Diversity and Division in Medicine

This is an innovative investigation of pluralism in health care. Using both extensive archival material and oral histories it examines relationships between indigenous healing, missionary medicine, and 'western' biomedicine. The book includes the different regions within South Africa although focusing in most detail on the Cape, the earliest area of white settlement. In a wide-ranging survey the division in medicine between 'western' and indigenous medicine is analysed through an exploration of the evolving practices of healers, missionaries, doctors and nurses. The book considers the extent to which there was a strategic crossing of boundaries in the construction of hybrid practices by these practitioners, and the extent to which patients pursued health by sampling diverse care options. Starting with missionary penetration during the early nineteenth century, the volume outlines interventions by the colonial state in medicine and public health, and the continued resilience of indigenous healing in the face of this. The book ends by relating past to present in scrutinising the legacy of historical structures including those of the apartheid state for current health care, and in briefly discussing the huge challenges that the HIV/Aids pandemic poses in impacting on them. The book thus provides an inclusive history of medicine for the 'New' South Africa.

Auteur

The Author: Anne Digby is Research Professor in History at Oxford Brookes University. Currently she is collaborating with colleagues from the University of Cape Town in researching the history of Groote Schuur Hospital, Cape Town, where the world's first heart transplant took place.

Résumé
«Diversity and Division in Medicine is a welcome addition to the history of medicine in South Africa. It ambitiously brings together analysis of many of the complexities of health care in that country during the last two centuries and highlights its differentiated and contested character. (Vanessa Noble, Medical History)
«This long-awaited book fills an important niche in the current medical historiography of Africa. [...] Diversity and Division in Medicine is an important study which makes a fearless attempt to provide a critically-aware, broad and comprehensive overview of the dynamics of medical pluralism within South Africa from the early 1800s until the present day. [...] It should be on the shelves of all those interested in colonial medical history.» (Anna Crozier, Social History of Medicine)

Contenu

Contents: Setting the scene within historiography - Medical diversity within a single region: Kuruman voices - Health care providers: missionaries, 'western' practitioners - doctors and nurses, African indigenous healers - Role of women as missionaries, as nurses, as healers - 'Western' medicine and extension of 'civilisation' - Disease, race and empire - Nurses as culture brokers in the community - Resilience of indigenous medicine - Medical pluralism: crossing boundaries in practitioner eclecticism, and crossovers in patient pluralism - Retrospect and prospect - past structures and present prospects - Segregation and apartheid in health care - The HIV/AIDS pandemic - Attempts to create a unified health care system for the nation.