Improvising Medicine

An African Oncology Ward in an Emerging Cancer Epidemic

Julie Livingston

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English

Duke University Press
29 August 2012

Health systems & services; Oncology

In Improvising Medicine, Julie Livingston tells the story of Botswana's only dedicated cancer ward, located in its capital city of Gaborone. This affecting ethnography follows patients, their relatives, and ward staff as a cancer epidemic emerged in Botswana. The epidemic is part of an ongoing surge in cancers across the global south; the stories of Botswana's oncology ward dramatize the human stakes and intellectual and institutional challenges of an epidemic that will shape the future of global health. They convey the contingencies of high-tech medicine in a hospital where vital machines are often broken, drugs go in and out of stock, and bed-space is always at a premium. They also reveal cancer as something that happens between people. Serious illness, care, pain, disfigurement, and even death emerge as deeply social experiences. Livingston describes the cancer ward in terms of the bureaucracy, vulnerability, power, biomedical science, mortality, and hope that shape contemporary experience in southern Africa. Her ethnography is a profound reflection on the social orchestration of hope and futility in an African hospital, the politics and economics of healthcare in Africa, and palliation and disfigurement across the global south.

By: Julie Livingston
Imprint: Duke University Press
Country of Publication: United States
Dimensions: Height: 235mm, Width: 156mm, Spine: 15mm
Weight: 340g
ISBN: 9780822353423
ISBN 10: 0822353423
Pages: 277
Publication Date: 29 August 2012
Audience: Professional and scholarly , Undergraduate
Format: Paperback
Publisher's Status: Active

Preface ix Acknowledgments xiii 1. The Other Cancer Ward 1 2. Neoplastic Africa: Mapping Circuits of Toxicity and Knowledge 29 3. Creating and Embedding Cancer in Botswana's Oncology Ward 52 Interlude. Amputation Day at Princess Marina Hospital 85 4. The Moral Intimacies of Care 93 5. Pain and Laughter 119 6. After ARVs, During Cancer, Before Death 152 Epilogue. Changing Wards, Further Improvisations 174 Notes 183 Bibliography 205 Index 221

Julie Livingston is Associate Professor of History at Rutgers University. She is the author of Debility and the Moral Imagination in Botswana and a coeditor of Three Shots at Prevention: The HPV Vaccine and the Politics of Medicine's Simple Solutions and A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship.

Reviews for Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic

Improvising Medicine is a luminous book by a highly respected Africanist whose work creatively bridges anthropology and history. A product of intense listening and observation, deep care, and superb analytical work, it will become a canonical ethnography of medicine in the global south and will have a big impact across the social sciences and medical humanities. --Joao Biehl, author of Will to Live: AIDS Therapies and the Politics of Survival and Vita: Life in a Zone of Social Abandonment