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Pluripotent trajectories: public oncology in Rwanda

Abstract

This article examines how Rwandan patients understand and represent cancer, as well as how state actors articulate the agenda of public oncology and related expectations of citizens. Patients view cancer and infection as co-existent and processually intertwined. This elides with the reality of epidemiology on the ground, as the local burden of disease encompasses both infectious and noncommunicable diseases. Further, patients still consider the efficacy of occult acts in causing tumors, particularly in the face of a disease marked by etiological uncertainty in the biomedical realm, and frequent resistance to treatment. At the same time, both policy makers and clinicians servicing public oncology expect citizens to quickly relinquish any beliefs in the occult and fully embrace a biomedical value system. Beyond the fact that this project cannot be fulfilled, its articulation only limits the ability to envision a more capacious framing of oncology which acknowledges both the limits of treatment, and the diverse ways in which patients suffering from cancer make meaning in the face of grave illness.

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Change history

  • 24 July 2019

    In the original publication of the article, the Acknowledgments section was omitted. The acknowledgements section and the revised author’s biography are given in this Correction.

Notes

  1. 1.

    See https://www.afro.who.int/health-topics/noncommunicable-diseases. Accessed March 27, 2019.

  2. 2.

    The Merriam-Webster Dictionary defines a boil as “a localized swelling and inflammation of the skin resulting from infection of a hair follicle and adjacent tissue, having a hard central core, and forming pus.” An abscess is “a localized collection of pus surrounded by inflamed tissue.”

  3. 3.

    In some instances, I offer both the singular and plural forms of Kinyarwanda nouns (singular/plural).

  4. 4.

    Examples of substances used are animal feathers, trees, or crushed powder from the bones of various animals.

  5. 5.

    The inauguration of Butaro Hospital took place in July of 2011. See the article “Rwanda: Clinton Hails Resilience of Cancer Patients.” http://allafrica.com/stories/201207190731.html. Accessed March 27, 2019.

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Author information

Correspondence to Darja Djordjevic.

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The author has no intellectual or financial disclosures with respect to the research.

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The research study received IRB approval from all pertinent institutions in the USA and Rwanda.

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Djordjevic, D. Pluripotent trajectories: public oncology in Rwanda. BioSocieties 14, 553–570 (2019) doi:10.1057/s41292-019-00160-w

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Keywords

  • Cancer
  • Public oncology
  • Rwanda
  • Infectious diseases
  • Noncommunicable diseases
  • Occult forces