Julie Livingston, a public health historian and anthropologist at Rutgers University, was recently named a MacArthur Fellow. For the past decade and a half, she spent time as an ethnographer in a small oncology ward in Botswana. Her work, detailed in Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic (2012), describes the care and treatment of patients and families who came in and out of the small ward while they dealt with chronic illnesses and suffered from debilitating diseases.1
As the post Millennium Development Goals conversation continues, advocates have already equipped themselves to push their topics of choice onto the post-2015 agenda. Non-communicable diseases (NCDs) are certainly one of the leading contenders as it has already been on the agenda at the UN General Assembly.
NCDs are the leading cause of death globally and are projected to increase by more than 50% in low-income and middle-income countries by 2030.2
Sadly, numbers alone will not make NCDs more appealing to get on the post-2015 agenda. Rather, advocates’ effective framing and communication of these issues in appealing ways can captivate leaders and stakeholders of influence. NCDs are already off to a great start. In 2011, the UN high-level meeting on the prevention and control of NCDs gave principal NCDs (cardiovascular disease, diabetes, cancer, and chronic respiratory diseases) a proper platform to set a global goal for a 25% reduction in relative mortality from NCDs by 2025.2
In Livingston, advocates have found a worthy collaborator and asset to push the issue forward. Unlike statistics, institutional briefs, or fact sheets, Livingston can strongly appeal to human emotion, understanding, and empathy through her framing of cancer through shared experiences and personal narrative.
“Cancer, like biomedicine itself, is neither an exclusively African problem, nor a particularly Western one. The problems of pain, death, illness, disfigurement, and care that lie at the heart of this book are basic human ones. But like all such experiences, they unfold on the ground in particular ways. Nor should cancer lend itself easily to the tales of redemption via biomedicine that make up the fantasies of global health.”3
Moreover, in Livingston’s role as an ethnographer, she not only speaks to her audience with profound respect, but she uses her words with great care to respect and honor patients and caregivers who allowed her the privilege to share their most vulnerable moments.
She writes, “The story before you necessitates the revelation of many personal matters and intimate details – a cancer ward is such a place where life is cut open, raw and exposed – but you won’t find X-rays my friend gave to me. They are simply too private…You will have to rely on my words and your imagination to grasp the humanity in the pages that follow.” 3
Without a doubt, Livingston will help advocates demonstrate that non-communicable diseases like cancer are no longer just ‘first-world’ problems, but a growing, encompassing global epidemic that needs the world’s shared attention.
1) Murphy, Tom. “A Conversation about Botswana’s First Oncology Hospital.” http://www.aviewfromthecave.com/2012/09/a-conversation-about-botswanas-first.html
2) Alleyne, et al. “Embedding non-communicable diseases in the post-2015 development agenda.” The Lancet 2013; 381: 566-574. http://www.ghdonline.org/uploads/Alleyne-Embedding_non-communicable_diseases_in_the_post-2015_development_agenda.-Lancet-2013.pdf
3) Livingston, Julie. “Improvising Medicine: An African Oncology in an Emerging Cancer Epidemic.” Duke University Press, 2012. http://www.scribd.com/doc/100443257/Improvising-Medicine-by-Julie-Livingston
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