Abstract Acceptance, faith, and duty are key for women navigating metabolic disorders in Senegal, West Africa. Senegalese women suffering from diabetes, hypertension, and kidney disease/failure found solace in Islam and their faith in Allah for navigating their disease experiences. Religion and faith are seen as sources of strength and agency rather than as foregone conclusions or as something “fated,” providing women ways to make meaning from their chronic illness experiences. Living with chronic illness in under- and low-resourced settings constrain women’s ability to navigate their disease. Religion and faith allow ways of making meaning from these challenging situations.

In hospitals in Zambia, family members carry out intimate and care procedures, run errands, and offer emotional and practical support to patients. However, their presence also creates challenges when they use resources, take up space dedicated to patients, and contribute to disease spread. The COVID-19 pandemic brought such tensions into view and drove hospital administrators, clinicians, and researchers to draw a bright line between family as caregivers (considered necessary) and family as visitors (considered extraneous). In this article, we ask: If caregivers are not visitors, then who are visitors? What is the work of visiting? From 2020 to 2021, we carried out research in a Zambian pediatric hospital when visitors were not allowed to enter the hospital, but a singular caregiver was required at the bedside of each child admitted. Our findings from interviews with 44 healthcare workers and 30 caregivers revealed several themes-that the care work required in hospitals surpasses the ability of a single caregiver; that ephemeral encounters between caregivers and visitors facilitate sympathy driven care; and that witnessing need could catalyze and exhibit support. We expand on these themes, focusing on one grandmother's months-long stay with her granddaughter in the hospital, to show how caregiver, visitor, and healthcare worker roles were improvised and reworked. Ultimately, this research breaks down binaries commonly cited in discussions of family caregiving, such as essential and non-essential, helpful and wasteful, caregiver and visitor. This has policy implications because ignoring or dismissing visitors as extraneous will further disadvantage caregivers and patients and disenfranchise families.

At the only standalone pediatric hospital in Zambia, patient wellbeing often rests in the hands of bedsiders. Bedsiders are caregivers, often family, who sit at the patient's bedside, feeding, cleaning them, and running medical errands. Bedsiders are critical human infrastructure for the hospital and its staff. In our research, we heard repeatedly that bedsiders must have a "heart" for caregiving, taking on unremunerated and exhausting informal labor. We draw on Wendland's "heart for the work," a phrase commonly used among healthcare workers in Malawi and Zambia describing the medical profession, to explore what this metaphor reveals about care.

In 2016, Human Rights Watch, an international human rights organisation, published a report on the use of forced anal examinations to identify and prosecute putative 'homosexuals'. The report provided detailed descriptions and first-person accounts of these examinations in several countries in the Middle East and Africa. Drawing on theories of iatrogenesis and queer necropolitics, this paper uses these accounts and other reports of forced anal examinations to explore the role of medical providers in the 'diagnosis' and prosecution of homosexuality. The goal of these medical examinations is explicitly punitive rather than therapeutic, making them quintessential examples of iatrogenic clinical encounters which harm rather than heal. We argue that these examinations naturalise socioculturally derived beliefs about bodies and gender that construct homosexuality as 'readable' on the body through close medical inspection. These acts of inspection and 'diagnosis' reveal broader hegemonic state narratives of heteronormative gender and sexuality, both within countries as well as internationally as different state actors circulate and share these narratives. This article highlights the entanglement of medical and state actors, as well as contextualises the practice of forced anal examination within its colonial roots. Our analysis offers the potential for advocacy and holding medical professions and states accountable.

Food insecurity affects close to half the population of Senegal, West Africa, a country simultaneously affected by the ongoing global diabetes pandemic. Diabetes and food inse-curity are associated with adverse mental health, yet research exploring the relationship between chronic physical illness, food insecurity, and mental illness in Senegal is currently lacking. The objective of this study was to investigate the association between food insecurity and depression and anxiety, separately, in Senegalese women living with diabetes and hypertension. Food insecurity was measured using the Household Food Insecurity Access Scale. Occurrence of depression and anxiety symptoms was assessed using the Modified Hopkins Symptoms Checklist Survey (HSCL-25). A sensitivity analysis examining the relationship between food insecurity and depression and anxiety was performed by comparing two previously validated cutoff values (1.75 and 2.25) on the HSCL-25. Most participants (83%) had some level of food insecurity. More than 80% of the sample were depressed or anxious using 1.75 as the cutoff, while 42 and 60% were depressed or anxious, respectively, using 2.25 as the cutoff. Food insecurity increased relative risk for depression (RRR: 1.40, 95% CI: 1.05-1.31, 1.75 as cutoff; RRR: 1.06, 95% CI: 0.99-1.14, 2.25 as cutoff) and anxiety (RRR: 1.17, 95% CI: 1.05-1.31, 1.75 as cutoff; RRR: 1.11, 95% CI: 1.04-1.19, 2.25 as cutoff). These findings demonstrate that among populations suffering from diabetes and hypertension, food insecurity is a modifiable risk factor for depression and anxiety and a potential intervention target in this setting.

Introduction: Global health researchers often approach fatherhood initiatives from a deficit-based perspective, assuming men need sensitization, education, or correction. Senegalese men, which some global health and development organizations have determined to be uninvolved, are part of a team of prenatal and postpartum support called the "entourage" and have a very specific role to play as ad hoc health interpreters. Methods: The findings of this article come from 12 months of ethnographic research in Dakar, Senegal in 2018. In addition to participant-observation in three maternity wards across the city, semi-structured interviews were conducted with 32 pregnant women, 27 expectant fathers, and numerous family members, midwives, physicians, and governmental and nongovernmental organization employees. Data were coded and evaluated using thematic analysis.Results: In Senegal, the Handbook of Mother and Child Health is distributed in state-funded maternity wards. The Handbook outlines what pregnant women should know about pregnancy and how to appropriately engage with clinical services. Male partners of pregnant women commonly read the book for and to their pregnant partners. Men are placed in the unique position of intermediary between pregnant women and the State and as such, they learn a lot about pregnancy and childbirth, as well as prenatal and postpartum care.Conclusions: Our ethnographic insights challenge global health rhetoric that frames men as uninvolved in women and children's health and this study demonstrates that future interventions should take an asset-based approach to men's involvement. Senegalese men are uniquely positioned by gendered expectations to act as health interpreters for their pregnant partners. We conclude with specific, actionable recommendations for the Senegalese case.

The recent focus on rural–urban cancer disparities in the United States (U.S.) requires a comprehensive understanding of the processes and relations that influence cancer care seeking and decision making. This is of particular importance for Black, Latino, and Native populations living in rural areas in the U.S., who remain marginalized in health care spaces. In this article, we describe the household production of health approach (HHPH) as a contextually-sensitive approach to examining health care seeking and treatment decisions and actions. The HHPH approach is based on several decades of research and grounded in anthropological theory on the household, gender, and therapy management. This approach directs analytical attention to how time, money, and social resources are secured and allocated within the household, sometimes in highly unequal ways that reflect and refract broader social structures. To demonstrate the benefits of such an approach to the study of cancer in rural populations in the U.S., we take lessons from our extensive HHPH research in Zambia. Using a case study of a rural household, in which household members had to seek care in a distant urban hospital, we map out what we call a rural HHPH approach to bring into focus the relations, negotiations, and interactions that are central to individual and familial health care seeking behaviors and clinical treatment particular to rural regions. Our aim is to show how such an approach might offer alternative interpretations of existing rural cancer research in the U.S. and also present new avenues for questions and for developing interventions that are more sensitive to people’s realities.

This article introduces the concept of interembodiment, animated bodily entanglements between people, to illustrate the shared sense of illness that transgresses discrete biological bodies. Drawing on 15 months of ethnographic research in Senegal, West Africa, this article expands common understandings of inheritance and intergenerational health by exploring how women caring for others with metabolic disorders come to interembody the afflicted's symptoms, regardless of their own diagnostic status. These experiences trouble the clear distinction between communicability and noncommunicability and disrupt Western understandings of distinct, unshared biologies. Through the concept of interembodiment, we can see how noncommunicable diseases come to be communicated. Interembodiment helps explain aspects of intergenerational health between mothers and daughters and allows for broader understandings that encompass multiple biologies. Shifting the focus of health and illness from the individual to multiple interembodied biologies allows for a more nuanced understanding of disease and disease transmission, which could enable global health and public health programs to better address noncommunicable diseases around the world.

This article explores the top-down production of the statistics frequently circulated in global health. These data must first originate in a place like the public hospital in Saint-Louis, Senegal, in doctor’s offices and laboratories and medical archives. At their root, these data are an accumulation of individual bodies, experiences, and intimate diagnostic moments. This aggregation turns the afflicted into categories and statistical regimes that shape a global health understanding of diabetes specifically, and noncommunicable diseases broadly. This article explores the individual diabetes diagnostic moment itself and the politics of the current nosology of Type 1 and Type 2, a seemingly neutral dichotomy that belies colonial relationships between Senegal, slavery, sugar production and consumption, and the effects these relationships have on contemporary conceptions of diabetes diagnosis in Senegal and global health.