In the Blood: Sickle Cell Anemia and the Politics of Race (review)

Melbourne Tapper. In the Blood: Sickle Cell Anemia and the Politics of Race. Critical Histories. Philadelphia: University of Pennsylvania Press, 1999. 163 pp. $22.50; £21.50.

Throughout its documented history, sickle cell anemia has been regarded as a racial disease. In this fascinating book, Melbourne Tapper "examine[s] the ideological underpinnings of the research projects and government actions that throughout this century have rendered sickling [sickle cell anemia] as a disease of the black body" (p. 2). In doing so he leads the reader over terrain both familiar and new, showing how the racialized nature of the disease has remained flexible enough to accommodate various (sometimes contradictory) racial ideologies and governmental policies in both the United States and Africa. In the end, he argues that the racial construction of sickle cell anemia both naturalized race and racialized disease. Sickle cell anemia served as a serological tattoo, deployed variously to explain the migratory history of human beings, to identify racial and cultural groups, and to justify governmental policy.

To support his arguments, Tapper examines four episodes in the history of the disease that demonstrate the varied constructions of sickle cell anemia and its relationship to the politics of race. He does not attempt to separate the "reality" of sickle cell anemia from its constructions, nor does he privilege one rendering of the disease over another. Rather, he reduces all accounts--be they personal, medical, anthropological, or political--to "discourse," and he analyzes these "discourse networks" for what they reveal about the history of the disease.

Chapter 1 focuses on the 1920s and 1930s (with an occasional trip to the 1940s) to demonstrate the link between sickle cell anemia and the black body. Tapper claims that the association became so strong that a diagnosis of sickle cell anemia in a "white" person led to a search for the source of "black blood." Ultimately, the continued discovery of the condition in white patients, particularly those of Mediterranean descent, forced a reexamination of the meaning of whiteness in both individuals and ethnic groups. In Chapter 2 Tapper argues that sickle cell anemia was part of a larger social project--to understand the distinctiveness of the "American Negro." Researchers claimed that because the disease was more prevalent in North America than in Africa, it provided an opportunity to examine African-American uniqueness. In this context, sickle cell anemia was used to "prove" the "dysgenic effects of race-mixing" (p. 35). Ironically, then, it has both indicated "blackness" in those assumed to be white and demonstrated the "whiteness" of those assumed to be black.

Chapter 3 leaves the United States and examines sickle cell anemia research in colonial Africa in the 1940s and 1950s. Tapper claims that sickling research in Africa during this period helped establish biological boundaries for "tribes"--entities that, until this research, had been cultural and political creations, dependent on language, history, and tradition for their boundaries. Statistical differences in sickling rates between tribes naturalized existing groups and allowed new, "truer" tribal histories to be written. Ultimately, Tapper argues, this helped colonial administrators manage and manipulate the tribes. In addition to showing that the research remapped the history of Africans within Africa, he claims that it supported a theory of Indian migration to east Africa.

Finally, in chapter 4 Tapper claims that the racialized discourse on sickle cell anemia in the United States in the 1970s provided the government with an opportunity to redress past neglect of African Americans. He focuses on the 1972 National Sickle Cell Anemia Prevention Act, which provided funds for medical research and genetic counseling. Seeing agency as the necessary precursor to citizenship, Tapper concludes that by assuming that blacks could and wanted to control their reproduction, the Act endowed African Americans with full citizenship. But he warns that by endowing black citizenship, the government assumed the authority to govern--perhaps control--black citizens...