Your Pocket Is What Cures You: The Politics of Health in Senegal

Your Pocket Is What Cures You: The Politics of Health in Senegal

Your Pocket Is What Cures You: The Politics of Health in Senegal

Your Pocket Is What Cures You: The Politics of Health in Senegal

Synopsis

In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal. Your Pocket Is What Cures You examines qualitative shifts in health and healing spurred by these reforms, and analyzes the dilemmas they create for health professionals and patients alike. It also explores how cultural frameworks, particularly those stemming from Islam and Wolof ethnomedicine, are central to understanding how people manage vulnerability to ill health.

While offering a critique of neoliberal health policies, Your Pocket Is What Cures You remains grounded in ethnography to highlight the struggles of men and women who are precariously balanced on twin precipices of crumbling health systems and economic decline. Their stories demonstrate what happens when market-based health reforms collide with material, political, and social realities in African societies.

Excerpt

It was a clear, hot day in September, and in spite of the relentless sun my friend Faatu decided she wanted to visit Amadu, a well-known healer in a neighboring village known for his skill at mocc. After taking our bucket baths and getting dressed, we set out trudging along the sandy road to the mocckat’s house. We walked a few kilometers and arrived in the neighboring village and then found Amadu’s house. His wives and several children were sitting outside in the courtyard. “Are you here for mocc?” asked one of his wives. Faatu nodded and the woman told us that Amadu was away but that we could go see his father instead. She pointed to a straw hut 20 meters from the main courtyard where we could find the senior mocckat.

We went to the older man’s hut and repeated our series of greeting, “Have you spent the day in peace? Is all well in the house? Is all well with your family?” After I promised that I would learn more of the Pulaar language before our next visit, the healer asked Faatu to explain her problem. She responded that she had a lot of pain on her right side and shoulder. He began reciting phrases in Arabic in a low voice and then applied pressure to several points on her back and squeezed her shoulders in a form of traditional massage. After several minutes of shoulder and torso manipulation the treatment was complete. Faatu paid him fifty cents, and he told us to come back if the pain continued. “Did it work?” I asked her as we headed back toward the main road. She nodded and said it felt better.

When we got to the road we found another villager loading sacks of onions into a car to take to the market in Saint Louis, about 25 kilometers away. After some banter with the driver we convinced him to drop us off in Mumbaay on his way to town, and then we squeezed ourselves into the back seat in between the 50-kilo bags of onions. In all likelihood, Faatu’s shoulder pain was the result of working on her own onion crop, which entails a daily routine of lifting bucket . . .

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