Cholera in KwaZulu-Natal : probing institutional governmentality and indigenous hand-washing practices

The paper reviews education activities in a successful anti-cholera campaign amongst rural communities in eastern southern Africa. It is centred on probing how a modern institutional governmentality was relatively blind to an historical legacy of Nguni hand-washing practices and came to exclude use of simple tests for coliform contamination in rural health education activities. The study examines institutional processes, probing discontinuities between the health education message and the complex social ecology of cholera. In so doing, it uncovers how a post-apartheid institutional rhetoric of participation, empowerment and social transformation is playing out in communicative interventions to instil healthier practices amongst the rural poor. Institutional perspectives such as this are rooted in an institutional legacy of appropriation and control. Despite the current rhetoric of participation, instrumental orientations are being sustained as the radical critique of struggle for freedom and change gives way, through comfortable submission and intellectual conformity, to an instrumental conservatism in many post-apartheid institutional settings today. The study notes and probes a surprising resonance between the ecology of the disease and an intergenerational social capital of indigenous hand-washing practices. The evidence suggests that these patterns of hand-washing practice would have served to contain the disease in earlier times and points to this social capital as a focus for co-engaged action on environment and health concerns. The findings suggest that an opposing of institutional and indigenous knowledge is not a simple matter and that moving beyond a legacy of cultural exclusion and marginalisation remains a challenge as the first decade of post-apartheid democratic governance comes to a close