Public Health and Spiritual Afflictions in Africa and the Diaspora

This book examines the paradox whereby spiritual afflictions (conditions attributed to ancestors, jinns, spirits, witchcraft, and other intangible entities) remain central to everyday therapeutic worlds in Africa and the diaspora, yet are routinely sidelined or rendered invisible in official public health policies and global health agendas. Drawing on ethnographic research in Cameroon, Congo, Côte d'Ivoire, Ghana, Mozambique, South Africa, Tanzania, Zanzibar, and African diasporic communities in Europe, the book's contributors analyse how people navigate intertwined therapeutic worlds in which invisible forces and biomedical logics coexist, collide, or bypass one another. It conceptualizes public health as a domain of ongoing epistemic struggle, examining how policies, legislation, and clinical encounters enact limited recognition and integration that keep spiritual healing subordinate even when they claim to include it. At the same time, the chapters illuminate vernacular governance, popular epistemologies, and informal infrastructures of care through which communities negotiate forms of accountability, regulate healers, and sustain therapeutic legitimacy beyond the clinic and the state. Ethnography is positioned here as an epistemic infrastructure in its own right, capable of unsettling dominant assumptions and opening space for more equitable, plural public health futures. The book speaks to scholars and students in anthropology, political science, and public health, as well as clinicians, policymakers, and practitioners in global health and development. It offers conceptual and methodological tools for rethinking what counts as evidence, legitimate care, and public health expertise, inviting readers to imagine health institutions that are attentive to plural epistemologies and responsive to the lived realities of those navigating diverse therapeutic worlds.

Boris Koenig is an FNRS postdoctoral fellow at UCLouvain and a former SSHRC postdoctoral fellow at the University of Michigan (Department of Afroamerican and African Studies). He has conducted long-term ethnographic research in urban and rural Côte d'Ivoire since 2012. His current work examines the intersections of public health, spiritual healing, and the digital transformation of plural therapeutic worlds in Africa and its diasporas.

Introduction: Reimagining Public Health's Epistemic Infrastructures from the Lived Realities of Spiritual Healing 1. Affliction, Healing, and Everyday Religion: Perceptions of Well-Being, Ill Health, and its Remedy in Zanzibar 2. The Payment of Spiritual Debts as Restitution Among the Babanki of Northwest Cameroon 3. Kindoki, Institutional Legitimacy, and Public Health in the Lower Congo 4. Entrepreneurs of Grievances and Entertainment: Negotiating Social Contention and Healing in Mozambique 5. "Walking the Road to Death": Perspectives on Cancer Causation and Interventions Among West African Immigrants in France 6. Spiritual Afflictions and Disagreements: Unpacking 'Collaboration' Between Community Psychiatry and Spiritual Healing in Rural Southwestern Ghana 7. Navigating Medical Pluralism: HIV/AIDS and Traditional Healing Practices in South Africa 8. Nganga and Public Health: How to Deal with the Ambiguities of Healing? 9. "Waganga Use Culture, Not Science": Traditional Healing, COVID-19, and Epistemic Contestation in Tanzania 10. Debilitating Afflictions, Christian and Islamic Healing Centers, and the Reshaping of Public Health in Côte d'Ivoire Epilogue