Borders and Healers: Brokering Therapeutic Resources in Southeast Africa (review)

This book is a comparative ethnography about how healers navigate borders and transgress boundaries in contemporary Southeast Africa, both literal (geopolitical boundaries), and figurative (traditional and modern, earthly and spiritual). Their analysis moves beyond literature that simply documents the geographic circulation of healers and ideas. They expound on how "acts of crossing" empower healers to make the work of healing possible, enabling them to broker resources that patients themselves are unable to access; healers thus produce and reaffirm borders, even as they traverse and transgress them. As Feierman notes in his afterword, all this achieves local relevancy in what is effectively a transnational region with often shared experiences of colonial exploitation, disease, poverty, political instability, and contemporary vulnerability within everyday life.

In Chapter 1, Harry West notes how emerging neoliberalism and a consultant medical anthropologist influenced the postsocialist Mozambican state to reverse official policy from oppressing to embracing traditional healers. In practice, however, the collaboration that policymakers imagined has not materialized. West attributes this to a concern on both sides with maintaining their own positions relative to boundaries: on the one hand, the boundaries of biomedicine, which has an interest in staking out a distinctively modern, ideologically pure, scientific rationalism (even as it attempts to gather indigenous knowledge into its folds); and on the other hand, traditional healers, whose power lies in their ability to transgress boundaries—indigenous and scientific, traditional and modern, global and local.

Next, Tracy Luedke writes of the entrepreneurial strategies of Mozambican healers immediately after the civil war, when healers created official spaces and titles for themselves by leading associations, churches, or social networks that resonated with existing social, religious, or political power structures. Luedke notes that healers get considerable authority from adopting the trappings of more familiar authority structures, even while they innovate challenging new orthodoxies and assert new creations.

David Simmons shows how in urban Zimbabwe, in the context of worsening economic crisis, boundaries assumed between "traditional" and "modern" medicine have eroded. Healing associations have been able to pull from a heterogeneous and shifting base of ideas about "science," "modernity," "Western," and "traditional," by reinventing the traditional with modern forms of workshops, medical schools, commodity packaging, prescriptive dosing, clinical trials, and commercial distribution. Though greeted with ambivalence by some, these practices resonate with urban residents, who have otherwise limited access to therapeutic resources.

Also in Mozambique, James Pfieffer looks at the increasing popularity of free or low-cost healing within African independent churches, in the circumstance of rising costs and public dissatisfaction with the increasing commodification practiced by traditional healers and pharmaceutical agents. Though both traditional and church-based healers "ply the same spiritual terrain" (p. 83) by exorcising malevolent spirits and battling the occult, church leaders have been largely successful in creating a boundary surrounding their own practice, by demonizing traditional healers and asserting themselves as morally unambiguous agents of the Holy Spirit.

The last four chapters focus in some way on the role of social discourse in shaping therapeutic border work.

In Botswana, Rijk van Dijk looks at the local success of transnational Pentecostal churches, as they interact with state policies designed to promote nationalism. Personal healing and globally relevant discourses about deliverance have allowed Pentecostal faiths in Botswana to achieve local relevance (particularly for immigrants) and craft an extraregional identity, one that appeals across borders and beyond state-sponsored xenophobia. Church leaders have learned that power lies in a publicly appealing message that addresses issues of identity that can itself reach across social divisions.

Julian Murchison's chapter examines narratives circulating in Tanzania that involve a miracle cure for AIDS, told at a time of increasing public frustration with the ineffectiveness of biomedicine in diagnosing, treating, or curing it. The miraculous substance supposedly resisted biomedical attempts at scrutiny or validation, and would operate only in locally meaningful ways. Murchison notes that in telling these miracle tales, Tanzanians are actively reconfiguring boundaries between control and the uncontrollable, the foreign and the local...