeatedly as something that requires additional justification, risk calculation, or postponement.

The outcome described by several manufacturers is not a total absence of innovation, but a change in innovation ecology: innovations increasingly need to be scalable, strategically planned, and financially “worth it” under the regulatory regime. Low-volume innovation becomes structurally disadvantaged.

SMEs Under Pressure: Paper Walls as a Question of Survival

Across conversations, MDR is frequently described as particularly demanding for SMEs. Not in the sense of rejecting regulation per se, but in the sense of experiencing a mismatch between regulatory infrastructures and small-firm realities.

Smaller firms often operate with limited internal capacities for documentation, compliance personnel, and administrative expansion. In this sense, MDR appears not just as a clinical safety framework but as a production condition that reorganizes firm life: staffing, time allocation, and development priorities.

Several interview partners also tried to make the scale of the burden tangible through concrete figures. They stressed that MDR-related certification and documentation costs can amount to around €30,000 for a single instrument type—a sum that may be manageable for large firms, but can be decisive for small workshops. As one interview partner noted, it becomes difficult to justify such costs when a small enterprise may produce tens of thousands of items (for example, scissors) in a year.

Against this background, several interview partners expressed the view that MDR effectively functions as a form of industrial policy, without explicitly being one. It does not directly instruct firms what to stop producing, yet it recalibrates the conditions under which certain products remain economically feasible. The cluster’s capacity to sustain diversity, especially in niche devices, becomes fragile.

In other words, paper walls are not made of stone, but they serve as structural boundaries.

Pediatric Devices as a Critical Limit Case: When Care Products “Quietly Disappear”

The most striking dimension of this reversed paper wall concerns low-volume devices – especially in pediatric contexts.

Across multiple interviews, pediatric instruments and special devices for infants emerge as a recurrent example of what becomes vulnerable under MDR: not because such instruments are unnecessary, but because their demand is limited, and their regulatory requirements can be substantial. Interview partners repeatedly described a dynamic of portfolio erosion, particularly when devices fall into higher risk categories.

One interview partner offered a statement that has stayed with us, because it frames portfolio decisions as a care issue:

“And then there’s something like a pediatric heart catheter — and I find that really terrible. Especially for infants and other special products, demand is low. But with the MDR hurdles, once you move towards Class II or even Class III, manufacturers will say: it’s no longer worth it. And then they simply drop it from their portfolio.” (Interview partner, translated from German)

This is the inverted logic of paper walls: the barrier does not block goods from entering Europe; it contributes to certain products vanishing inside Europe. The wall materializes as absence – devices not maintained, not re-certified, or no longer produced.

In this way, MDR becomes intertwined with questions of care. What disappears is not merely competitiveness. What disappears may also be access to specialized treatment options for vulnerable patient groups.

The FDA Paradox: When Europe Becomes the Harder Market

Another repeatedly voiced observation concerns global registration strategies.

Several interview partners suggested that while the FDA historically represented a major hurdle, MDR now feels like the more demanding barrier – both in terms of documentation complexity and overall effort. Some described a strategic reversal: prioritizing U.S. registration first, while treating EU approval as a potential second step only if the product proves commercially successful.

This dynamic is sociologically revealing. It signals that paper walls are not only geopolitical instruments through which Europe manages external market entry. They also restructure European firms’ outward orientations and market futures. Regulation becomes part of the global innovation geography.

Rather than a stable center of medical device production, Europe is described as a space where the costs of staying “in” rise, sometimes to the point where manufacturers consider stepping out.

Fieldwork Anchor: Learning Craft in the Cluster. Visiting the Ferdinand-von-Steinbeis-Schule

Our Tuttlingen fieldwork is still ongoing. Today, we are visiting the Ferdinand-von-Steinbeis-Schule Tuttlingen, where students are trained for professions such as Chirurgiemechaniker (surgical instrument mechanics).

This visit matters for our analysis because paper walls cannot be understood only through regulation, markets, and documentation. They are also entangled with education, vocational training, and the reproduction of craft knowledge.

A cluster does not survive solely on certificates. It survives through skills—through hands, routines, tacit knowledge, apprenticeship cultures, and the situated repair and refinement capacities that define craft-based medical manufacturing. In this sense, the school is not just an educational institution. It is part of the socio-technical infrastructure that sustains Tuttlingen as a global production site.

Seen through this lens, MDR’s effects are not limited to administrative burdens. They reach into the everyday conditions under which craft-based innovation can be learned, practiced, and transmitted.

Conclusion: From Paper Walls to Care Walls

In Samsun, paper walls were described as barriers of recognition and access, regulatory infrastructures that keep global manufacturing hierarchies in place.

In Tuttlingen, paper walls appear in reversed form. Here, they are described as internal filters that reshape innovation dynamics and portfolios from within, especially disadvantaging low-volume, care-critical products and incremental workshop-based innovation.

This suggests an important analytic shift for STS-oriented innovation research.

Paper walls are not merely bureaucratic obstacles.
They are not merely instruments of market protection.
They are infrastructures that re-distribute possibilities.

And when they contribute to the disappearance of pediatric devices or specialized instruments, they become something more unsettling:

Paper walls do not only regulate markets. They also redistribute care by shaping what is worth producing — and for whom.

 

This post builds on our earlier reflection: “Paper Walls and Endless Circulations: Epistemic Asymmetry in Surgical Instrument Manufacturing.” 

Arriving in the Cluster: Snow, Borders, and the Infrastructures of Fieldwork in Tuttlingen

Fieldwork rarely begins when the first interview starts. More often, it begins much earlier—at airports, border controls, rental car counters, and in the mundane yet deeply political infrastructures that shape who can move, when, and under what conditions.

Our MediCluster fieldwork in Tuttlingen began on 19 January 2026, long before we reached the town itself. Tuttlingen is a small town in southern Germany, located in Baden-Württemberg near the borders with Switzerland and Austria, and internationally known as a key centre of medical instrument manufacturing. Together with my colleague Gülşah Başkavak, I left Istanbul early in the morning from Sabiha Gökçen Airport. Getting there was already an ordeal: heavy snowfall turned a normally straightforward trip into a two-hour struggle through traffic and uncertainty. Flights were being cancelled across the region, and we waited almost two hours inside the plane before finally taking off.

Snow-covered runway and aircraft at Sabiha Gökçen Airport in Istanbul
Snow-covered runway and aircraft at Sabiha Gökçen Airport in Istanbul

These moments matter. I am describing them not as travel anecdotes, but because they are part of what fieldwork is, especially when research is transnational, collaborative, and shaped by unequal mobility regimes.

Although Tuttlingen lies in southern Germany, the closest airport geographically would have been Zurich (CH). We consciously decided against that option. While I hold a German passport, Gülşah travels with a Turkish one. Avoiding potential complications, delays, or misunderstandings at borders felt like a pragmatic decision, but it is also a telling one. For many researchers from Türkiye, visa procedures are a constant source of stress. They are time-consuming, unpredictable, and fundamentally at odds with the realities of research, which often requires spontaneity, flexibility, and rapid response.

This is not only an issue for researchers entering Germany. During MEDICA in Düsseldorf, I repeatedly heard German manufacturers complain that complex visa regimes make it difficult for international business partners to visit production sites. Visa regulations, in other words, do not simply “protect borders,” they actively shape scientific collaboration, economic exchange, and innovation pathways. This is a research question in its own right, and one I may return to later.

Border Infrastructures as Research Infrastructures

We landed at Stuttgart in the early evening, only to encounter another bottleneck: an enormous queue at border control. People were packed tightly together, waiting for a very long time. While I could use the faster EU lane, Gülşah stood in line for over an hour, an experience painfully familiar to me from past conferences outside Europe. I had already collected my luggage and waited on the other side, watching time stretch into frustration.

Crowded passport control area at Stuttgart Airport with travelers waiting in line
Border infrastructures in practice: waiting at passport control at Stuttgart Airport on the way to fieldwork.

This asymmetry is not incidental. It is part of the everyday politics of mobility that structure who waits, who moves, and who bears the temporal costs of “international” research.

We finally pick up our rental car, which is essential in a region like Tuttlingen, where innovation does not stop at city limits. Due to geographical constraints, environmental zones, and mountainous terrain, many companies have expanded into surrounding villages rather than remaining within the city itself. The district of Tuttlingen is thus a dispersed industrial landscape: small towns and rural areas densely populated with highly specialized firms producing medical instruments and technologies.

Snow-covered roads winding through a hilly landscape with houses and trees
A dispersed industrial landscape: roads connecting towns, villages, and production sites across the Landkreis Tuttlingen.

Industrial buildings with steam rising into the cold air, surrounded by trees in a rural landscape
Industrial production embedded in the landscape: manufacturing facilities in the Tuttlingen district, where industrial activity extends beyond the city into surrounding rural areas.

Innovation Everywhere—Including Where You Sleep

We arrived late at our apartment, exhausted but relieved. That very evening, on 19 January, we learned something that perfectly encapsulates Tuttlingen’s innovation ecology: the owner of our accommodation is himself an inventor and manufacturer of highly specialized medical vaporization devices.

The company, Storz & Bickel, is globally known for developing technologically sophisticated vaporizers—devices that heat plant material, including cannabis, without combustion, releasing active substances as vapor rather than smoke. From an STS perspective, what is fascinating here is not the substance itself, but the technologization of its application.

Encountering this example on the very evening of our arrival—still shaped by snow, delays, and border controls—proved analytically productive rather than incidental. It offered an early insight into how innovation in Tuttlingen often operates: not as spectacular disruption, but as the careful reworking of existing technical competencies into new socio-technical constellations.

From a MediCluster perspective, the relevance of this case lies precisely here. It is not interesting because it involves cannabis, but because it exemplifies how specialised medical–technical knowledge travels across domains. Long-standing expertise in precision engineering, material control, and regulatory compliance—historically associated with surgical instruments—does not remain confined to classical medical markets. Instead, it is mobilised to stabilise adjacent, highly regulated fields through technological translation.

Vaporizer technologies thus function as a lens into a broader cluster dynamic: innovation emerges less through radical invention than through the recombination of skills, infrastructures, and regulatory know-how. Existing competencies are repurposed to produce new applications, new forms of legitimacy, and new market niches. What changes is not only the device, but the socio-technical arrangement in which it becomes meaningful, acceptable, and governable.

From an STS perspective, this underscores how innovation is deeply situated. It is shaped by local histories of craftsmanship and industrial specialisation, but equally by regulatory regimes that define what counts as medical, legal, or legitimate. In this sense, Tuttlingen appears not only as a site of production, but as a translation space—a place where materials, standards, and meanings are continuously aligned and reworked.

Encountering such an example at the very start of our fieldwork sharpened our analytical lens. It reminded us that clusters are not bounded by sectors or product categories. They are socio-technical ecologies in which innovation often happens sideways, quietly, and in places one does not immediately expect—sometimes even in the apartment one arrives at after a long day of travel.

This first encounter set the tone for our research in Tuttlingen. It made clear that understanding clusters requires attention not only to factories, firms, and formal interviews, but also to infrastructures of mobility, accommodation, and everyday life. Innovation here is rarely loud. It is embedded.

In the days that followed, we began to explore Tuttlingen more systematically—walking through the city, engaging with its official histories, and tracing how the cluster narrates itself. These early encounters raised new questions for us about visibility, self-description, and the stories industrial regions tell about their pasts and futures.

We look forward to sharing these reflections in the next field notes from Tuttlingen, as our fieldwork—and our understanding of the cluster—continues to unfold.

MEDICA as a Global Socio-Technical Marketplace: Sociological Fieldnotes

This blog post presents ethnographic fieldnotes from MEDICA 2025, where exhibitors from our three MediCluster regions – Tuttlingen, Sialkot, and Samsun – converged in a shared global marketplace. It shows how the fair operates as a socio-technical field in which craft knowledge, production cultures, and innovation narratives meet and circulate. These observations form an integral part of our comparative ethnography on surgical-instrument manufacturing. 

One of the most significant global gatherings in the medical technology and device sector, MEDICA, was held this year at Messe Düsseldorf, attracting more than 5,300 participants from over 70 countries. The trade fair showcased a wide range of products, from surgical instruments to cutting-edge medical technologies, across its many booths. While it is primarily a commercial trade fair, it also serves as a rich socio-technical system where innovation, supply chains, circulation, and regulatory processes interact as active forces shaping the field. Among the fair’s more unusual visitors this year were Melike and me, attending as sociologists! 

Photo 1: The entry point to the MEDICA exhibition grounds in Düsseldorf (from left to right: Melike Şahinol Gülşah Başkavak)
Photo 1: The entry point to the MEDICA exhibition grounds in Düsseldorf (from left to right: Melike Şahinol Gülşah Başkavak)

First Encounters: Tuttlingen, Sialkot and the Global Cluster Landscape 

The primary purpose of this preliminary fieldwork in Düsseldorf was to meet companies based in Tuttlingen, our second research site, and to establish initial connections to guide our upcoming fieldwork in Germany. We were able to speak directly with numerous company representatives and owners from the Tuttlingen cluster, conducting several brief yet insightful interviews. Unexpectedly, we also established strong connections with surgical instrument manufacturers from Sialkot, our third field site, who were exhibiting at the fair as well. These encounters opened up productive conversations about manufacturing practices and regional production cultures. While our primary focus was on German firms and, to a lesser extent, Pakistani ones, the nature of our ethnographic observations led us to walk through and engage with nearly all the exhibitors in medical/surgical instrument manufacturing across three to four large halls, allowing for short yet significant exchanges. From a sociological perspective, these encounters clearly show that the exchange of knowledge in the global production of medical instruments cannot be understood solely through technological or commercial networks. Instead, it is also influenced by social and cultural relationships, face-to-face interactions, and the everyday practices that define the industry. As a result, our observations in Düsseldorf provided a solid foundation for the ethnographic work we will soon undertake in Tuttlingen. 

Mobilities and Micro-Spaces of Observation 

While staying in the nearby city of Duisburg and commuting daily to Düsseldorf, I quickly noticed that the 50-minute train ride had morphed into an extension of the fair itself. The sight of passengers with Düsseldorf Messe name badges set the tone, turning the train into a lively microcosm of MEDICA. I saw engineers or company representatives toting product prototypes in their backpacks, sales staff outlining their day’s plans, small teams discussing supply-chain challenges, and exhibitors hurrying to finalize their booth setups. This vibrant atmosphere created a multilingual buzz, enhancing our observations as we traveled. It soon became clear that the fair did not simply begin at the exhibition entrance; instead, it spilled over into the everyday rhythms of the region, crafting a continuous field of experience that stretched all the way from Duisburg. Even the small café next to the station became a condensed micro-sociological hub of MEDICA, where its dynamics were laid bare. 

Photo 2- During the train journey from Duisburg to Düsseldorf, there were encounters with various actors at the fair (from left to right: Gülşah Başkavak, Melike Şahinol)

Craft, Steel and the Invisible Labour Behind Surgical Instruments 

High-precision surgical instruments, robotic systems, AI-assisted clinical applications, sterilization technologies… Beyond the impressive technological landscape that greets you at the fair lies a tapestry of human stories woven into these innovations. Behind every medical instrument product are visible/invisible labor processes, craft-based skills, pressures of strict standardization, comprehensive certification procedures, and strategies that meet global competition head-on. In my field notes, these often-unseen structures carry equal analytical weight as the devices’ technical specifications. Indeed, these processes were the essence of our observations during our rewarding fieldwork in Samsun earlier this summer.

In conversations with representatives from major surgical instrument manufacturing hubs such as Tuttlingen, Sialkot, and Samsun, a recurring theme stood out. One aspect I want to emphasize from my observations is the practice of working with steel. The shaping of steel material may seem like a simple production process. However, forming, hardening, and refining steel involves culturally embedded craft-based knowledge passed down through generations. 

Photo 3-Surgical scissors

During this fieldwork, I recalled a series of surgical scenes observed throughout my doctoral researchThe surgeoncraftsmaand the end user of a surgical instrumentapproaches steel not merely as a tool in their occupation but as an integral component of their surgical practice. 

Photo 4- A snapshot from ethnographic observations conducted in operating theatres during my doctoral research ©Gülşah Başkavak

The way surgeons understand and use their instruments demonstrates a complex interdependence among tools, craftsmanship, and medical expertise, making this interdependence visible in the operating theatre’s practiced routines. The production of a single pair of surgical scissors encompasses a range of complex elements, including sensory motor skills, tacit knowledge, master-apprentice relationships, and the historical context of family-owned enterprises within medical clusters. Additionally, these factors are interlinked with global supply chains and the continuously evolving quality standards.  

During my visit to the Düsseldorf Messe, I was particularly struck not only by the dynamic interplay of production cultures as they interacted and transformed through these encounters. The importance of steel was a prominent theme throughout the fair. This was evident in product demonstrations, technical specifications, sustainability discussions, and casual conversations with manufacturers at various stands. As a result, we decided to proactively organize a series of workshops focused on steel once we returned.

Innovation, Green Technologies and Negotiating the Future of the Industry 

As I moved from one booth to another, striking words began to emerge. The concepts I encountered most frequently at the fair, often displayed on the walls of nearly every booth, were “innovation” and “future”. However, the meaning and scope of innovation vary widely across regions. Based on informal conversations and observed marketing narratives, innovation in Germany appeared to be often associated with precision, durability, and strict adherence to the highest standards. In contrast, within the scope of these observations, manufacturers from South Asia were often presented as emphasizing competitive pricing, rapid solution development, and quicker access to global markets. This difference highlights that innovation is not just about technical performance; it is a relational concept influenced by economic context, varying craft practices, and the geographies of production. 

One other aspect that genuinely caught my attention during the fair was the growing visibility of sustainability and green technology across the healthcare and medical technology sectors. Walking through the stands, engaging in brief, on-the-spot conversations with exhibitors, and browsing through brochures, I repeatedly encountered sustainability-oriented language and imagery. These encounters gave me the sense that green technology and environmental responsibility are increasingly shaping expectations and placing tangible pressure on actors across the sector. 

The tightening of EU regulations, rising certification requirements, expanding manufacturer responsibility policies, obligations for raw material traceability, and new waste management standards present both opportunities and challenges – especially for small and medium-sized producers.  

These dynamics have transformed the fair from a simple platform for showcasing products into a space for negotiating the industry’s future. Analysing these negotiations from a sociological perspective is essential for highlighting the social and cultural dimensions of global value chains. 

Reflections and Outlook: Preparing for Fieldwork in Tuttlingen 

During our brief visit to the Düsseldorf MEDICA Messe, we encountered a rich array of data invaluable to researchers studying global production geographies and craft-based knowledge systems. The initial connections we established with firms in the Tuttlingen cluster and with manufacturers in Sialkot laid a crucial strategic foundation for our upcoming fieldwork. This preliminary research not only helped us build valuable relationships but also provided a clearer understanding of the material culture, operational practices, and competitive dynamics within the global medical instrument sector.   

Even on the train back to Duisburg at the end of each day, my thoughts about the fair continued… One of the surprises of Germany’s cold November days is the opportunity to experience its wonderful Christmas markets (Weihnachtsmarkt in German). As I walked through the stalls in subzero temperatures, illuminated by the warm glow of the market lights and sipping mulled wine, I found myself reflecting on the craftsmanship and accumulated knowledge behind the hundreds of surgical instruments displayed at the fair. I was also thinking about the upcoming fieldwork in Tuttlingen. In that moment, it became clear to me how transformative it is to observe the networks involved in the manufacturing of surgical instruments in person, and I felt genuinely excited about the data and insights that the Tuttlingen fieldwork will provide! 

Photo 5- German Christmas market (Weihnachtsmarkt)

References
Başkavak, G. (2016). Understanding Surgical Craft in the Changing Context of Technology, Transformation of Healthcare and Marketization: A Case Study on Surgeons in Istanbul [Ph.D., Sociology, Middle East Technical University-METU]. https://etd.lib.metu.edu.tr/upload/12620889/index.pdf 

Başkavak, Gülşah (August 14, 2025). Fieldnotes from Samsun (Türkiye): Listening to the Masters – MediCluster Project. Manufacturing Practices of Medical Instruments (MediCluster). Retrieved December 12, 2025 from https://doi.org/10.58079/14hd1  

Kocager, Uğur (November 27, 2025). A Gathering on the Multiple Ontologies of Steel: A Workshop on Circulation, Knowledge, and Socio-Technical Imaginaries. Manufacturing Practices of Medical Instruments (MediCluster). Retrieved December 10, 2025 from https://doi.org/10.58079/158ds  

 

MediCluster at the Max Weber Foundation Conference Border Matters 2026: Paper Walls and Border Infrastructures

What happens when borders are not drawn in space, but in regulations or documents? This blogpost introduces our MediCluster research on “paper walls” and explains why it was selected for the Max Weber Foundation Conference Border Matters 2026. It shows how everyday regulatory practices quietly shape the global circulation of life-saving instruments.

 

How do artifacts – such as documents, standards, and regulations – in surgical instrument manufacturing become borders?
Our attention to “paper walls” arises directly from field research. Across all MediCluster sites, manufacturers repeatedly emphasized that documents and regulatory requirements – not geography – determine where instruments can circulate. This empirical finding forms the basis for our analysis of mobile border infrastructures in the MediCluster project.

 

Why this research matters – in four sentences

Every surgical instrument travelling through global production chains crosses borders that are not visible on maps. These borders take shape as documents, standards, stamps, inspection routines – the “paper walls” of global industry. Understanding these invisible boundaries reveals how recognition, value, and expertise circulate unequally across countries. By making these processes visible, MediCluster contributes to public understanding of global health, manufacturing, and transnational interdependence.

The Conference: A Stage for Publicly Relevant Border Research

The annual Max Weber Foundation Conference brings together researchers from all international institutes to rethink borders as:

  • material infrastructures,
  • spatial practices,
  • embodied experiences,
  • environmental and technical arrangements, and
  • dynamic processes rather than static lines.

This framing directly resonates with our MediCluster focus on borders that emerge through documents, standards, and everyday manufacturing routines.

Our research shows that borders in global manufacturing are enacted through documents, standards, and compliance routines — the “paper walls” that shape whose instruments may circulate, and whose remain invisible.

 

The conference themes resonate strongly with MediCluster’s commitment to studying how global medical technologies are made, circulated, and governed.

Our Contribution: “Beyond Borderlines: Paper Walls as Mobile Boundary Infrastructures”

Our analysis emerges from ethnographic fieldwork in Samsun and ongoing comparative research in Tuttlingen and Sialkot. Together, these sites form the basis of our multi-sited ethnography within the DFG-funded MediCluster project. This design enables us to follow how regulatory documents, audits, and stamping practices become mobile border infrastructures across clusters.

To understand how documents, standards, and regulatory routines become border-making devices in global manufacturing, we draw on Science and Technology Studies literature on boundary objects (Star & Griesemer 1989) and on research on boundary crossing (Akkerman & Bakker 2011). In our field sites, CE/MDR dossiers, inspection metrics, traceability sheets, and origin markings function much like boundary objects: they coordinate production across clusters while translating requirements between actors with different forms of expertise. Yet, these infrastructures do more than mediate collaboration—they also delineate boundaries, assign positions, and reproduce asymmetries. Seen in this light, “paper walls” are not merely bureaucratic artefacts but socio-technical infrastructures through which borders are continuously enacted, negotiated, and stabilized in everyday manufacturing practice.

Key Insight:
Surgical instruments cross national borders, but the real borders are created by documents, standards, and certificates. In many cases, the documents determine circulation more than geography does.

 

What Are “Paper Walls”? A concept explained for non-specialists

Surgical instruments travel through a dense web of:

  • CE/MDR conformity dossiers
  • inspection protocols
  • quality thresholds
  • routing and traceability sheets
  • origin markings (“Made in …”)
  • certification templates and audit requirements.

Paper Walls = the hidden borders of global manufacturing.
They slow down flows, assign responsibility, regulate trust, and distribute economic value.

 

These walls are:

  • mobile (they travel with documents, not geographies),
  • invisible (they appear in files, not fences),
  • highly consequential (they shape markets, legitimacy, and expertise).

Paper Walls decide:

  • where goods can move,
  • where reputations are made,
  • and whose expertise counts.

In our analysis, the concept of sociotechnical craftscapes makes visible how surgical instruments take shape through the continuous negotiation between embodied, haptic craft knowledge and the documentary regimes of standards, audits, and conformity assessments. It highlights the ways in which artisans align tactile judgment with metric thresholds and how local skills become entangled in global production chains.

Complementing this, an oceanic perspective allows us to view Tuttlingen, Sialkot, and Samsun as interconnected nodes within an archipelago of surgical craft. Across these sites circulate not only materials such as steel but also tacit expertise, inspection routines, certification practices, and regimes of recognition and value. Seen through this lens, borders in global manufacturing do not coincide with national lines on a map; rather, they emerge within the very circulations that bind these sites together, materializing through documents, audits, and origin markings that configure whose knowledge counts and where expertise is acknowledged.

Borders move like currents: they shift with documents, practices, and regulatory flows.

 

Looking Ahead: Preparing for Warsaw (and beyond)

For the conference presentation, we are developing a visual and narrative format that makes the core dynamics of our research tangible. We will work with schematic visualizations of document and standard flows, concise comparative vignettes from our three research regions, and illustrative examples of craft-based steelwork. These materials will be complemented by selected interview passages, for instance, the striking remark that an instrument bearing a German stamp is praised, whereas the very same object without that stamp is viewed with suspicion (see Şahinol 2025) . Together, these elements create an accessible narrative that links technical documentation to lived experience and highlights how regulatory infrastructures shape everyday work.

Our aim is to demonstrate how borders in surgical instrument manufacturing are continually made, shifted, and reassembled in practice. In a field often perceived as purely technical, we show that production is deeply social, political, and material.
The instruments designed to save lives emerge within an environment structured by invisible border regimes—regimes that are negotiated and enacted anew every single day.

Our goal: to reveal how borders are made, shifted, dismantled, and rebuilt – every single day – in the manufacturing of objects designed to save lives.

 

References
Akkerman, S. F., & Bakker, A. (2011). Boundary crossing and boundary objects. Review of educational research, 81(2), 132-169.

Melike Şahinol (August 29, 2025). Paper Walls and Endless Circulations: Epistemic Asymmetry in Surgical Instrument Manufacturing. Manufacturing Practices of Medical Instruments (MediCluster). Retrieved October 23, 2025 from https://doi.org/10.58079/14jtr

Star, S. L., & Griesemer, J. R. (1989). Institutional ecology, translations’ and boundary objects: Amateurs and professionals in Berkeley’s Museum of Vertebrate Zoology, 1907-39. Social studies of science, 19(3), 387-420.

Crafting Technotopias: Insights from the STS Türkiye 2025 Conference

This blog post offers a reflection on our contribution to the STS Türkiye 2025 Conference, highlighting how the MediCluster project engaged with discussions on craft, design, and global circulations within surgical instrument manufacturing.

Context: STS Türkiye 2025 Conference

The STS Türkiye 2025 Conference, “Technotopias – Imaginaries of the Past, Present, and Future,” took place on November 6–7, 2025, at HECAS – Hekimbaşı Center for Advanced Studies in Istanbul. Guided by the theme Technotopias – Imaginaries of the Past, Present, and Future, STS Türkiye 2025 gathered researchers from across disciplines to reflect on how science and technology shape — and are shaped by — socialtechnical imaginaries and everyday worlds.

The image is a poster for the STS Turkey 2025: Technotopias, Past, Present, and Future Imaginations conference, jointly organized by STS Turkey and HECAS. The image includes the conference location and date.
STS Türkiye 2025 Conference Poster

In the opening speech, Melike Şahinol invited us to rethink technotopias as lived, situated formations rooted in material practices and embodied expertise. This perspective framed many of the conversations that followed.

Melike Şahinol is presenting the STS Türkiye 2025 conference opening speech at HECAS

As part of the conference program, the panel “Craft, Design, and the Body”, chaired by Melike Şahinol, featured a talk by the MediCluster researchers, sharing insights from our ongoing research on global surgical instrument manufacturing.

The Panel Context

Our panel “Craft, Design, and the Body” brought together complementary perspectives on how craft, design, and technology shape sociotechnical futures. We opened the session with our joint presentation, which introduced findings from the Samsun fieldwork and examined surgical instrument production as part of globally circulating sociotechnical craftscapes.

This was followed by Dijan Özkurt’s contribution, exploring the Istanbul Design Biennial as a site where design functions as a relational practice and an infrastructure for producing public imaginaries. The final presentation by Burak Öztürk reflected on symbiotic art and the forms of human–machine co-agency that emerge in creative processes, prompting a rethinking of embodiment and aesthetic experience.

Together, the panel’s contributions demonstrated that craft, design, and innovation are deeply intertwined practices. Each talk highlighted how future imaginaries are shaped through material engagements, embodied expertise, and relational forms of making – reinforcing the conference theme of technotopias as lived and continuously negotiated formations.

Our Contribution: Local Craft Practices in Samsun

Building on this broader conversation, our presentation introduced the MediCluster Project and focused specifically on the Samsun field site – one of the three interconnected production clusters we examine alongside Tuttlingen and Sialkot. Drawing on completed fieldwork, including in-depth interviews and video ethnography conducted across enterprises of different scales, we traced how surgical instrument production in Samsun forms part of wider sociotechnical craftscapes shaped by embodied knowledge, material practices, and global circulations.

Gülşah Başkavak presentingReshaping the Future through the Heritage of Craftsmanship: The Sociotechnical Landscapes of Local Craft Practices in Samsun,” STS Türkiye 2025, HECAS, Istanbul

A key point of discussion was how instruments, ideas, and expertise move across regions, shaping technological geographies – the technotopias – of the future. By situating local craft practices within these global flows, we highlighted how Samsun’s production culture contributes to, and is transformed by, the circulations of skills, materials, and standards.

Reflections from the Discussion: “Sociotechnical Craftscapes” and the “Oceanic Perspective”

The discussion began by emphasizing the global significance of surgical instruments. Within this framework, the vital impact of surgical tools on living beings, the coexistence of automation and manual skill in production processes, and the various forms of specialization within global supply chains were addressed.

In the later stages of the session, the conceptual frameworks of “sociotechnical craftscapes” and the “oceanic perspective” (Şahinol, 2025) provided the theoretical grounding for the discussion. Through these concepts, the group highlighted that sociotechnical craftscapes are not neutral spaces but are shaped by historically rooted global inequalities. They show how imaginaries of medical technologies emerge within uneven conditions of recognition, mobility, and access to resources — and how local practices both navigate and challenge these asymmetries.

Şahinol emphasized that the oceanic perspective serves to unsettle rigid binaries such as center–periphery and North–South without ignoring their material effects. Rather than assuming free circulation, it draws attention to the frictions, blockages, and power relations that structure how knowledge, materials, and standards move across regions. As Şahinol noted, this perspective does not replace North–South or coloniality debates but deepens them by revealing how colonial power is enacted, redistributed, and contested through circulation itself — affecting actors across regions, from small manufacturers in so-called centers who struggle under tightening EU regulatory regimes to producers in places like Türkiye who experience these same regimes as paper walls that limit access and recognition. This approach makes it possible to see how global inequalities are reproduced through circulation — and how places like Samsun negotiate space within these uneven landscapes.

Shaping the Future Through the Traces of the Past: Samsun’s Craft Heritage

Samsun’s longstanding craft heritage illustrates how the future of medical instrument production emerges through the continuous interplay of past knowledge, present practices, and future aspirations. Historical craft traditions remain embedded in everyday production routines and influence contemporary political, economic, and technological decisions. Technotopias – the spaces of future technologies – take shape precisely in these flows, gestures, and fine-tuned adjustments of craft.

From the Field: Technotopias of Craft

  • Tacit Knowledge – At the heart of craftsmanship lies a form of knowledge that cannot be fully expressed in words or writing — tacit knowledge. A master cannot easily explain how they do their work but can demonstrate it in practice. This is a bodily form of knowing, learned through the senses — touch, sight, hearing, even smell. Alongside written ISO standards, there also exist “felt standards” — the sensory protocols of the craftsman.
  • Material Regimes – Material regimes constitute the invisible strategic framework of production. The quality of steel, the order of processing, and the surface finish determine not only the technical value of a product but also its status and the markets it can access. In Samsun, masters do more than shape steel; they shape its place within the global market.
  • Circulation and Recognition – Brand, origin, and expertise do not always align — there is a constant tension between them. Certification processes build “paper walls” that restrict the circulation of knowledge and labor. Yet, user-centered design and the sensory sensibility of craftsmanship serve as critical junctions that guide the direction of future technotopias.

From the Field: The Co-Production Matrix — Reading the Future of Craftsmanship

Analyzing the Samsun fieldwork through the lens of a co-production matrix reveals how norms, local practices, and material possibilities continuously shape one another. The “fine-tuning” gestures and sequences of operations observed in workshops already carry traces of the future within the present.

The co-production matrix is not merely a technical matter; it is also intertwined with questions of recognition and global positioning. Smart incentive policies that consider Samsun’s historical craft heritage and its layered traditions could negotiate between local knowledge and global quality regimes — paving the way for a more just and sustainable future of production.

The image features a diagram showing three boxes interacting in two directions. The first box contains Global Norms, the second box contains Local Practices, and the third box contains Material Possibilities.
Source: “Co-Production Matrix and Trajectories,“ in Şahinol, M., Başkavak, G., and Uçarol, A. B. (2025).

Future Orientation

The discussion reaffirmed that craftsmanship is not a remnant of the past, but a vital, living knowledge practice shaping the production worlds of tomorrow. With upcoming fieldwork in Tuttlingen and Sialkot, we aim to deepen our comparative understanding of how different clusters specialize within global surgical instrument supply chains. The thoughtful questions from the audience provided valuable impulses for the next phases of our research.

STS Türkiye 2025 conference snapshot, HECAS, Istanbul. From left to right: Ayşe Berna Uçarol, Gülşah Başkavak, Melike Şahinol
STS Türkiye 2025 conference snapshot, HECAS, Istanbul. From left to right: Ayşe Berna Uçarol, Gülşah Başkavak, Melike Şahinol

A Gathering on the Multiple Ontologies of Steel: A Workshop on Circulation, Knowledge, and Socio-Technical Imaginaries

The workshop titled “Multiple Ontologies of Steel: Circulation, Knowledge and Socio-Technical Imaginaries,” held on 27 November 2025 at the Orient-Institut Istanbul as part of the MediCluster project, created a productive space for rethinking both the production processes of steel and its multi-layered circulations within medical and surgical instrument manufacturing through an STS perspective. The invited expert was researcher Dursun Baş (IPC), whose work focuses on climate policy, carbon transitions, and transformations in the steel sector. His ongoing research is closely aligned with the “Türkiye Çelik Sektörünün Karbonsuzlaştırılması (Decarbonization of Türkiye’s Steel Sector)” project conducted at the Istanbul Policy Center: https://ipc.sabanciuniv.edu/tr/iklimprojeleri.

The workshop aimed to revisit questions that the MediCluster team — Melike Şahinol, Gülşah Başkavak, Ayşe Berna Uçarol and Uğur Kocager — encountered during fieldwork, through the material, political and epistemic dimensions of steel.

A visual poster promoting a workshop on Steel held at the Orient Institute in Istanbul on November 27, 2025.
Workshop flyer “Çeliğin Çoklu Ontolojileri” (MediCluster)

An Introduction to Steel: Material, Process and Geographies

The session opened with a brief presentation by Melike Şahinol, who revisited the project’s central focus. Drawing on conversations that stretch from the embodied know-how of master craftsmen in Samsun to the assessments of materials engineers in Germany, Şahinol outlined several points that stand out across these different perspectives.

Following this, Dursun Baş provided an overview of steel production not only in technical terms but also through its economic and political dimensions. He noted that steel is an alloy of iron and carbon, a “material multiplicity” that functions less as a single substance and more as a structure that can take on numerous combinations. As he put it,

“It is like following a recipe.”

Building on this foundational description, Baş offered a broader assessment of global and Turkish markets, as well as the distinctions between primary and secondary steel production and their implications.

When these insights are considered alongside MediCluster’s field observations, an evident tension emerges: countries with strong secondary production, such as Türkiye and Pakistan, still need to import high-quality stainless steel for the medical and surgical instrument sector.

Samsun, Sialkot, and Tuttlingen: A Transnational Flow of Material and Knowledge

One of the most engaging discussions of the workshop centered on how surgical instrument manufacturers in Samsun access high-quality steel.

Baş responded unequivocally:

“No one in Türkiye produces steel of that grade. Each product group requires different types of stainless steel. Manufacturers must import the material they need.”

This challenge connects directly to one of MediCluster’s key analytical frames: the asymmetric circulations of knowledge, materials, and labor.

Such circulations generate a double invisibility, both material and epistemic. Although Sialkot and Samsun form critical nodes in the global surgical instrument chain, they often remain obscured. Surgeons’ preference for “German-made” instruments reflects networks of trust, prestige, branding and epistemic authority rather than intrinsic material differences.

For this reason, Şahinol introduced the importance of an “oceanic perspective.” In this view, steel is not merely a material. It is a circulating, transforming and trace-bearing entity that gathers different meanings as it moves across geographies.

Socio-Technical Layers of Steel: Knowledge, Power and Effect

Three conceptual themes emerged prominently during the workshop:

    1. Epistemic Asymmetry

The informational history of a surgical instrument is frequently attributed to Germany. In reality, however, the tacit skills of craftsmen in Samsun, the technical labor in Sialkot and numerous local micro-innovations play a decisive role. Yet these contributions are seldom patented, named or formally recognized.

    1. The Invisibility of Micro-Innovations

Field research consistently reveals that companies, skilled artisans and engineers produce many small-scale technical improvements. These do not enter formal documentation systems such as patents or design registries. As a result, the knowledge they generate cannot be traced, which creates an epistemological problem beyond an economic one.

    1. The Multiple Ontologies of Material

Steel assumes different forms of being throughout its production and use:

  • For engineers, it is a technical alloy.
  • For manufacturers, it is a cost element.
  • For craftsmen, it is a material sensed through resistance and texture.
  • For exporters, it is a marker of quality.
  • For surgeons, it is a matter of precision and trust.
  • For patients, it becomes an invisible carrier of healing.

A Research Possibility: Tracing the Journey of Stainless Steel in Türkiye

One of Baş’s suggestions offers a strong starting point for a future collaboration: tracing the stainless-steel chain from its supplier to its arrival in Samsun.

Such a study would align closely with MediCluster’s interest in the socio-technical entanglements of material flows. Following this chain would illuminate not only the movements of material, but also:

  • the structure of trust relations,
  • the actors who define knowledge transfer,
  • the stages at which production becomes visible or hegemonic,
  • and the parts of the chain that are rendered invisible.

The image shows four people sitting around a table. It's an academic study environment. The table is lined with a computer, paper, pens, and various snacks. From left to right, Gülşah Başkavak, Melike Şahinol, Dursun Baş, and Ayşe Berna Uçarol are pictured.
Workshop snapshot “Çeliğin Çoklu Ontolojileri“, Orient-Institut Istanbul. From left to right to left: Gülşah Başkavak, Melike Şahinol, Dursun Baş and Ayşe Berna Uçarol

Rethinking Through Steel

The workshop demonstrated that steel is not simply a technical material. It is a socio-technical entity entangled with imaginaries, which fits squarely within the analytical scope of MediCluster.

This entity exists within circulations that transcend borders, reshape relations of knowledge and power, make epistemic asymmetries legible and link production practices across diverse geographies.

With this session, the analytical arc that MediCluster draws between Samsun, Sialkot, and Tuttlingen gained a deeper layer. Steel emerges not only as a material but also as an interface through which knowledge, labor, power and meaning are redistributed in the global production landscape.