Disease and African Society

by

Shane Doyle

• LAST REVIEWED: 29 November 2017
• LAST MODIFIED: 29 November 2017
• DOI: 10.1093/obo/9780199846733-0196

Introduction

Disease in Africa has been the subject of a large number of rich studies. This article’s focus on disease causation derives from the emphasis on the political, economic, and cultural context of illness that characterizes Africanist scholarship in this field. A prominent strand of writing has examined how Africa’s relationship with external forces, from imperial conquest through the development of tropical medicine to neoliberal privatization, has shaped how disease has both spread and been interpreted. Scholars have noted the continuities in the depiction of Africa and Africans as particularly prone to disease from the era of Western exploration, through colonization, missionization, and industrialization, into modern discourses around Global Health, emerging tropical diseases, and chronic illness. Within this narrative, debates around the relative significance of race and environment have proven remarkably resilient, due, in part, to commercial interest in genetic vulnerability to disease and investigations into the relationship between zoonoses and cancer. Significant research has also explored how the scientific sureties of Western biomedicine have often been filtered within Africa through faith-based organizations’ spiritually infused healthcare, particularly in the early colonial period and in response to the recent sidelining of public provision associated with structural adjustment and the international prioritization of vertical programs targeting specific illnesses. This interest is matched by explorations of evolving indigenous traditions of disease explanation, so often tinged with a concern for spiritual as well as physical healing, and with public as well as personal health. While the article is structured broadly around chronological shifts in thinking and practice, a number of specific diseases or groups of diseases—HIV/AIDS, malnutrition, mental illness, sleeping sickness, and STDs—have been selected to serve as case studies, due either to their significant role within the history of Africa or to the global importance of the academic writing on these conditions.

General Overviews

Jamison, et al. 2006 provides a useful overview of disease patterns in contemporary Africa. Schumaker 2011 is a helpful guide to scholarly debates. Janzen 1978 is an important example of work that focuses on the patient, indigenous theories of disease causation and perceptions about the relative strengths of local and biomedical therapies. Africans’ encounter with biomedicine, particularly in the colonial period, is the focus of Bado 1996, Feierman and Janzen 1992, and Vaughan 1991. The political contexts of, and cultural responses to, contemporary Africa’s encounter with chronic disease, Global Health, HIV/AIDS, and medical experimentation are best approached through Graboyes 2015 and Livingston 2005.

• Bado, Jean-Paul. Médecine coloniale et grandes endémies en Afrique 1900–1960. Paris: Karthala, 1996.

  Examines the colonial tendency to focus on epidemic disease in French West Africa, and the comparative neglect of endemic conditions such as leprosy, onchocerciasis, and sleeping sickness.

• Feierman, Steven, and John Janzen, eds. The Social Basis of Health and Healing in Africa. Berkeley: University of California Press, 1992.

  Influential collection, critical of colonialism’s impact on African health.

• Graboyes, Melissa. The Experiment Must Continue: Medical Research and Ethics in East Africa, 1940–2014. Athens, OH: Ohio University Press, 2015.

  Significant examination of the history of a series of medical experiments across East Africa, from the 1940s to the early 21st century. Analyzes the power imbalances and ethical issues surrounding medical research in both colonial and postcolonial Africa.

• Jamison, Dean, Richard G. Feachem, Malegapuru W. Makgoba, et al., eds. Disease and Mortality in Sub-Saharan Africa. Washington, DC: World Bank, 2006.

  Useful reference text. Chapters focus on a range of key diseases in Africa. Update since first edition adds considerably to consideration of HIV. Valuable data. Designed to support the World Bank’s work in the health sector.

• Janzen, John. The Quest for Therapy in Lower Zaire. Berkeley: University of California Press, 1978.

  Discusses indigenous conceptions of disease, and the willingness of the ill to seek medical support from both local and biomedical healers.

• Livingston, Julie. Debility and the Moral Imagination in Botswana. Bloomington: Indiana University Press, 2005.

  Examines the production of chronic illness by local patterns of poverty, labor migration, and familial relationships. Important for its focus on ageing, and indigenous conceptions of wellbeing.

• Schumaker, Lyn. “History of Medicine in Sub-Saharan Africa.” In The Oxford Handbook of the History of Medicine. Edited by Mark Jackson, 275–279. Oxford: Oxford University Press, 2011.

  Valuable discussion of recent scholarship around disease in Africa.

• Vaughan, Megan. Curing Their Ills: Colonial Power and African Illness. Cambridge, UK: Polity, 1991.

  Important analysis of both how Africans viewed Western biomedicine and how secular and missionary medicine understood African mental and physical illness.