LLabour and the Production of Affliction in Rural Southern Africa

Abstract

In the colonial vision of Southern Africa, rural people were seen as both underemployed and self-sustaining even while processes of commodification dependent on the exploitation of their labour were producing spatially and racially marked inequalities of wealth and consumption and related patterns of health and affliction. Affliction sometimes reflected denial of access to formal health provisioning, but it was also produced by the conditions of labour, including capital's largely successful struggle to externalize responsibility for the reproduction of its workers. This paper discusses various moments in the making of affliction in the region: the development of endemic tuberculosis, the resurgence of malaria, famine-related paralysis and HIV/AIDS. These cases illustrate how affliction has been shaped by the weight of long-term structural relations of class in the organization of labour and by the contingent outcomes of immediate political struggles. They suggest that efforts to improve health in Southern Africa today must address persistent structural patterns that underlie the causes of the incidence of disease; these are also relevant to questions of land reform. © 2012 Blackwell Publishing Ltd.