Predisposed to chaos

What do we gain by exposing the material shortcomings of African health systems?

People take precautions against COVID-19 in Mali. Image credit Ousmane Traore (MAKAVELI) via World Bank photo collection on Flickr CC.

Since early March of this year, we have been inundated with articles and opinion pieces about the ensuing doom of the novel coronavirus and its deadly disease COVID-19 soon to drive the continent of Africa into collapse. As I read the seemingly endless predictions of the ensuing chaos, in both African and western media, as an American in Khartoum, I am reminded of Saidiyah Hartman’s 1997 Scenes of Subjection. Reflecting on the violent spectacles that maintained the institution of slavery in the United States, she asks a series of questions relevant to what Simon Chikugudu has recently described as framing the experience of COVID-19 in Africa as a “catastrophe-in-waiting.” Hartman’s opening questions inspire me to ask a similar series of questions. In what ways are we compelled to cooperate with this dominant narrative of an Africa congenitally predisposed to chaos? Are we voyeurs fascinated with and repelled by the satisfaction of the presumed trajectory of global death and disease? What does the exposure of the material shortcomings of African health systems yield? Proof of African mortality, that the affluent world will not suffer alone, or the inhumanity of the system of global capital that transported this disease around the world laying bare the fragility of world-spanning chains of production?

While today the number of cases in the continent begins to exceed 70k, this number, even tripled, pales in comparison to the number of confirmed cases in the affluent worlds of northwestern Europe and the US. The focus of the WHO and the global media has been on the inadequate health systems and national economies throughout much of the continent. WHO director general Tedros Adhanom warned Africa to “wake up” to the coronavirus threat, citing the deadly potential of an unmitigated outbreak. Yet, if we situate this sentiment in the genealogy of how African states have been inculcated into the global political economic system, we can, following Hartman, interrogate how we understand the concept of an independent African government to be a “rational, acquisitive, and responsible” subject capable of responding to a global crisis. That is to say, we can begin to peel back the layers of our own racialized logic that situates the healthy, strong, rational, bourgeois self outside of Africa. This ideal self animates the ever-unfinished project of whiteness that recruits the university-educated, wealthy and propertied all over the world.

Given the comparatively slow spread of the novel coronavirus on the African continent, there is nevertheless a marked refusal to entertain the possibility that the facts on the ground in Africa may represent a reversal of the global trajectory of sickness and deprivation. It is incumbent upon us to ask what animates this refusal. Why, in this context, have so many dominant voices refused the facts on the ground in lieu of their own expectations? At a foundational level, this refusal seems to emanate from a similar site as what Liisa Malkki has called “the need to help” which animates the humanitarian enchantment with the “world outside” of the global north. Yet this need, she argues, is remarkably domestic. If we refuse to accept a scenario in which the geography of the “needy” has shifted under our feet, it reveals our desire to escape back into a familiar world in which residents of the affluent world can continue to engage in the fantasy of their own immortality. When western media houses recruit African professionals, medical workers and intellectuals, to confirm dominant narratives of impending doom, it fetishizes predictions of a future reality such that they become more valuable and more real than the reality in which we are living.

Yet, as Arundthati Roy and others have pointed out, this virus has followed the trails blazed by international trade and global capital. This pathway has not only frustrated the common sense of who should be falling ill and where widespread death should be taking place, but also, by extension, the very notion of the bourgeois self. The affluent world should be safely sheltering-in-place, sending its thoughts, prayers and donations to Africa rather than reeling from a global pandemic. Despite the facts on the ground that continue to tell us a new and complex story of health and humanity in the context of COVID-19 in Africa, the strength of our desire to right the course of global death reveals the profound destabilization in how we understand ourselves to be healthy, rational and responsible citizens of organized, albeit flawed, state governments. Our nutritious diets, vaccinations and long life-spans allow us to look into the mirror and see a super-human. If we are suffering and they are not, it must only be a matter of time. If not, it would be a matter of humanity. As this disease undermines our sense of security generated by hyper-modern medical technology and expensive privately-owned hospitals, the movement of sickness from over there to right here, threatens the presumption that the affluent shall inherit the world. That world may not last.

Due to decades of global public disinvestment in health and education, there was no preparation for this virus anywhere. Yet, the common sense of where sickness and deprivation should take place, has reconfigured Africa’s unpreparedness as both anomalous and insurmountable. Even as so many African nations have instituted screening and mitigation measures since February, the dominant logic peers into the unseen as though these efforts will amount ultimately to very little. The insistence on predicting a catastrophe-in-waiting reproduces the need for us, our expert knowledge, our superior management capacities, and seemingly endless funding streams that consolidate our sense of self as needful rather than needy. We want to escape into a future to grasp the normal order of things and reassure ourselves that we are in fact still the global north, a safe haven from the chaos of the world outside. This self-narrative has served to assuage the anxieties of the affluent world about its own monstrous self, ill-prepared to maintain the very system meant to indemnify it against destruction.

Arundhati Roy insisted that the pandemic is a portal and it is up to us how we choose to walk through it, either with our prejudices and dead ideas intact or “with little luggage” ready to envision a new world. Following this, the spread of the coronavirus also presents us with an opportunity to draw attention to the global understanding of the living geography of health, i.e. who is healthy, and where health takes place. In order to walk through the portal as Roy imagines we could, we must be willing to do so. That is to say, rather than searching for solace in the African catastrophe-in-waiting, we should reckon with the extent to which the presumption of sickness and death in Africa is foundational to the myths that residents of the global north will live nearly forever, that expansive chains of global production insulate them from—rather than expose them to—the health threats of the natural world, that “hygiene” is an outstanding issue to be solved elsewhere, and that because Euro-Americanness is synonymous with health and medicine, the rest of the world needs it to survive.

Further Reading

The “China virus”

The coronavirus COVID-19, just like Ebola, reminds us what happens when crisis ignite deep-rooted stereotypes. Yet viruses, or any disease for that matter, do not see color. Nor do they recognize states borders and ethnic enclaves.