The Next Epidemic

This chapter looks closely at some of the more fine-grained processes of clinical care in order to suggest how cancer, as an emergent issue in African public health, forces longstanding questions of palliation to the foreground and highlights the intensely social nature of pain. It explores the conditions that facilitate the marginalization of pain and palliation in African clinical practice and in global health more widely, and examines the contemporary clinical dynamics that engender this marginalization in the specific context of oncology, where many patients suffer severe and intractable pain, as a result either of their illness or the effects of biomedical therapies. In other words, the chapter explores how and why biomedicine proceeds in Africa with so little palliation and so much compliance. The context for this ethnography is Botswana's lone cancer ward, where the author has been researching conditions of care since 2006.