Historiography of Health, Disease and Healing in Eastern, Central, and Southern Africa

Abstract

This article examines the evolution of African historiography on health, disease, and healing in Eastern, Central, and Southern Africa. It argues that the production of historical knowledge about health, disease, and healing has been dynamic.  Until the 1960s, institutional histories of health, disease, and healing dominated.  These histories paid attention to the creation of western medical institutions and infrastructure in the colonies.  They also romanticised the introduction of colonial medicine as an important symbol of the benefits of colonialism to Africans.  The 1970s witnessed the emergence of ecological histories that conceptualised colonialism as a disaster to the conditions of health and disease in Eastern, Central, and Southern Africa. These histories pointed out that the imposition of colonialism disturbed the pre-colonial ecological equilibrium, and transformed many diseases, such as sleeping sickness, from endemic to epidemic proportions.  They also blamed colonial medicine for disregarding African indigenous ideas and practices of medicine, a development that undermined an important cultural resource Africans had historically utilised to cope with medical challenges in their homes and communities.  Ecologically oriented studies were followed by political economy histories of health and disease which evolved in the late 1970s, but became dominant in the 1980s.  They studied health and disease in the context of social, economic, and political changes, arguing that they were inseparable from the way households, communities and societies were organised.  In the 1990s and early 2000, two main historiographies – discourse analyses and socio-cultural histories – emerged and assumed dominance in shaping production of knowledge on health, disease, and healing. Discourse analysis histories paid attention to textual analysis of the politics of medical knowledge production and to the ideas, meanings, and practices of medicine.  Socio-cultural histories explored medicine as a complex cultural terrain of struggles, negotiations, and cultural exchanges between social communities engaged in it.