Iowa State University Capstones, Theses and Graduate Theses and Dissertations Dissertations 2018 Neoliberal effects as seen in village health dispensaries within the Kedougou Region of Southeast Senegal Samantha Salter Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/etd Part of the African Languages and Societies Commons, African Studies Commons, Health and Medical Administration Commons, and the Social and Cultural Anthropology Commons Recommended Citation Salter, Samantha, "Neoliberal effects as seen in village health dispensaries within the Kedougou Region of Southeast Senegal" (2018). Graduate Theses and Dissertations. 16664. https://lib.dr.iastate.edu/etd/16664 This Thesis is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. Neoliberal effects as seen in village health dispensaries within the Kedougou Region of Southeast Senegal by Samantha Salter A thesis submitted to the graduate faculty in partial fulfillment of the requirements for the degree of MASTER OF ARTS Major: Anthropology Program of Study Committee: Nell Gabiam, Major Professor Sebastian Braun Donna Winham The student author, whose presentation of the scholarship herein was approved by the program of study committee, is solely responsible for the content of this thesis. The Graduate College will ensure this thesis is globally accessible and will not permit alterations after a degree is conferred. Iowa State University Ames, Iowa 2018 Copyright © Samantha Salter, 2018. All rights reserved. ii TABLE OF CONTENTS Page LIST OF FIGURES .................................................................................................................. iv LIST OF TABLES .................................................................................................................... v ACKNOWLEDGEMENTS ..................................................................................................... vi ABSTRACT ........................................................................................................................... vii CHAPTER 1. THE BACKGROUND ....................................................................................... 1 1.1 Introduction ......................................................................................................... 1 1.2 The Research Site ................................................................................................ 4 1.3 The Literature ...................................................................................................... 6 1.3.1 Development ............................................................................................. 6 1.3.2 Neoliberalism Across the Continent ....................................................... 12 1.3.3 Brief Social History ................................................................................ 17 1.3.4 Neoliberalism in Senegal ........................................................................ 18 1.3.5 Health Discourse in Senegal ................................................................... 31 1.4 Conclusion ........................................................................................................ 35 1.4.1 The Role of Anthropology ...................................................................... 36 CHAPTER 2.THE METHODS ............................................................................................... 39 2.1 Introduction ....................................................................................................... 39 2.1.1 Background Information ........................................................................ 41 2.1.2 Reflexivity Statement ............................................................................. 42 2.2 The Study Design .............................................................................................. 44 2.2.1 The Study Approach ............................................................................... 44 2.2.2 Observations and Interviews .................................................................. 47 2.3 The Data Collection Process ............................................................................. 49 2.3.1 Anticipated Problems ............................................................................. 49 2.3.2 Ethics ...................................................................................................... 51 2.4 Approaches to Data Analysis ............................................................................ 53 CHAPTER 3. THE RESULTS ................................................................................................ 55 3.1 Introduction ....................................................................................................... 55 3.2 The Data ............................................................................................................ 55 3.2.1 Women Health Workers ......................................................................... 57 3.2.2 Culture vs Healthcare ............................................................................. 58 3.2.3 Kedougou Hospital Experiences ............................................................ 60 3.2.4 Dispensaries and Their Stories ............................................................... 62 3.2.5 Common Thread ..................................................................................... 66 iii 3.3 Money ................................................................................................................ 67 3.3.1 The Ninefescha Story ............................................................................. 70 3.3.2 Caring for the Community ...................................................................... 74 3.3.3 Government ............................................................................................ 75 3.4 Discussion .......................................................................................................... 77 3.5 Final Conclusions .............................................................................................. 79 REFERENCES ........................................................................................................................ 84 APPENDIX A. PROJECT PHOTOGRAPHS ......................................................................... 90 APPENDIX B. MAP ............................................................................................................... 91 APPENDIX C. IRB APPROVAL MEMO ............................................................................. 92 APPENDIX D. IRB APPROVED CONSENT FORM ........................................................... 93 APPENDIX E. INTERVIEW QUESTIONS .......................................................................... 94 APPENDIX F. TRANSCRIPT EXCERPTS ........................................................................... 96 APPENDIX G. INFORMANTS AND DISPENSARIES ....................................................... 97 APPENDIX H. PARTICIPANT FEEDBACK ....................................................................... 98 iv LIST OF FIGURES Page Figure 1. Partial View of the town of Kedougou ...................................................................... 3 Figure 2. View of the main road through Kedougou ................................................................. 3 Figure 3. The Bamako Initiative Principles ............................................................................. 25 Figure 4. Forest in Kedougou .................................................................................................. 30 Figure 5. Senegalese Tea ......................................................................................................... 49 Figure 6. Petit Oubadji Dispensary ......................................................................................... 60 Figure 7. Djinji Dispensary ..................................................................................................... 61 Figure 8. Baitilaye Dispensary ................................................................................................ 61 Figure 9. Chiobo Dispensary ................................................................................................... 62 Figure 10. Syllacounda Dispensary ......................................................................................... 63 Figure 11. Medicine ................................................................................................................. 65 Figure 12. Ninefescha Construction ........................................................................................ 68 Figure 13. African Renaissance Monument ............................................................................ 73 v LIST OF TABLES Page Table 1. Senegalese Budget ..................................................................................................... 65 Table 2. Percentage of Healthcare Costs per Individual ......................................................... 65 Table 3. Monthly Budget Example ........................................................................................ 65 vi ACKNOWLEDGMENTS I would like to thank