Imagine bringing the best of all academic disciplines, artistic creations, activist experience and health care knowledge to bear on understanding and addressing current health care concerns. Rather than silos of people working in their specific areas of interest, imagine collaborations committed to listening and learning from all participants.
This is the vision of Medical and Health Humanities in Africa. It’s a field that grew out of the medical humanities in the US and UK. It brings together academics, researchers, practitioners, creative artists, health care seekers and providers.
Essentially, it straddles disciplines and practices in an effort to address health concerns. Artists compose music to open up understandings of health care and specific conditions, such as delirium. Some academics open up new conversations about existing health concerns like AIDS or use everything from yoga to photography to observation and drawing to help educate health sciences students. Others pair academics and artists to help young people talk about sex and sexuality or tuberculosis.
At its core, Medical and Health Humanities is about conversations and collaborations between people who are interested in health. This encourages new understanding, practice and knowledge. It also seeks to provide “translators” who can make often complex ideas in science and humanities accessible. They can also use creative arts to change perceptions, frame new questions and direct new discussions that result in more nuanced answers to health issues.
While still a relatively new field on the African continent, it is growing and gaining momentum. The latest milestone is the first English-language special issue of the globally respected BMJ Medical Humanities Journal to deal exclusively with work on and about medical and health humanities in Africa.
The special issue came out in December 2018. It showcases work from various countries in Africa, among them Nigeria, Malawi, Kenya, Tanzania and South Africa.
The projects profiled in this special issue, and others elsewhere on the continent, reveal the vital role Medical and Health Humanities can play across Africa in bridging the gaps between disciplines to improve people’s experiences of health care.
Beyond disciplinary boundaries
One of the Medical and Health Humanities projects highlighted in the BMJ’s special edition deals with digital storytelling and antiretroviral adherence in KwaZulu-Natal, South Africa. Another article shows how opium, thalidomide and contraceptives contributed to the making of modern South Africa.
The projects and articles themselves are, of course, important. But another critical element that must not be overlooked is how the field exemplifies inter-, trans- and multidisciplinary research and practice. It removes people from their disciplinary silos.
This is becoming increasingly important across academia. In the worlds of medicine and health, people often work on similar concerns in familiar ways; in doing so, they miss out on new perspectives. Working across disciplines and practices is a way to learn from each other and reflect on how things could be changed for the better.
And, crucially, it creates conversations about how we might improve our collective understanding of health and wellness.
On the African continent, the Medical and Health Humanities community is also trying to do things differently when it comes to how research is conducted and presented.
If a field is genuinely committed to collaboration, collective engagement, building networks and relationships, it must do more than work quickly to “produce measurable outcomes” limited to academic articles. It must spend time building connections that extend beyond one event or “outcome”.
We attempted to do this during the writing of the special issue of the BMJ Medical Humanities journal. We were among a group of practitioners in South Africa who pooled resources from two universities to bring as many people who were working on the special issue together as possible. We wanted to ensure that experienced and emerging writers from multiple disciplines and practices had a chance to benefit from each other’s knowledge and experiences.
A workshop was held in 2017 at the Wits Institute for Social and Economic Research (WiSER). Participants came from Zimbabwe, Kenya, Nigeria, Tanzania, Malawi, Swaziland, South Africa, the UK and Canada and presented and discussed their work.
From this, people put together a range of material for the journal and the blog linked to the special edition. Some of this material took the form of academic articles; there are also podcasts, photographs, pieces of music, images and poetry.
This allowed us to present creative and academic work in a format that was more accessible to those with digital access and moved beyond academic journals. After all, part of what the field is concerned with is maintaining critical, intellectual rigour while making information available to people in a number of ways. In doing this the field tries to break down some of the barriers that prevent people from sharing work or ideas.
There is more to come for the Medical and Health Humanities field in Africa. A group called the Medical and Health Humanities Africa networkhas been established. CODESRIA, the Council for the Development of Social Science Research in Africa, among others, has been drawn into discussions about growing the field’s networks on the continent. The second conference organised by the Malawi Medical Humanities Network will be held in Zomba, Malawi in August and a workshop in Johannesburg in March called State of Dis-ease will continue these exciting new conversations.
-Carla Tsampiras; Senior Lecturer in Medical Humanities, University of Cape Town
-Nolwazi Mkhwanazi; Senior researcher, Wits Institute for Social and Economic Research, University of the Witwatersrand
Executive Travel: NaakMusiQ’s Dubai
The South African actor and musician was impressed with the city’s architecture, food and work ethic.
South African actor and musician Anga Makubalo, known by his stage name NaakMusiQ, calls the Middle Eastern emirate of Dubai a luxury destination.
NaakMusiQ, who hails from Port Elizabeth in South Africa’s Eastern Cape Province, shot to fame after appearing in the award-winning South African soap opera Generations and has since been in a number of television shows.
He has also had a chart-topping music hit, Ntombi ft Bucie.
NaakMusiQ’s first trip to Dubai, known as the melting pot of the Middle East, was last year on an Emirates flight when he traveled Business Class. The fashion-lover admits to being a light packer, although there are some items he would never travel without, such as cologne, a pair of sneakers, and his music.
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“I also carry my scripts all the time. Because of the long flights, I can get tired of watching a movie, I can get tired of listening to music, so the next best thing is to get into my script and get a head start.”
He has been to Dubai before, but only transiting the airport connecting to another flight, so this was his first official trip into the glistening city.
“Dubai is everything that people say it is,” he says. “We went to the mall. It was crazy! I’ve never seen anything like it before. [The Dubai Mall] has a full-on aquarium inside. In the middle of the center, there’s like this huge fish tank. It’s crazy! That was probably the highlight of my visit.”
The actor was also intrigued by the city’s architecture and skyscrapers.
“I’m actually very huge on architecture. It’s actually something I wanted to study. Their engineering is absolutely insane. The way they’ve built this place and the designs – it’s luxury, one after the other. We drove for hours admiring the architecture because I’m such a nerd when it comes to that. I love it.”
Dubai has a sizeable African expatriate community, and no dearth of African culture. As a musician, NaaqMusiQ had been invited to the city.
“Africans that have immigrated to Dubai request their favorite African artist to come over so that they’re still connected to Africa and home. The nice thing about that is, as much as it is our people that have invited us there to perform, they have influenced people from there [Dubai] and other parts of the country [UAE] to come and listen to our music.
“Because they’ve become residents there, they have friendships where they introduce African music to the people of Dubai. So when we went there, there were quite a lot of people, even though some couldn’t sing along, there were a lot of people who went crazy when my song [Ntombi] played.”
During his time there, NaakMusiQ was also taken to restaurants serving African food. This came as somewhat of a surprise for the actor that the Arab city boasted a range of eateries specializing in African cuisine.
“We had a lot of Kenyan food that I hadn’t tasted before, which was really nice. They’ve got Tanzanian food, they’ve got South African food, Zambian food; it’s just a whole African experience there. And they do well actually.”
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While NaakMusiQ didn’t interact with the natives of Dubai, he did get a sense of what they are like. The hustle and bustle of the city left him greatly motivated.
“Everyone in Dubai is there to work. Everyone is there to hustle. People think that Dubai is this big, fun place, which it can be, but even people from there aren’t out partying every night. It’s people from the countries that are visiting that are out partying. Everyone else is really working. Some people are so hectic when it comes to business and money that they don’t have a life outside of their work.
“When they do have nights off, they choose to be at home or to put in extra hours working. It just made me want to work harder. That is the impact… Everyone there wants to do better. The standards there are incredibly high. What we would consider as good here is probably entry-level there,” says the hit-maker who now plans to return to Dubai wealthier and with more cash to splurge.
Stone Town: From Freddie Mercury To The Farms
The sights, scents and sounds of Zanzibar include a 73-year-old tale of the iconic late British singer-songwriter.
Dress conservatively when walking the streets of Stone Town,” advises the tourist brochures in the predominantly Islamic society of Zanzibar, yet, the tiny Tanzanian archipelago proudly claims Freddie Mercury, the controversial frontman of British band Queen, as its own.
The singer, born in the windswept streets of Stone Town in Zanzibar in 1946 and one of the world’s most iconic voices in pop-rock, is this tourist town’s biggest currency-spinner.
Stone Town, which is a maze of historic alleys and spice bazaars with timber shutters, an old Arab fort, churches, mosques and 19th-century stone buildings, is a World Heritage Site overlooking the sea. Within its dusty bowels, leading up from its myriad walkways, is Shangani Street, starting with a white-washed, two-storied yellow building that was once Freddie Mercury’s home.
There are countless tours offered to what is emblazoned in gold outside as ‘Freddie Mercury House’, featuring four fully-furnished hotel apartments with balconies overlooking the Indian Ocean.
Outside are framed glass cases with sepia images of the songwriter and vocalist, describing his famous connection with Zanzibar. Born Farrokh Bulsara, Mercury’s family had immigrated to Zanzibar from Gujarat in India. He was born to Bomi and Jer Bulsara who were originally Parsis (a Zoroastrian community that migrated to the Indian subcontinent from Persia). In 1964, the Zanzibar Revolution forced the family to flee.
The island community’s lucrative tourist trade is even today cashing in on Mercury’s global image, with tours offered at the Zoroastrian Fire Temple where the Parsi family once worshipped, and to a restaurant named Mercury offering fresh seafood.
“Imagine, Freddie Mercury played on these white sandy beaches and clear waters at one time,” says my tourist guide, Amour, proudly, before taking me on a two-hour walking tour of Stone Town. He points to the domed white Zanzibar High Court where Mercury’s father once worked as a cashier.
His house on Shangani Street, where the first settlers arrived, is a hub of activity, with tourists, and touts selling everything from icecream to tanzanite jewelry and African bric-à-brac. Just a few steps up, is the Shangani post office and buildings boasting Indian, African and European architecture, where you discover your own Bohemian Rhapsody.
Amour helps me weave through the heaving mass of human traffic in the busy streets, to a fish and vegetable market in Stone Town that also sells spices in pretty bamboo gift-packs. The fish is sold fresh and the spices overpower the stench.
“Zanzibar used to be the largest exporter of cloves in the world, but from 70 percent, it’s only nine percent now,” Amour rues, thrusting a packet of cloves into my hand, “and that’s sad, because of declining prices, more competitors and the poor encouragement of farmers.”
Earlier, I had visited the spice farms Zanzibar is so famous for, finishing off with lunch in a Swahili home stationed on a peak in one of the scented valleys. It was modest home-cooked fare but with aromas as strong as the spice farms the ingredients came from: a banana dish with coconut milk and cardamom, flavored cassava from the fields, fried tuna, rotis and the most fragrant pilaf (rice dish) I have ever eaten, watered down with lemon grass and ginger tea.
I had been to the Muyuni village in the south tasting the sweetest mangoes and bananas in all of Africa, passing seaweed-strewn beaches, paddy fields and potholed roads with bullock carts, dala dala taxis and motorbikes.
In the lush mangroves of Jozani, I encountered the endangered red colobus monkeys. In the spice plantations, down slippery forest paths, I tasted nutmeg, cinnamon and cloves off the trees.
The natural treats along the way also included lemons and sweet green oranges. As we passed the red mahogany trees, “beware of the green mambas or pythons”, my host had warned. A vendor in the middle of the forest showed us his wares in a wicker basket: soaps and perfumes made from the Ylang-Ylang trees by the womenfolk.
“In Europe, Chanel No. 5 is made from this. Here, we call it Chanel No. 0, our products have no chemical or alcohol,” he says, pointing to the tiny bottles filled with red liquid. “These farms are so rich in spices that the chicken running around are already spiced, you don’t need to flavor them when you cook them,” laughs Amour, towards the end of our outing. From Freddie Mercury to the farms, Zanzibar beckons the senses.
Marvel Money: How Six Avengers Made $340 Million Last Year
Since its premiere in April, Avengers: Endgame has been sending shockwaves across the Marvel multiverse, with a worldwide gross of $2.77 billion and counting after the movie’s return to theaters last month. With its domestic gross sitting at $848 million, Endgame is the second-highest-grossing film ever both in the U.S. and overseas.
That means a payday not just for Marvel Studios but also for the Avengers themselves, who have negotiated their way to superpowered deals. Forbes’ Celebrity 100 list of the world’s highest-earning entertainers this year features six Endgame heroes, from Chris Hemsworth (a.k.a. Thor) at No. 24 overall with $76.4 million (not all of his earnings were from Avengers) to Paul Rudd (Ant-Man) at No. 83 with $41 million. Robert Downey Jr. (Iron Man), Bradley Cooper (Rocket Raccoon), Scarlett Johansson (Black Widow) and Chris Evans (Captain America) also assembled and made the cut. Together, the team earned $340 million.
“Celebrities such as Downey and Johansson currently have extreme leverage to demand enormous compensation packages from studios investing hundreds of millions of dollars in making tent-pole films, such as The Avengers series,” says entertainment lawyer David Chidekel of Early Sullivan Wright Gizer & McRae.
Kevin Feige, Marvel Studios’ president, seems to agree: “We started saying that the character is the marquee name, and I think that’s still true, but I think we’ve been very lucky and thankful that the actors that imbibe these characters have now become them,” he told Forbes of the highly compensated group in 2017.
Marvel signs actors to multi-movie deals that also include promotional commitments. These deals often start off in the seven figures, which helps explain why newer superheroes like Brie Larson (Captain Marvel) and Tom Holland (the latest Spider-Man) didn’t make the Celeb 100 cut. But as actors stay with the MCU, their salaries increase. Veteran Marvel stars can command an upfront salary as high as $20 million (Downey). Others top heroes can earn in the neighborhood of $15 million (Hemsworth, Johansson, Evans), while second-tier characters make about $8 million (Rudd).
But the real money comes in later. All of this year’s listees proved so valuable to Marvel that they were able to negotiate for a piece of the profit—also known as contingent compensation—on both the ensemble Avengers films and their individual superhero films.
“A studio’s incentive to grant contingent compensation to various actors, writers, directors and other key personnel is simple. Movie studios depend upon tent-pole films to support their financial performance,” says Chidekel.
These points pay off. Avengers: Endgame, for example, has made about $700 million in profit from its box office run so far. For Downey, who has around 8% in back-end points, that translates to about $55 million, for a grand total of $75 million for the one film.
Even smaller characters like Cooper can command about 1% of the back end, which would translate to $7 million for Endgame. For their star vehicles, these actors can negotiate an even bigger cut of the profit.
“The percent of budget cost have certainly skewed heavy, particularly on the Avengers movies, to cast now, whereas maybe in the early ones it was more visual effects or below the line,” Feige said in 2017. “But that’s okay because [the actors] are the best effects.”
These sky-high paychecks have proved to be a worthwhile investment for the studio. With a built-in audience of comic book fans, scripts that are both funny and socially aware, and a powerful marketing strategy, MCU films have grossed over $22 billion since 2008. These actors continually return many times their salaries in box-office dollars. For instance, while Downey earned that eye-popping $75 million from Endgame, the film grossed $36.90 at the box office for every dollar he was paid. Those on the lower end of the earnings spectrum, like Rudd, produced over $100 at the box office for every dollar they were paid.
“Certainly the strange alchemy of seeing characters you’ve never seen before teamed up together on screen, if they were different versions of those characters, it wouldn’t be as fun,” Feige said. “It’s expensive but well worth it.”
We think Nick Fury would agree.
-Madeline Berg; Forbes Staff
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