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Introduction Transnational Medicine, Mobile Experts Ethnographic and historical work on healing and medicine in Africa reveals a great deal about politics and power; social organization and economic conditions ; global regimes of value and local practices of valuing bodies, kin, and community. Medicine is significant not only for its therapeutic effects on individual bodies, whether biological, symbolic, spiritual, or otherwise mediated. Medicine and healing, as Steven Feierman (1985) argues, have also long been implicated in the organization and transformation of social and communal life in the sub-Saharan African region—and vice versa. Therefore, on a larger scale, as medicinal substances, therapeutic practices, and healing practitioners (as well as the institutions, technologies, policies, and ethical frameworks to which they adhere) circulate, they shape myriad aspects of social, political, and economic life. This volume takes the mobility of medicines, patients, and experts as its primary object of investigation. Few studies of the postcolonial transnationalisms that shape medicine in or out of Africa have included both “traditional” and “modern” medicines in their accounts. Yet the histories of “traditional” medicine, religious healing, and biomedicine are intertwined, and all indicate the importance of regional and inter-regional movement. That “mobility is power” is an old truism in African healing. Even in precolonial times, healing powers were assumed to increase significantly with the movements of healers and medicinal products across often wide regional distances (Comaroff 1981). Traditional African therapies and healers traveling from afar have long claimed heightened potency (Digby 2004), while biomedicine spread throughout the continent as a result of missionization, colonization, and international development (Vaughan 1991). Equally, military conquests as well as the establishing of labor markets, urban centers, and the associated infrastructures of mobility in colonial settings paved the way for the spread of epidemic diseases and mobile pathogens (Feierman 1985: 85f.); this in turn effected medical interventions and long-term changes in local social and moral orders (Ranger 1992: 247) and facilitated the incorporation of Africa into the emerging capitalist world order. 2 INTRoDUCTIoN The authors in this volume train attention on the transnational mobilities of therapies and therapeutic experts as they shape life, health, and healing for contemporary Africans. Together, these chapters catalyze new ways of understanding the imaginations, networks, movements, and practices—as well as the hopes, disillusions, and “failures”—that comprise contemporary globalized medicine. In so doing, they describe some of the forces shaping contemporary human experiences of affliction and healing that have often gone unacknowledged in studies more tightly organized around specific medical systems or geographic locales. We begin from the belief that accounting for globalization today requires a careful examination and historicization of mobility as an effect of power. This includes official movements—of international development experts, international migrants, consultants, essential medicines, WHo guidelines and national policy documents—as well as smuggled remnants of pharmaceutical prescriptions, remittances from distant relatives, and the circulation of traditional healers and medicines. We also attend to the “side effects” of biomedical programs—from the resistance to Western childhood vaccines in Niger to the end of the indigenous pharmacy industry in Nigeria. We describe the disconnects between public health notions of responsible behaviors, including moral ways of thinking and acting, and the situated ethics of the everyday struggles of men and women in Africa. Attention to the ways that Africans seek to gain control of their bodies and the meanings of their afflictions leads us to illustrate some of the more complicated dynamics that influence contemporary international health. It challenges the sometimes simplistic assumptions that underlie health interventions and globalized health priorities of basic treatment and care in resource-poor settings. And it calls for scholarship that resists being another “derivative” of African suffering (Hunt 1999). Similarly, the unofficial movements of healers and medicines from Africa to Europe (and vice versa) bring to light a subtler picture of medicine and health in Africa—from Somali healers who use new telecommunications technology to attend to clients in Scandinavia to Senegalese migrants who organize to provide their home village with ambulances. Furthermore, the circuits of exchange and the medical modernities they engender are diverse, as illustrated through the example of Chinese doctors in Kenya. We argue that neither a faithful epidemiological profile of Africa nor a rigorous account of the landscape of therapeutic options and the context of health-seeking behaviors can be conceived without attention to both official and unofficial movements of medicines and experts in and out of Africa. The multidirectional trajectories and transnational relations depicted in this volume have demonstrable impact...

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