Our last class, oh dear

Our last class, oh dear!
An ALMOST linear REVIEW
PRIMARY SOURCES

Monday, April 19, 1999

1858, Livingstone’s conversation with healer
early 1990s: "New York: The Secret African City" (film)

KEYWORDS

primary source vs. secondary source
diaspora
syncretism = being bi-lingual
transmission is not genetic; it is conscious

Medical anthropologists focus on:

1. people’s life worlds and experience of sickness and healing (phenomenology)
2. People’s ideas about disease causation and diagnosis (systems of meaning)
3. The material conditions in which their experiences and beliefs are situated (local disease ecology)

BIG QUESTION 1

What was the experience of illness?
Was the drought an "illness"?

BIG QUESTION 2

What caused the drought?
What were the ideas about causation?
What was the local diagnosis (or social analysis)?
What about the church bell?

BIG QUESTION 3

What was the relationship between wealth and health? Material conditions and disease?
(What was the disease/affliction ecology, including political economy?)

CHRONOLOGY

two key traditions: Yoruba and Kongo-- GO WAY BACK
yet cultures are mixtures. "Culture" was never pure. Always creolized, all the way back.
drum <---> spirit possession = ngoma--STILL THERE
MEANWHILE, biomedicine arrived. WITH WHAT and HOW? IMPLICATIONS?

Must distinguish between:

(1) medical TRADITIONS, such as biomedicine or ngoma cults of affliction
(2) medical SECTORS, the form(s) that a tradition takes in a given community
(3) medical SYSTEM = collection of traditions and sectors available to people living in a given community = PATTERNS OF RESORT = (therapeutic itineraries)

3 big events

domestication: surplus and LINEAGES
iron/cattle: prestige wealth
farmers populate the continent, carrying key vocabulary and social organization (people=wealth)

effects of domestication and pastoralism

proximity
diseases of crowds
disposal of wastes
breeding sites
animal husbandry

dramatic increase

in the variety and frequency of infectious disease

iron, power, healing, fertility
proto-Bantu vocabulary

wound, boil, sore
to become ill, to suffer
to bewitch, curse, power of words
medicine man, nganga
drum, ngoma
to become cold, cool down, become cured
interdiction, prohibition

Western Bantu

disease
ghost; healer, medicine man
to cure; to divine
white clay, pemba
consecrated medicine, charm
to protect with medicine
to bleed by cupping horn

Eastern Bantu

sore
witch, witchcraft; ordeal, poison
to practice medicine, divine
spirit, spirit of the dead
consecrated medicine, charm
cupping horn; to bleed by cupping
drum <---> spirit possession

what did/does a lineage look like?

triangle inside triangle
two assymetries: AGE and GENDER

health and wealth

big men
pioneered forest clearance
importance of people (not land)

kinds of wealth

in people
in things
food (subsistence)
prestige wealth
charms
in knowledge

lineage as building block

basic asymmetries
age
gender
father/patron/big man/king
kinship ideology
followers and dependents

two kinds of exchange

within and outside lineages
prestige wealth (among senior men)
subsistence wealth (between patrons and clients)
TENSION!!!! Contestation!!!, especially GENERATIONAL
sons struggle with fathers, wives with husbands

GOAL: people = wealth

implications for HEALTH???
Gender/age imbalances in nutrition?? Workload??

How was this goal upset and REMADE by:

export trade in slaves
legitimate commerce
colonial rule (new hierarchies and family forms)
postcolonial development, poverty, war, aspirations

What were the implications for health during each period?

How did biomedicine (race and science) intervene to complicate forms of domination and "patterns of resort" in each period?

PERIOD ONE: about 1500-1800

what happens to people= wealth???

big question

How did Africans cope with the contradictions, misfortune, and envy that arose in the era of the Atlantic trade?
Partly through nkisi
"things that do things"
one very important nkisi was lemba

pervasive assumption

human relations and human society can cause sickness and misfortune
diagnosis may entail research into social conflict

disease consequences within Africa

no postcontact pattern of mass death in Africa
shared enough of Old World disease pool
not depopulated by slave trade

Several things happened to people=wealth

men exported, women retained
kingdoms fall apart, others develop
NOUVEAU RICHE get power
polygyny grows
war, violence --->> health, fertility
gets twisted: need for ngoma forms
like lemba
like Kimpa Vita’s movement

generational tensions?

successful "sons" can break away from "fathers"
true of slaves in Africa

gender assymetries?

Women valued over men as slaves within Africa
integrated as pawns, wives, even if plantation workers

biomedicine present???

Only for slaves
Guinea surgeons
slave plantation doctors
not yet practiced within Africa

other religious traditions present?

Islam in west and east Africa
Christianity, exceptionally: as in Kongo kingdom
leads to syncretic mixtures

PERIOD TWO: export trade ends

"Christianity and Commerce" slogan of the day
1858, Livingstone’s conversation with the rainmaker
choices of Sechele: an early MIDDLE
WHAT WAS REMARKABLE IN THIS CONVERSATION???
If Sechele was a "middle"? What was the "rainmaker’??

What else in period two?

Equiano working on abolition
slave systems still operative in Americas

three stories

Guinea surgeons
treponemal travels and yaws
Cotton Mather’s discovery

What we learned about conscious transmission

hoodoo
conjuration
prayer
drumming
spirit possession

What we learned about early African rejections

of biomedical/Western/Anglo-European/white care
WHERE, WHEN, WHY???
The rainmaker???

2 momentous events in 19th c.

progress and power of industrial technology
domination and exploitation of Africa and much of Asia by Europeans

European control of world

1800, 35 percent of land surface of world
1878, 67 percent
1914, 84 percent

Imperialism

creation of colonies, which were
politically submissive and
economically profitable to their European metropoles

Frantz Fanon on colonialism

relationship of domination and subjection
violence
racial polarization
dehumanization
native, colonized intelligentsia as mediating group

GOAL and STAGES: pacified colonies

penetration and exploration by first Europeans
conquest of indigenous peoples; imposition of European rule
consolidation: make colony valuable adjunct to European economy

key technologies of these stages

penetration: steamers and quinine
conquest: rapid-firing rifles and machine guns
consolidation: steamship lines, telegraph cables, railroads

"the scramble"

dramatic expansion of European power in Africa
political motives
economic motives
Berlin Conference, 1884-85
critical period of new imperialism, 1880-1910
Conquest of Africa was CHEAPER than it had ever been
CHEAPER in lives and money that would ever be again

Both motives and means changed

True: growing European demand for colonies in the late 19th century.
Changes in TECHNOLOGY enabled MOTIVES to produce EVENTS.

Steamboats

harsh topography
lack of pack animals
areas with good water transportation colonized first

quinine

1880, French scientists discovered protozoa that invades blood stream
1897, vector, Anopholese mosquito, discovered
1820, French chemists extract alkaloid of quinine from cinchona bark
1827, commercial production of quinine began

quick-firing rifle

Technology is power.
History of imperialism is the history of warfare

gun revolution, 1860s-1890s

shift from muzzle-loaders to breech-loaders, 1860s
Maxim and other machine guns, 1890s
Disparity between the World War I rifle and the Napoleonic musket was greater than that between the musket and a bow and arrow.

Among most lopsided battles in history

for Africans: produced bewilderment and hopeless struggles
for Europeans: resembled hunting rather than war
"At no time in history has the distinction between tourists and conquerors been so blurred." Michael Adas

Winston Churchill

Battle of Omdurman, part of conquest of Sudan, 1898
Churchill took part in campaign
He declared it "the most signal triumph ever gained by the arms of science over barbarians."

Descriptions of these battles

emphasize not European superiority
but moral differences between opponents
European-led soldiers: daring, vigorous, resolute, bold
VS.
hordes of barbarians, savages, fanatics

WHY???

All of a sudden, after relative disinterest, do European states want formal annexation??

flow of new technologies

LOWERED THE COST in financial and human terms
made imperialism CHEAP
became acceptable to European peoples and states

"informal empire" and "legitimate commerce"

from about 1850
underwritten by social Darwinism from late 1850s

Berlin Conference, 1884-85

public signal, "Africa up for grabs"
"scramble" begins

KINDS OF COLONIES, two factors

RESOURCES, CLIMATE
NUMBERS OF WHITE PEOPLE
HOW THESE TWO COMBINED

settler colonies

where there were major minerals
where there was very rich land
WHERE???

cash-crop colonies

settlers were few
Africans still NOT in charge, BUT . . .

Indirect rule, why an important concept
colonial rule, basic binary

COLONIZER
COLONIZED

HOW THIS basic binary WAS COMPLICATED

HIGHS (whites)-- colonizers
middles
"LOWS"

kinds of middles

CHIEFS (INDIRECT RULE INTERMEDIARIES, "TRADITIONAL")
EDUCATED MIDDLES

WHAT HAPPENS TO THE LINEAGE TRIANGLE?

GENERATIONAL ASSYMETRIES??
GENDER??
WEALTH=PEOPLE?
WEALTH=HEALTH?

1880-1918

conquest and pacification

1918-1940

interwar period

1945 plus

"development" begins

European origins of colonial medicine

sailed in the ships of explorers
marched with the armies of the colonizers

19th c. miasmatic theories

encouraged recourse to evasive measures
segregation
focus on European health

close of 19th c.: germ theory of disease

disease less identified with pathogenic landscapes
more with living "native reservoirs: of disease
segregation and sanitary cordons intensified

expansion beyond white/military enclave

make colonial labor more productive and profitable
colonial plantations and mines

epidemics

late 19th-early 20th century
hastened the growth of colonial states

shift from narrow priorities of colonial state

to public health
poverty and malnutrition
rural hygiene and sanitation
women’s and children’s health
POST-WORLD WAR II!!!!

COLONIAL STATES

PRODUCTIVE OR REPRESSIVE POWER?
HOW CENTRAL WAS MEDICAL POWER/KNOWLEDGE TO COLONIAL CONTROL?
DID COLONIAL MEDICAL DISCOURSE CREATE SUBJECTS, OPERATE THROUGH INDIVIDUAL SUBJECTIVITIES? OR THINK IN TERMS OF GROUPS? CLASSIFICATION MORE THAN INDIVIDUALIZATION

COLONIAL MEDICAL DISCOURSE

worked through notions of difference, but difference changed
colonizer vs. colonizer always there BUT
early colonial; biological "RACE"
interwar: maladaption, problem of being partly "modernized"
NOT JUST NATURAL/BIOLOGICAL DIFFERENCE

SUBJECTIVITIES ARE MADE, NOT GIVEN

COLONIAL ATTEMPTS TO CONSTRUCT IDENTITIES
HOW THESE IDENTITIES ADOPTED, INTERNALIZED, REJECTED

MEDICAL DISCOURSE HIGHLY SEXUALIZED

MALE SEXUAL IMAGERY OF CONQUEST
AFRICA AS FEMALE BODY (DARK AND DANGEROUS SEXUALITY)
YET TENDED TO MAKE WOMEN INVISIBLE

DIFFERENCE BETWEEN STATE AND MISSIONARY??

WOMEN CENTRAL TO MISSIONARY MEDICAL DISCOURSE

ROOM FOR RESISTANCE AND REJECTION
my and vaughan’s vocabulary for kinds of colonies

settler regimes (mining and plantation labor forces)
cash-crop economies (no settlers)

STORY ONE and TWO

VAUGAN ON SLEEPING SICKNESS AND LEPROSY
DATE AND COMPARE
CONQUEST AND EPIDEMICS: TRYP
ODD OBSESSIONS OF COLONIALS: LEPROSY

VS. STORY TWO: 1890s-1940s +

SOCIAL EPIDEMIOLOGY
TB: A STORY OF NEGLECT
WORK, MALE MIGRATION, ILLNESS
where: classic settler regime.

what do we mean by social epidemiology???

How to date the postcolonial???

1960
but where??
Not southern settler regimes
Not lusophone Africa

BIG DATES--west, east, central (even south)

1960
1973
1989

post-colonial hierarchies

a puzzle still
work it through

increasingly within Africa

highs and lows
middle class almost disappearing, but aspirations are not (people who want to send their kids to school)

expatriates everywhere, visible or invisible

when does "development" begin??
Relationship to health???
Movie makers???