Seniority in Midwifery in Tanzania : Medical Local Practices Between Colonial Medicine and Postcolonial Modernization
Published 2024-12-19
Keywords
- age,
- health,
- maternity,
- midwifery,
- (post-)colonialism
- seniority,
- Tanzania ...More
How to Cite
Copyright (c) 2024 Veronica Kimani, Ulrike Lindner
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Concepts of seniority and elderhood were important structuring elements in many societies of precolonial Africa and were connected with social status. This changed with the European colonization of Africa, and strongly affected traditional cultures of elderhood and seniority. On a general level, this societal change took place through efforts at ‘modernization’, in the field of midwifery and maternity mainly through mission education and the introduction of Western medicine. The impact of colonialism continued in the postcolonial era when the former emphasis placed on old age as a structuring factor for societal hierarchies was partly replaced by other factors such as political power, monetary wealth (in the new capitalist economy), or the level of education, including access to scientific knowledge. These changes were certainly not always as linear as often portrayed in earlier historical research. In the case of traditional midwifery, several studies have shown its transformation through the process of medicalization and the decline of traditional midwives. However, in this paper, we will look at medical practice and analyse how – since colonial times – the attempts to end or transform traditional midwifery have been contested, had setbacks, and been full of varying, sometimes antagonistic developments. Using Kilombero in Tanzania as an example, we show how the services of traditional midwives continue to be sought, even in independent Tanzania. In this respect, the concept of age and seniority play a key role. Besides strong external influences, internal cultural interplay still favours the concept of elderhood, leading to the survival of traditional midwives.
References
- Ackerknecht, Erwin H. 1942. “Primitive Medicine and Culture Pattern.” Bulletin of The History of Medicine 12 (4): 545–574.
- Adu-Gyamfi, Samuel, and Eugenia Anderson. 2019. “Indigenous Medicine and Traditional Healing in Africa: A Systematic Synthesis of the Literature.” Philosophy, Social and Human Disciplines 1: 69–100.
- Ankasor, Justina. 2017. “A History of Traditional Birth Attendants and Maternal Health in Ghana, 1931–1992.” M.A. thesis, University of Cape Coast.
- Bech, Margunn, Yusufu Q. Lawi, Deodatus A. Massay, and Ole B. Rekdal. 2013. “Changing Policies and Their Influence on Government Health Workers in Tanzania, 1967–2009: Perspectives from Rural Mbulu District.” The International Journal of African Historical Studies 46 (1): 61–103.
- Beck, Ann. 1970. A History of the British Medical Administration of East Africa, 1900–1950. Cambridge, MA: Harvard University Press.
- Bruchhausen, Walter. 2003. “Practising Hygiene and Fighting the Natives Diseases: Public and Child Health in German East Africa and Tanganyika Territory, 1900-1960.” DYNAMIS 23: 85–113.
- Bruchhausen, Walter. 2018. “Medicalized Healing in East Africa: The Separation of Medicine and Religion by Politics and Science.” In Medicine – Religion – Spirituality: Global Perspectives on Traditional, Complementary, and Alternative Healing, edited by Dorothea Lüddeckens and Monika Schrimpf, 23–56. Bielefeld: Transcript Verlag.
- Burgt, Johannes Michael. 1914. “Zur Entvölkerungsfrage Unjamwenzis und Ussumbwas.” Koloniale Rundschau 1: 24–27.
- Cattell, Maria. 2002. “Holding Up the Sky: Gender, Age and Work Among the Abaluyia of
- Kenya.” In Ageing in Africa: Sociolinguistic and Anthropological Approaches, edited by Sinfree Makoni and Koen Stroeken, 157–177. Hampshire: Ashgate.
- Clyde, David F. 1962. History of the Medical Services of Tanganyika. Dar es Salaam: Government Press.
- Craddock, Sally. 1983. Retired, Except on Demand: The Life of Dr Cicely Williams. Oxford: Green College.
- Curtin, Philip D. 1996. “Disease and Imperialism.” In Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500–1900, edited by David Arnold, 99–107. Amsterdam: Rodopi.
- Dietsch, Elaine, and Luc Mulimbalimba-Masururu. 2011. “The Experience of Being a Traditional Midwife: Living and Working in Relationship with Women.” Journal of Midwifery and Woman’s Health 56 (2): 161–166.
- Dirr-Haller, Marita, and Walter Fust. 1997. “History in the Making.” In 75 Years Baldegg Sisters, Capuchin Brothers in Tanzania, edited by Marita Dirr-Haller and Walter Fust, 34–61. Stans: Paul von Matt AG.
- Dreier, Marcel. 2015. “Health, Welfare and Development in Rural Africa: Catholic Medical Mission and Configuration of Development in Ulanga, Tanzania, 1920-1970.” PhD diss., University of Basel.
- Eckart, Wolfgang U. 1997. Medizin und Kolonialimperialismus: Deutschland 1884–1945. Paderborn: Schöningh.
- Eckert, Andreas. 2007. Herrschen und Verwalten. Afrikanische Bürokraten, staatliche Ordnung und Politik in Tanzania 1920–1970. München: Oldenbourg.
- El Kotni, Mounia. 2022. “Midwifery in Cross-Cultural Perspectives.” In The Routledge Handbook of Anthropology and Reproduction, edited by Sallie Han and Cecília Tomori, 454–467. London: Routledge.
- Evans-Pritchard, Edward. 1940. The Nuer: A Description of the Modes of Livelihood and Political Institutions of the Nilotic People. Oxford: Oxford University Press.
- Feierman, Steven. 1985. “Struggles for Control: The Social Roots of Health and Healing in Modern Africa.” African Studies Review 28 (2/3): 73–147.
- Foner, Nancy. 1984. Ages in Conflict: A Cross-Cultural Perspective on Inequality Between Old and Young. New York: Columbia University Press.
- Frei, Markus. 1997. “St Francis Hospital, Ifakara.” In 75 Years Baldegg Sisters, Capuchin Brothers in Tanzania, edited by Marita Dirr-Haller and Walter Fust, 142–144. Stans: Paul von Matt AG.
- Freyvogel, Thierry A., and Tanner Marcel. “Research in Ifakara – From the Swiss Tropical Institute Field Laboratory to the Ifakara Centre.” In 75 Years Baldegg Sisters, Capuchin Brothers in Tanzania, edited by Marita Dirr-Haller and Walter Fust,138–142. Stans: Paul von Matt AG.
- Freixas, Anna, Barbara Luque, and Amalia Reina. 2012. “Critical Feminist Gerontology: In the Backroom of Research.” Journal of Women and Aging 24 (1): 44–58.
- Gish, Oscar. 1975. “The Way Forward: World Health Organisation.” Journal of World Health 6: 8–13.
- Green, Maia. 2003. Priests, Witches and Power: Popular Christianity after Mission in Southern Tanzania. Cambridge: Cambridge University Press.
- Hunt, Nancy Rose. 1988. “‘Le Bébé en Brousse’: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo.” The International Journal of African Historical Studies 21 (3): 401–432.
- Idang, Gabriel. 2015. “African Culture and Values.” Phronimon 16 (2): 97–111.
- Iliffe, John. 1998. East African Doctors: A History of the Modern Profession. Cambridge: Cambridge University Press.
- Jackson, Jonathan M. 2021. “‘Off to Sugar Valley’: The Kilombero Settlement Scheme and ‘Nyerere’s People’, 1959–69.” Journal of Eastern African Studies 15 (3): 505–526.
- Jennings, Michael. 2006. “‘A Matter of Vital Importance’: The Place of the Medical Mission in Maternal and Child Healthcare in Tanganyika, 1919–39.” In Healing Bodies, Saving Souls, edited by David Hardiman, 227–250 (Clio Medica, vol. 80). Amsterdam, New York: Editions Rodopi.
- Jennings, Michael. 2016. “Cooperation and Competition: Missions, the Colonial State and Constructing a Health System in Colonial Tanganyika.” In Beyond the State: The Colonial Medical Services in British Africa, edited by Anna Greenwood, 153–173. Manchester: Manchester University Press.
- Jones, Adam, ed. 2006. Men of the Global South: A Reader. London: Zed Books.
- Kalla, Kaarina. 2006. “Understanding the Concept of Age: When Determining the Capabilities of Leaders in Post-modern Organizations.” Paper presented at the OLKC Conference, Warwick, England, March 20–22, 2006.
- Kallaway, Peter. 2009. “Education, Health and Social Welfare in the Late Colonial Context: The International Missionary Council and Education Transition in the Interwar Years with Specific Reference to Colonial Africa.” History of Education 38: 217–246.
- Kallaway, Peter. 2020. “Welfare and Education in British Colonial Africa, 1918–1945.” In Education and Development in Colonial and Postcolonial Africa: Global Histories of Education, edited by Damiano Matasci, Miguel Bandeira Jerónimo, and Hugo Gonçalves Dores, 31–55. London: Palgrave Macmillan.
- Kalusa, Walima T. 2012. “Medical Training, African Auxiliaries and Social Healing in Colonial Mwinilunga, Northern Rhodesia (Zambia), 1945–1964.” In Public Health in the British Empire Intermediaries, Subordinates and the Practice of Public Health, 1850–1960, edited by Ryan Johnson and Amna Khalid, 154–170. London: Routledge.
- Kanogo, Tabitha. 2005. African Womanhood in Colonial Kenya 1900–50. Oxford: James Currey Ltd.
- Kennedy, Kathy I. 1990. “Lactation and Contraception.” Ginecologia y Obstetricia de Mexico 58: 25–34.
- Kigondu, J. G. 1993. “Breast Feeding as a Family Planning Method.” Malawi Medical Journal 9 (1): 16–19.
- Kimani, Veronica. 2015. “The Transformation of Circumcision and MasculinityAamong the Agikuyu of Kiambu, 1945–2008.” M.A. thesis, Kenyatta University.
- Kimani, Veronica. 2024. “Maternal Healthcare and Health Policy Planning in Tanzania, 1961–1970s.” African Development 49 (2): 89–118.
- Kolonialabteilung des Auswärtigen Amtes, ed. 1905. Medizinalberichte über die Deutschen Schutzgebiete für das Jahr 1903/04. Berlin: Ernst Siegfried Miller und Sohn.
- Kolonialabteilung des Auswärtigen Amtes, ed. 1907. Medizinalberichte über die Deutschen Schutzgebiete für das Jahr 1904/05. Berlin: Ernst Siegfried Miller und Sohn.
- Kolonialabteilung des Auswärtigen Amtes, ed. 1915. Medizinalberichte über die Deutschen Schutzgebiete für das Jahr 1911/12. Berlin: Ernst Siegfried Miller und Sohn.
- Kulet, Ole Henry. 1972. To Become Man. Nairobi: Longhorn Publishers.
- Langwick, Stacey A. 2011. Bodies, Politics, and African Healing: The Matter of Maladies in Tanzania. Bloomington, Indianopolis: Indiana University Press.
- Lindner, Ulrike. 2011. Koloniale Begegnungen. Deutschland und Großbritannien als Imperialmächte in Afrika 1880–1914. Frankfurt: Campus.
- Lindner, Ulrike. 2014. “The Transfer of European Social Policy Concepts to Tropical Africa, 1900–50: The Example of Maternal and Child Welfare.” Journal of Global History 9 (2): 208–231.
- Makoni, Sinfree, and Koen Stroeken. 2002. “Introduction: Towards Transdisciplinary Studies on Ageing in Africa.” In Ageing in Africa Sociolinguistic and Anthropological Approaches, edited by Sinfree Makoni and Koen Stoeken, 1–17. Aldershot: Ashgate.
- Malik, Sofianiza Abd, and Alistair Edwards. 2011. “What is Age?” In Issues of Human Computer Interactions and Computer Developments, edited by Sofianza Abd Malik, 25–30. Kuala Lumpur: IIUM Press
- Malowany, Maureen. 1997. “Medical Pluralism: Disease, Health and Healing on the Coast of Kenya, 1840–1940.” PhD diss., McGill University.
- Mbilinyi, Marjorie. 1980. “African Education During British Colonial Period, 1919–1961.” In Tanzania under Colonial Rule, edited by Martin H. Y. Kaniki, 236–275. London: Longman.
- Mbiti, John S. 1969. African Religions and Philosophy. Nairobi: Heineman
- Meixner, Hugo. 1914. “Säuglings- und Kinderernährung in Deutsch-Ostafrika.” Deutsches Kolonialblatt: Amtsblatt für die Schutzgebiete in Afrika und in der Südsee, 15/4/1914, 354–356.
- Monson, Jamie. 1991. “Agricultural Transformation in the Inner Kilombero Valley of Tanzania, 1840–1940.” PhD diss., University of California, Los Angeles.
- Musie, Maurine R., Rafiat A. Anokwuru, Roinah Ngunyulu, and Sanele Lukhele. 2022. “African Indigenous Beliefs and Practices During Pregnancy, Birth and After Birth.” In Working with Indigenous Knowledge: Strategies for Health Professionals, edited by Fhumulani Mavis Mulaudzi and Rachel Lebese, 85–106. Cape Town: AOSIS Books.
- Müller, Donat. 1997. “Missionar order Kapuziner?” In 75 Years Baldegg Sisters, Capuchin Brothers in Tanzania, edited by Marita Dirr-Haller and Walter Fust, 86–91. Stans: Paul von Matt AG.
- Nguyen, Thuy Linh. 2010. “French-Educated Midwives and the Medicalization of Childbirth in Colonial Vietnam.” Journal of Vietnamese Studies 5 (2): 133–182.
- Nhonoli, Aloysius M., and Aimon J. Nsekela. 1976. The Development of Health Services and Society in Mainland Tanzania: A Historical Overview – ‘Tumetoka Mbali’. Kampala: EALB.
- Nyerere, Julius K. 1973. Freedom and Development: A Selection from Writings and Speeches, 1963–1973. Dar es Salaam: Oxford University Press.
- Peiper, Otto. 1910. “Über Säuglingssterblichkeit und Säuglingsernährung im Bezirke Kilwa Deutsch-Ostafrika.” Archiv für Schiffs- und Tropenhygiene 14: 233–259.
- Ranger, Terence. 1981. “Godly Medicine: The Ambiguities of Medical Mission in Southeast Tanzania, 1900–1945.” Social Science & Medicine. Part B, Medical Anthropology 15 (3): 261–277.
- Sempebwa, Joshua W. 1983. “Religiosity and Health Behaviour in Africa.” In Health and Development in Africa, edited by Peter Oberender, Hans Jochen Diesfeld, and Wolfgang Gitter, 34–44. Frankfurt: Peter Lang.
- Sims, Lionel. 2015. “Out of Africa: The Solarisation of the Moon.” In Stars and Stones: Voyages in Archaeoastronomy and Cultural Astronomy, edited by F. Pimenta, N. Ribero, F. Silva, N. Campion, A. Joaqionto and L. Tirapicos. (Proceedings of a conference held September 19–22, 2011). Archaeopress/British Archaeological Reports, 200–206.
- Stephens, Rhiannon. 2013. A History of African Motherhood. The Case of Uganda. Cambridge: Cambridge University Press.
- Stroeken, Koen. 2002. “From Shrub to Log: The Ancestral Dimension of Elderhood Among
- Sukuma in Tanzania.” In Ageing in Africa: Sociolinguistic and Anthropological Approaches, edited by Sinfree Makoni and Koen Stroeken, 89–110. Aldershot: Ashgate.
- Svetieva, Anita. 2003. “Female Seniority Principle and Accompanying Elements in the Traditional Culture of Macedonia.” EthnoAthropozoom 3 (13): 121–135.
- Swantz, Lloyd W. 1990. The Medicine Man among the Zaramo of Dar es Salaam. Dar es Salaam: Dar es Salaam University Press.
- Tanganyika, Ministry of Health and Labour. 1961. Annual Report of the Health Division 1961, Vol 1. Prepared by the Chief Medical Officer. Dar es Salaam: Government Printer.
- Tanganyika, Ministry of Health. 1962. Annual Report of the Health Division 1962, Vol I. Prepared by the Chief Medical Officer. Dar es Salaam: Government Printer.
- The Citizen. 2021. “Switzerland–Tanzania: A Century of a Shared History.” The Citizen, 25/11/2021. Accessed November 2, 2024. https://www.thecitizen.co.tz/tanzania/supplement/switzerland-tanzania-a-century-of-shared-history-3631236
- Thomas, Lynn M. 2003. Politics of the Womb: Women, Reproduction, and the State in Kenya. California: California University Press.
- Tilley, Helen. 2011. Africa as a Living Laboratory: Empire, Development, and the Problem of Scientific Knowledge, 1870–1950. Chicago: University of Chicago Press.
- Titmuss, Richard M., Brian Abel-Smith, George Macdonald, Arthur W. Williams, and H. W. Christopher. 1964. The Health Services of Tanganyika: A Report to the Government. London: Pitman Medical Publishing Co. Ltd.
- Twigg, Julia. 2004. “The Body, Gender and Age: Feminist Insights in Social Gerontology. Journal of Aging Studies 18 (1): 59–73.
- United Republic of Tanzania and Zanzibar. 1964. Second Five-Year Plan for Economic and Social Development, 1st July 1964 to 30th June 1969, Vol 1.
- van Etten, Gerardus Maria. 1976. Rural Health Development in Tanzania. Assen: Van Gorcum & Comp. B.V.
- Vaughan, Megan. 1991. Curing Their Ills: Colonial Power and African Illness. Stanford: Stanford University Press.
- Webster, Charles. 1988. The Health Services Since the War, Vol.1: Problems of Health Care: The National Health Service before 1957. London: HMSO.
- WHO and UNICEF, ed. 1978. Primary Health Care: Report of the International Conference on Primary Health Care Alma-Ata, USSR, 6–12 September 1978. Geneva: WHO. Accessed December 19, 2023. http://apps.who.int/iris/handle/10665/39228
- Widlok, Thomas, Joachim Knab, and Christa van der Wulp. 2021. “African Time: Making the Future Legible.” African Studies 80 (3–4): 397–414.
- Wilson, Monica. 1951. Good Company: The Study of the Nyakyusa Age-Villages. Oxford: Oxford University Press.
- Wimmelbucker, Ludger. 2005. “Verbrannte Erde. Zu den Bevölkerungsverlusten als Folge des Maji-Maji-Krieges.” In Der Maji-Maji-Krieg in Deutsch-Ostafrika 1905-1907, edited by Felicitas Becker and Jigal Beez, 87–99. Berlin: Christian Links.
- Zeleza, Paul Tiyambe. 1997. Manufacturing African Studies and Crises. Dakar: CODESRIA.