'ENVIRONMENTAL AKALISM' AND THE WAR ON FILTH: THE PERSONIFICATION OF SANITATION IN URBAN NIGERIA.

In Nigerian cities, as across much of Africa, sanitation practices at zone, ward and street levels inscribe - in patterns of circulation and interaction around waste - not only the hopes and fears of urban residents and managers, but also the aspirations and failures encoded in colonial and post-colonial national and regional histories. Adjusting to numerous challenges - the interplay of racist colonial zoning strategies, rapid post-colonial urban expansion, the withdrawal of public services amid the liberalization programmes of the 1980s, the increasingly abject character of the social contract, and the ongoing tenuousness of economic life and activity - urban environmental sanitation in Nigeria has long struggled to keep pace with the historical dynamics of the country's emergent metropolises. Following the activities of a cohort of inspectors and volunteers at the Ministry of Environment and Water Resources, Oyo State, this article examines the politics of performance and coercion surrounding the monthly observance of Environmental Sanitation Day in Ibadan amid the heightened political tensions of the electoral season in 2011.

Dans les villes du Nigeria comme dans une grande partie de l'Afrique, les pratiques d'assainissement au niveau des zones, des quartiers et des rues inscrivent, dans des schémas de circulation et d'interaction autour des déchets, non seulement les espoirs et les craintes des résidents urbains et des gestionnaires, mais aussi les aspirations et les échecs encodés dans les histoires nationales et régionales post-coloniales. Confronté à de nombreuses difficultés comme l'interaction des stratégies de zonage coloniales racistes, la rapidité de l'expansion urbaine post-coloniale, le retrait des services publics qui a accompagné la vague de programmes de libéralisation des années 1980, le caractère de plus en plus abject du contrat social et la précarité persistante de la vie et de l'activité économiques, l'assainissement de l'environnement urbain au Nigeria peine depuis longtemps à suivre le rythme de la dynamique historique des métropoles émergentes du pays. En suivant les activités d'une cohorte d'inspecteurs et de bénévoles du ministère de l'Environnement et des ressources en eau de l'État d'Oyo, cet article examine la politique de la performance et de la coercition qui entoure la Journée de l'assainissement de l'environnement organisée tous les mois à Ibadan, sur fonds d'intensification des tensions politiques lors de la saison électorale en 2011.

INTRODUCTION: SUSTAINING THE LIFE OF THE POLIS.

How are publics of protection and care defined in African cities today? The effects of globalization and neo-liberal policies on urban space are well documented. From London to São Paulo, denationalization, privatization, offshoring and cuts in state expenditure are creating enclaves and exclusions, resulting in fragmented, stratified social geographies (see Caldeira 2000; Ong 2006; Harvey 2006; Murray 2011). 'Networked archipelagoes', islands connected by transnational circulations of capital, displace other spatial relations and imaginaries. Spaces of encompassment, especially, such as 'the nation' or simply 'society' as defined by inclusion within a whole, lose practical value and intellectual purchase as referents of citizenship (Gupta and Ferguson 2002; Ferguson 2005). In African cities, where humanitarian, experimental or market logics dominate the distribution of sanitation and healthcare, this fragmentation is particularly stark (see, for example, Redfield 2006, 2012; Fassin 2007; Bredeloup et al. 2008; Nguyen 2012). Privilege and crisis interrupt older contiguities, delineating spaces and times of exception. The 'public' of health is defined by survival or consumption, obscuring the human as bearer of civic rights and responsibilities, as inhabitants of 'objective' material worlds 'common to all of us' (Arendt 1958: 52). Is it possible, under these conditions, to enact and imagine public health as a project of citizens, animated in civic space?

The political economy of 'strengthening health services': The view from WHO AFRO, 1951-c.1985.

Our contribution to this special issue examines the early history of international striving for universal health care, from the perspective of the World Health Organisation's (WHO's) Regional Office for Africa (AFRO). The aspiration was repeatedly reframed, from 'strengthening health services' in the 1948 constitution of the World Health Organisation (WHO), to 'Health For All' through primary health care (PHC) in the 1970s, to today's articulations of universal coverage and 'health systems strengthening'. We aim to establish how AFRO supported member states in implementing these policies up to the mid-1980s, and with what degree of success. We also compare AFRO's experience to the established historiographical narrative of global health, as over-fixated on vertical interventions, save for the transitory impact of the PHC movement. Using the archives of WHO in Geneva and AFRO in Brazzaville, we first analyse AFRO's influence and capacity through quantitative financial data. The AFRO nations were net recipients of WHO resources, raising questions about their relative autonomy and voice in the organisation. We then examine AFRO's expenditure, showing that though circumscribed by funds with allocated purposes, there was nonetheless a significant proportion committed to services from the early 1960s, specifically capacity for planning and administration and the nursing, maternal and child health workforce. Counter to expectations though, there was no significant boost to these areas, nor to funding PHC projects, in the 1970s/early 1980s, when disease-specific interventions obtained a larger share. Qualitative sources show that despite its slender resources AFRO accomplished much with respect to training, capacity building and supporting innovative service-delivery, while insisting on African policy input into design and implementation. However country level system-wide planning in health was persistently vulnerable, and the bureaucratic capacity of post-colonial states often weak. Thus AFRO's overall impact was decisively bounded by the global structural inequalities in which it operated.

Leprosy in Eastern Nigeria and the social history of colonial skin.

To the historian, the 'historical' experience of leprosy control is not simply a backdrop to contemporary patterns or problems in disease control. The control of leprosy has been enacted in different ways in localities, territories and states across the world. The specific clinical, political, and institutional choices made in leprosy control have been highly significant in shaping attitudes and approaches to leprosy. The term stigma has a history of usage, contention and re-definition. Stigma, then, is a product of its intersecting social, economic, and medical contexts. In order to capture the degree to which stigma associated with leprosy has mutated and changed over time, this article concerns itself specifically with the colonial experience of leprosy, with a focus on the formerly leprosy-endemic area of southeastern Nigeria (known as the Eastern Region, or Eastern Nigeria) in the last quarter century of colonial rule ending in 1960. The article examines how leprosy was presented, identifying some of the forms in which ideas of stigma and taint with respect to leprosy were communicated. It goes on to examine how leprosy was encountered as a medical problem in Eastern Nigeria, placing leprosy in the context of skin diseases most commonly encountered by colonial medical services. It concludes by demonstrating how leprosy was understood, looking briefly at local and biomedical means of identifying and combating these diseases, and the meanings of these diseases in the rapidly changing contexts of mid- and late-colonial rule and the onset of Nigerian Independence in 1960.

Qua Iboe by motorcycle and launch: brokering public health coverage in 1960s Southeastern Nigeria.

Long an expatriate-run concern, leprosy control was subsumed as a key component of rural public health in the years following Nigerian Independence in 1960 by the enlisting of a cadre of African inspectors, deployed across an existing institutional landscape by a newly Nigerianized medical bureaucracy. The performative norms of leprosy control, once thoroughly colonial and suffused with the ripe vocabulary of a long-entrenched missionary diaspora, were renovated at the heart of a new concern with rural public health more broadly, as the needs, expectations and hierarchies encoded in relations between patient, court, bureaucrat and medical worker shifted and settled in accordance with new political horizons. For health workers, issues of patient and worker mobility, drug delivery, patient and community expectation, and their own physical and financial security were dramatized in a series of commentaries, complaints and reports denoting deeply felt anxieties over the viability of careers in the service of Nigerian health. This article outlines struggles surrounding leprosy control and rural public health work in the Qua Iboe Mission catchment, administered by the newly created Ikot Ekpene Medical Field Unit. It documents a shift in medical work from European missionary to national and technocratic, the foregrounding of concerns with African (worker and patient) welfare and mobility, and the emergence of novel post-colonial forms of public health advocacy and politics along the highways and byways of Ibibio- and Annang-speaking areas of southeastern Nigeria in the 1960s.

Health Planning in 1960s Africa: International Health Organisations and the Post-Colonial State.

This article explores the programme of national health planning carried out in the 1960s in West and Central Africa by the World Health Organization (WHO), in collaboration with the United States Agency for International Development (USAID). Health plans were intended as integral aspects of economic development planning in five newly independent countries: Gabon, Liberia, Mali, Niger and Sierra Leone. We begin by showing that this episode is treated only superficially in the existing WHO historiography, then introduce some relevant critical literature on the history of development planning. Next we outline the context for health planning, noting: the opportunities which independence from colonial control offered to international development agencies; the WHO's limited capacity in Africa; and its preliminary efforts to avoid imposing Western values or partisan views of health system organisation. Our analysis of the plans themselves suggests they lacked the necessary administrative and statistical capacity properly to gauge local needs, while the absence of significant financial resources meant that they proposed little more than augmentation of existing structures. By the late 1960s optimism gave way to disappointment as it became apparent that implementation had been minimal. We describe the ensuing conflict within WHO over programme evaluation and ongoing expenditure, which exposed differences of opinion between African and American officials over approaches to international health aid. We conclude with a discussion of how the plans set in train longer processes of development planning, and, perhaps less desirably, gave bureaucratic shape to the post-colonial state.

Global and local contexts: the Northern Ogoja Leprosy Scheme, Nigeria, 1945-1960.

Deriving funding from missionary sources in Ireland, Britain and the USA, and from international leprosy relief organizations such as the British Empire Leprosy Relief Association (BELRA) and drawing on developing capacities in international public health under the auspices of WHO and UNICEF through the 1950s, the Roman Catholic Mission Ogoja Leprosy Scheme applied international expertise at a local level with ever-increasing success and coverage. This paper supplements the presentation of a successful leprosy control program in missionary narratives with an appreciation of how international medical politics shaped the parameters of success and the development of therapeutic understanding in the late colonial period in Nigeria.

Global and local contexts: the northern Ogoja leprosy scheme, Nigeria, 1945-1960

A missäo católica Ogoja Leprosy Scheme aplicou, em nível local, os conhecimentos internacionais de ponta em lepra, com sucesso e resultados abrangentes, graças ao apoio finaceiro de instituiçöes missionárias da Irlanda, da Grä-Bretanha e dos Estados Unidos, assim como de organizaçöes internacionais como o British Empire Leprosy Relief Association (BELRA). Tirou proveito também de avanços ocorridos no domínio da saúde pública internacional sob os auspícios da OMS e Unicef, na década 1950. O presente artigo combina a apresentaçäo de um bem sucedido programa de controle da lepra, por obra de missionários, com a análise sobre como as políticas médicas internacionais modelaram os parâmetros de sucesso e desenvolvimento de conhecimentos terapêuticos na Nigéria, no final do período colonial.