Turning Therapies: Placing Medical Diversity — A special issue of Medical Anthropology

The journal Medical Anthropology has recently published a special issue, entitled “Turning Therapies: Placing Medical Diversity.” As Kristine Krause, David Parkin, and Gabi Alex write in their introduction:

Through their own ethnographies, the contributors to this special issue take a fresh look at longstanding debates in medical anthropology through the entry point of space, place, and movement. They explore the interrelations between pathways to healing, and medical movement and stasis. They look at how particular places are imbued with therapeutic qualities, how medical locations become places of aspiration, how religious and medical place-making intersect, how ethnically co-located places and practices are merged in therapeutic and bodily practices, and how transnational political spaces form the basis for actors and institutions to create ‘innovations’ in the field of health.

To that end, they offer the following five articles:

Communities of the Afflicted: Constituting Leprosy through Place in South India
James Staples

With the promotion of community-based rehabilitation (CBR) as a solution to health-related issues across the global South, leprosy colonies have long been out of vogue for nongovernmental organizations and State institutions alike. Such colonies, however, have endured. As is being increasingly recognized by those working in the leprosy field, such places have played a particular role not only in the provision of leprosy-related care but also in forging new and collective identities for people affected by leprosy that might otherwise not have been possible. In this article, I draw on ethnographic fieldwork in one such colony in coastal Andhra Pradesh, South India, and explore the values invested in it as a particular kind of place; its geographical location on the peripheries; and its architecture and layout (inspired in part by colonial sanatoriums), which have particular implications for how leprosy and its ramifications are constituted and managed.

Pathways to Healing: Curative Travel among Muslims and Non-Muslims in Eastern East Africa
David Parkin

Two areas of therapeutic provision in eastern East Africa are contrasted: a coastal stretch inhabited mainly by Muslims, and a largely non-Muslim hinterland, each with its own healers, medicines, and customary ethic. Spread over both areas are providers of biomedicine associated originally, and to some extent today, with Christianity. Whether or not they also attend biomedical sites, Muslims seek healers in the coastal stretch and non-Muslims usually in the hinterland, each following ethico-religious preferences. However, because people move through the two areas and compare treatments, individuals’ journeys can change direction, with non-Muslims sometimes seeking Muslim healers and either of these groups choosing the more dispersed biomedical outlets. The notion of ‘pathways’ to health thus combines set journeys to areas known for particular healers and a distinctive ethic, with possible detours to alternative sources of therapy, including biomedicine not regarded as governed by the same ethic.

Space in Pentecostal Healing Practices among Ghanaian Migrants in London
Kristine Krause

In this article I analyze different spatial practices related to Pentecostal healing, drawing on fieldwork with Pentecostal believers who have migrated from Ghana to London, UK. I explore the relationship between space and the manifestation of the Holy Spirit by looking at how points of contact with the divine are created in the personal life of people and at the sites where the casting out of demons takes place. Unlike in other spirit-centered healing traditions, the Christian Holy Spirit is not conceived of as embodied in specific places, but rather is spatially unbound. To manifest, however, the Holy Spirit requires specific spatial qualities and esthetics.

Claiming Territory: Medical Mission, Interreligious Revivalism, and the Spatialization of Health Interventions in Urban Tanzania
Hansjörg Dilger

Over the past decades, new religious actors have become involved in the provision of medical care in urban Tanzania. Muslim revivalist organizations and neo-Pentecostal churches in particular have established a range of health interventions that are tied to revisionist claims about religion, spirituality, and politics in society. In this article I discuss medical mission in Dar es Salaam in the light of (post)colonial histories of health service provision as well as with regard to inter- and intradenominational contestations over health and well-being, a morally acceptable life, and political participation. I argue that the nature of the inscription of revivalist organizations in urban space through health interventions depends on their structural location and their respective members’ social and economic capital. I also show that the ongoing transformations of urban space through medical mission have become reflective of, as well as are triggering, moral interpretations of history and social inequality in contemporary Tanzania.

Precarious Projects: Conversions of (Biomedical) Knowledge in an East African City
Ruth J. Prince

This article explores the orientations of lay people in Kenya to science—specifically to biomedical knowledge about HIV—and their struggles to convert this knowledge into meaningful futures. In Kenya, the global response to the HIV-AIDS epidemic has resulted in a highly stratified landscape of intervention. Globally-funded treatment programs and clinical trials, focusing on HIV, channel transnational resources, expertise, and knowledge into specific sites—HIV clinics, NGOs, and research stations—inscribing these spaces as ‘global’ while leaving others decidedly ‘local.’ Rolled out in the form of ‘projects,’ these interventions offer resources and opportunities for a limited time only. Based on ethnographic fieldwork in the city of Kisumu, this article follows the circulation of biomedical knowledge through such projects and its conversion in ways beyond those imagined by policy-makers, as it meets the aspirations of city-dwellers and enters into local livelihoods. Mediated by nongovernmental organizations through workshops and certificates, this knowledge is both fragmentary and ephemeral. I explore the temporal and spatial implications of such knowledge for those who seek to attach themselves to it and shape their identities and futures in relation to it.