Debility and the Moral Imagination in Botswana (review)

Julie Livingston states that her book is about "the ways people in Botswana experience history in their bodies and how they make historical sense out of their changing bodily experiences" (p. 1). Her central premise is that historical transformation in southeastern Botswana has wrought important changes in people's moral imagination, personhood, and health-related discourse and practice (p. 1). Two case studies are used in the analysis: (a) the historical development of labor migration by men to the mines in South Africa, and its impact on health and bodily experiences; and (b) the experiences of people with various types of disability in southeastern Botswana today. These are eventually brought together in the book's final analysis.

In analyzing the bodies and illnesses of the miners, and the transformation of the various sectors of their health care, Livingston relies extensively on existing historical sources, especially the writings of Isaac Schapera. Although there is little of this that is new to a longtime reader of Tswana ethnography and history, the way she brings these sources together to illustrate her points is very well done. The book would have profited greatly from concentrating on this case alone.

I find the link to the bodies and moral judgment of present-day people with disabilities more questionable. Here Livingston relies on several periods of her own fieldwork during the years 1997 to 1999. Some of her conclusions seem very dubious, especially the claim that the Tswana diagnosis of mopakwane (severe disability in a child as a result of parents' breaking a sexual taboo against having intercourse during postpartum confinement) has been on the rise since the 1940s. I did similar fieldwork from 1984 to 1986 in a much larger area, and found relatively few cases of mopakwane, while witchcraft was more frequently given as a reason for the impairment. Also I found that it was usually the fathers who were blamed for mopakwane; the women at that time still (almost always) went back to their mothers or grandmothers in the villages to be watched over and cared for during confinement, and thus had few chances to "run around" and get the blame for mopakwane. Thus while Livingston is probably correct in stating that mopakwane and the blame of mothers is on a rise in semiurban areas today as a result of more freedom for women, there is no convincing evidence for her claim that this change started in the forties. It is at best a hypothesis. It is a serious weakness of the book that she tends to draw some of her conclusions on the basis of one or a few informant interviews (according to her own footnotes), ignoring some of the existing literature that argues for different views.

Another issue that Livingston raises is that of the "hidden disabled." The important point here is not to argue about how many or how few people with disabilities have actually been hidden, but to see it as a matter of different perspectives: that of the families who struggle in the midst of poverty to care for their members with a disability, and that of the NGOs or rehabilitation workers who need to keep such a myth alive in order to raise money and feel that they are doing a job that is worthwhile. Talking about the "hidden disabled" easily places the blame on the families. In my own fieldwork, I aimed at relieving them of this burden by showing how most people tried to do their best against all odds but were often misunderstood and stigmatized by outsiders. For example, a person with a disability who spends most of the time in the back of a house may as well be being sheltered from the sun as being hidden. It all depends on the eyes that see it. Livingston worked closely with a rehabilitation worker, but does not discuss how her view might have been...