P145


African Women Interpreting and Redefining Public Health in late 20th and early 21st century Africa 
Convenor:
Leslie Hadfield (Brigham Young University)
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Format:
Panels
Location:
KH212
Start time:
1 July, 2017 at 14:00 (UTC+0)
Session slots:
1

Short Abstract:

This panel analyzes the role of African women in shaping notions of health in three African countries in the late 1900s and early 2000s. The papers examine women's roles in delivering public health and interactions between local notions of health and biomedicine, particularly in child birth.

Long Abstract

This panel highlights how local African women have played significant roles in shaping and redefining notions of health at the local level in the late 20th and early 21st centuries in three different African countries - Gambia, the Democratic Republic of the Congo, and South Africa. The three papers in the panel intersect with questions regarding women's roles in delivering public health and the interactions between local notions of health and healing and more global biomedicine, particularly in relation to fertility and child birth. Saho's paper examines how associations of infertile women in Gambia and the individual women that belong to them dealt with infertility by using "traditional" methods outside modern day hospitals and clinics. Hadfield analyzes how African nurses working in rural South Africa in the 1960s-1980s worked with rather than against local African beliefs about health and healing. Merten's paper examines the reception of cash transfers for birth-spacing in the DRC and Schneidermann's paper deals with the way women use technologies of pregnancy and childbirth to situate themselves in society. Together the papers reveal the critical actions of women who have shaped complex and varied approaches to public health in Africa.

Accepted papers:

Author:

Leslie Hadfield (Brigham Young University)

Paper short abstract:

This paper offers an investigation into the role of female African nurses in rural communities. Based on oral histories, it argues that nurses succeeded in spreading western biomedicine when they worked with rather than against Xhosa healing beliefs.

Paper long abstract:

Scholars of health and healing in African history have shifted from exploring the opposition between western biomedicine and African medicine to the exchanges between the two (Digby 2006, Flint 2008, Baranov 2008). The history of African nurses is particularly important to understanding this exchange as they often occupied the middle-ground between different healing traditions. Yet, there is still a need for an investigation into the work of female African nurses in rural communities where nurses had close relationships with the people they served and encountered 'traditional' healers and beliefs more than those in urban centers. This paper offers such an investigation, focused on the 1960s-1908s in the rural Eastern Cape region of South Africa formerly known as the Ciskei, a region dominated by the Xhosa people. Based largely on oral history interviews with over sixty retired Xhosa nurses, the paper shows how these nurses contested, shared, and negotiated Xhosa beliefs. Being Xhosa themselves, these nurses had a good understanding of the beliefs of their patients and thus could translate biomedical terms linguistically as well as conceptually. The paper argues that nurses succeeded in spreading health education and delivering biomedical health care when they worked with rather than against Xhosa healing beliefs. Most often, nurses motivated their patients to take both Xhosa and clinic medicines while others stressed the importance of informal and formal health education. Ultimately, these nurses played a central role in providing critical health services to their communities and influencing notions of health and healing.

Author:

Bala Saho (The University of Oklahoma)

Paper short abstract:

My paper examines how voluntary associations of childless women, or Kañeleng Kafo, shape perceptions of infertility in modern Gambia and how they counter the burden of childlessness and reflect – or help redefine – the cultural construction of womanhood.

Paper long abstract:

My paper examines how voluntary associations of childless women, or Kañeleng Kafo, shape perceptions of infertility in modern Gambia and how they counter the burden of childlessness and reflect - or help redefine - the cultural construction of womanhood. Kañeleng is a woman who cannot bear children, whom society considers infertile, or whose children die at an early age. One of the main goals of the group is to increase the chances of its members to bear children and raise them to maturity. To become a member, the aspirant has to undergo a ritual bath to cleanse the body of any "bad" spirit. In Africa, anthropologists have long studied the subject of infertility and how individual women confront the problem especially in patrilineal groups where the highest duty of a woman is to bear children. Very little is known about the practices of kañeleng groups and how these women confront the problem by using traditional mechanisms. My study introduces the traditional processes and mechanisms (efforts and practices that lay outside modern day hospitals and clinics) by which the kañeleng struggle to cope with and challenge the issues of childlessness in the Gambia by participating in rituals, prayers, performances, songs, thieving, and transvestite role inversions. I examine how these infertile women assert themselves in a social order that rejects them, highlighting the creation and meaning of ritual space. The rituals attain the purpose of redefinition because of the objectionable attitudes that have characterized relationships between kañeleng and the general Gambian public.

Author:

Sonja Merten (Swiss Tropical and Public Health Institute)

Paper short abstract:

Fertility practices, moral economies and gendered power dynamics on which a conditional cash transfer for birth spacing in Congo-DR is founded are explored. Particular women’s subscription to narratives constructed by the program and how, why and which women resist these constructions are analyzed.

Paper long abstract:

Following 'disappointing' rates of contraceptive uptake after decades of investment in family planning education and contraceptive availability throughout sub Saharan Africa, health and development program implementers are turning to 'new' market-based, demand-side strategies such as cash transfers conditional on the adoption of certain reproductive behaviors. These programs operate on principles and assumptions of neo-liberal moral economies, including economic benefits and the inherent 'good' of using contraceptives, making generalized assumptions of the ways in which women can and 'should' make decisions surrounding fertility, sexuality and their reproductive health. Programs are often implemented with little understanding of or consideration for the contexts in which fertility decisions are actually made and the real consequences of those decisions for women implicated in these programs.

Using both ethnographic and quantitative data, this paper explores the foundational gendered assumptions of and body politics constructed and promoted by a conditional cash transfer program in eastern Democratic Republic of Congo aimed at encouraging women to practice longer birth spacing intervals. Regional colonial histories of reproductive coercion and the consequences of the global north's changing attitudes towards fertility for women of the global south set the stage for analysis. Program emphasis on the realization of reproductive freedom through individual choice, divorcing fertility from its greater communal context and consequences, is considered. Specifically, this paper discusses the gendered bodies and practices that are promoted by these market-based strategies, how and which women adopt/subscribe to these narratives and how, why and which women resist them.

Author:

Nanna Schneidermann (Aarhus University)

Paper short abstract:

Technology appears as central ordering devices for experiences of pregnancy and birth for mothers and birth practitioners in the city of Cape Town. Through technologies of motherhood users seek to place themselves in relation to (post-)colonial ideas about urban modernity.

Paper long abstract:

This paper examines the role of medical and everyday technologies in relation to pregnancy and birth, from public health SMS text messages to ultrasound scans to forceps to cesarean sections. The use of these technologies of motherhood has come to define and characterize differences between the private health care sector, the public clinics, and alternative birth practitioners in Cape Town. They are used, taken for granted, aspired for and resisted. They are enacted in multiple and at times mutually exclusive ways; as means to managing different forms of risk, as interventions that are risky in themselves, as luxury commodities, as alienating and dangerous. But they are central to choices, practices and experiences of pregnancy and birth, and reflect and engage processes of commodification of health services in South Africa, but also (post-)colonial intersections of status, power, wealth and modernity.

Based on 9 months of ethnographic fieldwork in Cape Town, the paper argues that technologies of motherhood make pregnancy and birth into political events in a city characterized by economic, social and ethnic inequality. In tying technologies of motherhood with ideas of urban modernity and affluence, their use come to signify particular forms of belonging and morality. Mapping out different approaches to technologies of motherhood tells stories of women's attempts to place themselves as good mothers in relation to urban modernity and a changing state. In short, technologies used in pregnancy and birth become the contested grounds upon which good health and motherhood is predicated in Cape Town.