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By Julie Livingston

In Improvising Medicine, Julie Livingston tells the tale of Botswana's purely devoted melanoma ward, positioned in its capital urban of Gaborone. This affecting ethnography follows sufferers, their family, and ward employees as a melanoma epidemic emerged in Botswana. The epidemic is a part of an ongoing surge in cancers around the worldwide south; the tales of Botswana's oncology ward dramatize the human stakes and highbrow and institutional demanding situations of a pandemic that would form the way forward for worldwide health and wellbeing.

They exhibit the contingencies of high-tech medication in a sanatorium the place important machines are frequently damaged, medicines move out and in of inventory, and bed-space is usually at a top rate. in addition they show melanoma as anything that occurs between humans. severe ailment, care, discomfort, disfigurement, or even dying become deeply social reviews. Livingston describes the melanoma ward when it comes to the forms, vulnerability, energy, biomedical technological know-how, mortality, and wish that form modern event in southern Africa. Her ethnography is a profound mirrored image at the social orchestration of desire and futility in an African medical institution, the politics and economics of healthcare in Africa, and palliation and disfigurement around the international south.

Julie Livingston is affiliate Professor of background at Rutgers collage. She is the writer of Debility and the ethical mind's eye in Botswana and a coeditor of 3 pictures at Prevention: The HPV Vaccine and the Politics of Medicine's easy options and A demise Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of scientific Citizenship.

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

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G, a Liberian surgeon at Mpilo, would also make their way from Bulawayo across to pmh. And so Dr. P, the lone hematologist and oncologist at the hospital, found himself consulting with a cluster of colleagues with whom he had worked in the heyday of social medicine in Zimbabwe. Unfortunately, Botswana’s gain was Zimbabwe’s loss—something both Dr. P and Dr. K felt acutely. No lunchtime consult was complete without a brief exchange of news about Zimbabwe. Botswana is unique in the southern African region (indeed, the continent) for its steady development trajectory, stable democracy, and system of functioning social-welfare programs, including its national healthcare program.

If oncology obscured African cancer in the final decades of the twentieth century, African public health, driven in large part by external interests, did likewise, failing to fit cancer into its logics or its politics of triage, despite a promising moment of critical intersection in the 1960s.

Questions of therapeutic intervention and futility also take on a different tone here. The desire to intervene in cancers, to extend life, to palliate through surgery, radiation, or chemotherapy is fueled by a daily look at the natural course of disease progress. A context, as in the United States, wherein many cancers are treated aggressively when they are still microscopic or asymptomatic engenders a public conversation about iatrogenic effects of aggressive therapies and their value. In Botswana, where florid, disfiguring growths and horrible pain drive patients with late-stage cancers into the clinic for diagnosis each day, the palliative nature of oncology for the terminally ill is more clearly recognized as a public good, and stage 0 cancers or precancerous growths are not part of the popular experience of the disease.

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