Productive misunderstandings and the dynamism of plural medicine in mid-century Bechuanaland

This article explores innovation in Tswana medicine (bongaka), and examines the effects of language translation in a plural medical world. Since practitioners and patients of bongaka locate medical authority in the language of 'tradition', innovation is often hidden under a gloss of semantic continuity that locates knowledge as ancient and immutable; yet Tswana medicine has changed over time, as all medical systems do. Bongaka embraces a historically fluid nosology, and diagnostic logic that attends to social circumstances and bodily symptoms simultaneously. This enables local medical epistemology to incorporate novel ideas and biological events within a larger framework that reinforces the over-arching unity of the bodily, ecological, and social realms - all of which are in flux. The discussion focuses on Tswana diagnostics and epidemiology in post-Second World War southeastern Bechuanaland, where increasingly pervasive experiences of particular forms of bodily misfortune merged with trends in women's extra and pre-marital sexual activity, male labour migration, intergenerational struggles over (blood, semen, money), and collapsing public health became manifest and understood in terms of evolving disease etiologies. Rather than envisioning medical pluralisation as a process that produces hybrids, the case in question suggests that translation creates productive misunderstandings that facilitate the coexistence of distinct medical categories, while patients become adept at moving across ontologically distinct domains of medical practice.