Event Report: "Africa in Front of Us" Seminar Series No.12 "Biomedicine/Ethnic Group/Trust: Search for Malaria Remedy among the Egun in Lagos State, Nigeria"
On July 17, 2015 (Fri.) the twelfth seminar of the “Africa in Front of Us” series entitled “Biomedicine/Ethnic Group/Trust: Search for Malaria Remedy by the Egun in Lagos, Nigeria” organized by Research Center for Ars Vivendi, Ritsumeikan University was held at the 3rd Study Group Room of the Gakujikan Hall, Kinugasa Campus.
For the seminar we invited Takashi Tamai, visiting researcher of the Center and director of the Africa Japan Forum, who gave a lecture on medical anthropology. Lagos State of Nigeria where Mr. Tamai conducts his fieldwork currently does not have a state-run healthcare system. From the 1980s onward, the role of the state to provide medical services to the population has been played, although neither continuously nor stably, by various international organizations, agencies sponsored by governments of various countries, NGOs, private enterprises, and various foundations. Mr. Tamai referred to this situation using the term “global health” (area of interdisciplinary research and practices concerning the problem of medical care across the world), and illustrated how the urban poor create therapy networks to survive.
Makoko area located in Lagos, Nigeria is one of the largest slums in the country. Here the lecturer is conducting a fieldwork studying the relationship of the Egun people, who immigrated to Nigeria from south-east of Benin and the Nigerian Yoruba. These two ethnic groups used to live a long distance from each other and had almost no direct interaction through marriage, and today the Egun people assume that all tumults in the area by gangs called “area boys” and harassment by the police, are caused by the Yoruba people, and are maintaining and reproducing their Egun self-identity with the Yoruba playing the role as the other.
When an Egun gets malaria, he goes to a Nigerian hospital in his place of residence but makes sure the hospital is not run by a Yoruba doctor. The Egun know well themselves that clinics managed by Egun doctors are often illegal, and that both medical treatment and other health services are inferior in quality to other such institutions. Nevertheless, they still chose to rely on medical treatment network of their compatriots. When the condition is too serious to be dealt with in Makoko, they travel a long way using buses and return for treatment to their hometowns in Benin. This not only means an increase in the medical costs, but also that oftentimes the patient simply cannot get the treatment in time. Based on these findings, Mr. Tamai made two points, namely, (1) for the Egun people, the important basis for trust in medical care is not the quality of the health service received but the fact who administers this service and (2) the fact that the Egun prefer health services provided by other Egun people is more a product of social bonds and restraints than of individual choice. Closing the lecture, Mr. Tamai spoke on the possibilities for understanding such practices of health service embedded into the society.
In the questions and answers session, the participants came to the conclusion that in a situation where state-run medical care system is nonexistent, continuing fieldwork that differentiates between trust in a medical-care system, trust in an ethnic group, and personal trust in a concrete individual, can make a contribution to political discussions and practices. Also, a number of ideas regarding what trust means for the Egun have been voiced.
The lecture mainly focused on a relationship between people of two ethnic groups, but the fact that we cannot treat trust in health services as merely a problem of technology or quality is a universal phenomenon that can be perceived for example in the current state of medical care in marginal villages of Japan. We felt that there is a need to conduct diverse research on the local medical-care practices both in Japan and across the world.
(The original report in Japanese is prepared by Mr. Kenya Araki, student of the Graduate School of Core Ethics and Frontier Sciences, Ritsumeikan University. It is translated into English by the Research Center for Ars Vivendi, Ritsumeikan University.)