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
The Baskets Holding Them Together
The female basket-weavers of Rwanda. When destiny failed them, they saw hope, in gentle strands of sisal and grass. The art helped them heal, reconcile and live again.
‘Art As A Reconciliatory Tool’
As dusk descends on the verdant valleys of Kigali, the green of the city’s rolling hills and its red terraced homes relinquish their arresting appeal to the most sparkling jewel of the night – the landmark Kigali Convention Centre (KCC), easily one of Africa’s brightest spots, with its multi-tiered colors and unique architectural aesthetic.
It is striking in contrast to the landscape around and occupies center-stage, both in the city as well as the psyche of the proud Rwandan. Resembling the traditional, intricate, hand-woven Agaseke basket, the KCC stands atop the hills as a symbol of hope in Rwanda, and as a beacon of a new Africa.
It’s a sight most reassuring for the plethora of female artisans and entrepreneurs in the country. In villages and districts far from this dome in the city center, women sit huddled together in tiny cooperatives weaving with nimble fingers beautiful Agaseke baskets, in all forms, shapes and sizes, oblivious to the impact their creations have on the tourism economy – and more so, in their own lives.
Bella Rukwavu, Project Coordinator of the Agaseke Project, which was initiated by the City of Kigali in 2007, recounts the beginnings of some of these cooperatives, after the new government took over, post the horrific genocide against the Tutsi that left a million dead across the country.
“When the city was trying to reorganize itself, part of the problem was the streets were filled with women hawkers, prostitutes, the disabled and the sexually-abused,” says Rukwavu.
There had to be a sustainable, lasting solution that gave the destitute women, most of them widows and survivors of the genocide, a viable alternative, and the idea for cooperatives training them with the art of basket-weaving was born.
The women had a natural flair for it, as basket-weaving was an inherent part of their upbringing and culture, so they could be easily skilled. The women were a mix of both ethnic groups, Tutsis and Hutus, and slowly, surely, through their collective efforts sewing sisal fiber and grass to make and sell objects of beauty, put their ugly past behind them.
The City of Kigali now oversees the Agaseke Project with 2,000 women, distributed among 50 cooperatives in three districts across Kigali.
“The project acted as a reconciliatory tool and promoted peace,” says Rukwavu, in the car as we drive from the City Council to Gatsata sector in Gasabo district to meet with some of the artisans at the cooperative located there. “In some cases, both the victims of the genocide and the wives of the perpetrators worked together, and the art unified them. They have forgotten their differences. Today, they all live as Rwandans.”
Past the thatched homes on the hillside, and up a muddy road, the red earth leads to a one-storied edifice with yellowing walls and blue windows. Here, a group of 25 women sit on the hard cement floor, indulging in light banter and expertly weaving dyed sisal, grass and papyrus reeds to create a raft of colorful basket containers. These are arranged on a wooden shelf and on frayed floor mats.
On the shelf are two wooden boxes with locks. This is where the women store their money as part of their self-styled loan-and-savings scheme; the boxes a repository of their collective earnings – and trust.
The cooperative receives orders from clients in the United States (US), Europe and Japan. The baskets have given the women economic security and a social network. Says Rukwavu: “Some of these women are doing so well and have become so successful they have come out of these cooperatives to start businesses of their own, making diversified products and selling them elsewhere.”
The Agaseke Project is but one snapshot of the larger community of female basket-weavers in Rwanda. In the pages that follow, FORBES AFRICA visits more social enterprises, profiling the artists, artisans and entrepreneurs this industry has spawned. In a country where drones are delivering medical supplies and innovation is a daily buzzword, these women are keeping alive a traditional art form that has found its way into the snazzy department stores and boutiques of the world. To them, fortune is not dollar figures, but mere survival. Their future is in their own hands.
The Single Survivor
Catherine Uwimana, 48
In Gikondo, about a 30-minute drive from the city, a dirt road with a morass of overhead power and telephone cables leads to an unassuming grey gate with colors bursting within. These are the premises of Talking Through Art, a not-for-profit focused on art-related employment opportunities for people with physical disabilities. It was started by Petr Kočnar, from the Czech Republic, who initially came to Rwanda from Kenya to learn French. He encountered destitute people with disabilities on the street and decided to start the center in 2015 with his own savings, to rehabilitate them with art therapy and traditional basket-weaving.
Each of the 25 women, young and old, at this center make about $5 for each of the medium baskets they craft. Placide Ndacyayisenga, the manager, offers a cup of steaming Rwandan coffee, and pointing to the dainty handcrafted bowls on the walls, says: “The baskets we make are inspired by nature, such as the sun, the birds and the baobab trees. Foreign tourists buy from here and our products are also available in premium boutiques and gift shops in Kigali. The artisans here were wandering the streets before, now they can sustain their families, and even have bank accounts.”
One such is Catherine Uwimana. She lost her right leg during the genocide, hit by a grenade when in hiding at her home in Kacyiru.
Save for her older sister, all her family died around her. Having never married, Uwimana lives alone and is grateful she makes enough money weaving baskets to feed herself and pay her rent. “I have been here four years now and this is my family,” she says in Kinyarwanda, her eyes not concealing the pain of her past. “These baskets give me hope for the future.”
Baskets To Theater
Emilienne Muhawenimana, 35
Muhawenimana arrives at the Talking Through Art center in Gikondo riding a scooter. It’s hard to tell she is polio-afflicted and needs crutches to walk. Muhawenimana’s nature-inspired paintings light up the walls here just as she does. She leans against one of them, posing genially for pictures. One of the most prolific basket-weavers at the center, she is today into stage plays, and even traveling outside of Rwanda as part of theater groups. “She was one of our best basket-weavers and is a good actress today,” beams Placide Ndacyayisenga, the center’s manager. The multi-talented Muhawenimana also recites poems and mentions her work with the British Council; one of the many empowered at the center to make a living through art.
The 8-To-5 Weaver
Vestine Nyiravesabimana, 49
A mother of nine children, Nyiravesabimana has been weaving baskets at the Agaseke Project cooperative in Gazabo district for the last 12 years. Making an average of $5 per fruit bowl that she handcrafts, over time, she has been able to send her children to school. She makes a minimum of $100 a month, working 8AM to 5PM through the week.
She is vaguely aware her creations sell well locally, to NGOs and at retail shops, but also “far, far away”, in America and Japan, lands she will perhaps never see.
Some of the women working with her face immense hurdles to come to work. But the project has helped Nyiravesabimana attain economic independence. Her husband, who works as a plumber, respects her more now, she says; they have fewer quarrels.
“She also knows how to bank,” says Agaseke’s project coordinator Rukwavu. “She has an independent bank account.” Nyiravesabimana is also a part of the loan-and-savings scheme at the cooperative with her fellow female weavers. Working collaboratively in a group with the other women has helped her speed on the time-intensive art, as the more baskets she crafts, the more money she makes.
Dressed in a cheerful red chitenge outfit, her megawatt smile fills the small room she is in, as she gives the finishing touches to yet another signature fiber container that will make its way out of Africa to the world beyond.
Farida Umuhoza, 43
A bored housewife for a long time until she discovered her skill crafting baskets, Umuhoza was with the Agaseke Project cooperative in Nyarugenge district for seven fruitful years from 2010.
A self-made entrepreneur today retailing her own range of handmade products, she is thankful for that epiphany, as today, she is the sole bread-winner for her family, supporting a sick husband and two children – a son aged 23 and a daughter aged 21.
We meet Umuhoza at her make-shift shop at the far-end of the car-free exhibition zone, by the towering citadels of capitalism in the heart of Kigali.
At the Agaseke cooperative, she shone with her expertise weaving baskets, quickly moving on to open her own permanent shop, named Chic, in a shopping mall in downtown Kigali. Umuhoza has been expanding her business since.
She also designs chitenge clothing, but her specialty is “the peace-maker, a sort of an oven made of fabric, sponge and cotton wool that saves energy and time and keeps food warm”. She sells it from $20 to $40 a piece, depending on the size.
As we speak, she pauses to “hello and welcome” curious shoppers, mainly international tourists, who walk in to look at her collection of baskets, clothes, and African bric-à-brac. Her attentive son hovers around her, as she settles the deal with a woman bargaining for a wooden stool.
Her finances have been stable, she says, as she has been able to meet her husband’s medical expenses, educate her children and re-stock her shop. She has traveled across East Africa, invited to showcase her baskets, and even once to the Netherlands for further training.
She has come a long way from her 18-year-old self when she lost her entire family in 1994, during the genocide against the Tutsi.
As the sun dips on this August evening, her shop gets busier with office commuters and government workers, her largest clientele.
She is grateful for every sunrise and sunset. “Back then, sitting under the hot sun, weaving them, the baskets taught me about life. I knew they would take me out of poverty. Dare to start, don’t ever quit!” she says, before attending to yet another paying client.
The community builder
Mukeshimana Grace, 52
The Nyamirambo Women’s Center, an NGO on a bustling street in Nyamirambo, is a hive of activity the afternoon we visit. The cooperative doubles as a charming shop retailing all kinds of delectable African print clothing, accessories, home decor and trinkets, and buzzes with dollar-waving foreign tourists. Grace is about to give a presentation on the art of basket-weaving to them when we meet her. She has been mastering the craft for over six years now and says she has had a life-long connection with weaving, having learned it at her mother’s knee.
In an ante-room at the center, women are hard at work at their sewing machines. There are 55 seamstresses here turning cloth into craft.
“I enjoy being a part of a community, and building it.– Mukeshimana Grace
The shop offers a sense of community and camaraderie as visitors stop by to chat to the staff. Launched in 2007 by 18 Rwandese women to address gender-based violence and inequality, today, the center provides skills and training to women so they can better their chances for employment. It’s a self-sustaining model, also offering tours into the neighborhood. The profits from the tours go back into paying the seamstresses and funding more community engagement initiatives.
Mary Nyangoma, Project Manager at the center, who has been a part of it from inception, finds time to break away from the unending stream of clients. She says: “Sewing is very popular in this neighborhood. Some of the women with us never got a chance to go to school, so we also taught them to read and write. And we came up with the idea of the neighborhood tours. Six years ago, we also started selling the in-house products we make.”
Nyangoma is effusive in her praise for Grace, who is too shy to speak. She was the first basket-weaver that joined the center and is now working full-time with them, making the baskets at home, and earning about RWF300,000 ($330) a month. A widow, she has four children to feed. Yet, there is no where she would rather be.
“I prefer working here, in a group,” Grace opens up, “as when I am alone, I tend to think of my worries. I enjoy being a part of a community, and building it.”
Forbes Africa’s Best Photographs In 2019
[Compiled by Motlabana Monnakgotla, Gypseenia Lion and Karen Mwendera]
Kabelo Mpofu, an entrepreneur, took over his mother’s shop in Meadowlands, in the South African township of Soweto. He is hopeful of making the family business a success despite big retail stores opening up in the townships and swallowing up the corner groceries.
Africa is the youngest continent in the world. Every year, South Africa observes June as Youth Month, honoring the anniversary of the Soweto Uprising on June 16. In this image, the country’s sprawling township of Soweto comes alive with youth dancing in the winter weather to local and international music at the Soweto International Jazz Festival, an annual confluence of history, art and culture.
Women hold up placards against gender-based violence during a ‘Shutdown Sandton’ campaign; this after a spate of brutal rape and killings in South Africa.
Car dealerships were among the businesses set alight in Johannesburg’s Jules Street, during the spate of xenophobia attacks in South Africa in August this year. The spark that fueled the raging fire began in Pretoria, the country’s capital, when a taxi driver was shot dead by a foreign national who was selling drugs to a youngster in the central business district.
Sibusiso Dlamini, the co-founder of Soweto Ink, works on one of his regular clients at his tattoo parlor founded in 2014 with his long-time friend, Ndumiso Ramate. In 2019, Soweto Ink held the fourth annual tattoo convention, and for the first time in partnership with BET Africa, to break tattoo taboos in Africa.
Mmusi Maimane, the former leader of South Africa’s opposition party, Democratic Alliance, is about to cast his vote in front of local and international media houses who had wrestled to get the perfect shot in his hometown in Dobsonville, Soweto, during the elections in South Africa in 2019.
The brother of South African journalist, Shiraaz Mohamed, begs for government intervention after Mohamed was kidnapped in Syria on January 2017 by a group of armed men. The group demanded more than $500,000 for his freedom.
South African President Cyril Ramaphosa with his body guards at the Sandton Convention Centre in Johannesburg, South Africa, where the three-day South Africa Investment Conference was held in November.
In a world that’s embracing new technology, inspiration is being found in bug behavior. The hard-bodied dung beetle is now key to robotics research, in Africa too. Astounded by this discovery early this year is Marcus Byrne, a researcher at the University of the Witwatersrand in Johannesburg who has been studying dung beetles for over 20 years. He holds up a metallic replica of a dung beetle in his hand in his office at the university.
Mzimhlophe Hostel, a hostel among many others in Soweto, erupted with service delivery protests prior to the elections in South Africa. In the same vicinity, an informal settlement was also allegedly set on fire. Brothers Mduduzi (32) and Kwenzi Gwala (22), pictured, had arrived in Johannesburg looking for employment. They sold African beer, but their shack was set alight while they were still at church. They lost all their stock and possessions.
A thrift market in the heart of Johannesburg’s central business district, not too far from a busy taxi rank, known for its pavement robberies. Despite the crimes, thousands of small entrepreneurs trade in this raucous market every day.
ANC, DA and EFF supporters dancing and chanting outside the Hitekani Primary School in Chiawelo, Soweto, South Africa, as they await South African President Cyril Ramaphosa to cast his vote in his former primary school.
Tenants in the discarded Vannin Court in Johannesburg look on from their balconies as jubilation erupts on the ground floor.
Vestine Nyiravesabimana makes money weaving intricate baskets made of grass to feed her nine children in Kigali, Rwanda.
Can Diddy’s Ciroc Recipe Work On Alkaline Water?
The first time Sean “Diddy” Combs took a sip of Aquahydrate alkaline water—given to him by pal Mark Wahlberg at a Las Vegas boxing match in the early 2010s—he found it to be an ideal antidote for evenings spent consuming adult beverages.
“I went out that night and had a Vegas night, and I woke up and had a Vegas morning,” Diddy told me in 2015. “I drank two of the [Aquahydrate] bottles and it was, like, the best tasting water that I’ve tasted. And it really, honestly helped me recover.”
Diddy became the face of the company alongside Wahlberg shortly thereafter, and the pair invested $20 million in Aquahydrate over the years while billionaire Ron Burkle’s Yucaipa added another $27 million.
They aren’t the only ones with lofty ambitions for the brand: last week the Alkaline Water Co., the publicly-traded purveyor of competitor Alkaline88, bought Aquahydrate in an all-stock deal that valued the latter at about $50 million.
For Diddy, who ranks No. 4 on our recently-released list of hip-hop’s top earners and boasts a net worth of $740 million, alkaline water holdings are just a drop in his financial bucket. His Diageo-backed Ciroc vodka—and its myriad flavors, from Red Berry to Summer Watermelon—is responsible for the lion’s share of his wealth. But it’s clear he thinks alkaline water, flavored variants included, could swell his portfolio. So do his new partners.
“You put both these brands under one public company, it makes a ton of sense,” says Aaron Keay, Alkaline’s chairman, of the Aquahydrate deal. “We see synergies on distribution, we see cost-savings on cost of goods. On production, on logistics, on staffing. … And we don’t see both brands actually then competing for the same target market.”
In the past, flavored water has enriched investors including some of Diddy’s hip-hop world comrades. A little over a decade ago, 50 Cent famously took Vitaminwater equity in lieu of stock as payment for his endorsement—and walked away with some $100 million when Coca-Cola bought its parent company for $4.1 billion in 2007.
A ten-figure valuation for an alkaline water company seems an outlandish target even for the notoriously bombastic Diddy. But Keay notes Alkaline clocked $33 million in revenues over the past fiscal year and had been expecting $48 million in 2020; now, with Aquahydrate on board, he projects closer to $60-$65 million. That compares favorably to Core Water, which was doing some $80 million as of last year before getting acquired.
“For two or three years, Core Water was just another clear water,” says Keay. “Then they added about a half dozen flavors. Sales doubled. They got bought for $500 million. I mean, for us, $500 million would be a big number off of where our market cap is right now.”
Diddy appears to be an ideal ally in achieving that goal. With Ciroc, once a middling vodka in Diageo’s roster, he was able to articulate importance of the brand’s defining trait: it was made from grapes, not grains (never mind that this might technically disqualify it from being considered a vodka). His contention, according to Stephen Rust, Diageo’s president of new business and reserve brands, is that grapes are simply sexier than potatoes.
“One of his favorite things [to say] is, ‘If you can have a vodka that comes from a history of winemaking, why would you do that versus the history of coming from potatoes?’” Rust explained in an interview for my book, 3 Kings: Diddy, Dr. Dre, Jay-Z, And Hip-Hop’s Multibillion-Dollar Rise. “That’s Sean.”
With alkaline water, Diddy has demonstrated a similar knack for sizing up a product and extracting an elemental notion that passes muster with consumers (if not necessarily scientists). If “you’re full of acid,” Diddy once explained to me, you need to “get your body leveled out.”
Vodka and water, of course, are two very different products, and the same tactics won’t necessarily translate from one business to another. Flavored water itself seems to have been over-carbonated of late, as the recent struggles of brands like La Croix show; Alkaline’s shares have slumped this year as well.
Perhaps that’s why Alkaline is looking beyond its flagship bottled water business. Future plans call for a move towards cans in a nod to environmentally-conscious customers, as well as expansion into the nascent CBD-infused beverage space. Keay figures Diddy and Wahlberg, along with fellow celebrity investor Jillian Michaels, should provide a boost across the board.
“Once the FDA makes a ruling about how CBD is going to be distributed through those chains and channels, those guys are going to want trusted brands, brands that they know already have a consumer following,” says Keay. “And that was another big reason why it made sense to bring [Diddy, Wahlberg and Michaels] in, because it’s only going to help.”
–Zack O’Malley Greenburg; Forbes
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