Matheus Alves Duarte da Silva is a Wellcome Trust funded postdoctoral research fellow at the University of St Andrews. He was a Visiting Fellow at CRASSH (gloknos) in 2022.
Christos Lynteris is Professor of Medical Anthropology and PI of the Wellcome Trust funded project The Global War Against the Rat and the Epistemic Emergence of Zoonosis at the University of St Andrews. He was a Mellon/Newton Interdisciplinary Postdoctoral Fellow (2011-2013) & ERC StG PI (2013-2018) at CRASSH.
Q: What is your book Rural Disease Knowledge: Anthropological and Historical Perspectives about?
The nine chapters of the book investigate historically and ethnographically what we called rural disease knowledge. With this term we aimed to make sense of two intertwined processes. On the one hand, how doctors and health officers have been explaining and managing diseases in rural areas since the end of the nineteenth century – what one could call the biomedicalisation of rural spaces. And on the other hand, how interactions with rural populations and their knowledge, within different ecological, epidemiological, and social contexts, have impacted medical and epidemiological theory and practice – in other words, the ruralisation of biomedicine.
Q: What drew you to the subject and what do you find particularly interesting about it?
The idea for the book started with a chat during a walk at St Andrews’s iconic West Sands. We were drawn to this subject by our common research on rats, zoonosis, and plague, and a shared perception that, since the 1920s, the most innovative studies on plague epidemiology as well as the most aggressive anti-plague measures were being carried out no longer in urban settings (as had been the case since the start of the Third Plague Pandemic in 1894) but in rural spaces: from the Brazilian backlands and Jujuy in Argentina to the South African Veld, the border between Angola and Namibia, or farmlands in California. Drawing upon this example and expanding it to other regions and diseases, we wondered: in which ways did biomedicine transform rural areas, and conversely, how did the study of rural areas impact biomedicine? This was the main question behind the workshop we organised at CRASSH in November 2022, a collaboration between the Wellcome-funded project The Global War Against the Rat and the Epistemic Emergence of Zoonosis and Professor Inanna Hamati-Ataya’s Gloknos, leading to this book.
Q: Around which themes did you decide to structure the book, and to what end?
The book is structured around the themes of the production of biomedical knowledge in and on rural spaces, the management of rural diseases, and the conflicts and collaborations between scientific experts and rural communities. Most chapters dialogue with these three themes and then zoom in one of them through a focused case study. This structure is aimed at revealing the complexity of rural disease knowledge by bringing together the standpoints of medical experts, health officers, and rural communities.
Q: In your view, wherein lies the book’s main contribution to our understanding of Rural Disease Knowledge?
One of the book’s main contributions is to access the historical development and contemporaneity of rural disease knowledge, The chapters could be divided into three main periods. First, the 1900s-1920s, corresponding to the decades in which microbiology and tropical medicine allowed doctors to discover new microbes, and therefore new diseases, in rural spaces – such as trypanosomiases in South Africa, Argentina and Brazil, yaws in Dutch East India, and sheeppox in England. Second, the 1930s-1960s, when doctors realised that two classic urban diseases – plague and yellow fever – were becoming established in rural spaces in Argentina, Brazil, and West Africa; a process that fostered innovative concepts, such as rural and sylvatic plague and jungle yellow fever, and called for new forms of sanitary intervention. Finally, our One Health-informed era, when rural spaces in the Global South, for example in Colombia and Tanzania, are medicalised not only as a result of local or national interests, but also because of a perception that infectious diseases potentially threatening the Global North are more likely to emerge in these rural areas.
Q: What would readers be surprised to learn about in your book?
In the West, cities have been usually perceived as sites and drivers of progress, modernity, and science, whereas rural areas have been framed either as idyllic Arcadias or as backward spaces, but almost never as places where scientific and medical knowledge may emerge. Readers could thus be surprised to learn that rural populations played an active role in the development of rural disease knowledge. As different chapters demonstrate, rural communities were not simply recipients or targets of biomedicalisation, but also developed complex forms of epistemic agency in relation to this process that more often than not troubled and unsettled it. Moreover, the formation of rural disease knowledge is shown to have developed in dynamic exchange with non-human animals, such as rodents, whose mastery required posing medical and epidemiological questions contra prevailing orthodoxies.
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