‘I could not be idle any longer’: buruli ulcer treatment assemblages in rural Ghana

Abstract

Buruli ulcer is a necrotizing skin infection that largely affects poor people in the tropics. In Ghana, federal policies promise free treatment to all individuals with the disease. Yet, this research found there is a tension between official policy narratives and the lived experiences of people in endemic regions. I demonstrate that as top-down government channels struggle to provide sick people with care, new treatment assemblages emerge in rural areas. I use the experiences of two individuals and one group of practitioners—the pirate, hybrid herbalist, and practitioners for profit—to detail the social relationships and practices governing Buruli ulcer treatment. These treatment assemblages reflect diverse knowledge and economic forms and represent lines of flight from official, and exclusionary, systems of disease surveillance. In contrast with existing literature on Buruli ulcer in Africa, I argue rural people's engagement with “traditional” medicine is often the result of policy failures and the disease is under-represented in national case counts. This work contributes to a growing body of critical political ecologies of health by examining the ways non-humans (e.g. Mycobacterium ulcerans, wild plants, anti-biotics), policy, desire, and prosaic practices combine to shape disease and treatment dynamics.