Medical History

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.

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.

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.

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.

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