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Borders, healers, politics: Brokering therapeutic sources in Zanzibar

Subject Area Social and Cultural Anthropology and Ethnology
Term from 2015 to 2024
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 266953613
 
Final Report Year 2024

Final Report Abstract

This project explored the reintegration of traditional healing practices into public healthcare in Zanzibar after a history of political repression. This shift, driven by local and international forces, aimed to transform traditional medicine from a colonial “public health evil” to a valuable postcolonial health resource. Key influences include the Ministry of Health’s (MoH) efforts to standardize traditional medicine, its response to declining public health access due to structural adjustment programs, and the international NGO “World Doctors,” which collaborates with the MoH to regulate traditional healing. The research focused on the “Traditional Medicine Policy Act” and its implementation by the MoH and World Doctors, examining how these initiatives affected traditional healers’ roles and governance structures. The project particularly analyzed how new policies addressed non-communicable diseases (NCDs) in Zanzibar, where cardiovascular diseases and diabetes are increasing yet understudied. The study highlighted the complex boundary work involved in traditional healing, considering Zanzibar’s diverse cultural influences. It examined how traditional medicine is being transformed into a recognized resource under specific political conditions, contributing to the broader field of resourcification studies and with theoretical implications for the anthropology of traditional medicine, religion and healing, and the living with chronic diseases within the scope of NCDs and critical global health. Building on the first phase, the second research period investigated the assemblages of health actors, therapeutic routes, and resources involved in NCD management. It emphasized the role of social, economic, and political conditions, as well as biopolitics and environmental factors, in shaping health outcomes. The study particularly focused on the management of diabetes and hypertension, within the context of neoliberal health policies that emphasize selfcare and individual responsibility. The research also explored gendered aspects of health, particularly how Zanzibari women navigate the complexities of managing NCDs. It highlighted the impact of stress and precarious living conditions on health, emphasizing that “lifestyle choices” are often constrained by broader socio-economic factors. Additionally, the study examined the increasing awareness of environmental toxins, particularly pesticides, and their role in shaping NCD aetiology. It noted the challenges posed by unregulated pesticide use and persistent toxins in the environment. The research highlighted the broader implications for the field of planetary health, social and gender inequality, and the governance of environmental health issues due to industrial pollution in East Africa. The project stressed the importance of a comprehensive approach to understanding NCDs, integrating human health with environmental and societal factors, to address the complex realities of NCDs in Zanzibar and beyond.

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