Pharmaceuticals in Divergence: Chakachua (Fakes), Fugitive Science, and Postcolonial Critique in Tanzania

Abstract

Powerful pharmaceuticals are readily available for purchase throughout Tanzania and global health policy makers decry this situation as dangerous and disordered, as if no rules govern the use of drugs in Africa. In the prevailing global health understanding, ‘truth’ lies in the laboratory science that goes into the making and proper prescription of drugs, and such deviations as ‘overuse’ and ‘misuse’ result from the fact that locals misunderstand what these drugs are and how they should be used. To investigate this global health concern, I employed a grounded ethnographic approach, carried out in the regional capital of Iringa, Tanzania, a city with a drug shop on every corner downtown. During two and a half years of fieldwork, I accompanied my companions on their quests for healing (from doctors, pharmacists, traditional healers, and others), without knowing beforehand when or if they might seek out pharmaceuticals. This approach revealed how pharmaceutical capacities are forged by divergent practices, ranging from helping to determine if a child was real or a demon imposture, to palliating a mother’s wounds of grief in the stomach, to intensifying the fermentation process in the brewing of sacred beer. In this talk, I begin by discussing the problem of chakachua (fake) drugs and the embodied epistemological practices employed by medical personnel and lay people in response to such conditions. I conceptualize these empirical practices as methods of ‘fugitive science’ and discuss local beer brewing as a prime example of this: in experimenting with different additive agents, including pharmaceuticals, brewers radically reconfigure the capacities of such substances in ways that exceed biomedical frameworks. Finally, I explore critiques of western pharmaceuticals as poisonous, concerns which were frequently expressed to me by traditional healers and biomedical personnel alike. Across all of these cases, I demonstrate how my interlocuters are concerned with differentiating between pharmaceuticals as medicines, counterfeits, or poisons, and with developing empirical practices for coming to know and deploy these divergent and unstable potentialities. I conclude that this forces us to reconsider global health assumptions about the so-called ‘overuse’ or ‘misuse’ of pharmaceuticals in the Global South.