Bodies, Politics, and African Healing: The Matter of Maladies in Tanzania

7 Interferences and Inclusions

7 Interferences and Inclusions In southern Tanzania, degedege and malaria are considered two of the most common threats to the well-being of pregnant women and young children. Respondingtointernationalandnationalconcernsthatmalariacontributessignificantlyto poverty and to highratesofmaternal andchildmortality inAfrica, theTanzanian Ministry of Health has implemented programs to motivate stricter adherence to malaria prevention and treatment protocols. These programs include local public health education initiatives that aim to impress upon people the importance of recognizing certain physical symptoms as malarial and the urgency of the need to go to the health clinic at the first sign of these symptoms. In these efforts, the “traditional” malady known in Kiswahili as degedege has come to be translated as the “modern” malady of malaria. By tracing the processes involved in treating degedege and the processes involved in treating malaria, this chapter examines what is at stake in assertions that degedege is malaria. Public health narratives draw an equivalence between degedege and malaria by insisting that these maladies refer to the same physical condition caused by the same biomedically recognized entity. This understanding makes it possible for health care professionals to see degedege as the Kiswahili interpretation of a biological reality. From this perspective, healing practices that treat degedege threaten to interrupt, delay, or interfere with life-saving malaria treatments. Individuals who accept this model feel that those who pursue therapies other than those supported by the hospital are the victims of a dangerous form of ignorance. The translation of degedege as malaria masks the possibility that there is another set of relationships, another network of actors, institutions, and propositions in which to locate experience. There are, however, other translations. Healers, for instance, argue that the needles of malaria treatments will kill a person if he or she has not been treated for degedege first. These multiple and layered translations connect and separate degedege and malaria. Any focused attention on the work to make degedege into malaria (by and) for southern Tanzanians reveals that these maladies are identified, shaped, and Figure 7.1. A poster placed in pharmacies in Newala. Translation: “Recognize the Origin of Degedege. Malaria is the main reason. Quickly take your child with degedege to the health care clinic in order that s/he gets proper treatment.” Photo by author, 2008. Interferences and Inclusions 177 elaborated in relation to each other. For example, nurses diagnose degedege when hospital medicine for malaria does not appear to be “working” and refer patients to healers outside of the clinic. Family members slip herbal medicine into the nasal-gastric tubes of loved ones whose diagnoses of malaria have confined them to hospital beds. Degedege and malaria are both propositions constituted through the encounters of healers, doctors, nurses, needles, medicinal baths, and innumerable other objects and agents. The analysis below examines the making of these collectivities and the ways that therapeutic practices formulate objects of therapeutic intervention and care such as bodies, parasites, and disease entities. In this way, the contours and materialities of degedege and malaria are seen to be less dependent on their membership in mutually distinct alternative systems of healing and more profoundly defined by the objects of therapeutic care that emerge through practices conducted in their names. In southern Tanzania, degedege practices are primarily focused on the articulation of a body—something that is being afflicted—while curative malaria practices are primarily focused on the articulation of a parasite—something that is afflicting the body. This chapter considers the ways that similarities and dissimilarities between degedege and malaria are articulated, and by whom. Focusing on the details of therapeutic practices challenges facile translations of indigenous categories of healing into biomedical ones. As discussed in the introductory chapter, I do not meanjust linguistic translation but rather howwe come to explain—sometimes to explain away—one cultural concept with another. Some voices and agendas seek to explain degedege away, to see it as encompassed in explanations of “malaria.” More than language is at stake in these descriptions and translations. When hot, convulsing bodies become a ground for ontological struggles between healers and biomedical practitioners over devils and parasites, they illustrate the stakes implicit in descriptions of affliction—most acutely because these descriptions circumscribe the sorts of interventions that are conceivable. As biomedical and nonbiomedical practitioners work to maintain the salience of their forms of expertise, they also articulate the separations and connections that structure life (and death) in southern Tanzania. Locating the Comparison In southeastern Tanzania, degedege...