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In Search of the State. an Ethnography of Public Service Provision in Urban Niger

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In Search of the State. an Ethnography of Public Service Provision in Urban Niger In Search of the State ACTA UNIVERSITATIS UPSALIENSIS Uppsala Studies in Cultural Anthropology no 51 Gabriella Körling In Search of the State An Ethnography of Public Service Provision in Urban Niger Dissertation presented at Uppsala University to be publicly examined in Geijersalen, Engel- ska Parken, Thunbergsv. 3H, Uppsala, Wednesday, September 28, 2011 at 10:15 for the degree of Doctor of Philosophy. The examination will be conducted in English. Abstract Körling, G. 2011. In Search of the State. An Ethnography of Public Service Provision in Urban Niger. Acta Universitatis Upsaliensis. Uppsala Studies in Cultural Anthropology 51. 299 pp. Uppsala. ISBN 978-91-554-8127-8. This study explores public health and education provision in Niamey, the capital of Niger, by merging the ethnographic study of public services with an anthropological analysis of the state and of local politics. Based on anthropological fieldwork carried out in a group of neighbourhoods in the periphery of Niamey, the study highlights the political dimensions of public service provision in a local arena where international development interventions and national plans meet local realities and where a wide range of actors and institutions, dis- courses, meanings, and practices are mobilized in the offering of and the regulation of access to public services. It focuses on the political, economic, and socio-cultural aspects of public service provision, too often hidden behind contemporary buzzwords of development such as community participation and decentralization that dominate global debates about education and healthcare in developing countries. The study brings forth the strategies of urban resi- dents in dealing with daily challenges in the consolidation of service provision and in educa- tion and health-seeking trajectories. It shows that access to a satisfactory treatment of illness or a successful school career is premised on the ability to navigate on the medical and educa- tion markets, which are made up of a plurality of providers and of official and unofficial costs and transactions. Further, these public services engage different actors such as commu- nity committees, traditional chiefs, local associations, the municipality and elected municipal councillors, emergent leaders, NGOs, and international development aid. The study demon- strates that despite the uncertainty of state support in health and education provision and a widespread dissatisfaction with these public services, the image of the state as service pro- vider is reproduced on a day by day basis through local efforts at securing public services. Keywords: anthropology, the state, public services, healthcare, education, development, Niamey, Niger Gabriella Körling, Department of Cultural Anthropology and Ethnology, Cultural Anthro- pology, Box 631, Uppsala University, SE-751 26 Uppsala, Sweden. © Gabriella Körling 2011 ISSN 0348-5099 ISBN 978-91-554-8127-8 urn:nbn:se:uu:diva-157119 (http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-157119) Printed in Sweden by Edita Västra Aros, Västerås 2011. To Anders and Lydia, my parents Contents Acknowledgements...............................................................................11 1. Introduction .....................................................................................13 Focus and objectives.........................................................................14 The setting: The urban margins........................................................16 Health, education, and the state .......................................................18 The urban privilege......................................................................20 Studying the politics of public service provision ...............................22 The everyday state .......................................................................22 Public service provision ...............................................................27 Governance, public authority and local politics ............................29 Methodology ...................................................................................31 Field sites ....................................................................................32 Research process..........................................................................33 Outline of the thesis .........................................................................36 2. A historical overview of healthcare and education in Niger................39 Health, education, and the colonial state in French West Africa........40 Colonial rule, medicine, and education in Niger ...............................43 Legacies of colonial education and medicine ................................47 The expansion of health and education after independence ...............50 Economic recession, the debt crisis, and structural adjustment..........57 The consolidation of reforms............................................................65 Discussion........................................................................................70 3. Filling in the blanks: The politics of visibility ....................................73 Colonial and post-colonial Niamey...................................................74 Urban planning and urbanization from below ..................................78 Zoning.............................................................................................80 The appropriation of land in the urban periphery .............................82 Saga.............................................................................................83 Pays Bas ......................................................................................91 Tondigamay ................................................................................95 Discussion........................................................................................98 4. The chieftaincy and the municipality ...............................................103 The administration of Niamey........................................................103 Decentralization in practice ............................................................106 The trajectory of an urban municipality .....................................110 The resurgence of the traditional chieftaincy...................................115 The traditional chieftaincy in Niger ................................................116 The evolution of the traditional chieftaincy in the capital ...........120 Chieftaincy in practice in the urban periphery.................................123 The chiefs and the yan banga .....................................................126 The creation of a market............................................................128 ‘…a modern population wants a modern chief’ ..........................132 Revalorization of the chieftaincy................................................135 Discussion......................................................................................138 5. The story of a peri-urban dispensary ...............................................141 The public dispensary in Saga as a political space............................141 The visit of a Minister................................................................142 The ‘ressortissants’ and the dispensary..........................................145 The MP, a youth association, and the maternity ward ................149 Local political stakes of public service provision.........................151 The rise and fall of a health committee ...........................................157 The election of a new health committee .....................................158 Biographies of the management committee members ................159 Community management in practice .........................................162 ‘It is your dispensary’: Community participation........................165 The health committee and the free healthcare reform .................166 The chiefs and the recruitment of a new pharmacy manager.......168 Negotiating with the state ..............................................................170 The ambulance and the MP .......................................................170 Discussion......................................................................................172 6. Therapeutic encounters: Paying for care and ‘la gratuité’.................175 From free healthcare to cost recovery .............................................175 The daily activities of the public dispensary ....................................176 Paying for care and prescriptions ...............................................178 Infant and child health...............................................................182 An inhospitable environment.....................................................184 Paying for care and the medical encounter......................................187 Therapeutic alternatives and itineraries ...........................................189 The medical market ...................................................................194 The free healthcare reform and the public dispensary......................196 Discussion......................................................................................199 7. Public education provision in the absence of the state......................201 A local history of schooling ............................................................201 The creation of a new public primary school...................................205 Community participation in practice: Making
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