Fierce Medicines Fragile Socialities

Set in Tanga, a city on the Tanzanian Swahili coast, Dominik Mattes examines the implementation of antiretroviral HIV-treatment (ART) in the area, exploring the manifold infrastructural and social fragilities of treatment provision in public HIV clinics as well as patients’ multi-layered struggles of coming to terms with ART in their everyday lives. Based on extensive ethnographic fieldwork, the book shows that, notwithstanding the massive rollout of ART, providing treatment and living a life with HIV in settings like Tanga continue to entail social, economic, and moral challenges and long-term uncertainties, which contradict the global rhetoric of the “normalization of HIV”.

Caring for small children and the family in Burkina Faso is hard work. Although the health infrastructure in Burkina Faso is weak and many citizens feel neglected by the state, Fragile Futures shows that the state continues to play an important role in people’s engagements and hopes for a better future. Based on more than twenty years of research engagement with Burkina Faso, it is an ethnography of how rural citizens address ambiguities of sickness and care and try to secure a decent future for themselves and their families.

In health and medicine, imagining the future is essential in giving meaning to the past and the present and for propelling people into action. This is true not only at the level of individuals as they envision and carry out everyday activities and long-term plans but also for institutional practices framed by and unfolding within various socio-political ecologies and transfigurations. Hope and uncertainty are critical affective and knowledge-related modalities of such imaginations and assume vital meanings in policing, managing, and experiencing health, illness, and well-being. This volume brings together contributions from medical anthropologists who address this theme across various medical spheres, including the pragmatics of hope and uncertainty, the techno-sphere, health management, and individual and socially distributed emotions.

Based on fieldwork conducted between 2001-2008 in urban East Africa, this book explores who the patients, practitioners and paraprofessionals doing Chinese medicine were in this early period of renewed China-Africa relations. Rather than taking recourse to the ‘placebo effect’, the author explains through the spatialities and materialities of the medical procedures provided why - apart from purchasing the Chinese antimalarial called Artemisinin - locals would try out their ‘alternatively modern’ formulas for treating a wide range of post-colonial disorders and seek their sexual enhancement medicines.

Expanding our understanding of contagion beyond the typical notions of infection and pandemics, this book widens the field to include the concept of biosocial epidemics. The chapters propose varied and detailed answers to questions about epidemics and their contagious potential for specific infections and non-infectious conditions. Together they explore how inseparable social and biological processes configure co-existing influences, which create epidemics, and in doing so stress the role of social inequality in these processes. The authors compellingly show that epidemics do not spread evenly in populations or through simple coincidental biological contagion: they are biosocially structured and selective, and happen under specific economic, political and environmental conditions. This volume illustrates that an understanding of biosocial factors is vital for ensuring effective strategies for the containment of epidemics.

Sufism is known as the mystical dimension of Islam. Breathing Hearts explores this definition to find out what it means to ‘breathe well’ along the Sufi path in the context of anti-Muslim racism. It is the first book-length ethnographic account of Sufi practices and politics in Berlin and describes how Sufi practices are mobilized in healing secular and religious suffering. It tracks the Desire Lines of multi-ethnic immigrants of color, and white German interlocutors to show how Sufi practices complicate the post secular imagination of healing in Germany.

Introduction -- Uneven Anthropological and Epidemiological Stories in Historical HIV Context -- HIV and Legacies of Racism, Political Violence, and Ethnic Conflict -- Stigma and the Cultural Politics of Uncertainty -- Economic Inequalities, Social Change, and the Politics of Gender and Sexuality -- (Re)Imagining Stigma at the Intersection of HIV and Mental Health Statuses -- HIV and the (Re)Making of Moral Personhood -- Conclusion.

Affective Health and Masculinities in South Africa explores how different masculinities modulate substance use, interpersonal violence, suicidality, and AIDS as well as recovery cross-culturally. With a focus on three male protagonists living in very distinct urban areas of Cape Town, this comparative ethnography shows that men’s struggles to become invulnerable increase vulnerability. Through an analysis of masculinities as social assemblages, the study shows how affective health problems are tied to modern individualism rather than African ‘tradition’ that has become a cliché in Eurocentric gender studies. Affective health is conceptualized as a balancing act between autonomy and connectivity that after colonialism and apartheid has become compromised through the imperative of self-reliance. This book provides a rare perspective on young men’s vulnerability in everyday life that may affect the reader and spark discussion about how masculinities in relationships shape physical and psychological health. Moreover, it shows how men change in the face of distress in ways that may look different than global health and gender-transformative approaches envision. Thick descriptions of actual events over the life course make the study accessible to both graduate and undergraduate students in the social sciences. Contributing to current debates on mental health and masculinity, this volume will be of interest to scholars from various disciplines including anthropology, gender studies, African studies, psychology, and global health.