Medical research has been central to biomedicine in Africa for over a century, and Africa, along with other tropical areas, has been crucial to the development of medical science. At present, study populations in Africa participate in an increasing number of medical research projects and clinical trials, run by both public institutions and private companies. Global debates about the politics and ethics of this research are growing and local concerns are prompting calls for social studies of the "trial communities" produced by this scientific work. Drawing on rich, ethnographic and historiographic material, this volume represents the emergent field of anthropological inquiry that links Africanist ethnography to recent concerns with science, the state, and the culture of late capitalism in Africa.
Author: P. Wenzel Geissler,Catherine Molyneux
Publisher: Berghahn Books
Category: Health & Fitness
Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for “resource-poor” hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science. Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money—as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.
AIDS, Expertise, and the Rise of American Global Health Science
Author: Johanna Tayloe Crane
Publisher: Cornell University Press
Category: Social Science
What is the value of medical research? With contributions from anthropologists, sociologists and activists, this approach brings into focus the forms of value – social, epistemic, and economic – that are involved in medical research practices and how these values intersect with everyday living. Though their work covers wide empirical ground –from HIV trials in Kenya and drug donation programs in Tanzania to industry-academic collaborations in the British National Health Service – the authors share a commitment to understanding the practices of medical research as embedded in both local social worlds and global markets. Their collective concern is to rethink the conventional ethical demarcations betwweenpaid and unpaid research services in light of the social and material organisation of medical research practices. . Rather than warn against economic incursions into medical knowledge and health practice, or, alternatively, the reduction of local experience to the standards of bioethics, we hope to illuminate the array of practices, knowledges, and techniques through which the value of medical research is brought into being. This book was originally published as a special issue of Journal of Cultural Economy.
Labour, Participation and Care
Author: Ann H. Kelly,P. Wenzel Geissler
Africa has emerged as a prime arena of global health interventions that focus on particular diseases and health emergencies. These are framed increasingly in terms of international concerns about security, human rights, and humanitarian crisis. This presents a stark contrast to the 1960s and ‘70s, when many newly independent African governments pursued the vision of public health “for all,” of comprehensive health care services directed by the state with support from foreign donors. These initiatives often failed, undermined by international politics, structural adjustment, and neoliberal policies, and by African states themselves. Yet their traces remain in contemporary expectations of and yearnings for a more robust public health. This volume explores how medical professionals and patients, government officials, and ordinary citizens approach questions of public health as they navigate contemporary landscapes of NGOs and transnational projects, faltering state services, and expanding privatization. Its contributors analyze the relations between the public and the private providers of public health, from the state to new global biopolitical formations of political institutions, markets, human populations, and health. Tensions and ambiguities animate these complex relationships, suggesting that the question of what public health actually is in Africa cannot be taken for granted. Offering historical and ethnographic analyses, the volume develops an anthropology of public health in Africa. Contributors:Hannah Brown, P. Wenzel Geissler, Murray Last, Rebecca Marsland, Lotte Meinert, Benson A. Mulemi, Ruth J. Prince, Noémi Tousignant, and Susan Reynolds Whyte
Ethnographic and Historical Perspectives
Author: Ruth J. Prince,Rebecca Marsland
Publisher: Ohio University Press
The Oxford Handbook of Modern African History represents an invaluable tool for historians and others in the field of African studies. This collection of essays, produced by some of the finest scholars currently working in the field, provides the latest insights into, and interpretations of, the history of Africa - a continent with a rich and complex past. An understanding of this past is essential to gain perspective on Africa's current challenges, and this accessible and comprehensive volume will allow readers to explore various aspects - political, economic, social, and cultural - of the continent's history over the last two hundred years. Since African history first emerged as a serious academic endeavour in the 1950s and 1960s, it has undergone numerous shifts in terms of emphasis and approach, changes brought about by political and economic exigencies and by ideological debates. This multi-faceted Handbook is essential reading for anyone with an interest in those debates, and in Africa and its peoples. While the focus is determinedly historical, anthropology, geography, literary criticism, political science and sociology are all employed in this ground-breaking study of Africa's past.
Author: John Parker,Richard Reid
Publisher: OUP Oxford
During the first decade of this millennium, many thousands of people in Uganda who otherwise would have died from AIDS got second chances at life. A massive global health intervention, the scaling up of antiretroviral therapy (ART), saved them and created a generation of people who learned to live with treatment. As clients they joined programs that offered free antiretroviral medicine and encouraged "positive living." Because ART is not a cure but a lifelong treatment regime, its consequences are far-reaching for society, families, and individuals. Drawing on personal accounts and a broad knowledge of Ugandan culture and history, the essays in this collection explore ART from the perspective of those who received second chances. Their concerns about treatment, partners, children, work, food, and bodies reveal the essential sociality of Ugandan life. The collection is based on research undertaken by a team of social scientists including both Western and African scholars. Contributors. Phoebe Kajubi, David Kyaddondo, Lotte Meinert, Hanne O. Mogensen, Godfrey Etyang Siu, Jenipher Twebaze, Michael A. Whyte, Susan Reynolds Whyte
Surviving AIDS in Uganda
Author: Susan Reynolds Whyte
Publisher: Duke University Press
Category: Social Science
Critical health communication scholars point out that the acceptance of HIV risk prevention methods are bound inside inequitable structures of power and knowledge. Nicola Bulled’s in-depth ethnographic account of how these messages are selected, transmitted and reacted to by young adults in the AIDS-torn population of Lesotho in southern Africa provides a crucial example of the importance of a culture-centered approach to health communication. She shows the clash between traditional western perceptions of how increased knowledge will increase compliance with western ideas of prevention, and mixed messages offered by local religious, educational, and media institutions. Bulled also demonstrates how structural and geographical forces prevent the delivery and acceptance of health messages, and how local communities shape their own knowledge of health, disease and illness. This volume will be of interest to medical anthropologists and sociologists, to those in health communication, and to researchers working on issues related to HIV.
Bringing Culture into Global Health Communication
Author: Nicola Bulled
Publisher: Left Coast Press
In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and – albeit sometimes counterintuitively - trust for their people. “The state” has morphed into the “para-state” — not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure. Tracing the emergence of the “global health” paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional. Contributors. Uli Beisel, Didier Fassin, P. Wenzel Geissler, Rene Gerrets, Ann Kelly, Guillaume Lachenal, John Manton, Lotte Meinert, Vinh-Kim Nguyen, Branwyn Poleykett, Susan Reynolds Whyte
Making African Global Health
Author: Paul Wenzel Geissler
Publisher: Duke University Press
The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries. Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans have perceived research differently than researchers do and that the active participation of subjects led to the creation of a hybrid ethical form. By writing an ethnography of the past and a history of the present, Graboyes casts medical experimentation in a new light, and makes the resounding case that we must readjust our dominant ideas of consent, participation, and exploitation. With global implications, this lively book is as relevant for scholars as it is for anyone invested in the place of medicine in society.
Medical Research and Ethics in East Africa, 1940-2014
Author: Melissa Graboyes
Recent political, social, and economic changes in Africa have provoked radical shifts in the landscape of health and healthcare. Medicine, Mobility, and Power in Global Africa captures the multiple dynamics of a globalized world and its impact on medicine, health, and the delivery of healthcare in Africa--and beyond. Essays by an international group of contributors take on intractable problems such as HIV/AIDS, malaria, and insufficient access to healthcare, drugs, resources, hospitals, and technologies. The movements of people and resources described here expose the growing challenges of poverty and public health, but they also show how new opportunities have been created for transforming healthcare and promoting care and healing.
Transnational Health and Healing
Author: Hansjörg Dilger,Abdoulaye Kane,Stacey A. Langwick
Publisher: Indiana University Press
The Republic of Therapy tells the story of the global response to the HIV epidemic from the perspective of community organizers, activists, and people living with HIV in West Africa. Drawing on his experiences as a physician and anthropologist in Burkina Faso and Côte d’Ivoire, Vinh-Kim Nguyen focuses on the period between 1994, when effective antiretroviral treatments for HIV were discovered, and 2000, when the global health community acknowledged a right to treatment, making the drugs more available. During the intervening years, when antiretrovirals were scarce in Africa, triage decisions were made determining who would receive lifesaving treatment. Nguyen explains how those decisions altered social relations in West Africa. In 1994, anxious to “break the silence” and “put a face to the epidemic,” international agencies unwittingly created a market in which stories about being HIV positive could be bartered for access to limited medical resources. Being able to talk about oneself became a matter of life or death. Tracing the cultural and political logic of triage back to colonial classification systems, Nguyen shows how it persists in contemporary attempts to design, fund, and implement mass treatment programs in the developing world. He argues that as an enactment of decisions about who may live, triage constitutes a partial, mobile form of sovereignty: what might be called therapeutic sovereignty.
Triage and Sovereignty in West Africa’s Time of AIDS
Author: Vinh-Kim Nguyen
Publisher: Duke University Press
Category: Social Science
"Edition History: Margaret Lock and Vinh-Kim Nguyen (1e, 2010) published by Blackwell Ltd."--T.p. verso.
Author: Margaret Lock,Vinh-Kim Nguyen
Publisher: John Wiley & Sons
This book presents a close look at the vestiges of twentieth-century medical work at five key sites in Africa: Senegal, Nigeria, Cameroon, Kenya, and Tanzania. The authors aim to understand the afterlife of scientific institutions and practices and the "aftertime" of scientific modernity and its attendant visions of progress and transformation. Straightforward scholarly work is juxtaposed here with altogether more experimental approaches to fieldwork and analysis, including interview fragments; brief, reflective essays; and a rich photographic archive. The result is an unprecedented view of the lingering traces of medical science from Africa's past.
An Archaeology of Medical Science in Twenty-First Century Africa
Author: Paul Wenzel Geissler,Guillaume Lachenal,Nomi Tousignant,John Manton
Publisher: Intellect (UK)
"What are the moral challenges and consequences of animal research in academic laboratory settings? Animal Ethos considers how the inescapable needs of lab research necessitate interspecies encounters that, in turn, engender unexpected moral responses among a range of associated personnel. Whereas much has been written about codified, bioethical rules and regulations that inform proper lab behavior and decorum, Animal Ethos, as an in-depth, ethnographic project, probes the equally rich--yet poorly understood--realm of ordinary or everyday morality, where serendipitous, creative, and unorthodox thought and action evidence concerted efforts to transform animal laboratories into moral, scientific worlds. The work is grounded in efforts to integrate theory within medical anthropology (and, more particularly, on suffering and moral worth), animal studies, and science and technology studies (STS). Contrary to established scholarship that focuses exclusively on single professions (such as the researcher or technician), Animal Ethos tracks across the spectrum of the lab labor hierarchy by considering the experiences of researchers, animal technicians, and lab veterinarians. In turn, it offers comparative insights on animal activists. When taken together, this range of parties illuminates the moral complexities of experimental lab research. The affective qualities of interspecies intimacy, animal death, and species preference are of special analytical concern, as reflected in the themes of 'Intimacy,' 'Sacrifice,' and 'Exceptionalism' that anchor this work"--Provided by publishe
The Morality of Human-Animal Encounters in Experimental Lab Science
Author: Lesley A. Sharp
Based on several years of ethnographic fieldwork, the book explores life in and around a Luo-speaking village in western Kenya during a time of death. The epidemic of HIV/AIDS affects every aspect of sociality and pervades villagers' debates about the past, the future and the ethics of everyday life. Central to such debates is a discussion of touch in the broad sense of concrete, material contact between persons. In mundane practices and in ritual acts, touch is considered to be key to the creation of bodily life as well as social continuity. Underlying the significance of material contact is its connection with growth – of persons and groups, animals, plants and the land – and the forward movement of life more generally. Under the pressure of illness and death, economic hardship and land scarcity, as well as bitter struggles about the relevance and application of Christianity and 'Luo tradition' in daily life, people find it difficult to agree about the role of touch in engendering growth, or indeed about the aims of growth itself.
Contingency, Creativity and Conflict in Western Kenya
Author: Paul Wenzel Geissler,Ruth Jane Prince
Publisher: Berghahn Books
Category: Social Science
When People Come First critically assesses the expanding field of global health. It brings together an international and interdisciplinary group of scholars to address the medical, social, political, and economic dimensions of the global health enterprise through vivid case studies and bold conceptual work. The book demonstrates the crucial role of ethnography as an empirical lantern in global health, arguing for a more comprehensive, people-centered approach. Topics include the limits of technological quick fixes in disease control, the moral economy of global health science, the unexpected effects of massive treatment rollouts in resource-poor contexts, and how right-to-health activism coalesces with the increased influence of the pharmaceutical industry on health care. The contributors explore the altered landscapes left behind after programs scale up, break down, or move on. We learn that disease is really never just one thing, technology delivery does not equate with care, and biology and technology interact in ways we cannot always predict. The most effective solutions may well be found in people themselves, who consistently exceed the projections of experts and the medical-scientific, political, and humanitarian frameworks in which they are cast. When People Come First sets a new research agenda in global health and social theory and challenges us to rethink the relationships between care, rights, health, and economic futures.
Critical Studies in Global Health
Author: João Biehl,Adriana Petryna
Publisher: Princeton University Press
Category: Social Science
This book is a collection of fictionalized case studies of everyday ethical dilemmas and challenges, encountered in the process of conducting global health research in places where the effects of political and economic inequality are particularly evident. It is a training tool to fill the gap between research ethics guidelines and their implementation "on the ground." The cases focus on "relational" ethics: ethical actions and ideas that continuously emerge through relations with others, rather than being determined by bioethics regulation. They are based on stories and experiences collected by a group of social anthropologists who have worked with leading transnational medical research organizations across Africa in the past decade. Accompanied by guidelines, discussion questions and selected further readings, the book provides a flexible resource for training and self-study for people engaged in health research with, universities, international collaborative sites and NGOs and for everyone interested in the realities of global health research today."
Ethics Case Studies from Africa
Author: Gemma Aellah,Tracey Chantler,P. Wenzel Geissler
Focused on Botswana's only dedicated oncology ward, Improvising Medicine renders the experiences of patients, their relatives, and clinical staff during a cancer epidemic.
An African Oncology Ward in an Emerging Cancer Epidemic
Author: Julie Livingston
Publisher: Duke University Press
The brain and the nervous system are our most cultural organs. Our nervous system is especially immature at birth, our brain disproportionately small in relation to its adult size and open to cultural sculpting at multiple levels. Recognizing this, the new field of neuroanthropology places the brain at the center of discussions about human nature and culture. Anthropology offers brain science more robust accounts of enculturation to explain observable difference in brain function; neuroscience offers anthropology evidence of neuroplasticity's role in social and cultural dynamics. This book provides a foundational text for neuroanthropology, offering basic concepts and case studies at the intersection of brain and culture. After an overview of the field and background information on recent research in biology, a series of case studies demonstrate neuroanthropology in practice. Contributors first focus on capabilities and skills -- including memory in medical practice, skill acquisition in martial arts, and the role of humor in coping with breast cancer treatment and recovery -- then report on problems and pathologies that range from post-traumatic stress disorder among veterans to smoking as a part of college social life. ContributorsMauro C. Balieiro, Kathryn Bouskill, Rachel S. Brezis, Benjamin Campbell, Greg Downey, José Ernesto dos Santos, William W. Dressler, Erin P. Finley, Agustín Fuentes, M. Cameron Hay, Daniel H. Lende, Katherine C. MacKinnon, Katja Pettinen, Peter G. Stromberg
An Introduction to Neuroanthropology
Author: Daniel H. Lende,Greg Downey
Publisher: MIT Press