Into Africa: A Transnational History of Catholic Medical Missions and Social Change by Barbra Mann Wall (review)

Into Africa is a fresh and substantial history of Catholic nuns working in diverse contexts across colonial and postcolonial Africa. It examines transformations in Africa's Catholic medical mission movement from 1945 up to the advent of the AIDS crisis about 1985. The author is a seasoned historian of nursing who previously wrote on American Catholic hospitals, nursing nuns, and nursing relief in disaster zones. Barbra Mann Wall takes a decidedly multisited and gendered approach to the history of Catholic medical missions in three countries, each formerly part of the British Empire.

This is Wall's first book on Africa, and she used the occasion to read with care many of Africa's medical histories. The book largely begins with the post–World War II years, and carefully reads the archives of the Medical Mission Sisters of Philadelphia, the Irish Medical Missionaries of Mary, and the Maryknoll Sisters of New York. Wall conducted a few oral histories, too. Three of six chapters are devoted to nurse or medic nuns and their medical missions in Ghana, Tanzania, and Nigeria. The Ghana chapter focuses on a hospital and nursing school in Berekum, operated by an order of nuns; it has lively material on a mother's protest against hospital rules and also on nurse walkouts. The Tanzania chapter investigates the politicization of the Maryknoll Sisters after Vatican II within Nyerere's Tanzania; exposed to his ujamaa ideology as well as to wafts of liberation theology, their ideas and practices did not always please the Vatican. (Why these nuns left Kowak by the mid-1980s is left unclear.) The Nigeria chapter focuses on three orders of nuns who worked in the southeast before and during the Nigerian civil war; the focus is on these war and relief years of 1967 to 1970. Drawing on Biafran war dairies and other sources documenting humanitarian relief within this nasty warzone, Wall also discusses why an Irish order of nuns was expelled.

This is a richly indexed history; scholars may easily track how Wall's many histories reveal intersections between Catholic nursing and historic events of note. The other three chapters provide historical and historiographical depth while assessing the work, thought, religiosity, and roles of nuns. All of the congregations initiated new forms of transnational collaboration. Many of these led to 1970s initiatives in prioritizing primary health care, engaging international organizations (like the World Health Organization), instituting hybrid TBAs (traditional birth attendants, right now being closed down), and embracing traditional healers as no longer shunned figures.

Wall's many stories about medical nuns within three postcolonies compose this multisited history. Her conceit is that forms of transnational, religious health work constituted antecedents to today's global health, though she makes this argument largely uncritically. The conceit is surely plausible, though her study ends rather weakly: it is worth wondering why.

Wall argues that medical nuns in Africa learned about the vernacular and political contexts in which they worked, while their work intersected with African and also global persons, groups, and institutions. An impressive amount of documentary research went into this detailed and inventive empirical history of nuns performing medical and humanitarian work and navigating politics of difference. The book is advertised as a groundbreaking study of globalization, medicine, and transnational partnerships. It is worth asking if the word "transnational" depoliticizes colonial tensions and decolonization. Wall uses the word to gloss exchanges and entanglements amid colonial and then North-South relations. She is hardly oblivious to racial or colonial hierarchies, but the "transnational" term—especially given her focus on one category of subjects, these active, alert, and often forceful nuns—perhaps leads her to overly emphasize their accomplishments. A sharp critical edge before the traces of ambivalence is less evident. Still, Into Africa does something quite important by opening three of Africa's late colonies and fledgling...