The embodied politics of health in Dar es Salaam, Tanzania

Considerable attention has been given over to the politicisation of life within the 21st century: the threat of new disease and the promise of new drugs; the advancement of technology capable of transforming live anew; and the recasting of biological citizenship. This thesis, however, responds to the growing calls, made by the likes of Kearns and Reid-Henry (2007), to consider the other side of our contemporary biopolitical regime and the avoidable suffering that is played out against this backdrop of possibilities. Utilising malaria as the disease specific entry point, the thesis aims to disclose the way in which health is mediated by (biological) events within the body as well as (political) events outside of the body and explore the dialogue that takes place across the body’s fleshy barrier. In doing so, I aim to interrogate the injustice and reveal the structural violence anonymously enacted through systems but personally embodied by certain individuals. Thus, the thesis contributes to, and moves forward, the on going work on the critical geographies of global health by traversing scales, bringing the critical conversations that have been predominantly focused at the all-too-impersonal global level down to those ‘at the sharp end’ (Dixon and Marston 2011, 445), ensuring such voices join the conversation and speak back to the global narrative. In doing so I provide a more geographically and personally attuned account of the ‘epidemiology of inequality’ (Sparke and Anguelov 2012) currently being sketched out within the discipline. By embedding personal experiences of (ill)health within a national and international context, I work to ensure that such episodes of illness are not framed as sad, unfortunate, biologically inevitable, or bad luck, but unequivocally as episodes of violence (after Craddock 2009). The thesis does so through a series of distinct chapters, each offering different perspectives yet threaded together with the themes of (structural) violence and the valuation and management of life today. From an initial focus on the (de)valuation of life implicit in an economic conceptualisation of the disease burden within the global health arena, the thesis goes on to focus on the politics of life from the perspectives of individuals themselves. Drawing on conversations with women in Dar es Salaam, Tanzania, the thesis seeks to recover the journeys travelled to and through the health system, pausing to reflect on the situations that influence the contours of this journey as well as the biological consequence of them