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This article made an important point with regard to decision-making of parents when their child is critically ill. While the fact that in the three case studies presented, all children eventually died, and this may (or may not) have been prevented would they have been rushed to a hospital rather than a traditional healer, Kamat makes the important point of structural obstacles - some of the parents did not have the money to pay for transport costs to go to the hospital, and to pay for the costs of treatment. Knowing this from the start, they of course went to the traditional healer as an affordable option. Moreover, one father had made negative experiences in a biomedical clinic, having been humiliated by staff previously, due to his belief in degedege as an illness rather than malaria. These case studies highlight how structural inequalities prevent people from being able to seek adequate healthcare.

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Marsland and Langwick both discuss their observations on the same topic, yet their accounts offer different details. Langwick describes the relationship between practitioners of "traditional" medicine and biomedical medicine as much more nuanced than Marsland, who depicts a clear division between the two worlds - one where biomedical practitioners do not refer patients to waganga. Additionally, Marslands recounts how waganga may wait for the effects of biomedical treatments to clear from the body before carrying out treatment to avoid potentially problematic intervention between the two, which was a behaviour observed by Langwick to be occuring in the other direction - Biomedical practitioners would wait for the treatments of waganga to be cleared before administering full treatments. It would seem that neither paper captures the whole picture, but in combination they can generate a holistic understanding of the subject.

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In this article Langwick explored the 'Biomedicine' and the 'traditional medicine'. It was interesting because Langwick considered the interactions between both forms of healing and the atmosphere in which these occur. An example I found interesting was that 'Twenty-three of the 26 nurses and aides I interviewed described using traditional medicine at least once in their lives. The chief nursing officer swore by an herbal treatment that he argued saved him from having to pull one of his teeth.’ P. 431. I found this particularly interesting that in comparison to other readings where there was criticism from nurses and senior medical professionals there was actually support - albeit perhaps covertly. I was especially interested in the covert nature of this 'traditional medicine' and how this is combated within the field by those who do not support it. I feel Langwick could have explored the social dynamics more than simply stating the social dynamics, especially in consideration of the fact that patients were told they could request a “discharge without the doctor’s consent.” which is an interesting power dynamic and structure to explore

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Kamat understands one form of health-seeking behaviour by interpreting “the micropolitics of therapy management — the not-so-obvious sociocultural and contextual factors that influence the manner in which people negotiate the identity of an illness” (2008: 68). In thinking about the health-seeking in Zaramo of Tanzania, Kamat takes the ‘household’ approach of contextualising the particular circumstance. Importantly, in Dying under the Bird's Shadow, individuals negotiate, think and act ‘rationally’ in their particular situation. Nevertheless, the individual’ circumstantial health-seeking process is intersect with structural constrains, for instance, the unequal distribution of health biomedical health facilities and the lack of social support one's social networks.

This paper inspires me to

re-think some question on public health: to what extend individual’s health-seeking behaviours is driven by logic of ‘reasoning’ and ‘rationality’; can we abandon the framework of ‘rationality’ in thinking about the ways people consider health, and what are the alternative conceptualisations; what is the collective meaning of health?

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An insightful journal article which delves into the importance of the urgencies and inadequacies of biomedicine in Africa. Many clinics in Africa are not consistently equipped with the most well known technologies and medicines, which is a cause for concern. Postcolonial biomedicine is therefore being refigured. Langwick refers to a district hospital in Tanzania as "Hospital T." Nurses are being trained from cleaners to nurses in a year with inadequate knowledge within these hospitals. The medical staff's position by the state are shaped by their training, their position as "professionals" and their position in the complicated class structure. It is important to highlight how herbal medicines are being used intravenously which attributes to the deaths of patients. In so doing, the mixing of traditional and modern medicine is the cause. In the 1970s-80, president Julius Nyerere aimed to build and maintain a dispensary within ten kilometers to ensure that health care could be provided in the community conveniently. When biomedicine expanded into Africa, missionary and colonial doctors and nurses confronted a diverse range of healing practices. Langwick further denotes that medicine has now moved from the missions and colonial powers to the responsibility of national governments. With this information, we are able to come to the conclusion that nurses are at the heart of this change as they dominate the administration of hospitals in Africa.

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Rolled out in the form of ‘projects,’ interventions also have temporal
effects; they offer resources and opportunities, but only for a limited time. (71)
It is very interesting to see how Development operates with non-continuous, managerial processes that often leave gaps in their efforts.

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'Plagues have changed and elites have swapped, but the response of the state continues to perpetuate division and political repression'

This article does well in highlighting the parallels between the states response during the current Covid-19 pandemic and the British response to Uganda's 1910s epidemics. An important note to take from this is the underlying feature of violence and division which still lingers in Kampala today as a public health intervention tool by the state. This form of intervention has had a devastating impact on the lives of the urban poor and also increased death rates in Kampala.

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Marsland offers a really interesting investigation into how the dichotomy between biomedical practice and traditional healing practice has been broken down by the creation of the ostensibly oxymoronic concept of 'modern traditional healers'. Marginalised by government policy and left out of national debate on issues like AIDS, waganga practices have begun to blur the line with their competition through adoption of modern technological practices like making their medicine in pill form. This, in the article, seems to be a function of staying relevant rather than a recognition of the medical prowess of a centre ground. With waganga practitioners 1:400, and biomedical practitioners 1:20,000 in Tanzanian society, it will be incredibly interesting to see how this hybridity develops alongside the changing demographic proportions of each group of practitioners.

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The ‘inverted directionality’ of the Covid-19 virus challenges the ‘century-old colonial narrative of Africa as a diseased continent’ now that Europe is the epicentre of the pandemic.

The western world has become a threat in a new embodied way, not only via ‘symbols of historical violence or effigies of the global economic order’, but via their ‘touch and breath’. Furthermore, the pandemic has revealed the vulnerability of the so-called invincible, world-leading nation states, as they struggle to manage their own healthcare services, let alone tend to the “white man’s burden” of developing healthcare services of their colonial subjects.

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Bryony and Tom point out the relationality of traditional healing and biomedical medicine, a relationality that is far from strictly antagonistic. As Bryony identifies that “ Marslands recounts how waganga may wait for the effects of biomedical treatments to clear from the body before carrying out treatment to avoid potentially problematic intervention between the two”; and as Tom summarizes from The Modern Traditional Healer that “waganga practices have begun to blur the line with their competition through adoption of modern technological practices like making their medicine in pill form”.

Nevertheless, as for Marsland that “it is in the interests of biomedicine to work at keeping the ‘traditional’ and the ‘modern’ apart in medical practice” (2007:754). As such, it might be that both traditional healing and biomedical medicine are productive in the making and practice of the other. The making of the ‘modern’ is at the same time the construction of the ‘traditional’. Nevertheless, how other actors, namely state, capitalism, legislature and so on can also be productive in the changing of the ‘traditional’ and the ‘modern’ medical practices?

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responding to Yana's post:
I also believe that on top of the more 'practical' issues of such a situation – decisions related to money for a such and such a healing method, or the consideration of time and of which method was available at the needed time – the emotional importance of the situation was mentioned, but not particularly highlighted. I would think that when people are about to lose their child, it is hard to have a lucid mind to come up with the most sustainable and rational decision.

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The aim of this article is to reflect on anthropological findings of what Allen and Storm call “quests for therapy” amongst the Madi people in Laropi, Northern Uganda. Through ethnographic encounters Allen and Storm make a convincing argument that medical pluralism exists. Madi people have not completely put aside their traditional forms of healing and beliefs associated with them. While they still have embraced biomedicine and such advances that have come with time. It was interesting to see generational parallels in the 50s and 60s when people would express that illnesses were caused by gods will or the invocation of ancestral ghosts because they have been wronged. Ultimately, there was more exposure to biomedicine via dispensaries for example, widespread treatment for malaria through syringes in the 1980s. However, if biomedicine did not work then people would consult with more traditional forms of healing.

Allen and Storm note that there were not sufficient ethnographic accounts of Madi people in the 50s, so in order to analyse the changes, they compared their findings with Middleton’s work on the linguistically related Lugbara and Barnes-Dean’s in the 70s. I thought that this was useful.

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I found interesting how the clear distinction between modern and ‘traditional’ medicine is embedded in the language and reflects the way people think: the words associated with traditionalism are slightly pejorative, while the words associated with modernism are seen in a different and progressive light. (754). However, towards the end of the article, we learn how traditional healers have been modifying their practice in order to (somewhat) keep up with the time. As such elements change, will the language to address them be modified as well? Or will the language stay the same, but the idea that it conveys will be modified (ie. the terms used to talk about ‘traditional’ medicine won’t be perceived as pejorative anymore)?

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Response to Edward

Following on from Edward’s comments about Development, the nature of these ‘Precarious Projects’ certainly give pause for thought. Prince provides the example of a German-funded project coming to a halt overnight because of allegations of financial mismanagement (p. 78). This brought to mind Allen’s observations about MSF visits to Laropi in the 1980s (Allen and Storm pp. 34-5). For the most part, MSF volunteers failed to engage with the local community on any meaningful level and rumours spread that they were making money from experiments being carried out on patients in a nearby hospital. “By and large, they were thought of not as real people at all but as a resource”.

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"For the Madi it is also important to understand that enthusiasm for biomedicine is not simply recognition of superior scientific knowledge and practice. As medical terms and treatments have been introduced since early Protectorate times, they have been linked to other ideas and given local meanings and interpretations. This is not in any way unique to the people of Laropi, nor is the fact that for the Madi, biomedicine has deep cultural associations. In certain respects, biomedicine is as traditional a body of knowledge as any other local approach to therapy. " (42)
I find it most interesting the bit where Allen and Storm argued that biomedicine is inextricably linked to the notion of modernity, citizenship, collective identity, and political integration. They have engaged with the concept of 'medical pluralism' critically by exploring the contextuality of biomedicine's (re)appropriation into a localised knowledge system. It reminds me of Chirikure (2015) who, talking about precolonial African metallurgy, argued that African technologies and innovations are in most cases cultural as well.

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Referring to a Sunday morning clinic held in the back room of a pharmacy in Laropi: “A queue of people began to form at about 10 o’clock, not long after the Catholic Church service finished and the market started to bustle”. (p. 39). Allen describes how Catholic activists have targeted ancestral shrines and spirit mediums and forced them underground. Do these 21st century Sunday morning activities represent swapping old traditional rituals for new ones rooted in ideas of Western modernity?

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responding to Sophie

It is absolutely shocking how old colonials powers failed to address the health crisis in their own countries whereas Africa as a continent had recorded far fewer cases than any other continent due to early intervention (according to BBC: https://www.bbc.co.uk/news/world-africa-54248507)
However old day colonial imagination of Africa as a continent composed of a population that is incapable of problem-solving still strides on. Earlier on in April, two high-profile medical figures appeared on a French TV and suggested to test COVID vaccine on African bodies. They were forced to apologize afterwards, but I'm absolutely gaffed to see this kind of narrative still lingering today.

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In this article, Langwick explored the relationship between biomedicine and traditional medicine in Tanzania. Reading this article, it was interesting to see the dynamics between the two and how they intertwined with each other. To an extent I think this strong relationship between biomedicine and traditional medicine was inevitable considering the conditions that hospitals faced in general. 'Faced with these harsh realities and the frustrations of not being able to offer ideal care, nurses in Hospital T seem to evoke traditional medicine in an effort to address the immediate needs of their patients.' (p430) Due to the inadequacies of biomedicine and the overall condition of hospitals and clinics not just in Tanzania but across Africa, many nurses and nurses aides are left to rely heavily on Traditional medicine.

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Marginalised by government policy and left out of national debate about urgent issues such as HIV/AIDS and malaria, they are using (or hope to use) biomedical technology to ensure that their place in the centre is recognized (763).

I found the extent to which the West’s understanding of medicine dictated the legitimacy of the Waganga problematic. The association of modernity and progression with the West led to the Waganga feeling the need to appropriate aspects of Western biomedicine in order to gain credibility, be perceived as ‘legitimate’, and break through the stereotype of ‘backwardness’.

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By outlining to us the complex history of traditional healing with  little data available on the Madi and (linguistically related) Lugbara, Allen and Storm present to us the medical pluralism that exists in Northern Uganda today. With the increasing provision of biomedicine,  traditional healing practices were often used if  "modern" biomedicine was not effective. I found it particularly interesting that changes in therapies have been driven by complex social factors such as morality and social exclusion. Because the Madi lived outside of Laropi for considerable amounts of time, either as refugees or migration workers in the south, they attempted to "reconnect to their ancestral home". Biomedical care arguably presented a sense of belonging, something their government provided for them and therefore gave them "right to health". What struck me as interesting was that this view was so widely spread, even though people often had little knowledge about biomedicine and rarely would consult a doctor. Even though Allen and Storm mention some type of resistance to the 'modernising' biomedical aspects from the Madi and Lugbara, I think the article would have benefited from more detail on this.

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Marsland shows how ‘‘in this discourse modernity is defined in opposition to tradition, and from here a series of familiar dichotomies – urban–rural, male–female, knowledge – belief, developed – undeveloped – emerge’’ (752).

I find interesting how both biomedicine practitioners and traditional healers are attached to these constructed categories while challenging them.

The mganga groups together a set of herbalists, practitioners of Islamic medicine, sorcery and witchcraft, midwives and healers who depend on spirits. For patients, who represent one Tanzanian out of 400, waganga are central to medical care. Moreover, waganga challenge the status of ‘traditional’ and ‘backward’ they have been assigned to, by innovating, co-operating and learning from biomedical technology on their own terms. They used mass produce pharmaceuticals with Ngetwa which ‘‘localised the global’’. (752)

On the other hand, the understanding of ‘modern’ biomedicine in Tanzania, is closely related to President Nyerere’s African socialism and more specifically to maendeleo, a development project based modernist values of education and rationality, and expert knowledge. Maendeleo is linked to westernisation and material improvements. For Marsland, it is also a moral project that sees tradition as an obstacle. Although biomedicine is less flexible regarding the two categories of medicine because of its ‘‘claim to medical hegemony’’ (764), biomedicine practisioners are  interested in identifying and testing herbal medicines, and  accept a certain ‘‘division of labour’’ which reserves diseases associated with witchcraft to traditional healers. Wouldn't this be, in a way, an acknowledgment by both categories of their limits?

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Response to Umu

I think that the Marsland’s article provides key insights on the situation of hospitals in Tanzania mentioned by Umu. Biomedicine has failed to address major health issues, such as high childhood mortality and morbidity. The waganga, the traditional healers associate this, to the limits of biomedical knowledge and corruption. However, Marsland explains that this failure is due to poverty, insufficient infrastructure and lack of political engagement. She links the regression of public health services to structural adjustment and health service reform and to the demanding needs of the HIV/AIDS epidemic.

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This article by Prince examined the dynamics between biomedical knowledge of HIV and the residents of Kisumu in Western Kenya. I found many areas of this investigation very intriguing. It was interesting to see how the knowledge of HIV was treasured by the residents of Kisumu and the impact it had on their trajectories. Many of the Kisumu residents that engaged with such knowledge were mostly HIV positive and by engaging in these interventions and 'knowing oneself' it also changed their trajectory. Another aspect of this article that I found particularly interesting was the value of volunteering and how it meant son much to not only those interviewed by Prince but other residents of Kisumu. For many people, volunteering enabled them to gain recognition in society and improve their social standing. Also, by gaining certificates, the majority felt empowered and enlightened although these certificates were not as valuable as degrees or diplomas.

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[response to Lyn and Edward] -

I also found it interesting how these governmental/state intervention programmes left some form of gaps within the lives of those who engaged in it. Prince's article highlights how the unstable and fragmented these intentions were and how they impacted their lives. In most cases, the failure of projects, units and lack of resource meant that many people had to find alternative routes to gain knowledge of HIV or interact with these interventions.

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I find Allen and Storm's analysis of how the Madi  perceive and relate to the multiple therapies available to them (in 2008) incredibly interesting. On the one hand the Madi have a deep belief and trust of biomedicine, which is not only due to its proved success, but also due to political and economic factors; "for the Madi, access to allopathic medicines represents the recognition of their needs by the state and the act of swallowing the small white tablets embodies their ties to a "modern", "western" and "global" world" (40). Nevertheless, the embracement of biomedicine by the Madi has not defeated traditional local concepts of misfortune and illness, and the use of traditional therapies including overcoming witchcraft. Allen explains the continued presence of traditional therapy; "it becomes apparent that medical pluralism remains... because therapies are inextricably linked to broader issues and concerns - including who needs to be recognized as a moral person and who needs to be socially excluded" (43). Therefore, the persistence of medical pluralism remains legitimate and meaningful for the Madi, as traditional therapy and biomedicine offer different solutions to different problems in their society.

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Response to Umu

Umu identifies a key point in Langwick's text; that the inadequacies of biomedicine in Hopsital T and in Tanzania more broadly, mean that nurses are often forced to resort to traditional medicine. However, I think that crucial point that explains the persistence of traditional medicine in Tanzania is Langwick's concept of 'the body as multiple'. This concept is described through the example of Mama Ramadhani's son's chronic illness. "Her son’s body required both traditional and modern medicines. He did not have separate afflictions or afflictions with distinctly traditional and biomedical causes as much as his affliction struck a complexly configured body. Treatment for his acute condition required articulation of multiple spheres, the effects of which had to be carefully coordinated. Mama Ramadhani did not return to the hospital because the traditional treatment did not work; she returned because the biomedical treatment could only work after the sorcerer’s mischief was removed. The treatment of one body and one affliction required moving between therapeutic spaces" (436). The continued prevalence of traditional medicine, and the complex ways that traditional medicine and modern medicine interact, are often a result of different fields of belief in these communities, to explain different phenomena. On the one hand, a belief in science, and on the other, a belief in the supernatural. Robin Horton terms this very pertinently; (referring to the congruity between African Traditional healing practices and western biomedical practices) "both invoke theoretical entities of different kinds for explanatory purposes and to bring order/regularity into a world of disorder/irregularity".

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"“Mzungu” had for the moment morphed into “Corona.” White man had become a virus." Its interesting to compare the racial divide to the class divide: "On Kenyan TV, villagers urge their educated urban relations to stay in the city, as they threaten the lives of their elders if they come home to visit."

The article describes the way that COVID19 is being used to incite racism, division and anger and also to question the position of  Europeans in Africa, and how these reactions are directly informed by events and Eurocentric assumptions of a colonial past and present.

The image of Mama Africa mentioned in the article who threatens a doctor who is testing vaccines on African people, has a post below it which says "DEAR AFRICANS, LETS MAKE THIS GO VIRAL". There is an interesting double use of the word "viral" and how the spread of blame, hatred and fear is also causing a pandemic of misinformation, and the inability to extricate the abuse of colonial power from today's actions is perhaps more dangerous to human relations than COVID19 will ever be.

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Soraya saber
‘Maybe if you go to a traditional healer you can get better.’
This article highlights medical pluralism in Tanzania where traditional healers are are becoming professionalised and being incorporated into the clinics. Nurses and nurse aids have a significant role - developing ways of coordinating diverse therapies; rendering bodies which are compatible with both traditional and modern treatment. I found it interesting to see how the personal philosophies around the effectiveness of the different kinds of healing can greatly affect the way people are treated. It became evident that traditional healing was most favoured as clinic staff were described to "grant a discharge without the doctor’s consent provided a space to discuss the use of traditional medicine." "The hospital served as a site for the negotiation of afflictions and medicines, rather than as a separate sphere of therapeutic practice."

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responding to Narjiss
I like the double use of the word "viral" you mentioned and I totally agree that spread of blame, hatred and fear is also causing a "pandemic of misinformation". The inverted colonial narrative about Africa as "backward" and "ill" vs now the white man being the virus struck me as an interesting image. I have noticed it myself, during the outbreak of corona in Jordan, I have often been called "Corona" in the streets.

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Marsland aims to highlight the dualism of biomedicine in Tanzania similar to Langwick's article however explains it differently. From her research anger is felt by traditional healers who had little referrals from biomedical practitioners to use their traditional healing services; they believe that boundaries are put in place by practitioners in order to put off competition. She presents biomedicine as less flexible and emphasises the biomedical practitioners aim to prevent ‘hybrids’ of biomedicine and traditional medicine as they don’t want modern medicine/biomedicine to be seen as a hybrid in itself

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Brown (2012) is as reading we were given as part of Theory in Anthropology Module, which relates to this week's topic on the relationship between the individual body and larger social body, and how illness and death are dealt with  through different types of care: "familial" and "biomedical".

https://ble.soas.ac.uk/pluginfile.php/5238001/mod_resource/content/6/Brown%202012%20Hospital%20Domestics.pdf

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Eleonora's point about how and if language will change, taken together with Nours comment on the use of dichotomies here is really relevant to our world and the knowledge crisis we are witnessing. The fact that "traditional" (or "alternative") and "modern" medicine are often presented as an either/or option makes the intersections between them less visible. Some medical phenomenon and practices cannot be explained in the language of modern medicine (such as Chi in Traditional Chinese Medicine), this means it is often overlooked or explained as a form of faith-healing. This lack of available language means western medicine limits its own understandings and ability to engage with other forms of healing.

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Ladwick not only explores the way’s healers innovate in the face of biomedicine’s interruptions but also the ways that biomedical practitioners innovate in the face of traditional medicine’s interruption. It was interesting to observe the ways neo-liberal reforms in Tanzania contributed to medical pluralism within hospitals- the sufficiency of staffing, conditions of the clinics and availability of medicine suffered under the IMF structural adjustment program which reduced state funding on social services. It is my position that this analysis positions traditional medicine as a last resort- a consequence of underfunding instead of a significant element of treatment across Africa. 

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Ladwick not only explores the way’s healers innovate in the face of biomedicine’s interruptions but also the ways that biomedical practitioners innovate in the face of traditional medicine’s interruption. It was interesting to observe the ways neo-liberal reforms in Tanzania contributed to medical pluralism within hospitals- the sufficiency of staffing, conditions of the clinics and availability of medicine suffered under the IMF structural adjustment program which reduced state funding on social services. It is my position that this analysis positions traditional medicine as a last resort- a consequence of underfunding instead of a significant element of treatment across Africa.

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I found the section titled 'knowing who I am' particularly interesting, explaining the ways in which people react to their HIV positive status.

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I was wondering about the way the writers used the few past ethnographies available about this area. In the conclusion the authors recognise that the changes in anthropology over the years will have changed the methodologies and emphases of the studies, but they still use them to construct a chronological historical narrative. They also use accounts from different areas, assuming that geographical and linguistic similarity mean that the historical developments are part of the same continuous narrative. Maybe this is not too much of a problem since the authors still make the readers aware of where the information comes from?

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The efforts of nursing staff at Hospital T. in tending to their patients’ needs can be articulated as a form of medical pluralism in the juncture of the state-sanctioned exertions to modernize/ professionalize the medical fields, which eventually led to a ‘staffing crisis and the certain afflictions that biomedicine could not address or more importantly could not present a remedy for. The nurses are at the center of this narrative because it was the nursing practices that rendered “bodies compatible with both traditional and modern treatment” (429). They went beyond the confines of biomedical cognizance in their interpretations of the particular contexts in which bodies, as a result of cultural conventions at large, have been articulated as new bodily ‘assemblages’ that require different forms of treatment.

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(response to Umu's comment)
I liked your point about the value of volunteering to people who were HIV positive. When I read the article, I noticed more the precarity of the training and unstable employment in the HIV programs, so I missed the point that volunteering was meaningful for people.

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Naliyes Moses
In this blog, Geissler and Prince state their experience in Kenya during the first wave of COVID-19. What I found interesting is that the spread of  corona virus From Europe to Africa particularly Kenya triggered triggered some Kenyans to conceptualise this pandemic as a European disease. This is manifested when the children greet Geissler and Prince in a friendly manner by exclaiming, "Coronavirus, how are you?". This shows that illnesses can be conceptualised differently in a country and in fact in this case the pandemic led to colonial imaginaries in Kenya.

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One thing that struck me about the Allen reading was how he looked at language, Health translates into something good, but might not fit many peoples description of healthy. The words for illness and disease also don't have a direct translation and it can refer to any type of suffering. I like that it implies a more holistic look at medicine. In the west we are very medicalised and in examples of things like trauma that can then cause physical symptoms, only the physical symptoms are treated rather than a persons full well being.

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In response to Umu Bashir:

I found the idea of a 'certificate' especially interesting too, like you, the impact on their identity was clear and profound. As Prince said 'They are highly affective documents,

deeply entwined with identities and relationships and invested with hope and anticipation’ p. 79. In consideration, a certificate bears no value but the qualification does. It does not only represent knowledge but it also represents hope for the future and their wider family.

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The article is very interesting, since it givesa particular  insight in the various cultures, traditions and health. It is apparent, that all the nations have particular philosophy over the traditional medicine and most of them still refer to it as an opportunity when the contemporary therapy is ineffective.
Taking in the account the harsh realities in Africa, it is obvious why people and medical staff turn to the traditional healers. The ideal care does not exist, but Neoliberal reforms, unfunded hospitals, low-level clinic staff, imported medication- are the Government's act and position in regards to the healthcare of their countries. They  can do more for their population.

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Although Prince in her paper does not reach this conclusion in her discussion of certificates, I think it can be said that knowledge ( particularly self knowledge) can be a prized possession in a social milieu dominated by uncertainty and a lack of opportunity. These things are debilitating to an overall sense of personhood such that even negative identity traits can take on a positive meaning, as well as produce practical benefits for the management of HIV.

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Marsland argues the inability of modern medicine to deal with major health issues which can be linked to poverty, lack of infrastructure and lack of political commitment. This I found really interesting. No, one medicine should have privilege over the other. This research highlights how poverty and infrastructure is one of the biggest causes for health decline. Natural medicines are far more affordable and accessible. The article really reminds its readers that there needs to be greater understanding in terms of the collaboration that natural and biomedicine can deliver together and that assumptions about the harms of natural medicine be challenged and removed.

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response to Benn:
That is really mad to hear about the case of those french scientists suggesting to test vaccines on Africans, what an embarrassing exposure of the views clearly still pervasive among the professional elites in the west!
And Narjiss that is also fasicnating to look at class division compared to racial division as if the threat of the virus is model on which division becomes apparent.

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Langwick makes important points in this article to show the relevance of traditional medicine  in Tanzania especially in hospital T. Basically, neoliberal reforms have had enormous impacts on hospitals and clinics in Tanzania, "affecting the quality and sufﬁciency of

stafﬁng, the conditions of the clinic, and the availability of medicines" (p 430). These harsh realities triggered nurses in hospital T to employ  "traditional

medicine in an effort to address the immediate needs of

their patients" (p 430).

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In response to Ria

I too found the analysis of the word 'health' in different languages interesting.

‘The term used to translate the word ‘‘health’’ among the Madi is cwe, which basically suggests something which is ‘‘good’’, so it is not confined to conventional notions of being healthy.’ p25

‘It is also difficult to translate precisely the words ‘‘illness’’ or ‘‘disease’’. In Madi both are translated as laza, but this can also refer to almost any kind of suffering, misfortune or pain.’ p25

what I found most interesting is the way the WHO defines Health as  ‘a complete sense of mental, physical and social wellbeing, and not just the absence of disease’’. P25

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In response to Olga, I agree this article does demonstrate clearly some of the reasons why people and medical staff tend to go to traditional healers, I also understand how neoliberal reforms, affect ‘the quality and sufﬁciency of stafﬁng, the conditions of the clinic, and the availability of medicines’ but I do tend to question whether if quality and access to biomedicine improved drastically whether traditional healers would still be popular, I only question this much because despite living in the west I have family members who frequently use and even favour traditional methods of healing to this day.

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In response to Umu and Nour that whilst the article displayed an interesting insight into dynamic relationship between traditional medicine and biomedicine, I agree with my peers in that this relationship is flawed. I follow on from Nour’s post in that the author highlighted the failure of biomedicine being due to political issues, poverty, and major health issues. My input further includes that this involves a clear case of colonialism’s impact in Tanzania, much like the rest of Africa. Their traditional and relied on medicinal care is undergoing modernisation that followed on post-colonialism.

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Marsland’s article explores the dualism between biomedicine and traditional medicine in Tanzania. What stood out most is Marsland’s interest in the “ways that the language and practices of waganga and biomedical practitioners work to challenge or stabilise the boundaries which are so essential to the ways in which their medicine is imagined” (756). Creating a clear distinction between both types, with the traditional being categorised as backward and marginal whilst biomedicine is seen as modern and progressive. By the end of the article, Marsland highlights how many of the waganga she spoke to were trying to learn how to modernise their medicines. However, it might be too simplistic to assert that its that simple, especially since evidence of colonialism is still found lurking in this exact dualism. Lastly, the fact that some of the doctors/healers follow Islamic traditional medicine does not make them backward seen as in my culture - a muslim one- we still rely on said traditional medicine today!