A Heart for the Work: Journeys through an African Medical School


Claire L. Wendland - 2010
    But, as A Heart for the Work makes clear, Malawian medical students learn to confront poverty creatively, experiencing fatigue and frustration but also joy and commitment on their way to becoming physicians. The first ethnography of medical training in the global South, Claire L. Wendland’s book is a moving and perceptive look at medicine in a world where the transnational movement of people and ideas creates both devastation and possibility.Wendland, a physician anthropologist, conducted extensive interviews and worked in wards, clinics, and operating theaters alongside the student doctors whose stories she relates. From the relative calm of Malawi’s College of Medicine to the turbulence of training at hospitals with gravely ill patients and dramatically inadequate supplies, staff, and technology, Wendland’s work reveals the way these young doctors engage the contradictions of their circumstances, shedding new light on debates about the effects of medical training, the impact of traditional healing, and the purposes of medicine.

The Invisible Cure: Africa, the West, and the Fight Against AIDS


Helen C. Epstein - 2007
    Now, in her unsparing and illuminating account of this global disease, she describes how international health experts, governments, and ordinary Africans have struggled to understand the rapid and devastating spread of the disease in Africa, and traces the changes wrought by new medical developments and emerging political realities. It is an account of scientific discovery and intrigue with implications far beyond the fight against one tragic disease. The AIDS epidemic is partly a consequence of the rapid transition of African societies from an agrarian past to an impoverished present. Millions of African people have yet to find a place in an increasingly globalized world, and their poverty and social dislocation have generated an earthquake in gender relations that deeply affects the spread of HIV. But Epstein argues that there are solutions to this crisis, and some of the most effective ones may be simpler than many people assume. Written with conviction, knowledge, and insight, Why Don't They Listen? will change how we think about the worst health crisis of the past century, and our strategies for improving global public health.

The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS


Elizabeth Pisani - 2008
    With swashbuckling wit and fierce honesty, she dishes on herself and her colleagues as they try to prod reluctant governments to fund HIV prevention for the people who need it most—drug injectors, gay men, sex workers, and johns.Pisani chats with flamboyant Indonesian transsexuals about their boob jobs and watches Chinese streetwalkers turn away clients because their SUVs aren't nice enough. With verve and clarity, she shows the general reader how her profession really works; how easy it is to draw wrong conclusions from "objective" data; and, shockingly, how much money is spent so very badly. "Exhibit A": the 45 billion taxpayer dollars the Bush administration is committing to international AIDS programs.

28: Stories of AIDS in Africa


Stephanie Nolen - 2007
    It is essential reading for our times.In 28, Stephanie Nolen, the Globe and Mail’s Africa Bureau Chief, puts a human face to the crisis created by HIV-AIDS in Africa. She has achieved, in this amazing book, something extraordinary: she writes with a power, understanding and simplicity that makes us listen, makes us understand and care. Through riveting anecdotal stories – one for each of the million people living with HIV-AIDS in Africa – Nolen explores the effects of an epidemic that well exceeds the Black Plague in magnitude. It is a calamity that is unfolding just a 747-flight away, and one that will take the lives of these 28 million without the help of massive, immediate intervention on an unprecedented scale. 28 is a timely, transformative, thoroughly accessible book that shows us definitively why we continue to ignore the growth of HIV-AIDS in Africa only at our peril and at an intolerable moral cost.28’s stories are much more than a record of the suffering and loss in 28 emblematic lives. Here we meet women and men fighting vigorously on the frontlines of disease: Tigist Haile Michael, a smart, shy 14-year-old Ethiopian orphan fending for herself and her baby brother on the slum streets of Addis Ababa; Alice Kadzanja, an HIV-positive nurse in Malawi, where one in six adults has the virus, and where the average adult’s life expectancy is 36; and Zackie Achmat, the hero of South Africa’s politically fragmented battle against HIV-AIDS. 28 also tells us how the virus works, spreads and, ultimately, kills. It explains the connection of HIV-AIDS to conflict, famine and the collapse of states; shows us how easily treatment works for those lucky enough to get it and details the struggles of those who fight to stay alive with little support. It makes vivid the strong, desperate people doing all they can, and maintaining courage, dignity and hope against insurmountable odds. It is – in its humanity, beauty and sorrow – a call to action for all who read it.

AIDS and Accusation: Haiti and the Geography of Blame


Paul Farmer - 1992
    Does the scientific "theory" that HIV came to North America from Haiti stem from underlying attitudes of racism and ethnocentrism in the United States rather than from hard evidence? Anthropologist-physician Paul Farmer answers in the affirmative with this, the first full-length ethnographic study of AIDS in a poor society.

Race Against Time


Stephen Lewis - 2005
    Lewis's determination to bear witness to the desperate plight of so many in Africa and elsewhere is balanced by his unique, personal, and often searing insider's perspective on our ongoing failure to help.Lewis recounts how, in 2000, the United Nations Millennium Summit in New York introduced eight Millennium Development Goals, which focused on fundamental issues such as education, health, and cutting poverty in half by 2015. In audacious prose, alive with anecdotes ranging from maddening to hilarious to heartbreaking, Lewis shows why and how the international community is falling desperately short of these goals.This edition includes an afterword by Lewis, covering events after the lectures were delivered in fall 2005.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World


Tracy Kidder - 2003
    Doctor, Harvard professor, renowned infectious-disease specialist, anthropologist, the recipient of a MacArthur "genius" grant, world-class Robin Hood, Farmer was brought up in a bus and on a boat, and in medical school found his life’s calling: to diagnose and cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most.Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity"—a philosophy that is embodied in the small public charity he founded, Partners in Health. He enlists the help of the Gates Foundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb "Beyond mountains there are mountains": as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

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


Julie Livingston - 2012
    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.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."Improvising Medicine is as good as it gets. It is a book that will be read for decades to come. I have always thought that great ethnography transcends the specificities of time and place, of the particular, to offer a glimpse of the universal. This gripping book does just that, and the subtle and grounded way that it speaks to global health and debates in medical anthropology makes it a major addition to both fields."—Vinh-Kim Nguyen, M.D., author of The Republic of Therapy: Triage and Sovereignty in West Africa's Time of AIDS“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.”—João Biehl, author of Will to Live: AIDS Therapies and the Politics of Survival and Vita: Life in a Zone of Social Abandonment

The Origins of AIDS


Jacques Pepin - 2011
    Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanization, prostitution, and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Leopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learnt if we are to avoid provoking another pandemic in the future.

An Imperfect Offering: Humanitarian Action in the Twenty-first Century


James Orbinski - 2008
    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

The Cholera Years: The United States in 1832, 1849, and 1866


Charles E. Rosenberg - 1968
    Its defeat was a reflection not only of progress in medical knowledge but of enduring changes in American social thought. Rosenberg has focused his study on New York City, the most highly developed center of this new society. Carefully documented, full of descriptive detail, yet written with an urgent sense of the drama of the epidemic years, this narrative is as absorbing for general audiences as it is for the medical historian. In a new Afterword, Rosenberg discusses changes in historical method and concerns since the original publication of The Cholera Years."A major work of interpretation of medical and social thought . . . this volume is also to be commended for its skillful, absorbing presentation of the background and the effects of this dread disease."—I.B. Cohen, New York Times"The Cholera Years is a masterful analysis of the moral and social interest attached to epidemic disease, providing generally applicable insights into how the connections between social change, changes in knowledge and changes in technical practice may be conceived."—Steven Shapin, Times Literary Supplement"In a way that is all too rarely done, Rosenberg has skillfully interwoven medical, social, and intellectual history to show how medicine and society interacted and changed during the 19th century. The history of medicine here takes its rightful place in the tapestry of human history."—John B. Blake, Science

The Big Truck that Went By: How the World Came to Save Haiti and Left Behind a Disaster


Jonathan M. Katz - 2013
    Jonathan M. Katz, the only full-time American news correspondent in Haiti, was inside his house when it buckled along with hundreds of thousands of others. In this visceral, authoritative first-hand account, Katz chronicles the terror of that day, the devastation visited on ordinary Haitians, and how the world reacted to a nation in need.More than half of American adults gave money for Haiti, part of a monumental response totaling $16.3 billion in pledges. But three years later the relief effort has foundered. It’s most basic promises—to build safer housing for the homeless, alleviate severe poverty, and strengthen Haiti to face future disasters—remain unfulfilled. The Big Truck That Went By presents a sharp critique of international aid that defies today’s conventional wisdom; that the way wealthy countries give aid makes poor countries seem irredeemably hopeless, while trapping millions in cycles of privation and catastrophe. Katz follows the money to uncover startling truths about how good intentions go wrong, and what can be done to make aid “smarter.”With coverage of Bill Clinton, who came to help lead the reconstruction; movie-star aid worker Sean Penn; Wyclef Jean; Haiti’s leaders and people alike, Katz weaves a complex, darkly funny, and unexpected portrait of one of the world’s most fascinating countries. The Big Truck That Went By is not only a definitive account of Haiti’s earthquake, but of the world we live in today.

Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty


Abhijit V. Banerjee - 2011
    But much of their work is based on assumptions that are untested generalizations at best, harmful misperceptions at worst.Abhijit Banerjee and Esther Duflo have pioneered the use of randomized control trials in development economics. Work based on these principles, supervised by the Poverty Action Lab, is being carried out in dozens of countries. Drawing on this and their 15 years of research from Chile to India, Kenya to Indonesia, they have identified wholly new aspects of the behavior of poor people, their needs, and the way that aid or financial investment can affect their lives. Their work defies certain presumptions: that microfinance is a cure-all, that schooling equals learning, that poverty at the level of 99 cents a day is just a more extreme version of the experience any of us have when our income falls uncomfortably low.This important book illuminates how the poor live, and offers all of us an opportunity to think of a world beyond poverty.Learn more at www.pooreconomics.com

Band-Aid for a Broken Leg


Damien Brown - 2012
    But the town he's sent to is an isolated outpost of mud huts, surrounded by landmines; the hospital, for which he's to be the only doctor, is filled with malnourished children and conditions he's never seen; and the health workers—Angolan war veterans twice his age who speak no English—walk out on him following an altercation on his first shift. In the months that follow, Damien confronts these challenges all the while dealing with the social absurdities of living with only three other volunteers for company. The medical calamities pile up—including a leopard attack, a landmine explosion, and having to perform surgery using tools cleaned on the fire—but it's through Damien's evolving friendships with the local people that his passion for the work grows. This heartbreaking and honest account of life on the medical front line in Angola, Mozambique, and South Sudan is a moving testimony of the work done by medical humanitarian groups and the extraordinary and sometimes eccentric people who work for them.

Getting to Zero: A Doctor and a Diplomat on the Ebola Frontline


Sinéad Walsh - 2018
    Completely overwhelmed and wrapped in stifling protective suits, he and his team took it in turns to provide care to patients while removing dead bodies from the ward. Against all odds he battled to keep the hospital open, as the queue of sick and dying patients grew every day. Only a few miles down the road the Irish Ambassador and Head of Irish Aid worked relentlessly to rapidly scale up the international response. At a time when entire districts had been quarantined, she travelled around the country, and met with UN agencies, the President and senior ministers so as to be better placed in alerting the world to the catastrophe unfolding in front of her.In this blow-by-blow account, Walsh and Johnson expose the often shocking shortcomings of the humanitarian response to the outbreak, both locally and internationally, and call our attention to the immense courage of those who put their lives on the line every day to contain the disease. Theirs is the definitive account of the fight against an epidemic that shook the world.