i n t r o d u c t i o n
This book proposes a new way of thinking about health, from daily interac-
tions with biomedical professionals and alternative prac titioners to address-
ing some of the most pressing problems of global health. But the fundamental
insights on which it draws did not emerge sitting at a desk or staring calmly at
a computer screen, nor are we their originators. They were born in the middle
of a terrifying and confusing epidemic in the Delta Amacuro rain forest of
eastern Venezuela, forming part of parents’ and caregivers’ efforts to save the
lives of their children. They also emerge from reflections on why the epidemic
occurred and why it has never been officially diagnosed and on the unconscio-
nable everyday health conditions that preceded and followed it. And, finally,
they were born of a conviction on the part of people who face some of the worst
health conditions on the planet that their ideas could play a crucial role in
making a healthier and more just world. We accordingly need to introduce the
book’s contribution by placing it in the context in which it was forged.
The issue is global in scope. As we were finishing the manuscript, Ebola
hemorrhagic fever was wrenching apart areas of West Africa. As of 6 May 2015,
26,593 cases and 11,005 deaths were reported in the region.1 Some observers ap-
pealed to cultural logics— projecting West Africans as believing in “witchcraft”
and “witch doctors” and impeding the efforts of physicians—in explaining the
disease’s wide dissemination and substantial case fatality rate.2 Others rejected
these sorts of cultural logics in favor of structural explanations, reading the
epidemic as a symptom of the inadequacy of health infrastructures in the
region,3 exacerbated by rising global income inequalities and policies fostered
by multilateral lending organizations and First World governments. When ex-
perimental drugs and multimillion- dollar treatment modes were used to save
the lives of white health professionals from the Global North but not West
Africans, perceptions that some lives were judged more valuable than others
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