A. Butchart, THE BANTU CLINIC - A GENEALOGY OF THE AFRICAN PATIENT AS OBJECT AND EFFECT OF SOUTH-AFRICAN CLINICAL MEDICINE, 1930-1990, Culture, medicine and psychiatry, 21(4), 1997, pp. 405-447
This paper is about power, medicine and the identity of the African as
a patient of western medicine. From a conventional perspective and as
encoded in the current ''quest for wholeness'' that characterises Sou
th African biomedical discourse, the African patient - like any other
patient - has always existed as an authentic and subjectified being, w
hose true attributes and experiences have been denied by the ''mechani
stic,'' ''reductionistic'' and ''ethnocentric'' practices of clinical
medicine. Against this liberal humanist perspective on the body as ont
ologically independent of power, this paper offers a Foucaultian readi
ng of the African patient as - like any other patient - contingent upo
n the force relations immanent within and relayed through the clinical
practices of biomedicine. A quintessential form of disciplinary micro
-power, these fabricate the most intimate recesses of the human body a
s manageable objects of medical knowledge and social consciousness to
make possible the great control strategies of repression, segmentation
and liberation that are the usual focus of conventional investigation
s into the place and function of medicine in society. Since the 1930s
when the African body first emerged as a discrete object of a secular
clinical knowledge, these have repeatedly transformed the attributes a
nd identity of the African patient, and the paper traces this archaeol
ogy of South African clinical perception from then until the 1990s to
show how its ''quest for wholeness'' is not an end point of ''discover
y'' or ''liberation,'' but merely another ephemeral crystallization of
socio-medical knowledge in a constantly changing force field of disci
plinary power.