Global Health: The Debts of Gratitude

By Kenworthy, Nora J. | Women's Studies Quarterly, Spring 2014 | Go to article overview

Global Health: The Debts of Gratitude


Kenworthy, Nora J., Women's Studies Quarterly


It permits us always to say: "Careful, you think there is gift, dissymmetry, generosity, expenditure, or loss, but the circle of debt, of exchange, or of symbolic equilibrium reconstitutes itself according to the laws of the unconscious; the generous' or 'grateful' consciousness is only the phenomenon of a calculation and the ruse of an economy. Calculation and ruse, economy in truth would be the truth of these phenomena."

Jacques Derrida, Given Time: I. Counterfeit Money

In early April 2013, Madonna's ongoing troubles with Malawi boiled over in a spat with President Joyce Banda that aired across the Internet (Gumede 2013; Ross 2013). Without delving into the disputed details of Madonna's pitfalls trying to "do good" (Fisher 1997) in the country, it is worth repeating a small part of the lengthy statement released by President Banda's office as Madonna departed Malawi in a flurry of complaints, her public relations team still sparring with critics (Ross 2013). The statement, which President Banda later said she had neither seen nor approved, nevertheless resonated so powerfully with many in the country that few expected a retraction (Harding 2013; "Joyce Banda Disowns" 2013). An early section reads: "Granted, Madonna has adopted two children from Malawi. According to the record, this gesture was humanitarian and of her accord. It, therefore, comes across as strange and depressing that for a humanitarian act, prompted only by her, Madonna wants Malawi to be forever chained to the obligation of gratitude. Kindness, as far as its ordinary meaning is concerned, is free and anonymous. If it can't be free and silent, it is not kindness; it is something else. Blackmail is the closest it becomes" (Ross 2013).

To focus solely on Madonnas sense of entitlement or her misbehavior here is to miss the larger source of Malawians' anger and take all-too-easy aim at the pitfalls of celebrity philanthropy. African leaders and their citizens are no strangers to the "obligation of gratitude" incurred while at the receiving end of philanthrocapitalism, development schemes, or humanitarian aid. Even the most elementary student of theories of exchange will remind us that no gift is merely a symbol of generosity but is embedded in complex relations of hierarchy and expectations of reciprocity (see Derrida 1992; Graeber 2001; Mauss 1990). The language of "obligation" and "blackmail" reflects the ways in which "gifts" become debts, and charity creates subtle forms of peonage. What is notable in this incident-and indeed, vaguely titillating for critical Western observers-is that Banda steps so boldly outside her role in the contrived theater of aid recipiency.

Even on the eve of African independence, however, Frantz Fanon (1963) unmasked the dangers of colonial charity:

And when we hear the head of a European nation declare with hand on heart that he must come to the aid of the unfortunate peoples of the underdeveloped world, we do not tremble with gratitude. On the contrary, we say among ourselves, "it's a just reparation we are getting." So we will not accept aid for the underdeveloped countries as "charity." Such aid mustbe considered the final stage of a dual consciousness-the consciousness of the colonized that it is their due and the consciousness of the capitalist powers that effectively they must pay up (59; emphasis in the original).

Fanon reframes the seeming generosity of the developed nations as material and psychological reparations. Here, the final step toward liberation requires a psychological shift, in which the mystifications of charity fall away, and what is given becomes what is owed.

The perceptual shift Fanon once anticipated seems long forgotten, buried under layer upon layer of initiatives for the betterment of the Global South. More recently, the vast expansion of global health programs has provided a new platform for the mystifications of donation, aid, and generosity. Although many recent critiques of global health endeavors have emphasized their unintended costs, and the exacerbations of inequalities and hierarchies they can elicit (see, for example, Benatar 2005; Crane 2011, 2013; Lewis 2007; Swidler 2009), a more explicit focus on debt may help us to fully grapple with the obligations and disenfranchisements that continue to arise despite the good intentions, "best practices," and humanitarian ideals of global health enterprises (Bornstein and Redfield 2011; Elyachar 2006). …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Global Health: The Debts of Gratitude
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.