The paper abstract is here, with the panel abstract below:
The sum of their parts? Writing post-independence histories of health in Ghana (1957-2019)
In Ghana, an uneven but voluminous system of health records production was maintained after the Second World War and into the early independence era. After the overthrow of Ghana’s first independent government in 1966, the country passed through several decades of rapid political and institutional change. This restructured the national health system at many levels – temporarily disrupting and enduringly reshaping its production of official records, and reconfiguring the repositories of documentation now available to historians. In the 1960s and 1970s these domestic shifts came as the WHO assumed an increasingly influential role in shaping Ghana’s state healthcare. From the 1990s to the present, WHO authority has to some extent been supplanted by the influence of organisations like the World Bank and Gates Foundation. These transnational bodies produce their own well-funded archives, which have sometimes occluded the significance of less-accessible sources and localised perceptions of change.
This paper discusses sources for writing social and political-economic histories of public health in Ghana. Drawing on examples from 1957 to the present – smallpox eradication in the rural north, the Onchocerciasis Control Programme in West Africa, the 1978 Alma Ata Declaration and the creation of Ghana’s National Health Insurance Scheme in the early 2000s - it charts an unstable production of historical records from different vantage points since independence, and examines how historiographical possibilities are constrained by this variable source base. With reference to regional and household archives, in tandem with oral histories, the paper argues for the importance and complications of local, social and subjective sources: for writing closely-textured histories of health in Ghana, and for more effectively illuminating the wider world of global health.
Panel Abstract: Archival resilience in global health history: aspects of preservation and failure
This panel revisits the dispersed African archives of global health and disease control, in the light of questions of access, preservation, and use – in short, their resilience. For historians based in European institutions, understanding, utilisation, and interpretation of this archive has hitherto largely been shaped by the documentation and preservation habits of international and intergovernmental bodies (such as WHO) and transnational NGOs; local documentation and scholarship from Africa, and South and East Asia is difficult to access and under-used (as recently reiterated by Steven Feierman for the East African case), and the historiography is dominated by questions of policy over practice.
But the life of paper, at the heart of bureaucratic and historical practice, has been a structuring accompaniment to global health practice, implementations and failures of policy in grounded processes and circumstances. Writing on imperial and postcolonial India respectively, Rohan Deb Roy and Nayanika Mathur have explored the intimate and material lives and demise of paper, as document, collection, artefact, communicative medium, and articulation of bureaucratic power in its limits and at its margins. We draw inspiration from these investigations, to focus on the implications of coming to work with unusual, fugitive, decaying, or unsystematically collected evidentiary traces of global health practice in Africa, and thus encountering dimensions of resilience and failure in the unexpected fates of paper and accompanying means of materialising global health policy in recent African history.