Testing the waters: Syndemic gastrointestinal distress in Lambaréné, Gabon, 1926-1932.

This paper argues that a cluster of pathogens, hazardous labor conditions, and environmental constraints rendered chronic gastrointestinal distress fatal for African laborers living near Lambaréné, Gabon during the 1920s. Application of syndemic theory and epidemiological methods on patient records at Hospital Schweitzer, the central hospital of the region, explain how a seemingly simple diagnosis of chronic gastrointestinal distress belied a complex web of worsening biological and social outcomes for laborers in the tropical forests of central Gabon. An analysis of the syndemic suffering of GI patients reveals how the dysentery pathogen became tied to the peaks and valleys of the colonial economy, and in particular, the colonial extraction of tropical hardwoods. These processes culminated in the summer of 1929 when the highest number of timber exports coincided with the deadliest months of dysentery outbreak for the patient population at Hospital Schweitzer. This case study proposes syndemics as an effective theoretical framework to research historical precedents of the entanglement of people, pathogens, and illness.

United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic.

Detention and removal of unauthorised immigrants by United States (U.S.) Immigration and Customs Enforcement (ICE) has steadily increased despite declining rates of unauthorised migration. ICE detainees are held in overcrowded detention centres, often without due process and deprived of adequate food, sanitation, and medical care. Conditions of ICE detention contribute to malnutrition and increase the likelihood of infectious disease exposure, including tuberculosis (TB). TB infection interacts with Type 2 Diabetes (DM2), disproportionately affecting individuals who are routinely targeted by federal immigration practices. When two diseases interact and exacerbate one another within a larger structural context, thereby amplifying multiple disease interactions, this is called a syndemic. In this paper, we examine malnutrition in ICE detention as a pathway of bidirectional risks for and interactions between TB and DM2 among ICE detainees. Drawing from literature on detention conditions, TB, and DM2 rates along the U.S.-Mexico border, we propose an ICE-TB-DM2 syndemic model. We present a map displaying our proposed syndemic model to demonstrate the spatial application of syndemic theory in the context of ICE detention, strengthening the growing scholarship on syndemics of incarceration and removal.