Religion and healing are useful scholarly constructs in summarizing, consolidating, and interpreting a myriad of details from the historic African-Atlantic experience. For heuristic purposes, religion is understood as the worldviews, rituals, and supernatural beings that represent ultimate reality; healing is the understanding of, and responses to, affliction and misfortune, and the struggle to achieve wholeness. Combining religion and healing in an overview of the African diaspora experience will consider the following: original African worlds in four regional contexts in Western and Western Central Africa (e.g., Senegambia, Upper Guinea, Southern Guinea, Kongo-Angola); the traumatic middle passage refracted in the “broken mirrors” of memory; how this memory is mixed and reinterpreted with the New World experience of slave markets, plantations, maroon settlements, and during post-slavery, post-empire times; scholarly models of continuity and transformation; and modern constructions of religion and healing.
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African Religion and Healing in the Atlantic Diaspora
John M. Janzen
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The African Rinderpest Panzootic, 1888–1897
Thaddeus Sunseri
Between 1888 and 1897, rinderpest virus (cattle plague) spread throughout sub-Saharan Africa, presumably for the first time, killing over 90 percent of African cattle and countless wildlife, expedited by European colonial conquest. Beginning in the Eritrean port of Massawa, the virus was transmitted across the Sahel, reaching the Senegal River by 1891. The epizootic spread south out of the Horn of Africa, into the western and eastern Rift valleys, and likely by sea with coastal commerce, infecting East Africa after 1891. Although slowed by the Zambezi River, in 1896 rinderpest reached the regions of modern Zimbabwe, Mozambique, Botswana, South Africa, Namibia, and southern Angola before it burned out or was arrested by breakthroughs in vaccine therapy by 1900. South of the Zambezi, early European methods of stanching rinderpest by destroying all cattle exposed to the virus often elicited protest, resistance, and sometimes rebellion. Rinderpest was eliminated from southern Africa shortly after the turn of the 20th century but became enzootic in other parts of the continent, often in wildlife, until eradicated globally in 2011. In each region of infection, local ecologies, trade patterns, agricultural bases, social structures, and power dynamics shaped the impact of rinderpest. Almost everywhere, rinderpest was preceded by drought and locust plagues, and followed by human diseases, especially smallpox and malnutrition.
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Cannabis and Tobacco in Precolonial and Colonial Africa
Chris S. Duvall
Cannabis and tobacco have longstanding roles in African societies. Despite botanical and pharmacological dissimilarities, it is worthwhile to consider tobacco and cannabis together because they have been for centuries the most commonly and widely smoked drug plants. Cannabis, the source of marijuana and hashish, was introduced to eastern Africa from southern Asia, and dispersed widely within Africa mostly after 1500. In sub-Saharan Africa, cannabis was taken into ethnobotanies that included pipe smoking, a practice invented in Africa; in Asia, it had been consumed orally. Smoking significantly changes the drug pharmacologically, and the African innovation of smoking cannabis initiated the now-global practice. Africans developed diverse cultures of cannabis use, including Central African practices that circulated widely in the Atlantic world via slave trading. Tobacco was introduced to Africa from the Americas in the late 1500s. It gained rapid, widespread popularity, and Africans developed distinctive modes of tobacco production and use. Primary sources on these plants are predominantly from European observers, which limits historical knowledge because Europeans strongly favored tobacco and were mostly ignorant or disdainful of African cannabis uses. Both plants have for centuries been important subsistence crops. Tobacco was traded across the continent beginning in the 1600s; cannabis was less valuable but widely exchanged by the same century, and probably earlier. Both plants became cash crops under colonial regimes. Tobacco helped sustain mercantilist and slave-trade economies, became a focus of colonial and postcolonial economic development efforts, and remains economically important. Cannabis was outlawed across most of the continent by 1920. Africans resisted its prohibition, and cannabis production remains economically significant despite its continued illegality.
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Christian Missions and the State in 19th and 20th Century Angola and Mozambique
Teresa Cruz e Silva
Christian missionary work in Angola and Mozambique during the colonial and postcolonial eras was shaped by a complex of factors related to religion, education, and politics. Missionaries’ networks of local support played an outstanding role in their humanitarian work, particularly in the 20th and 21st centuries.
By the end of the 19th century, Catholic and Protestant missions had established themselves in Angola and Mozambique. Until 1974, Protestants had a tense relationship with the Portuguese authorities, as they were suspected of serving the political interests of some European countries against Portugal, and later of supporting African opposition to colonial domination. Unlike the Protestants, the Catholic Church enjoyed a close collaboration with the ruling regime. Under the Concordat and the Missionary Accord of 1940 and the Missionary Statute of 1941, which were agreed between the Vatican and Portugal, Catholic missions enjoyed a privileged position to the detriment of Protestants, whose activities were severely restricted.
The years that followed the independences of Angola and Mozambique in 1975 were characterized by open hostility to religion, aggravated by the nationalization of missions’ assets and properties in both countries. Mission activities related to education and health became hard to carry out. With the civil wars in Angola and Mozambique, warfare and dislocation gave a new social role to the churches. Between the mid-1980s and 1990 the first signs of new policies emerged. While in Angola the relationship between church and state was marked by ambiguity and mistrust, cooperation and collaboration prevailed in Mozambique, where the 1980s saw a rapprochement and constructive dialogue between the two institutions. This was sealed by the roles both Protestants and Catholics played in the peace and democratization processes.
The political opening that characterized the 1990s and 2000s brought significant changes for both countries including the presence in the public space of new churches, especially those of Pentecostal denominations. The new sociopolitical contexts in Angola and Mozambique between the late 20th and early 21st centuries shaped the new roles of the missions, which remain more focused on social, rather than political, activities.
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Disease and Epidemiology of Humans and Animals: Methods
James L.A. Webb, Jr.
Research in the field of historical epidemiology involves a multidisciplinary approach that integrates evidence from the biomedical and public health sciences with other sources for historical analysis. Its principal goal is the understanding of the distribution of disease over time and space and the ways in which disease control efforts have had an impact on disease transmission. Based in part on microbiological data and analysis, the historical burdens of infectious disease for human beings and domesticated livestock in early tropical Africa appear to have been high relative to other world regions. Although Africans developed indigenous treatments that provided relief for many human diseases (and, in the case of smallpox, used variolation with smallpox matter to induce immunity), it was only in the 20th century that major scientific advances in disease control and treatment through the use of antibiotics and vaccines began to substantially reduce the overall burden of human and animal infectious disease. The advances in Western biomedicine did not displace African systems of indigenous medicine, and in most African contexts, different systems of medicine coexist.
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Disease Control and Public Health in Colonial Africa
Samuël Coghe
Disease control and public health have been key aspects of social and political life in sub-Saharan Africa since time immemorial. With variations across space and time, many societies viewed disease as the result of imbalances in persons and societies and combined the use of materia medica from the natural world, spiritual divination, and community healing to redress these imbalances. While early encounters between African and European healing systems were still marked by mutual exchanges and adaptations, the emergence of European germ theory-based biomedicine and the establishment of racialized colonial states in the 19th century increasingly challenged the value of African therapeutic practices for disease control on the continent.
Initially, colonial states focused on preserving the health of European soldiers, administrators, and settlers, who were deemed particularly vulnerable to tropical climate and its diseases. Around 1900, however, they started paying more attention to diseases among Africans, whose health and population growth were now deemed crucial for economic development and the legitimacy of colonial rule. Fueled by new insights and techniques provided by tropical medicine, antisleeping sickness campaigns would be among the first major interventions. After World War I, colonial health services expanded their campaigns against epidemic diseases, but also engaged with broader public health approaches that addressed reproductive problems and the social determinants of both disease and health.
Colonial states were not the only providers of biomedical healthcare in colonial Africa. Missionary societies and private companies had their own health services, with particular logics, methods, and focuses. And after 1945, international organizations such as the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) increasingly invested in health campaigns in Africa as well. Moreover, Africans actively participated in colonial disease control, most notably as nurses, midwives, and doctors. Nevertheless, Western biomedicine never gained hegemony in colonial Africa. Many Africans tried to avoid or minimize participation in certain campaigns or continued to utilize the services of local healers and diviners, often in combination with particular biomedical approaches. To what extent colonial disease control impacted on disease incidence and demography is still controversially debated.
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HIV/AIDS in South Africa
Rebecca Hodes
Approximately 36.7 million people worldwide are living with the Human Immunodeficiency Virus (HIV). Almost 20 percent of South Africa’s adult population (aged fifteen to forty-nine) is HIV-positive, and about one in every five people living with HIV worldwide is in South Africa. The pandemic, and the political controversies it elicited, have come to define both local and global understandings of the post-apartheid nation. The history of HIV in South Africa begins in the 1980s during an era of heightened repression by the apartheid state, in which discriminatory laws and fearful public responses tapped into broader prejudices relating to race and sexuality. During the 1990s, as South Africa transitioned to democracy and as rates of HIV reached pandemic levels, partnerships were built between civil society and state actors to confront the many challenges that the HIV epidemic presented. However, from the late 1990s, corruption and the abuse of political power within the Department of Health, together with the government’s refusal to provide life-saving antiretroviral treatment (ART), ignited a new era in health advocacy. While the HIV-treatment activist movement won the struggle for public access to treatment, Jacob Zuma’s succession to President Thabo Mbeki heralded a new era of political controversies in the state’s HIV response. A copious historiography on the HIV epidemic in South Africa maps the contemporary chronology and evolution of the disease, including a focus on changing public understandings and responses
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HIV and AIDS in Africa
Krista Johnson
Africa has the largest number of people living with HIV, with an estimated 25.7 million HIV-positive people in Africa by the end of 2018. This figure represents over two-thirds of infected people globally. African women and girls represent a majority of those infected, and Africa is home to three-fourths of all HIV-infected women and girls. Across African countries, there are differences in the sizes and trajectories of HIV epidemics. Southern Africa has the worst epidemic, with the numbers infected still rising in some countries. Prompting a development and governance crisis in many southern African countries, HIV prevalence rates are as high as 20 percent of the adult population in some countries and nearing 50 percent of the adult population in certain communities. East Africa too has been hit hard by HIV, leading to high mortality and morbidity rates in that region as well. In most of West and North Africa, there has been limited spread of HIV, with most countries in these regions having HIV prevalence rates of less than 3 percent.
Africa’s encounter with HIV and AIDS began before it was first identified as a medical condition early in the 1980s. However, it was not recognized as an epidemic in most parts of Africa until much later. Framed largely as a public health crisis rather than a developmental one, much of the world’s focus on the AIDS pandemic in Africa has centered on access to treatment, and developing effective prevention strategies that have principally focused on behavior change practices for targeted populations. However, the HIV and AIDS pandemic in Africa did not emerge in a vacuum. It is the consequence of longer historical processes such as massive demographic growth, urbanization, and social change, as well as global inequalities and historical legacies of colonialism and imperialism. In this regard, a historical account of HIV in Africa offers an important corrective to the dominant biomedical response to AIDS in Africa. It is important to take note of longer historical processes that have shaped both the virus and the human response to it.
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Malaria in Africa
James C. McCann
Malaria has been a fundamental, shape-shifting player in African human and natural landscapes and their history of interactions. Malaria spreads as a result of human contact with female anopheline mosquitos, whose habitat interacts with human populations. Human blood nourishes the mosquitos’ eggs and allows larvae to survive to the adult stage. Furthermore, the adults carry the plasmodia protozoan that cause the fever and symptoms in humans, who serve as hosts for the next mosquito vector bites.
African ecologies were historically the original source of malaria infection, though the disease has spread worldwide, as anopheline mosquitos have spread to tropical and subtropical areas of the world. Yet, Africa has continued to be the most affected part of the globe as mosquitos have adapted, and human populations have tried, and often failed, to adapt to mosquito populations and to develop biomedical and behavioral responses to the seasonal and geographical patterns of human–disease interactions. Africa’s malaria conditions reflect its challenges in economic and political local instabilities. No effective vaccinations have emerged globally, and Africa remains both malaria’s point of origin and its most profound and visible point of malarial transmission and affliction.
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Medico-Legal History of Infanticide in South Africa, Late 19th to the Early 20th Century
Prinisha Badassy
By early 20th-century South Africa, discourses around the definition and designation of infanticide as a criminal act developed with three main foci: medical, moral, and legal. State and official concerns about this crime were part of a larger preoccupation with moral reform specifically related to sexual morality, legitimacy, good parenting, and racial purity. Within the medical and legal fraternities, debates at the time were fixated on nebulous understandings of illicit sex and illegitimacy. The narratives of these criminal cases pry open the social dynamics of private and intimate spaces where love, lust, incest, ignorance, poverty, seduction, and rape sometimes resulted in undesirable and “illegitimate” pregnancies. In the early years of the Union, state interventions (medical and legal) in this realm were crucial to the constitution of whiteness and the consolidation of racial boundaries. The codes of shame, honor, and good conduct that operated during this time reveal that assumptions about dangerous or bad parenting, bastardy, and miscegenation served as indices from which the state regulated and created malleable categories of respectability, further mythologized the concept of motherhood, and increasingly cast women as social causalities and inescapable victims of their biological make up. However, cases of infanticide as a deliberate act also reveal that for some women and men, this implied a life saved from economic ruin or material and moral poverty. Throughout the late 19th and first half of the 20th centuries, men and women who wished to terminate and conceal unpropitious pregnancies were not only responding to socioeconomic and religious pressures but more so to the lack of effective alternatives: reliable and accessible contraception or recourse to foster care and adoption. The layers of pathos, desperation, prejudices, and pity reflected in incidences of infanticide are not only illustrative of the socioeconomic and political context in which they are located, but this also reveals the deep emotional entanglements of love, affect, and emotional currencies that were constantly under state surveillance.
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Mental Illness, Psychiatry, and the South African State, 1800s to 2018
Julie Parle
Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist epistemologies of the body and mind, influential from the 18th century, which rejected the spiritual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, diagnose, and treat disorders and illnesses of the mind. This was the emergence of psychiatry and of a professional psychiatric sector. With origins in the West, at a time of capitalism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country’s economic, political, ideological, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discrimination and segregation were constant features, but it is helpful to identify three broad phases of the history of the psychiatric sector in South Africa. First, its most formative period was during colonial rule, notably from the mid-1800s to c. 1918, with an institutional base in asylums. The second broad phase lasted from the 1920s to the 1990s. A national network of mental hospitals was created and changes in the ways in which mental illnesses were classified occurred at the beginning of this period. Some new treatments were introduced in the 1930s and 1950s. Law and the profession’s theoretical orientations also changed somewhat in the 1940s, 1960s, and 1970s. Institutional practice remained largely unchanged, however. A third phase began in the 1980s when there were gradual shifts toward democratic governance and the progressive Mental Health Act of 2002, yet continued human rights violations in the case of the state duty of care toward the mentally ill and vulnerable.
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Reproductive Health, Fertility Control, and Childbirth in Africa
Susanne M. Klausen
Fertility has long been highly prized in Africa, especially in societies where economic production depended mainly on human labor power. In addition to their role as future workers, children were crucial for, inter alia, securing lineages, providing social security, and ensuring spiritual safekeeping. Women were therefore expected to produce offspring. For them, bearing children was elemental to their social identity, security, and status; failing to reproduce could be calamitous. For both women and their husbands, infertility was often stigmatizing, but women usually bore the brunt of blame for involuntary childlessness and therefore could suffer especially devastating social consequences, such as divorce and ostracism. Managing fertility involved a wide range of reproductive practices. Africans believed infertility was caused by supernatural forces; consequently they sought assistance from spirit mediums and traditional healers to help women achieve or maintain fecundity. Postpartum women practiced birth spacing to ensure infants’ health, achieved through sexual abstinence and prolonged breastfeeding. Because premarital pregnancy was often a serious violation of social norms, youth were typically taught ways to avoid conception while engaging in premarital sex play. Women procured abortions using a variety of methods, including ingestion of plant-based concoctions and extreme manual pressure to kill the fetus. Childbirth, though feared for the risk involved, was typically a welcomed event although the social context for birth varied according to culture and social organization. In some societies, midwives attended women, whereas in others, solitary birth was the ideal. The reproductive politics and practices of precolonial societies informed those of the colonial era, which in turn helped shape postcolonial Africa. Western incursions into African societies had uneven effects on indigenous practices related to reproductive health, fertility control, and childbirth. While some indigenous ideas and practices persist, others, such as post-partum sexual abstinence, have been severely undermined.
