Based on several years of ethnographic fieldwork, the book explores life in and around a Luo-speaking village in western Kenya during a time of death. The epidemic of HIV/AIDS affects every aspect of sociality and pervades villagers' debates about the past, the future and the ethics of everyday life. Central to such debates is a discussion of touch in the broad sense of concrete, material contact between persons. In mundane practices and in ritual acts, touch is considered to be key to the creation of bodily life as well as social continuity. Underlying the significance of material contact is its connection with growth - of persons and groups, animals, plants and the land - and the forward movement of life more generally. Under the pressure of illness and death, economic hardship and land scarcity, as well as bitter struggles about the relevance and application of Christianity and 'Luo tradition' in daily life, people find it difficult to agree about the role of touch in engendering growth, or indeed about the aims of growth itself.

Based on several years of ethnographic fieldwork, the book explores life in and around a Luo-speaking village in western Kenya during a time of death: the epidemic of HIV/AIDS, which by the turn of the century had affected every aspect of sociality and pervaded villagers' debates about the past, the future and the ethics of everyday life. Central to such debates is a concern with touch in the broad sense of concrete, material contact between persons. In mundane practices as much as in ritual acts, touch is considered to be key to the creation of bodily life as well as social continuity. Underlying the significance of material contact is its connection with growth - of persons and groups, animals, plants and the land - and the forward movement of life more generally. Under the pressure of illness and death, economic hardship and land scarcity, as well as bitter struggles about the relevance and application of Christianity and "Luo tradition" in daily life, people found it difficult to agree about the role of touch in engendering growth, or indeed about the aims of growth itself. Yet they drew upon shared experiences and imaginaries in their struggles to restore a forward direction to their lives.

This book presents a close look at the vestiges of twentieth-century medical work at five key sites in Africa: Senegal, Nigeria, Cameroon, Kenya and Tanzania. The authors aim to understand the afterlife of scientific institutions and practices and the 'aftertime' of scientific modernity and its attendant visions of progress and transformation. Straightforward scholarly work is juxtaposed here with altogether more experimental approaches to fieldwork and analysis, including interview fragments; brief, reflective essays; and a rich photographic archive. The result is an unprecedented view of the lingering traces of medical science from Africa's past.  

In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and - albeit sometimes counterintuitively - trust for their people. "The state" has morphed into the "para-state" - not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure. Tracing the emergence of the "global health" paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional. Contributors. Uli Beisel, Didier Fassin, P. Wenzel Geissler, Rene Gerrets, Ann Kelly, Guillaume Lachenal, John Manton, Lotte Meinert, Vinh-Kim Nguyen, Branwyn Poleykett, Susan Reynolds Whyte

In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and - albeit sometimes counterintuitively - trust for their people. "The state" has morphed into the "para-state" - not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure. Tracing the emergence of the "global health" paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional. Contributors. Uli Beisel, Didier Fassin, P. Wenzel Geissler, Rene Gerrets, Ann Kelly, Guillaume Lachenal, John Manton, Lotte Meinert, Vinh-Kim Nguyen, Branwyn Poleykett, Susan Reynolds Whyte