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Work In Progress

Chronotopes, Governmentality and the Changing Regulation of Traditional Medicine in Kenya. Professor John Harrington.

22 April 2018

Work In Progress seminar series. 23.03.2018.

On the 23rd of March, Professor John Harrington presented his paper entitled ‘Chronotopes, Governmentality and the Changing Regulation of Traditional Medicine in Kenya’ at the ISRU bi-weekly Work In Progress seminar. John is a Professor of Global Health Law and founding director of the Univesity’s Centre for Law and Global Justice. Before arriving in Cardiff, John worked as a Professor of Law at the University of Liverpool, a lecturer at Warwick University, and the Free University of Berlin. John has also worked as a visiting scholar in Melbourne, Florence, Cape Town, Berlin and Nairobi.

This paper is part of a wider strand of research looking at the role of the representation of national interests in global health discourse. Based on extensive fieldwork in East Africa, it challenges the assumption that global health norms simply emanate from international and donor institutions, in Washington and Geneva, for example.

The paper which John presented looks at the increasing regulation and legal reform in Kenya concerning the previously broadly neglected area of traditional medicine. In Kenya, Africanisation of the health sector was about removing racial barriers to modern and western medicine, rather than the development of traditional medicine. Despite this, traditional medicine remains highly prevalent in Kenya with over 70% of the population reliant on it as their primary source of health care.

Kenya has lately entered a period of regulation of this traditional medicine sector. Drawing on govermentality theory, John argues that this regulation has been achieved through a problematisation of this issue as a political problem demanding intervention. This problematisation is achieved through the articulation of moral, epistemic and rhetorical elements of the issue. There are multiple, and sometimes competing, problematisations of any one issue; with regards to traditional medicine in Kenya we see that this issue is problematised in terms of safety, health, resource sovereignty and national development.

In this paper, John concentrates primarily on the rhetorical elements of problematisation, arguing that a range of chrontopes, or combined space-time images, are used to ‘encapsulate and give force to different problematisations of traditional medicine’. According to the Russian literary theorist Mikhail Baktin chronotopes are modes giving expression ‘to the intrinsic connectedness of temporal and spatial relationships’. Although chronotopes were originally developed to talk about literary texts, John argues they can be identified in many non-literary texts as sources and articulations of rhetorical problematisations. John highlights the use of legal chronotopes such as the patent form itself, and social chronotopes such as the village in these competing problematisations at the heart of regulation attempts of traditional medicine in Kenya.

John argues the chronotope of the village, as the source of traditional medicine associated with tradition and rural communities, serves to limit the frontiers of ‘legitimate’ traditional medicine. The chronotope is utilised by actors to divide the ‘fakes’ and the traditional healers in the quest for regulation and governance. The traditional healers, in this context, being the elderly traditional rural healers and the ‘fakers’ being those who mix traditional and modern techniques or those who mix different traditional techniques in the multiethnic urban context. 

This chronotope is juxtaposed with the legal chronotope of the patent. In accordance with WTO obligations, Kenya issues 20 year patents valid within the national territory. The patent is associated with a moment of genius or intervention creating something new and protecting intellectual property. However, there is a fear these patent laws could be used to enable biopiracy, as Kenyan natural resources and traditional medicine practices could be acquired and used by multinational pharmaceutical companies and then patented – with no financial compensation or benefits for the communities. 

Responding to these fears in 2016 the Kenyan National Assembly passed the ‘Protection of Traditional Knowledge and Cultural Expressions Act’. This Act grants communities rights over traditional medical practices and local natural resources and demands that if they decide to allow this traditional medical knowledge to be used commercially that they are financially compensated. 

Yet this Act in itself embodies another chronotope at play in the problematisation of regulation of traditional medicine in Kenya; the nation. Elements of theAct allow an articulation of the nation’s legal primacy over community rights. Most importanly, the state has the ultimate power to issue patents if it believes that these resources are not being sufficiently commercially exploited by local communities. Indeed the chronotope of the nation state is to rhetorically express a problematisation of traditional medicine as a neglected source of economic development within a broader discourse of development within which the nation is the primary actor and the agent of that development.

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