A Heart for the Work
Journeys through an African Medical School
Burnout is common among doctors in the West, so one might assume that a medical career in Malawi, one of the poorest countries in the world, would place far greater strain on the idealism that drives many doctors. But, as A Heart for the Work makes clear, Malawian medical students learn to confront poverty creatively, experiencing fatigue and frustration but also joy and commitment on their way to becoming physicians. The first ethnography of medical training in the global South, Claire L. Wendland’s book is a moving and perceptive look at medicine in a world where the transnational movement of people and ideas creates both devastation and possibility.
Wendland, a physician anthropologist, conducted extensive interviews and worked in wards, clinics, and operating theaters alongside the student doctors whose stories she relates. From the relative calm of Malawi’s College of Medicine to the turbulence of training at hospitals with gravely ill patients and dramatically inadequate supplies, staff, and technology, Wendland’s work reveals the way these young doctors engage the contradictions of their circumstances, shedding new light on debates about the effects of medical training, the impact of traditional healing, and the purposes of medicine.
“Drawing on an impressive amount of original, empirical research and written in an engaging style, A Heart for the Work is an extremely interesting look at medical training in Malawi. Claire Wendland argues that trainee doctors, facing an enormous gap between the ideals of their training and the conditions of medical practice, forge their own set of practical ethics and their own professional culture. Though this creativity is largely born of necessity, it is remarkable.”
“Wendland delivers a tour de force on the culture of biomedicine and biomedicine as African healing. A Heart for the Work details how the clinical experience for Malawian interns yields a very different outcome than in the global North, despite similar courses and curricula. Rather than emotional detachment from their patients in a stance of scientific objectivity, they commit to ‘love, passion, and spirit’—‘having a heart for the work, for their patients’ in a moral economy shaped by extensive kinship ties, religious ideals, the need for hope when medicines are scarce, Umunthu— humanity—and political engagement. Wendland argues for the cultural understanding of all medicine, including that in the North driven by high-tech, pharmaceutics, and ‘objective’ science.”
“This engaging and at times contentious book explores the lives of Malawian medical students and, through their stories, questions our assumptions about medicine, Africa, colonialism and globalization. . . . A fascinating work.”
Acknowledgments
Abbreviations
Prologue: Arrival Stories
1. Introduction: Moral Order and Medical Science
All Part of the Same Big Mess: Mkume Lifa
2. Medicine and Healing in a Postcolonial State
Serving Our Nation: Joe Phoya
In the District: Evelyn Kazembe
3. Paths to Medicine
Welcome to the College of Medicine
4. Seeing Deeply and Seeing Through in the Basic Science Years
Welcome to Queens
5. The Word Made Flesh: Hospital Experience and the Clinical Crisis
Complications: Johnson Chisale
On the Ward: Enelesi Nyirenda
6. Resource Is a Verb: Realities and Responses
Someone Else in This World: Duncan Kasinja
As Human as Everybody Else: Zaithwa Mthindi
7. Doctors for the People: Theory and Practice
Epilogue: Departure
Technical Appendix: Research Methods
Notes
Glossary
References
IndexYou may purchase this title at these fine bookstores. Outside the USA, see our international sales information.
