Medicine, Mobility, and Power in Global Africa: Transnational Health and Healing ed. by Hansjörg Dilger, Abdoulaye Kane, and Stacey A. Langwick (review)

This stimulating volume brings together an impressive range of essays examining the changes in health and healing in Africa brought about by the mobilities—of patients, treatments, and experts—that create new therapeutic landscapes and shape access to care across the continent. Methodologically the bulk of the research in this volume is ethnographic and takes as its point of entry the “everyday encounters of Africans and their practical efforts to communicate, care for loved one; relieve discomforts; address misfortunes; and attend to the health and future of communities, nations and regions” (p. 23). This focus and methodological approach helps to dismantle taken for granted oppositions between “traditional” healing and “Western” biomedicine, but also between Africa and elsewhere, home and diaspora, and traveling and staying in place. The novelty of the volume lies in the way it brings studies of globalizing Africa into a productive dialogue with literatures on medicine, healing, and modernity. The volume deftly and convincingly demonstrates that questions of mobility are vital to understanding the complex and plural cultures of healing in contemporary Africa and reminds us that rather than Africa being an “exceptional” terrain of experimentation, exploitation, or exclusion, cultures of care and practices of mobility in Africa are marked by “circuits of exchange” (p. 2) and by persistent relations of “connectivity, multidirectionality, and return” (p. 9).

The volume is divided into three sections. The first, “Scale as an Effect of Power,” groups essays broadly addressing the ways in which the “global” becomes a concrete object “in relation to the national, the local and the individual” (p. 16). These essays offer a range of rich case studies that demonstrate how global health solutions enter into and act upon spheres of African social, moral, and medical reasoning. The second section, titled “Alternative Forms of Globality,” addresses the localization and negotiation of global medical norms “on the ground”—although the “ground” here is a shifting one, composed of multiple places and folding in a range of scales and locations. This section contains essays considering the health experience of migrants—such as Adam Mohr’s study of Ghanaian men in the United States whose experience of diminished masculine power in the diaspora leaves them vulnerable to spirit possession—but also considers flows of medicine and medical goods. Viola Hörbst’s fascinating study of the circulation of assisted reproductive technologies in West Africa explores how new technologies create new markets, novel desires, and new exclusions.

The third section, “Moving through the Gaps,” contains a range of essays that foreground unexpected and striking attempts to fill the many “gaps” in the global health system, to compensate for shortfalls in care and extend the possibilities offered by biomedicine. The essays in this section foreground circulation and exchange of patients, goods, and expertise. These chapters are beautifully juxtaposed and resonate with each other and very interesting ways. Marja Tiilikainen’s chapter examines diaspora Somali women traveling back to Somalia to treat the physical and emotional consequences of the traumas of migration and exile which manifest in their bodies. Clara Carvalho’s work on Guinean healers in Portugal explores how these healers experiment with new theories and techniques in order to treat the afflictions of migrants. The knowledge that is created in response to these conditions and collisions is of a distinctive order and is used as part of the necessary daily migrant “work” of creating and sustaining an identity far from home. Elisabeth Hsu examines different kinds of entrepreneurial migrants, Chinese doctors in Kenya whom she describes as “mobile but connected” (p. 300). These doctors pursue a range of different migration projects, each of which poses dilemmas to solve about where, how, and with what values a transnational, transcultural life should be lived.

Each of the chapters in this final section develops an ethnography that illustrates the...